Preconception counselling

Your decision to have a baby and plan for their arrival is exciting but requires thorough planning to ensure that your pregnancy and delivery goes smoothly.

Why is preconception counselling so important?

Preconception counselling helps you plan for your pregnancy beforehand and can help you avoid miscarriage, stillbirth and genetic defects such as Spina Bifida or cleft lip and palate at birth. As soon as you receive a positive result on your pregnancy test, your journey for a healthy delivery begins. 

Preconception counselling for most couples helps plan and set reproductive goals for the future. Usually, women schedule their first preconception appointment three months before a successful pregnancy.

What happens at my first preconception counselling appointment?

Your OB-GYN first discusses your family history of hypertension, diabetes, psychiatric illnesses, congenital disabilities and multiple pregnancies. A thorough examination of medical conditions and prior procedures such as transfusions and surgeries are considered. Your doctor takes note of your gynaecological history, including any sexually transmitted diseases and urinary tract infections.

Blood tests and cervical culture tests rule out any severe viral illnesses or diseases that could affect your pregnancy.

A detailed medical history provides information on the following:

• Prior pregnancies
• Use of contraception
• Abnormal results from a Pap smear
• Up-to-date vaccinations

A physical exam is the next part of the appointment. Your doctor will ask you to lie flat on your back while he examines you. He examines your thyroid, checks your blood pressure and listens to your breathing and heart rate. At the same time, your doctor will perform a pelvic exam.

What happens during a pelvic exam?

Your gynaecologist carefully inserts two of his gloved fingers into your vagina while he presses against your lower abdomen. This examination is done to assess the structure of your uterus and the health of your ovaries. Any abnormalities or growths will be felt at this time.

What forms of contraception are there?

Should you reconsider or not ready to have a child and wish to set reproductive markers until that time, your OB-GYN will advise on forms of birth control to use.

Contraceptives available are:

• Spermicide is a jelly or foam that is designed to destroy sperm. The formula is applied inside the vagina before sexual intercourse. There are, of course, side effects when using spermicide for a long time. Most people prefer using spermicide because it’s relatively easy to use even though there is a 29% chance of pregnancy on the first try.
• A female condom is a plastic that slides into the vagina eight hours before sex. The downsides of using a female condom are the noise it makes and the fact that it cannot be used again. Other than this, it is widely used and protects against some sexually transmitted diseases.
• A diaphragm is a rubber contraption that rests over the cervix before intercourse.
• The cervical cap (FemCap) is placed over the cervix and is much smaller than a diaphragm. A cervical cap works over 48 hours but needs to be inserted by a professional.
• Birth control pills are a combination of oestrogen and progestin that stops ovulation. These birth control forms are highly effective but present side effects of tender breasts, high blood pressure and spotting.

Your OB-GYN will discuss contraceptive options with you and their side effects for you to decide on the most suitable one.