In Australia around half of pregnancies are unplanned. Whilst this is a happy event and nearly always goes well, a lack of pre-pregnancy review limits opportunities for preventative healthcare and optimising health in order to maximise the odds of a healthy mother and baby.
For this reason wherever possible a pre pregnancy review and plan is preferred.
What can you expect in a pregnancy planning appointment?
This visit is not only about routine blood tests, cervical screening 'pap' testing and starting folic acid (in the correct dose for your body mass index or BMI) but it is also about:
a detailed medical, surgical and psychiatric history to identify conditions which require management to reduce the odds of complications during your pregnancy . Following on from this is a plan for monitoring the effect of the pregnancy on your condition and of your condition on your pregnancy. If you see multiple specialists, it is helpful to ask your family doctor to send along letters from these doctors with their referral letter as this gives good background to your health.
an assessment of couple risk factors for infertility and screening where indicated for problems with ovulation, the patency of fallopian tubes ('blocked tubes') and of male sperm count.
identification of medications that should not be taken in pregnancy or that can be substituted to an alternate drug and when this should occur. For some medications, switching when you become pregnant is acceptable and for others the risk of harm is too high and they should be switched when or before you cease contraception. For some medicines you are important in the decision making as there is a balance of risk versus benefit for you, your baby and the health of the pregnancy overall.
a general gynaecological well woman check, including cervical screening, and breast screening if required.
a thorough obstetric history to determine your risk factors for complications such as preterm birth, pre-eclampsia and other conditions that can be assessed and optimised early including gestational diabetes. There are several specific preventative therapies and lifestyle strategies in each area.
general lifestyle advice for healthy pregnancy including diet, exercise, sleep habits and how often you should 'try'.
In general, the healthier you are before pregnancy, the healthier your pregnancy will be!