The average pregnancy is counted as 40 weeks, starting from the first day of the mother’s last period. Pregnancy is divided into three trimesters, with different stages in each. The development of a pregnancy can be followed week by week, but it’s important to remember the experience varies for every mother and baby.…
What is a pre-pregnancy check-up?
Pre-pregnancy check-ups are promoted as a way to improve pregnancy outcomes by identifying risk factors that can result in complications. The provision of information about lifestyle factors such as diet, smoking and alcohol intake allows individuals to make healthy informed decisions about their pregnancy in the hope it will lead to better outcomes and lessen pregnancy complications.
During the check-up
During your pre-pregnancy check-up, you can expect your doctor to take a detailed medical history from you and your partner. Diet and lifestyle factors will also be taken into consideration, with folate supplements and stress management techniques often recommended.
It is likely that your doctor will also take a blood sample and Pap test for analysis (if not up to date), to ensure you do not have any underlying medical conditions that might affect your pregnancy.
It is important that your vaccinations are up-to-date. Some vaccines are associated with complications during pregnancy, so it is sometimes advised to wait about a month before trying to conceive after receiving such vaccines. Your doctor can advise you which vaccines are safe to use and which ones you may need to wait to have.
Your doctor may also test for a range of illnesses including thyroid problems (hyperthyroidism / hypothyroidism), toxoplasmosis, chickenpox, HIV, hepatitis B, and other sexually-transmitted infections. Some conditions, such as sickle-cell anemia and thalassemia, can be passed down generations in people of certain ethnic backgrounds. Depending on your ethnicity, you may be tested to see your risk of passing these conditions on to your newborn.
Disease management in pre-pregnancy
It is important to seek medical advice before trying to conceive if you have a medical condition that puts you at increased risk, such as diabetes, epilepsy, high blood pressure (hypertension), or asthma. Some medications you might be taking for these conditions may cause complications for your pregnancy. If this is the case, your doctor might suggest substitute medications.
For those with diabetes it is especially important that blood sugar levels be controlled to ensure the health of mother and baby. Management for diabetes during pregnancy may be a controlled dietary intake and lifestyle measures with or without insulin. Hypoglycemia (low blood sugar) more often occurs overnight, between 6-18 weeks' gestation, during which time insulin intake may need to be decreased. After that time, resistance to insulin increases, so insulin may need to be increased until around 32 weeks when blood sugar levels may fall again. Your doctor will explain all of this during your pre-pregnancy check up and may involve a specialist endocrinologist in your care.
High blood pressure
If you know you have high blood pressure (hypertension), it is important to have a pre-pregnancy check-up before you try to get pregnant, because some medications used to control hypertension can cause complications. You will also need to be advised on the process of managing your condition during pregnancy. If you do not have it previously, sometimes hypertension can develop during pregnancy, so it is important to have blood pressure checks at antenatal visits.
Heart disease is one of the most common causes of maternal death during pregnancy. Pregnant women with a heart disease (such as angina or atrial fibrillation) are at higher risk due to the heart working harder during pregnancy than it normally does. Many of the medications used for treating heart disease can cause developmental issues for the baby. It is important to speak to your doctor prior to pregnancy so that a medication regime can be optimized to ensure the health of you and your baby.
Hormonal and other changes during pregnancy can alter the effects of antiepileptic drugs during pregnancy, resulting in complications to the baby. Your doctor will discuss options to manage your epilepsy during pregnancy.
Asthma can often become worse during pregnancy, so if you have asthma, pre-pregnancy check-up can help prepare you to manage it. It is important to keep taking your medications as prescribed by your doctor for your asthma during pregnancy. The medications used to treat asthma are generally much less likely to harm your baby than the actual effects of asthma.
It is recommended that you see your doctor before you become pregnant, because a pre-pregnancy check-up can help to reduce the risks of pregnancy to you and your child.
- The Royal Womens Hospital. The Womens Health Book: A Complete Guide to Health and Wellbeing for Women of All Ages.
