This provides a window of opportunity for health promotion, as it is thought that women are very motivated to alter unhealthy lifestyles at this time. Preconceptual care is distinct from antenatal care. It should include:
Informed choice, which helps women and men to understand health issues that may affect conception and pregnancy.
Women and their partners being encouraged to prepare actively for pregnancy, and be as healthy as possible.
Optimizing management of chronic health problems.
Identifying couples who are at increased risk of having babies with a genetic malformation. Provide them with sufficient knowledge to make informed decisions.
A large number of pregnancies are unplanned – approximately a quarter in one study in Southampton.
The haphazard seeking of pre-pregnancy advice by many patients means that many opportunities for pre-pregnancy counseling are missed. By the first antenatal visit, organogenesis is well underway and interventions to avoid malformations may be too late.
Efforts need to be made to offer pre-conceptual care opportunistically as part of other consultations – eg, contraception, diabetes or epilepsy reviews. Any couple being referred for infertility assessment should have had a full pre-conception assessment prior to further investigation or treatment. School-based programmes, in the context of children’s reproductive and sex education, might offer better public health coverage