Smita has been married for a year and a half. Having postponed a pregnancy because she and her husband are both busy software engineers, they have now scheduled an appointment with an obstetrician for pre-pregnancy counselling (also called preconceptional care.) Basically, it is a checklist for couples to make sure that they have a healthy pregnancy.

Becoming a parent is a major decision. It brings its own uncertainty and apprehensions. Smita and her husband have made the right choice in seeking pre-pregnancy counselling. During a preconceptional visit, your obstetrician will try to identify things that may pose risks to you or the baby you are planning to have. Keeping fit, eating healthy, and avoiding certain things that could be harmful to the baby are the first steps to a healthy pregnancy.

Previous medical problems

Some women have medical problems, such as diabetes, high blood pressure, asthma, epilepsy or cardiovascular (heart and blood vessel) problems, which may increase risks for them or their fetus.

Diabetes:

Women need to ensure very tight control of their blood sugar levels during pregnancy. Women, who are on tablets for diabetes, may need to be changed to insulin. To avoid abnormalities in the baby, it is very important that blood sugars at the time of conception are under strict control.

High blood pressure:

If a woman has high blood pressure, it is important to make sure that it is well under control before attempting pregnancy. Medications must be changed to those that are safe in pregnancy.

Asthma:

A high level of control is essential during pregnancy. Check with your doctor on what medications are safe when you are trying for a pregnancy. Inhalers, by and large, are safe because the medications do not get absorbed into the blood stream.

Epilepsy:  

It is safe for most epileptics on medications to try for a pregnancy. Most anti-epileptic drugs have the potential to cause fetal abnormalities although the risk is reduced if a single drug is used.  It is essential to discuss with your physician which drug is safer when you are trying for a pregnancy. It is important not to stop your medication.

Problems in previous pregnancies

Some problems with past pregnancies can occur again. If there has been more than one miscarriage, a previous baby with a birth defect, or a baby who died before birth or soon after birth, the obstetrician may suggest studies to find out the cause. It is important to keep all records of previous pregnancies and show them to the obstetrician.

Family health history

Diabetes and high blood pressure are common conditions which may be present in the family. Even if the mother-to-be does not have these conditions, it is important to know if there is a family history because these conditions may show up in pregnancy.

Some genetic conditions, such as mental retardation, may run in the family. If there is a history of such a condition, then genetic counselling might be offered so that it can help the couple find out the chances of having a child with a birth defect.