What is a Preconception Visit?
A preconception visit is simply a doctor's appointment scheduled before getting pregnant to make sure that a woman's health is in good shape before pregnancy.
What Doctor Should I See?
Most commonly, women schedule a preconception checkup with their primary care physicians and gynecologists.
If a couple struggles to get pregnant, a fertility specialist, such as a reproductive endocrinologist, will generally be more capable of providing better care. Women with chronic conditions, such diabetes, obesity, or thyroid disease, should also consult with a specialist for individualized counseling.
When Should I Make an Appointment?
There is no deadline for making a preconception appointment. As soon as a woman decides to have a baby, whether it be within the next ovulation cycle or a few months ahead, she should schedule a visit for a consultation and basic tests before pregnancy to assess her overall health.
What are the Benefits of a Preconception Checkup?
Through preconception counseling and various pre-pregnancy tests, a woman will receive guidance on how to prepare her body and mind for the demands of pregnancy as well as peace that she did all she could to give her baby a healthy head start.
What to Expect during a Pre-pregnancy Checkup?
A typical doctor's visit before conceiving resembles a general revision of one's overall health and lifestyle practices to catch any potential fertility-inhibiting problems early on. Preconception counseling might concern the following topics:
Current Health Conditions
Making a plan to manage a woman's health conditions is the most important part of a pre-pregnancy checkup. Having uncontrolled conditions before getting pregnant, like endometriosis, diabetes, sexually transmitted diseases (STDs), and polycystic ovary syndrome (PCOS), can not only substantially decrease a woman's chances of getting pregnant, but also lead to life-threatening pregnancy complications. This even includes controlling mental health diseases, such as depression or anxiety.
During a pre-pregnancy checkup, a doctor might also review patterns of menstruation to estimate when a woman's ovulation is most likely to take place. Timing intercourse with one's fertile window, which covers a period of three to five days before and of the day of egg release, is key to quick conception. A history of irregular periods or ovulation problems might indicate hormonal imbalance or another undiagnosed health issue that might hinder fertility. Women can keep an eye on their ovulatory patterns with ovulation tests and trackers.
An important part of a preconception visit is reviewing family history of inheritable disorders, which means those that can be passed from parents to children. These diseases include cystic fibrosis, sickle cell disease, or fragile X syndrome. Undergoing a preconception genetic testing, also called carrier screening, can determine what gene mutations are carried by the parents and the risk of them having a child with a genetic condition.
Because some medications, over-the-counter and prescription, can cross the placenta and affect the baby's health, they have to be discontinued or substituted with safer alternatives. If a woman is taking fertility vitamins and supplements before getting pregnant to boost her chances of conceiving, she should discuss continuing their use once she is pregnant to make sure they are safe and will not cause harm.
Although vaccination is usually not one of the first things a woman thinks about as she is scribbling down her preconception checklist, it is a crucial step that should not be overlooked. Contracting an infectious disease during pregnancy can not only affect the mother's health, but also her unborn child's. Before getting pregnant, it is recommended to check if a woman's immunization against measles, mumps, rubella, and chicken pox is up to date
Preconception counseling is also a good opportunity to review one's lifestyle practices. A doctor can give recommendations about proper pre-pregnancy nutrition, stress the importance of exercise and fertility, and give guidance to quitting addictions to smoking or excessive alcohol drinking. She or he can also assess if there are any troubling situations in a woman's life that could affect her pregnancy outcomes, such as abusive relationships and domestic violence, among others.
Getting off Birth Control
Women on contraception often worry that it will hamper their ability to have children, especially if they used birth control for several years. Because fertility is affected by numerous others factors, most important being age, women should consult with their doctor during their pre-pregnancy checkups to know what to expect when they get off birth control, when ovulation will be restored, and how long it will take to get pregnant after getting off contraception.
A meticulous preconception appointment should also include a discussion about dangers in a woman's environment that might have an impact on her pregnancy. They include teratogens, or substances that disrupt the baby's development and cause miscarriages or birth defects, such as pesticides, lead, mercury, ionizing radiation, and others. Cat owners should stay away from cat feces as it can transmit parasites that cause toxoplasmosis, an infection associated with serious pregnancy complications.
Getting a preconception checkup is perhaps the best gift a woman can give her future baby. It can not only help her optimize her fertility to get pregnant faster, but it also has been shown to lower the risk of developing serious complications during pregnancy that might potentially affect the baby's health. A typical pre-pregnancy appointment is scheduled with the primary care physician and a gynecologist as soon as a woman decides to have a baby. It is a good time to make sure chronic conditions are well managed; talk about fertility after getting off birth control; review current medications and immunizations; and discuss adjusting lifestyle habits and avoiding environmental contaminants, all which translate to having a safer and healthier pregnancy.
- American College of Obstetricians and Gynecologists. (n.d.). Carrier Screening. Retrieved December 20, 2018 from https://www.acog.org/-/media/For-Patients/faq179.pdf
- American College of Obstetricians and Gynecologists. (2018). Nutrition During Pregnancy. Retrieved December 19, 2018 from https://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy
- American Journal of Obstetrics and Gynecology. (2008). Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. Retrieved December 19, 2018 from https://www.ajog.org/article/S0002-9378(08)01029-6/abstract
- CDC. (2018). Planning for Pregnancy. Retrieved December 19, 2018 from https://www.cdc.gov/preconception/planning.html
- March of Dimes. (2017). Your Checkup Before Pregnancy. Retrieved December 20, 2018 from http://www.marchofdimes.org/pregnancy/your-checkup-before-pregnancy.aspx
- Planned Parenthood. (n.d.). Pre-Pregnancy Health. Retrieved December 19, 2018 from https://www.plannedparenthood.org/learn/pregnancy/pre-pregnancy-health