Chapter 4 Preconception
PRECONCEPTION
Preconception Counseling and Care
Preconception health promotion provides women and their partners with information that is needed to make decisions about their reproductive future. Preconception counseling guides couples on how to prevent unintended pregnancies and to achieve pregnancy when desired, stresses risk management, and identifies healthy behaviors that promote the wellbeing of the woman and her potential fetus (Moos, 2006).
All providers who treat women for well-woman care or other routine care should incorporate preconception health screening as part of the routine care for women of reproductive age (Johnson, Posner, Biermann, Cordero, Atrash, Parker, et al., 2006). The initiation of activities that promote healthy mothers and babies must occur before the period of critical fetal organ development, which is between 17 and 56 days after fertilization. By the end of the eighth week after conception and certainly by the end of the first trimester, any major structural anomalies in the fetus are already present.
Because many women do not realize that they are pregnant and do not seek prenatal care until well into the first trimester, the rapidly growing fetus may be exposed to many types of intrauterine environmental hazards during this most vulnerable developmental phase.
Preconception care is important for women who have had a problem with a previous pregnancy (e.g., miscarriage, preterm birth). Although causes are not always identifiable, in many cases, problems can be identified and treated and may not recur in subsequent pregnancies. Preconception care is also important to minimize fetal malformations. For example, the woman may be exposed to teratogenic agents such as drugs, viruses, and chemicals, or she may have a genetically inherited disease. Preconception counseling can educate the woman about the effects of these agents and diseases, which can help prevent harm to the fetus or allow the woman to make an
Preconception Counseling and Care
Preconception health promotion provides women and their partners with information that is needed to make decisions about their reproductive future. Preconception counseling guides couples on how to prevent unintended pregnancies and to achieve pregnancy when desired, stresses risk management, and identifies healthy behaviors that promote the wellbeing of the woman and her potential fetus (Moos, 2006).
All providers who treat women for well-woman care or other routine care should incorporate preconception health screening as part of the routine care for women of reproductive age (Johnson, Posner, Biermann, Cordero, Atrash, Parker, et al., 2006). The initiation of activities that promote healthy mothers and babies must occur before the period of critical fetal organ development, which is between 17 and 56 days after fertilization. By the end of the eighth week after conception and certainly by the end of the first trimester, any major structural anomalies in the fetus are already present.
Because many women do not realize that they are pregnant and do not seek prenatal care until well into the first trimester, the rapidly growing fetus may be exposed to many types of intrauterine environmental hazards during this most vulnerable developmental phase.
Preconception care is important for women who have had a problem with a previous pregnancy (e.g., miscarriage, preterm birth). Although causes are not always identifiable, in many cases, problems can be identified and treated and may not recur in subsequent pregnancies. Preconception care is also important to minimize fetal malformations. For example, the woman may be exposed to teratogenic agents such as drugs, viruses, and chemicals, or she may have a genetically inherited disease. Preconception counseling can educate the woman about the effects of these agents and diseases, which can help prevent harm to the fetus or allow the woman to make an