Chapter 9 – Preconception Care and Pregnancy

Summary of chapter

Optimising the health of patients prior to conception is critical for the health of parents, babies and future generations. General Practitioners (GPs), nurses and midwives play a central role in the delivery of optimal preconception care.

Good preconception care addresses lifestyle risk factors, nutritional status, pre-existing medical co-morbidities and risk factors, vaccination status, medication and any substance use, and an assessment for possible familial genetic issues of the prospective parents (see Table 9.1 Preconception care checklist). The preconception period is a unique opportunity for intervention to optimise pregnancy outcomes.(1, 2)

Since a significant number of pregnancies are unplanned, it is important that clinicians opportunistically offer information on preconception care to all patients of reproductive age. The concept of “One Key Question” is a strategy developed by the Oregon Foundation for Health and endorsed by the American Public Health Association.(1, 3) The approach encourages clinicians to routinely ask patients of reproductive age during consultations the screening question “Would you like to become pregnant in the next year” with the answer either triggering provision of opportunistic preconception care, or provision of adequate contraception. Effective contraception until the time of desired pregnancy is a key strategy in preconception planning. Clinicians can ... Buy now