Preconception counseling should include addressing this issue prior to pregnancy. The use of alcohol during pregnancy can result in neuropsychologic adverse outcomes in the newborn. The literature is unable to recommend a safe level of alcohol use (Level A). Women should be advised to avoid alcohol if they are planning a pregnancy.
Smoking cessation should be offered to the woman and her partner before and during early pregnancy (Level A). Women should be counseled that secondhand smoke can impact both fertility and the perinatal period.Īlcohol use in pregnancy is associated with fetal alcohol syndrome and fertility problems.
Smoking cessation can reduce perinatal mortality and low birth weight by at least 20%. Tobacco use is associated with preterm labor, intrauterine growth retardation, low birth weight, and placental abruption. Counseling about short interval pregnancy and the negative impact would likely reduce the number of short interval pregnancies (Level B). Short interval pregnancies are associated with preterm deliveries, premature rupture of membranes, maternal morbidity, and mortality, the third trimester bleeding, myometritis, and anemia. Short Interval Pregnancy (less than 18 months) Women of reproductive age should be prescribed folic acid during the preconception period and throughout pregnancy. The genetic counselor can also educate the family on disorders that might impact fertility.Įarly use of Folic acid prevents neural tube defects. Patients with diseases or health issues associated with progression during pregnancy such as severe depression and anxiety, seizure disorders, diabetes, cardiac, renal disease, and other long-term illnesses should be referred for further counseling with a high-risk provider to discuss possible changes in medical management during pregnancy.įamilies with histories of genetic disorders should be referred to a genetic counselor to discuss the risks of passing the disorder to the newborn. Any identified risks including disease history and status, current medications, social barriers, and limited support systems or financial barriers must also be reviewed. Preconception counseling must focus on optimizing both primary and secondary prevention, treatment compliance, and improving overall well-being prior to becoming pregnant. Pregnancy can increase risks for both the mother and the child requiring additional visits, changes in routine care, and possible prolonged hospital stays if the perinatal period and pregnancy outcomes are not optimal. A few important items to discuss during preconception counseling include:Īny woman with a chronic disease should review her desire to become pregnant with the primary care physician or provider and her family. This risk assessment must include evaluation of overall well-being, medical history, surgical risks, social and behavioral risks, medication risks, occupational risks, education risks, and any other barriers that may pose an undue risk to fertility or pregnancy. Both the woman and man must be assessed for risks and educated about the risks associated with poor perinatal outcomes. Unplanned and unintended pregnancy results in late prenatal care which can subsequently contribute to adverse events during pregnancy and poor perinatal outcomes. Family planning and pregnancy prevention are key to pregnancy readiness. Every couple must have the opportunity to choose when they are ready to reproduce. Although education may not correlate with delayed sexual activity, it is important to educate young males about their responsibilities in reproductive health. As children enter puberty, both boys and girls must be educated about the delay in sexuality, pregnancy prevention, and prevention of sexually transmitted infections. In anticipation of future childbearing years, every individual benefit from education about pregnancy readiness and the role of family and parenting with age-appropriate education.
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