preconception counselling

1. TRAVANCORE COLLEGE OF
NURSING,KOLLAM
Preconception
Care And Preparing
For Parenthood

2. PRECONCEPTION CARE

3. DEFINITION
 When a couple is seen and counseled about
pregnancy , its course and outcome well
before the time of actual conception is called
preconception counseling.
 A set of interventions that aim to identify and
modify (biomedical, behavioral and social)
risks to a women’s health or pregnancy
outcome through prevention and
management(CDC 2006)

4.  The counseling should be done by primary
health care providers; the help of an
obstetrician, physician and geneticist can be
received.

5. GOALS
 Improve knowledge, attitude and behavior of
men and women related to preconception
care
 Ensure that all women of child bearing age
receive preconception care services that
enable them to enter pregnancy in optimum
health
 Reduce risks associated with the previous
adverse pregnancy outcome.

6. Vision:
improve
health and
pregnancy
outcome
Recommendation: Individual
responsibility ,service provision, Quality
assurance
Goals: Coverage, risk
reduction,
empowerment
Action steps: Research, Surveillance, Clinical
interventions
Guidelines for
preconception
care

7. COMPONENTS OF PRECONCEPTION
CARE
 Risk assessment
 Health promotion
 Intervention

8. 1. Risk assessment

9. A. History
1.Reproductive History
h/o infant death
Still birth
Birth defects
Preterm births
Low birth weight babies

10. 2. Medical History
RHD, Hypertention
Thromboembolism
Autoimmune disease
Diabetes
Thyroid disease
asthma

11. 3.Medication Use
Category X: estrogen androgen and
thalidomide
Category D: phenytoin, valproic
acid,diazepam, Captopril, thiazides,
spirinolactones, Coumarine,
tetracycline,streptomycin, methotexate,
vinblastin, azathioprine

12. 4.Substance Abuse
 Tobacco
 Alcohol
 Drug abuse

13. 5.Toxins and teratogens
 Heavy metals
 Solvents
 Pesticides
 Allergents

14. B. Physical examination
 Nutritional assessments
 Periodontal
 Thyroid
 Heart
 Breast
 Pelvic examinations

15. C. Screening
 Infections and immunization
 Screen for peridontal, STD, Hepatitis C
infections
 Immunization – hepatitis-B, Rubella,
Varicella, HPV and influenza
 Genetic screening and family history of cystic
fibrosis, sickle cell anemia, thalassemia etc
 Psychosocial: screen for depression, anxiety,
domestic violence

16.  Lab tests:
CBC, urinalysis, blood type, and others
like syphilis, gonorrhea, Chlamydia, diabetes

17. HEALTH PROMOTION
 Family Planning
 Healthy weight and nutrition
 ideal BMI is 20-26kg/m2
 exercise and nutrition
 Healthy behaviors
 Nutrition, exercise, safe sex, effective
contraceptive use, dental flossing
 Discourage the use of alcohol, smoking,
substance abuse

18.  Avoid overuse ofV-A (limit-3000 IU/day)
 V-D (limit-400IU/day)
 Caffeine(limit to 2 cups)
 Healthy environment
 Interconception Care

19. INTERVENTIONS
 INTERVENTION
1. Follic acid
supplementation
2. Rubella vaccination
3. Diabetes
management
4. Hypothyroidism
management
 BENEFIT
 To prevent occurrence
of neural tube defects
 Protection against
congenital rubella
syndrome
 Reduce birth defects
 Proper neurological
development

20.  INTERVENTION
5. Hepatitis B vaccination
6. HIV screening and
treatment
7. STD screening and
treatment
 BENEFIT
 Prevents transmission of
infection to the infants
 Prevents transmission of
infection to the infants
 Reduce risk for chronic
pelvic pain, ectopic
pregnancy and infertility

21.  INTERVENTION
8. Maternal
phenylketonuria
9.Oral anticoagulants use
and management
 BENEFIT
 Prevent babies being
bone with PKU related
MR
 Changing to less
teratogenic treatment
regimen from
teratogenic Warfarin

22.  INTERVENTION
10.Antiepileptic drug use
and management
11.Smoking cessation
 BENEFIT
 Changing to less
teratogenic treatment
regimen.increase follic
acid intake
 Prevent preterm birth
and low birth weight
babies

23.  INTERVENTION
12.Eliminating alcohol use
13.Obesity Control
14.couple with history of
recurrent fetal loss
 BENEFIT
 Prevents fetal alcohol
syndrome
 Reduce risk of neural
tube defect, DM, LSCS,
hypertensive
thromboemblic diseases
 Investigation and
counselling helps in treat
the cause

24. BARRIERS TO PRECONCEPTION
CARE
Patient aspects
 High rate of unintended pregnancies
 Ignorance about importance of good
health habits prior to conception
 Limited access to health services in
general

25. Provider aspects
 Feeling of having inadequate
knowledge
 Perception of preconception care
being time consuming
BARRIERS TO PRECONCEPTION
CARE

26. Preparing For
Parenthood

27. Preparing For Parenthood
 Preparing for parenthood begins
with the decision to become
pregnant or the discovery of the
pregnancy in an unplanned
circumstance

28. Preparing For Parenthood
 Department of education and
science(DES) and Department
of health and social
security(DHSS) stressed the
importance of school in
preparing the young children
for adult life.

29. APPROACHES

30. Preparation for parenthood
in school setting
 Never enter into the unplanned
pregnancies as parenthood is a
lifelong commitment that needs
physical and psychosocial maturity.
 For successful parenthood, good
physical health healthy relationship
with parents and partner is required
 Financial stability
 Emosional readiness

31. Preparing For Parenthood
during pregnancy
 Prepare the pregnant women and the partner
for the birth of their child, through individual
and group counseling sessions
 5-10 classes emphasis on partner
relationship, family life, child care, sibling
rivalry on arrival of new baby
 Events and problems faced by the first time
parents and how can the parents make use of
the formal and informal support systems

32. Supportive services for the
parents during the early years
after the birth of children
 The problems experienced during
the post natal period and its effect
on mother and child relationship
 Problems related with when the
mother return to their job, and
how to solve these problems

33. Thank You