1. Premarriage Counseling
Dr. Renu Chawla
Dr Sharda Jain

2. Objectives
• Introduction
• Healthy relationships and communication
• Understanding sexual health and contraception
• Reproductive health and fertility
• Genetic testing for family planning
• Preparing for pregnancy, childbirth, and postpartum care
• Conclusion: Benefits of premarriage counseling for a happy and healthy
marriage

3. Premarriage counselling
• In india we have an age old system related to marriages.
• The girl and the boy meet each other, then their families meet and after a total
of three meetings they decide to get married.
• Even before the girl and boy meet their kundalis meet each other. Once the
kundalis match, they are considered suitable for marriage.
• They are expected to spend the night together immediately after marriage.

4. Premarriage counselling
• In our country talking about sex is a taboo.
• The would be bride has to rely completely on what her mother tells her or
what her married friends tell her or if she is tech savvy, then what porn or
books tell her.
• All this gives too much of false information.
• There is anxiety, inadequate knowledge and a sense of falling blindly into
something.
• This is where premarriage counselling plays a major part.
• A premarriage counsellar is a qualified gynaecologist who can explain about
sexual intercourse, her body, the changes that can occur, the pain that she may
feel and also the contraception options available for her.

5. BUSTING MYTHS
• Young couples normally have doubts and fears in their mind about the
honeymoon night.
• The fears range from pain during intercourse, bleeding during intercourse to
establish whether the bride to be is a virgin, planning pregnancy etc.
• If the girl is virgin, the initial tearing of the hymen during penetration may cause
pain.However this is bearable pain.
• To enhance the experience, couple can use a lubricating jelly, indulge in adequate
foreplay and be mentally relaxed.
• Some brides have misconception that the initial intercourse causes unbearable
pain as a result they push away their partner and the couple comes with the
problem of unconsummated marriage after few months.
• Yet another myth about virgin brides bleeding at the time of the first intercourse.

6. Healthy Relationships and Communication
• Building Trust
• Create a safe space for open communication and cultivate trust to strengthen
your relationship.

7. Reproductive health education
• Emphasis should be given on the importance of understanding ones
reproductive organs and health.
• Discuss the normal menstrual cycle,ovulation, and the basics of fertility to
help the couple make decisions about family planning.
• Since there are lots of rituals before marriage, the girl might want to prepone
or postpone her periods and the gynaecologist can help for the same
• Discuss common menstrual disorders like PCOS and its management.
• If she is already a diagnosed case of PCOS then see her past prescriptions to
know the details of treatment.

8. Sexual health awareness
• Lifestyle has changed tremendously in past few years. People are more
experimental, open minded and basically a lot more free about things.
• There is increased incidence of premarital sex, alcohol,smoking,and drugs.
• Openly discuss sexual health including safe sexual practices,contraception
and the prevention of sexually transmitted infections.
• Since there is so much taboo related to sex people are not
• Really forthcoming about their past relationships and activities.So basically
when marriage is decided between two people they do not know anything
about each others past.
• If the couple plans to have children then guidance on preconception care
should be given.
• Discuss the importance of balanced diet& folic acid supplementation.

9. Emphasize consent
• Stress the importance of consent in intimate relationship.
• Explain that both partners must willingly agree to engage in sexual activity
and consent should be ongoing and enthusiastic.
• No marriage before 18 should be specified
• Various issues including gender equality,liberalisation and opening up of
society ,women adopting equal responsibility as bread winner, nuclear
families, demanding lifestyle,extremely cut throat competitive world and
stresses and strains of day to day life are discussed during the session..

10. Mental health
• Address mental health issuses, such as
• Anxiety
• Depression
• Stress
• which can impact sexual and reproductive health.
• Encourage open communication and seek professional help if needed.

11. Nutrition and lifestyle
• Advice both partners to maintain healthy
lifestyle
• Proper nutrition
• Regular exercise
• Stress management
• Can positively impact reproductive health and overal well being.

12. Genetic Testing for Family Planning
Understanding Genetic Risks
• Discover the role of genetic testing in determining potential health risks for
your future family.
Preventing Inherited Conditions
• Explore how genetic testing can empower informed choices to prevent
inherited conditions.
Family Planning Strategies
• Discuss family planning options and considerations based on genetic testing
results.

13. Contraceptive Options
• Explore various reliable contraception methods and find
the one that suits you and your partner.

14. Lab tests and medical checkups
• Viral markers ,
• Tests to exclude thalassemia,
• Blood sugars
• Thyroid profile
• Complete blood examination should be done.
• Other tests to be done depending on past and family history.
• Pap smear if indicated
• Various vaccinations like MMR, chicken pox, hepatitisB,HPV should be advised if
not immunized
• Encourage regular medical checkups for both partners to detect and address any
underlying health issues that could affect their reproductive life.
• .

15. Safe Abortion Information And Cultural
Sensitivity
• Recognize and respect cultural and religious beliefs that may influence the
couples decisions regarding sexual and reproductive health.
• Offer guidance that aligns with their values and preferences.
• Provide information about safe and legal abortion options in India to avoid
complications.
• Discuss the importance of seeking medical advice from Gynaecologists rather
then resorting to unsafe practices.
•

16. MEDICAL OR SURGICAL
TREATMENT IF ANY
• They hide Thyroid, Epilepsy, PCOD,Surgery of any kind especially
• For ovarian cysts or T.B or premarital pregnancy complications.s

17. COMMUNICATE WITH PARTNER
• Stress the importance of open and honest communication between
• Partners about their sexual desires, boundaries and expectations.
• Seek professional help if required.
• Inform the couple about the legal aspects of marriage and reproductive rights
including issues related to age of consent, marital rape laws and property
rights.
• Failure to have intercourse leads to marriage being null and void.

18. • Its essential to create a safe and nonjudgemental environment during
• Premarriage counselling to facilitate open and honest discussions on these
topics, ensuring that both partners are well prepared for a healthy and
fulfilling marriage.

19. Conclusions
• Strong Foundation: Establish a solid base for a lifelong partnership.
• Healthy Communication: Enhance understanding and connection within your
relationship.
• Family Planning: Make informed decisions about starting a family.
• Preventive Measures: Identify potential health risks and take appropriate actions.
• Preparation: Equip yourselves with knowledge and resources for a smooth journey
into parenthood.