Having a preconception check up is important for couples who want to try to conceive within the next few months. While it is well known that women should contact a doctor after having a positive pregnancy test, few know that to optimize their chances of conceiving and having a healthy pregnancy, they should actually make a preconception check up a priority.
Scheduling a Check Up
Ideally, women and their partners should make an appointment to visit with their family doctor or OB-GYN three months before they start trying to conceive to avoid conception problems. Both partners should plan to attend, as the family health history of the man is just as important as the woman. Additionally, should genetic counseling or testing be recommended, it is important that he be tested, too.
While scheduling the appointment, find out if any documents are necessary. Bring any relevant records, such as immunizations and vaccines. Sometimes women may be required to have a pelvic examination or pap smear, depending on when their last exam was. Ask if a full health physical for both partners will be needed, again, so the man can be sure to come along.
The American College of Obstetricians and Gynecologists recommends women develop a plan for their reproductive health before they become pregnant. During this appointment, they recommend that women speak with their doctors regarding the number, spacing, and timing of their planned children, plans for pregnancies/prevention of pregnancies, current health, and other issues relevant to reproductive health.
Information Covered at Preconception Check Up
Upon arriving at the doctor's office, full health histories will often be taken. Factors that impact pregnancy and birth will be talked about. Information and questions regarding family health history, personal medical history, lifestyle choices, and conception tips will be discussed.
Family Health History
Both partners should be able to answer questions regarding general family health. Most physicians want to know about cardiac, cancer, blood pressure, cholesterol, stroke, and other problems within each partner's family. This usually includes siblings, parents, grandparents, and sometimes aunts/uncles.
Genetic information will be gathered. If there is any chance one or both partners may be a carrier for a certain condition, genetic counseling or testing may be recommended. Women who are over 35 or 40 may also be given information regarding genetic counseling.
Personal Medical History
Women will be asked about their full medical histories. Prior pregnancies, miscarriages, abortions, sexually transmitted diseases, and current birth control methods will be covered. Information about their monthly cycles will often be taken regarding when their menstruation first started, length of cycles, and any known problems.
Both parents-to-be should be prepared to discuss any current medications they are taking. Over-the-counter medications and prescriptions should both be listed. Immunization and vaccination records will be reviewed. Known allergies should also be told to the doctor. Any known psychological problems, such as depression or a mental disorder, should be disclosed to the healthcare provider.
Women and men may be required to do a blood and urine test for checking of sexually transmitted diseases and other problems that may affect their ability to conceive.
Lifestyle choices are often the most difficult for people to discuss with their doctors. However, it is important that both partners answer honestly so they have the best chance of conception when the time comes. Accurate information regarding alcohol, tobacco/nicotine, and drug use/abuse will be needed.
Maintaining a healthy weight is important for women and men who are trying to conceive. Eating healthy and balanced meals while exercising will be emphasized by the doctor. He/she may recommend that the woman begin taking prenatal vitamins and folic acid now.
Occupational and industrial hazards are other things that will be discussed, along with environmental exposures. At this time, patients should bring up any concerns they might have about conception.
The last thing doctors will discuss with their patient is how to optimize conception. They will discuss ovulation so that both partners understand how pregnancy occurs. Based upon prior test results, the doctor may recommend some lifestyle changes (such as losing weight or quitting smoking) before the couple starts trying to have a baby.
Centers for Disease Control Preconception Recommendations
In 2006, the Centers for Disease Control (CDC) issued the report Recommendations to Improve Preconception Health and Health Care---United States. This report finds that preconception care is extremely helpful in taking care of the health of women and optimizing pregnancy outcomes.
The report identifies several areas that are considered risk factors for adverse pregnancy situations. Doctors and women who want to conceive should discuss any relevant topics at their check up such as:
- Isotretinoin use
- Alcohol misuse
- Anti-epileptic drug use
- Diabetes (onset before pregnancy)
- Folic acid deficiencies
- Hepatitis B diagnosis
- HIV/AIDS diagnosis
- Maternal phenylketonurea (PKU)
- Rubella seronegativity
- Oral anticoagulant use
The March of Dimes also has a list of conditions and medications that are considered preconception risks and should be evaluated to prevent pregnancy and/or conception problems.
Additionally, the CDC study made ten recommendations to doctors, patients, and the public for optimizing the health of mothers and babies through preconception health checks. These ten recommendations are:
- Men and women should have a lifelong reproductive plan.
- Increase awareness of the public to preconception health.
- Women of childbearing age should be given risk assessment and educational/health information during primary care doctor visits.
- Interventions should be done if risk screening comes back negatively.
- Provide interconception care to women between pregnancies who had an adverse outcome (miscarriage or premature birth, for example).
- Offer a preconception visit to couples or women considering pregnancy.
- Increase health insurance coverage to women with low incomes.
- Add preconception health objectives into existing public health programs.
- Increase research to help improve preconception health.
- Improve public health monitoring and research related to preconception.
A preconception check up is important for women who are planning to become pregnant. Not only may this check up help improve the mother's health before conception, but help keep pregnancy complications from occurring.