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The importance and value of prenatal care are well-documented as it keeps track of the mother-to-be and her baby. Medical check-ups during pregnancy are quite frequent and have been recommended by doctors and gynaecologists for long. However, in recent times, most experts have suggested pre-pregnancy or preconception care.
What is a Pre-Pregnancy Check-Up?
A pre-pregnancy check-up includes a set of tests your doctor may run on you and your partner to ensure that both of you are free from illnesses that can ruin your chances of becoming pregnant. Based on the results of these tests, your doctor will provide you with instructions to follow in areas like exercising, diet, lifestyle, and necessary supplements. He will also recommend changes in certain habits like smoking and consumption of alcohol to have a safe pregnancy and a healthy child.
Why is Preconception Check-Up Important?
A pre-pregnancy check-up is essential to make sure that a woman is healthy and physically prepared to nurture and bear a child. A pre-pregnancy check-up is important for a couple, as it can enhance the possibility of the woman conceiving. The risk of congenital disabilities, anomalies or miscarriage is also reduced if a pre-pregnancy check-up is carried out. It helps to rule out any future complications that may arise during pregnancy as a result of existing health issues with the man and woman.
What Prenatal Care Providers Can You See for Pre-Pregnancy Examinations?
While choosing a pre-pregnancy care provider for preconception care, you can choose the same doctor or provider to whom you plan to entrust your prenatal care later on. This way, the same set of medical practitioners can care for you in pre-pregnancy, prenatal and post-delivery care too. You will have to see the following providers for pre-pregnancy examinations:
1. Family Physician
Also known as a family doctor, this trained professional is capable of treating ailments and taking care of you before, during and for post-pregnancy related issues. Although a gynaecologist is always better, it is up to you to consult a family physician
A midwife is a trained and professionally educated person who can take care of women, pregnant or otherwise, irrespective of their age.
This is a doctor who is trained to care for pregnant women and carry out deliveries of their babies.
4. Maternal-foetal Medicine Specialist
An MFM specialist is an Obstetrician who specialises in taking care of women facing high-risks. You may have to see a Maternal-foetal medicine specialist if you have health conditions that could lead to complications during or after pregnancy.
5. Family Nurse
This is a practitioner with nursing qualifications and thoroughly qualified to care for pregnant women.
6. Women’s Health Nurse Practitioner
Otherwise known as WHNP, this qualified individual is specially trained to look after women and is knowledgeable about pregnancy-related problems women face.
What Happens at the Check-up?
During a pre-pregnancy check-up, your doctor or health provider will carry out various examinations and tests to make sure you are ready for pregnancy. A few are listed below:
1. Weight Check
This is necessary to know if your body weight is ideal for your body size and type. If it isn’t, then the doctor will suggest certain changes in your food intake and diet or prescribe medications to help bring the weight to normal. Unless your body weight is right, the doctor will not suggest getting pregnant. A Body Mass Index (BMI) between 18.5 and 22.9 is the ideal BMI for women.
2. Mental Health Screening
Mental health issues like anxiety disorders, depression or eating disorders can pose a problem while conceiving a baby. Since there will be massive mood swings, this may increase the disorders and will interfere with conception. To decrease the risk of mood disorders, a preconception mental health screening will be carried out by your doctor during or after the check-up. This also concerns any changes pertaining to drugs that were being used previously
3. Urine Tests
Checking urine for the presence of a urinary tract infection and kidney ailments is a part of every pre-pregnancy check-up.
4. Gynaecological Screening
This screening is carried out to check for uterine fibroids, cysts, benign tumours or any pelvic inflammatory diseases (PID). It also checks for irregular periods and PCOS (polycystic ovarian syndrome) or any other gynaecological condition which could hamper pregnancy.
5. Breast, Pelvic and Abdominal Examinations
The pelvic examination checks for infections such as yeast or trichomoniasis, which may pose a problem. The abdomen is examined to check if there are any physical anomalies. The breasts are examined to check for lumps which may need attention.
6. Blood Pressure Reading
The blood pressure is checked to identify very high or very low BP, as both may lead to complications.
7. PAP Test
A Pap smear test is an integral part of your first visit to your doctor. The test is done by inserting a speculum into the vagina for a view of the cervix. The doctor then runs a cotton swab over the cervix and collects cells which are sent to the lab to be analysed. This test assesses whether you are infected with Sexually-Transmitted Diseases (STD) like gonorrhoea, syphilis, HIV or Hepatitis B. A colposcopy will be carried out if the doctor finds abnormal cells during this examination.
8. Blood Tests
The following blood tests are carried out to check for various conditions:
- Vitamin D deficiency
- Haemoglobin count
- Rh factor
- Hepatitis B
- Thyroid functions
9. Genetic Conditions
Speak to your doctor if your family has a history of thalassemia, cystic fibrosis or Down Syndrome so that further investigations can be conducted.
