To get the most out of your pregnancy, you have to plan it right even before conception.
This is called pre-pregnancy care, which is especially important when you are planning to start a family.
Pre-pregnancy care, or pre-conception care, improves your pregnancy outcomes and ensure you are healthy throughout the pregnancy. It also helps you manage risk factors, if any, that may affect your pregnancy.
Planning For A Life Journey
I have always told my patients that pregnancy is a journey, and planning it is important before you embark onto this journey.
Of course, at the end of this journey, all you want is a healthy mother, healthy child, and a happy family.
This is where pre-pregnancy counselling comes into play to ensure everything is optimum from the very beginning.
This counselling session is to manage parents’ expectations and outline a plan for a smooth pregnancy journey.
Some patients may have underlying medical conditions that are not improving. Some may be on drugs which are not suitable during early pregnancy.
Others may have previous pregnancy complications that require them to be tested before becoming pregnant again.
At times, some women may not be advised to get pregnant at all. They have to know what is at stake. It is important to find out if they have any medical disorders that may affect their baby.
Generally, in Malaysia, there are those who are reluctant to see a doctor, much less go for a medical screening.
They avoid hospitals unless they feel really ill or need a follow-up appointment. This makes them oblivious to their health condition.
For those who enter matrimony later, for example after 35 years old, unaware pre-existing medical conditions may result in complications both to the mother and baby.
Importance Of Health Screenings
Screening is essential if you plan to get pregnant. After evaluating couples holistically, doctors will suggest a suitable procedure or treatment to address any health issue detected.
This would usually involve checking haemoglobin and sugar levels, and whether either parent has thalassemia, etc. It would also be worthwhile to check for sexually transmitted diseases (STDs), just to be safe.
In the case of thalassemia, if one or both parents have it, chances are the child may have a risk to be thalasemic too.
Testing will surely help the obstetrician manage the pregnancy and suggest further tests that are appropriate for mother and baby.
Some medical conditions such as diabetes, hypertension, or maternal blood disorders can affect the baby.
If a mother is diabetic, the result can be to both the baby and mother. The risks of miscarriage, foetal demise, and foetal structural abnormality are among some complications that can happen. Ideally, optimisation of sugar before pregnancy is important.
Risk Categories In Pregnancy
It’s about managing expectations. I would advise couples to seek professional medical advice and undergo some tests, before embarking onto parenthood.
There are risk categories in pregnancy and ways to know which risk category you belong to. There are low risk and high-risk pregnancies.
Maternal age, maternal comorbidities, previous pregnancy outcomes, and such will determine the category the patient falls into.
High-risk pregnancy require specialised care as there are at risk of complications such as preterm labour, foetal demise, or morbidity to the expecting mother.
Underlying conditions can be optimised for you to have a safe pregnancy. Yes, the mother’s condition requires a thorough evaluation, but assessment may not only involve the mother but may require both mother and father.
If You Are On Medication
You need to inform your doctor regarding any existing medications you are on. Some medications can affect the developing foetus.
Therefore, if patients have the intention to get pregnant, medications need to be changed to safer alternatives.
There are safer drug options that will not compromise your medical conditions and your pregnancy. The best alternative is to ensure the wellbeing of both your medical condition and your baby’s.
For example, some antihypertensive may affect the growth of the baby and will be changed to another drug to minimise these unwanted defects to the baby. The same goes for diabetic medications, blood thinning agents and such.
Your Doctor Can Be Your Counsellor
Should you prepare and plan, and yet find out that pregnancy is still not advised, you may be wondering what is the point of a counselling session?
An unplanned pregnancy with a less than ideal medical condition may end up with a poor pregnancy outcome, or worse, a termination of pregnancy.
This can be very traumatising for the couple. Imagine terminating the pregnancy due to a potential life-threatening issue for the mother.
In obstetric practice, the mother always comes first. If her pregnancy continues to make her health deteriorate, she will be advised against it or only when she is deemed fit for pregnancy.
If pregnancy is not possible and will endanger her, the doctor may suggest alternatives such as adoption.
Some couples may feel devastated when they are not able to have children from their own flesh and blood.
However, it is more important to avoid taking chances with loss of life or pre-term labour that can bring mental and physical effects on the baby, and even termination of pregnancy, especially when the mother is already halfway through pregnancy
Pre-pregnancy care should be sourced from an expert who manages high risk pregnancies. A maternal foetal medicine specialist is specifically trained in analysing the optimal condition for a pregnancy or otherwise. It is wise to seek consultation if you are planning pregnancy at a mature age, i.e. beyond 35 years.
On the other hand, if you are planning on getting pregnant, start preparing your body at least with nutrition, and decrease your intake of caffeine, raw eggs, and fish with possible mercury content.
You may want to increase consumption of fruits, vegetables, as well as water, and follow the Ministry of Health’s recommendation comprising quarter carbohydrate, quarter protein and half fibre.
Stay healthy for a healthy start in pregnancy.
Dr Vijayaletchumi Thandayathany is a maternal foetal medicine specialist and consultant obstetrician and gynaecologist at Columbia Asia Hospital Seremban.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.