- Asthma NSW DL Brox.qxd. Accessed 26 August 2014 from http://webcache.googleusercontent.com/search?q=cache:JG2x9SdEbjUJ:www.asthmaaustralia.org.au/uploadedFiles/Content/About_Asthma/Resources/Asthma_And_Pregnancy_DLBrochure.pdf+&cd=1&hl=en&ct=clnk&gl=au&client=firefox-a
- Hypertensive disorders of pregnancy - Australian Prescriber. Accessed 23 August 2014 from http://www.australianprescriber.com/magazine/35/2/47/50
- Management of Epilepsy and Pregnancy Thomas SV - J Postgrad Med. Accessed 26 August 2014 from http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2006;volume=52;issue=1;spage=57;epage=64;aulast=Thomas
- Management of Sickle Cell Disease in Pregnancy. Accessed 23 August 2014 from http://webcache.googleusercontent.com/search?q=cache:M0rbkKRsKzEJ:https://www.ranzcog.edu.au/doc/RCOG%2520Sickle%2520Cell%2520Disease.html+&cd=14&hl=en&ct=clnk&gl=au&client=firefox-a
- RACGP - Epilepsy in pregnancy: a collaborative team effort of obstetricians neurologists and primary care physicians for a successful outcome. Accessed 23 August 2014 from http://www.racgp.org.au/afp/2014/march/epilepsy-in-pregnancy/
- Routine pre-pregnancy health promotion for improving pregnancy outcomes - The Cochrane Library - Whitworth - Wiley Online Library. Accessed 23 August 2014 from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007536.pub2/full
- The Australasian Diabetes in Pregnancy Society consensus guidelines for the management of type 1 and type 2 diabetes in relation to pregnancy | Medical Journal of Australia. Accessed 23 August 2014 from https://www.mja.com.au/journal/2005/183/7/australasian-diabetes-pregnancy-society-consensus-guidelines-management-type-1
- The importance of pre-pregnancy counselling in cardiac disease | The British Journal of Cardiology. Accessed 23 August 2014 from http://bjcardio.co.uk/2014/03/the-importance-of-pre-pregnancy-counselling-in-cardiac-disease/
FAQ Frequently asked questions
What is a pre-pregnancy check-up?
A pre-pregnancy (also known as pre-conception) check-up is when you see your doctor before trying to get pregnant. This allows your doctor to identify any risk factors that may cause complications during your pregnancy and provide you with ways to manage …
Is a pre-pregnancy check-up really necessary?
A pre-pregnancy check-up is essential if you have a medical condition such as diabetes, high blood pressure (hypertension), heart disease or epilepsy. The better informed you are about your pregnancy and health, the better decisions you can …
Should I update my vaccines before I try to become pregnant?
It is generally advisable to be up to date with all your vaccinations before trying to conceive. However, it is important to do so in consultation with your doctor, because some vaccines can cause complications for your baby. …
If I stop taking the Pill, how long will it be before I can become pregnant?
Ovulation can occur in the first cycle after you stop taking the Pill. If you are using long-term birth control measures such as contraceptive injection, it may be several months before you can conceive.
What is the best time to get pregnant?
When one of your ovaries produces an egg, this is called ovulation. It is the best time to try to get pregnant and usually occurs about halfway through your monthly menstrual cycle.
Why do I need to stop drinking alcohol during pregnancy?
Alcohol may harm your baby if taken during pregnancy. There is no safe limit to the amount of alcohol that can be had during pregnancy. Therefore, it is generally best to avoid drinking alcohol during pregnancy.
What is a sperm test?
A sperm test is often carried out when a couple are having problems conceiving, to see if the reason is the male's fertility. Sperm are examined to see how many there are and how well they move around, as well as how many abnormal sperm there are.
What is genetic counselling?
Genetic counselling is advice given to you by a specially-trained genetic counsellor and is often necessary when your family has a history of inherited disorders such as hemophilia or cystic fibrosis.
I have heavy and painful periods. Will it be difficult for me to conceive?
Heavy, painful periods probably won't have any impact on your ability to conceive, but if you have severe symptoms, it is best to talk to your doctor so they can rule out endometriosis, fibroids and pelvic infection.
My partner and I are both over 30 years of age, will this affect our chances of conceiving?
Male fertility is not hugely affected by age, but female fertility tends to decline after age 35.
Why should I stop smoking if I am pregnant?
Smoking can harm your baby during pregnancy, so it is a good idea to cut down or quit smoking when you are pregnant.