Inform your doctor about the contraceptive methods you have been using. Most practices do not impact how much time it takes conceive as soon as you stop using them. However, if you have been using contraceptive injections, it may take up to a year to get your fertility to return to normalcy.
11. Past Pregnancies
It is always advised to discuss any past miscarriages, terminations or ectopic pregnancies you may have had in the past. Though this can be hard for you, it will help the doctor to prepare for the best care.
12. General Queries
You can expect the doctor to discuss your diet, your health in general, the lifestyle you follow, your exercise routine, and your current occupation. Share any complications with your menstrual periods. Any existing health conditions like asthma or diabetes will also be of interest to your doctor during the check-up.
The following preconception blood tests should be carried out before you decide to get pregnant. Of course, your doctor is the best person to suggest the right tests, so it is better to consult with him/her for the same:
1. Complete Blood Count (CBC)
This is a mandatory test to determine if you need to be started on iron supplements. You could suffer from anaemia if you become pregnant while your body is facing an iron deficiency.
2. Hepatitis B Test
This test is recommended if the doctor feels you are at risk for this disease. Before you get pregnant, you can get yourself vaccinated against Hepatitis B.
3. Herpes Test
If you or your partner have a history of having contracted herpes, this test has to be carried out before you conceive. This test should be carried out even if you have never shown the symptoms of herpes.
4. Blood Test
Your immunity to rubella can be found out by conducting this blood test.
5. Test for Syphilis
This test ensures that if the mother is infected with syphilis, it does not pass on to the baby. Untreated syphilis can lead to miscarriage or stillbirth, and hence your doctor will recommend taking this test.
6. Test for HIV
The test for Human Immunodeficiency Virus is mandatory since HIV reduces the body’s ability to fight infections by attacking the body’s immune system. This virus can pass on to your baby during birth and while breastfeeding too.
As you plan to take on the responsibility of becoming a mother and starting a family, you will have a number of thoughts and doubts in your mind. The following Frequently Asked Questions will help you to put your mind to rest:
1. Do I Need Pre-Pregnancy Dental Check-Up?
A thorough dental examination is as important as the other pre-pregnancy check-ups. By eliminating the chances of bacteria in your gums, you are sure that the bacteria are not transferred to the baby through the amniotic fluid. Also, a simple dental issue can significantly worsen during pregnancy, since your immunity is low at this time. If there are pre-existing dental lesions, they need to be addressed.
2. What to Do If I Am Unhappy With My Gynaecologist?
There is a possibility that you could feel disconnected from your gynaecologist during your meetings. He may not provide satisfactory answers to your queries or may not understand your fears as a first-time mother-to-be. You may even be uncomfortable or something about his personality could make you unhappy. However, you should be clear about the reasons if you feel so.
It is always best to ask for recommendations and references for gynaecologists while you are searching for one. Females often prefer female gynaecologists, as it allows a certain amount of comfort. However, there is no harm in seeking consultation with a male doctor if you are comfortable. Continue with the doctor only if you trust her completely otherwise you can surely ask for a second opinion and switch.
3. Do I Need to Take Someone With Me to the Doctor’s Appointments?
It is always a great idea to take along your partner or husband for the first consultation with the doctor. Make a list of the questions and doubts you may have about the check-up after mutually discussing the same. There are many advantages to jointly visiting the doctor for the check-up. The doctor will make suggestions for changes in your current lifestyle and diet amongst other things. He will also list out the precautions to be taken and the tests you both will have to undergo.
If your partner is present for the appointment, he will realise how important it is for you to eat well, reduce stress and take rest. Visiting the doctor together helps your husband to feel more involved with the pregnancy, and this will bring you closer as a couple. It is also easy to recall the doctor’s instructions when both are present for the doctor’s appointment.
4. How to Make the Most of the Check-Up?
While visiting your gynaecologist for a preconception health screening, you should remember that he or she will be pressed for time. This means that you will have to make most of the time you spend with the doctor, as the average consultation time does not exceed beyond 15-20 minutes with a busy doctor. Here’s how you can maximise the check-up:
- Always book a prior appointment which allows you and the doctor to plan properly.
- Write down an agenda so if you have more than one problem. Share it with your doctor at the start of the check-up or ask one by one. Discuss the most important concern at the beginning of the consultation, or you could run out of time.
- While seeing a gynaecologist for the first time for a health check-up before getting pregnant, you should give a summary of yourself. The doctor rarely has time to read your complete medical history between two appointments.
- If the doctor has shared his number with you, ask basic queries over the phone, so you have more time to discuss important issues during the check-up
Starting a family and bringing a brand new life into this world is a huge decision a couple takes. However, it makes sense to prepare for the baby by sorting out parental health problems before becoming pregnant. A healthy mother improves the chances of a healthy pregnancy and, hence, it is important to carry out all the requisite tests and exams needed, after consulting the doctor.
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