Pre-conception counselling is a concept that is just coming of age in India. Only recently have couples realised the benefits of consulting a counsellor before they prepare for a pregnancy. The reason could be that planning a pregnancy or being pregnant is a relatively private matter in our culture. People attach a lot of importance to things such as matching horoscopes, family status and education before marriage. However, no one really considers how the pair’s reaction to a pregnancy will be. There are various tests that should be undertaken by both the male and female partners before starting marital life together, to make sure that the child, which is born, will be healthy.
After marriage, pre-conception counselling should be sought from a gynaecologist. Along with ruling out possibilities of TORCH (Toxoplasmosis, Rubella, Cytomegalovirus and Herpes) infections, Hepatitis B, C and AIDS, HPLC (High-Performance Liquid Chromatography) and Venereal Disease Research Laboratory tests (VDRL) should also be done to know whether or not both the parents are carriers. “A comprehensive approach to pre-conception counselling, which includes all care-givers and extends to settings such as school, community centres and hospitals will be very beneficial. We must encourage awareness of this concept at the grass-root level in India,” says Dr. Anjali Chhabria, consultant psychiatrist in Mumbai.
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“In a couple with a history of recurrent early pregnancy loss, counselling is of particular importance, because women are invariably more distressed and require reassurance that everything possible is being done to avoid future pregnancy losses, because their subsequent pregnancies are more likely to be planned,” says Dr. Santosh Jaybhave, obstetrician, gynaecologist, gynaecological endoscopist based out of Mumbai. These patients may be most willing to adopt recommendations that have been offered to them, and it becomes more important to identify which investigations and interventions are most beneficial.
Several interventions, ranging from lifestyle changes to medication may have a good effect on the chances of a successful pregnancy. “In case, the mother-to-be is diabetic, then proper diet control, and in some circumstances, insulin, is recommended to maintain the glucose level at an optimum level before conception. Women with heart disease or chronic hypertension and headaches should, ahead of their pregnancy, consult their doctor, who might perform some tests to assess renal, blood and cardiac functioning,” says Dr. Santosh Jaybhave. Lifestyle changes, such as weight reduction, balanced nutrition, an increased physical activity in the form of walking, jogging or yoga for approximately 30 minutes a day, and quitting smoking, drinking may be advised.
The weight of the mother also plays a major role in determining a safe pregnancy. Obesity can lead to reduced fertility rates and can be a contributing factor to many diseases such as diabetes, hypertension, heart disease, etc., resulting in a difficult pregnancy. On the other hand, being underweight can also lead to the problem of infertility. Hence it is very important to ensure that your weight is within the normal range before getting pregnant. “If you are above age 35 and are considering getting pregnant, be aware that you are at a high risk of pregnancy-related complications and of giving birth to a baby with congenital disorders,” warns Dr. Santosh Jaybhave.
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Emotional factors
Besides being physically prepared for pregnancy, your emotional readiness to conceive is equally important. It is the emotional preparation that is most crucial to healthy family development and often it is this preparation which is ignored by expectant parents. “Parents-to-be not only feel excited but also nervous regarding the changes a baby will bring into their lives. It can be an overwhelming experience for some, especially for the mothers-to-be. While the couple may have had a planned conception, they may not feel emotionally quite equipped for parenthood,” says Dr. Anjali Chhabria. In order to be better prepared and make this transition in their lives a smooth one, they can support one another by sharing their feelings and thoughts, she adds. It is a time when every woman undergoes many physical changes that will bring along low energy levels, morning sickness and vomiting for which you need to be prepared well in advance.