Preconception Counseling

Before a woman starts trying to conceive, it is a good idea for her to speak to her healthcare provider about how to best facilitate a healthy pregnancy. Preconception care and counseling revolve around evaluating a woman’s overall health and wellness while addressing lifestyle changes that will promote conception and fetal development.

Preconception care may occur during a scheduled annual exam, but some patients prefer to make a separate appointment dedicated to addressing their questions and concerns. Additionally, women who are having difficulty trying to conceive, or suspect that they may be experiencing infertility, may wish to speak with their OB-GYN about underlying factors that may be contributing to their struggle.

Health and wellness evaluation before trying to conceive

The early stages of pregnancy are critical for a baby’s development. In many ways, these initial weeks lay the groundwork for the entire pregnancy. The baby’s organs and major systems will start to form during the first two months following conception. Because of this timeline, a woman should ensure that any chronic health issues and risk factors are treated, controlled and addressed before trying to conceive.

During a preconception care appointment, an OB-GYN will talk to the patient about her health history, including vaccination records, previous pregnancies and any pressing concerns the patient may have. Additionally, the provider will identify any chronic health issues and talk about strategies for treating and managing them before and during pregnancy.

Depending on the issues identified, a woman may need to see a primary care provider or, less commonly, a specialist. Underlying issues that may affect healthy conception and pregnancy include:

  • Irregular menstrual cycles and periods
  • High blood pressure
  • Thyroid conditions
  • Asthma
  • Depression
  • Obesity
  • Diabetes
  • Seizure disorders
  • Substance abuse.

The presence of one or more of these conditions does not necessarily mean that a woman will have an unhealthy or complicated pregnancy. Rather, they are indicators that extra care and attention should be paid to managing these issues before and during her pregnancy to keep her and the baby safe, healthy and thriving.

Finally, some women may be identified as being at a higher risk for passing on certain birth defects or congenital disorders. If this is the case, an OB-GYN may discuss options for genetic testing of the mother and father.

Preconception care and lifestyle adjustments

Equally important to evaluating a woman’s overall health is addressing lifestyle factors that will contribute to her success when trying to conceive. Leading a healthy lifestyle can alleviate some of the chronic health issues listed in the previous section and lower the risk of complications such as miscarriage and birth defects. Before trying to get pregnant, a woman will be advised to:

  • Stop using tobacco products
  • Stop using all recreational drugs, including marijuana
  • Moderate alcohol consumption while trying to conceive
  • Stop drinking alcohol as soon as pregnancy is suspected
  • Lose weight if necessary
  • Limit or eliminate exposure to environmental toxins at home or in the workplace.

Toxoplasmosis, a parasite infection that is often spread by cat feces, poses a risk to an unborn fetus if the mother is infected. For this reason, pregnant women and women trying to conceive may be advised not to change cat litter. But if a woman has had toxoplasmosis in the past, she will be immune to the infection and will be at a very low risk of developing it during pregnancy and passing it on to the fetus.

Because toxoplasmosis often does not cause symptoms in adults, a blood test may be ordered to determine if a woman is immune. When in doubt, it is best for all pregnant women to err on the side of safety and avoid changing cat litter until after the baby is born.


Medications and prenatal vitamins

A woman should start taking a prenatal vitamin containing at least 400 micrograms (mcg) of folic acid around three months in advance of trying to get pregnant. Folic acid is a vitamin found naturally in certain foods.

It is added to common grocery items like cereals, pastas and breads due to federal regulations. Folic acid plays a key role in fetal development, and supplementation helps to prevent miscarriage and major birth defects such as spina bifida.

Certain prenatal vitamins cause unpleasant side effects in certain women. These may include nausea, loss of appetite and digestive issues. It can therefore be a process of trial and error to determine which prenatal supplement is the best fit.

Some prenatal supplements are only available via prescription and others are sold over the counter (OTC). Prescription supplements are not necessarily better than OTC options. A woman’s OB-GYN can help her determine which prenatal supplement(s) are best suited for her individual needs.

Lastly, women who are trying to conceive should follow the same advice that is given to pregnant women regarding all OTC medications. They should limit or eliminate their use of certain medications taken for common ailments such as allergies, colds and headaches. This includes commonly-used drugs such as aspirin and ibuprofen.