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What is pre-conception counselling?
Whether you’ve already had a child or would like to start a family, pre-conception counselling can help you plan for a future pregnancy. Here, I explain why it’s important to talk to your GP before pregnancy, and what pre-conception counselling involves.
What is pre-conception counselling?
If you’re planning to have a child, pre-conception counselling can help you prepare for pregnancy. During pre-conception counselling, your doctor may advise you about the following.
Timing
If you’ve already had a child, you might wonder how long to wait before you have another. Your GP can also discuss how your age might affect pregnancy outcomes. This is because women older than 35 have an increased risk of miscarriage, chromosomal abnormalities, and complications such as gestational diabetes compared to younger women.
Improving your chances of pregnancy. If you’re trying for a baby, you’ll need to stop using contraception. Your GP can advise you about this – for example, if you have an intrauterine device (IUD) fitted, it will need to be removed. They can also give you more information if you’re having trouble getting pregnant.
Diet and weight
A healthy, balanced diet is important for the health of you and your baby. Some foods should be avoided in pregnancy so if it’s likely that you’ll become pregnant soon, your GP can advise you on what to avoid.
Your weight is also important because being overweight or underweight can affect your chances of conceiving. Having a BMI between 18.5 and 24.9 means you’re more likely to conceive. It also reduces the risk of complications, such as high blood pressure (hypertension).
Medicines
If you take medication, your GP can advise you on what you can still take, or they may suggest changing your medicine. This is because some medicines are not safe to take while pregnant and you may need to stop taking them before you try to conceive. But make sure you speak to your doctor before you stop taking any prescribed medicines.
Your general health
It’s important to speak to your GP about conceiving if you have a long-term (chronic) medical condition. If needed, they can refer you to a specialist for assessment before you try for a baby. The same is true if you have a mental health condition, so they can signpost you to extra support, if you need it.
Who should have pre-conception counselling?
If you want to start trying for a baby, it’s a good idea to mention this to your GP. They’ll discuss factors that could affect your pregnancy, such as your medical history and lifestyle. They can also answer any questions or concerns you might have.
It’s not just your health that’s important - the health of your partner can also affect your pregnancy. For example, men who live a healthy lifestyle are more likely to produce healthy sperm.
The family history of you and your partner will be considered during pre-conception counselling. This is because some conditions, such as cystic fibrosis, are genetic - they can be passed from parents to their children. If either you or your partner have a family history of a genetic condition, your GP may refer you to a specialist. It’s better to do this before you become pregnant, rather than after.
Why is pre-conception counselling important?
The aim of pre-conception counselling is to improve the health of you and your child. Learning about the factors that affect conception and pregnancy can help you make informed choices before you try to conceive. These include changes to your diet or weight, or managing long-term health problems.
You might also find it helpful to know when in your cycle is best to conceive, and how long it may take to conceive. Especially if you’re concerned about the fertility of you or your partner.
When should I have pre-conception counselling?
Preconception counselling can form part of antenatal care. Antenatal care is the support you receive during pregnancy, but ideally it should start before conception. This is a good time to assess potential risks and start preparing for pregnancy. For example, it’s recommended that you take folic acid supplements before conception and during the first trimester. And vitamin D supplements before pregnancy can benefit you and your baby.
Even if you’re not sure about having a baby, you may still find it helpful to speak to your GP. They can give you advice and information that could help in the future.
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Sources Sources
- Pre-conception – advice and management. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2023
- Preconception care: maximising the gains for maternal and child health. World Health Organization. who.int, accessed March 2024
- Routine antenatal care. Details. BMJ Best Practice. bestpractice.bmj.com, last updated January 2024
- Glick I, Kadish E, Rottenstreich M. Management of Pregnancy in Women of Advanced Maternal Age: Improving Outcomes for Mother and Baby. Int J Womens Health 2021;13:751-759. DOI:10.2147/IJWH.S283216
- Pre-pregnancy counselling. Patient. patient.info/doctor, updated November 2020
- Rabiei Z, Shariati M, Mogharabian N, et al. Men’s knowledge of preconception health: A systematic review. J Family Med Prim Care 2023;12:201-207. DOI:10.4103/jfmpc.jfmpc_1090_22
- O’Brien AP, Hurley J, Linsley P, et al. Men's Preconception Health: A Primary Health-Care Viewpoint. Am J Mens Health 2018;12:1575-1581. DOI:10.1177/1557988318776513
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