Top Preconceptional Counselling in South Delhi


Pre-conception counseling (also called pre-conceptual counseling) is a meeting with a health-care professional (generally a physician or midwife) by a woman before attempting to become pregnant. It generally includes a pre-conception risk assessment for any potential complications of pregnancy as well as modifications of risk factors, such as increasing folic acid intake to reduce the risk of neural tube defects and counseling on smoking cessation, alcohol reduction, and medications that may compromise fetal development. Physicians, midwives and baby experts recommend that a woman visit them as soon as the woman is contemplating having a child, and optimally around 3 to 6 months before actual attempts are made to conceive. This time frame allows a woman to better prepare her body for successful conception (fertilization) and pregnancy, and allows her to reduce any health risks which are within her control.

Top Preconceptional Counselling in South Delhi

Agencies such as the March of Dimes have developed screening tools that healthcare providers can use with their patients. In addition, obstetricians or midwives (see Obstetrics, Midwifery, General Practitioner) have developed comprehensive check-lists and assessments for the woman who is planning to become pregnant.

In one sense, pre-conception counseling and assessment can be compared to a well-baby visit in which a baby is screened for normal health, normal development, with the benefit of identifying emerging problems that may have gone unnoticed in an infant. For a woman, the Pre-Conception Counseling Assessment and Screening is intended to assess normal health of a child-bearing woman, while at the same time identifying:

  • Existing or emerging illness or disease which may have gone undetected before, and
  • Existing risks for the woman who may become pregnant, and
  • Existing risks which may affect a fetus if the woman does become pregnant.
  • Preconception health evaluation.
  • Nutrition and weight management
  • Diet
  • Folic acid/multivitamin use
  • Ideal body weight
  • Family history
  • Heritable conditions
  • Previous birth defects
  • Social
  • Pregnancy intention/access to care
  • Occupational hazards
  • Mental health conditions such as depression
  • Use of alcohol, tobacco, recreational drugs
  • History of physical or psychological abuse
  • Medical disease
  • Diabetes
  • Respiratory
  • Renal conditions
  • Lupus
  • Thyroid disease
  • Cardiac disease
  • Epilepsy
  • Reproductive history
  • Uterine/cervical anomalies
  • One or more fetal deaths
  • Previous small-for-gestational-age infant
  • 2 or more previous miscarriages
  • Previous preterm birth
  • One or more infants with a birth defect
  • Medication
  • Drugs that must be stopped/ changed
  • Infections/vaccinations
  • Sexually transmitted diseases
  • Immunity against rubella/varicella
  • HIV and prevention of mother-to-child

who meet these nine targets at initial prenatal assessment are considered to have a high degree of preconception wellness.

  • Pregnancy intention;
  • Access to care;
  • Preconception multivitamin with folic acid use;
  • Tobacco avoidance;
  • Absence of uncontrolled depression;
  • Healthy weight;
  • Absence of sexually transmitted infections;
  • Optimal glycemic control in women with pre-gestational diabetes;
  • Teratogenic medication avoidance.

Clinical Significance

Preconception counseling must include communication with the potential mother and father. During preconception counseling, the provider has the opportunity to perform the risk assessment. Risk assessment includes reviewing a thorough history of medical, surgical, psychosocial, genetic, nutrition, and behavioral risks. These include screening for alcohol and drug use. Couples should be reminded about the importance of vaccination for the mother and early access to prenatal care if pregnancy occurs. Women with behavioral health issues should be counseled to see their provider for medication management and changes if needed. Early preconception counseling and intervention have the potential to reduce perinatal morbidity and mortality. Pregnancy readiness and a planned pregnancy is the optimal goal. Families seeking future pregnancies should be counseled to seek primary care to address any identified risks and to discuss pregnancy planning. The overall goal is preconception wellness and optimal management of chronic health and behavioral issues.

Enhancing Healthcare Team Outcomes

Preconception counseling, risk identification, and intervention require an interprofessional approach and consistent documentation in the healthcare record. The healthcare team should have access to the complete plan of care from the services used by the patient within the system. In order to improve patient outcomes, every provider should address the potential impacts of health status on pregnancy in women and men of reproductive age. In women seeing multiple providers for medical and behavioral care, an interprofessional approach to planning pregnancy can be advantageous in identifying and addressing risks prior to pregnancy.