Seeing Your Doctor for Preconception Care: What to Expect

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Thinking about having a baby? You may want to consider seeing your doctor for what’s known as a preconceptional health visit, says Kathryn M. L. Konrad, a registered obstetric nurse, childbirth educator, and assistant professor of nursing. Konrad sat down with HealthCentral to have a conversation about the importance of this appointment and how to ensure your body is prepared for a healthy pregnancy.

HealthCentral (HC): What is preconception health?

Kathryn Konrad (KK): Preconception health is the term we use to talk about the health status of a woman and her partner prior to pregnancy. Part of this involves having a preconceptional health visit. This is typically an appointment with your doctor that may or may not include your annual exam, but uses the time to talk about planning a pregnancy.

In some ways, the preconceptional health visit looks like your regular check-up. They will look at your weight, your blood pressure, and your blood sugar. This also includes your vaccines. They should be up to date, including pertussis, tetanus, and your yearly flu shot. They will look at all of the medication you are taking. This is all to see where you are healthwise. You may need to make some adjustments to prepare yourself for a healthy pregnancy. Let’s say you have blood pressure issue — getting that down first will put you and your baby at a lower risk of complications.

HC: Are preconceptional health appointments just for women?

KK: No — men should be seen as well. A healthy pregnancy is a healthy family; both partners are important and should be seen on a regular basis. People do not realize that the DNA of a man can be altered by poor health as well. Sometimes certain conditions can even impact his fertility. Planning ahead can help you head off trouble at the pass.

HC: When should you have your preconceptional health visit?

KK: Ideally, you should see your practitioner about a year before you want to try to conceive. This gives you time to work on any health issues you may have. It can also gives you time to work on figuring out which birth control is right for you during this time period.

So, for example, if you have a long-acting reversible contraceptive (LARC), like a birth control implant or IUD, you may want to have that taken out sooner than you are ready to start trying. This means you would need to switch to a short-term method like condoms, a diaphragm, etc. This is to help prepare your body to get pregnant.

HC: Who provides preconception care?

KK: Many types of medical professionals can provide this care, from your regular family practitioner to the obstetrician or midwife. I think many people use this visit as a chance to get to know their practitioner and perhaps audition them for the part of prenatal care provider. It can be quite a shock when your beloved gynecologist turns out to not be the best match for your ideal obstetrician.

HC: Do you need to have a preconceptional health visit with every baby, or is just once enough?

KK: Every baby deserves a healthy start, so you should be seen annually. In fact, after you have had a baby, we start talking about the concept of “interconception care” — the car between pregnancies. You can imagine that after you have had one baby, your body may have different health issues than you had prior to your first pregnancy.

HC: What other things are covered during a preconceptional health visit? Is fertility awareness discussed?

KK: This visit is a great time to talk about fertility awareness. Most people have grown up not really thinking about their fertility except knowing that if they stopped taking birth control, they’d get pregnant. It doesn’t always work that way. Some people will try for a year and still be completely healthy. Using the time before you intend to become pregnant to learn more about your fertility and your cycle can help you get pregnant faster when you’re ready. And if you’re the 1 in 8 couples who do suffer from a fertility issue, you will have a heads up in figuring that out and data to start with.

Most practitioners will talk to you about tracking your cycle and trying to figure out when you’re ovulating. This might include using an app or using a basal thermometer.

HC: Are there certain vitamins women need to take before they try to get pregnant?

KK: It is recommended that anyone who is sexually active should be taking folic acid. If you haven’t started that, you should do that at the very least. Some practitioners advise that you begin taking prenatal vitamins. A general multivitamin with the right amount of folic acid is usually good enough.

HC: What should you avoid if you’re trying to conceive?

KK: In general, a good rule of thumb is that if you’re actively trying to be pregnant, you should act pregnant. This means no alcohol, no smoking (including secondhand smoke), no recreational drugs, etc. This is also a good rule for your partner. If your partner is drinking, smoking pot, etc., this can affect his sperm count and quality, and perhaps create other problems.

Use the year leading up to the official start of the trying-to-get-pregnant phase as a way to begin to limit your exposure to things you won’t want to continue when you’re pregnant.

This interview has been condensed and edited.

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