Preconception Office Visits are Critical to Good Maternal, Fetal Outcomes

1/31/2023

In order to improve pregnancy outcomes, there are important steps women can take to increase their chances of having a healthy pregnancy and baby - before they ever become pregnant.

Preconception care is individualized and designed for women considering pregnancy. This important type of preventive care focuses on identifying behavioral, environmental, biomedical and social risks that could impact a person’s fertility and pregnancy outcome. Through education, counseling and any appropriate interventions, the goal is to reduce a woman’s risk for an adverse pregnancy and birth.

Yet while the majority of pregnant woman in the United States receive prenatal care, most do not schedule a preconception care visit. Inadequate health insurance coverage and limited resources in some geographic areas often create barriers for women to get proper care before they conceive. For others, they simply don’t know they should receive it.

“Preconception care should be a standard part of preventive medicine for every woman who has childbearing potential,” said Guillermo Font, M.D., a maternal and fetal medicine specialist who sees high-risk OB patients at Northwest Health. “Nearly 50% of pregnancies in the United States are unplanned, so even if a woman is not interested in conceiving now, she may unexpectedly become pregnant or be interested in conceiving at a later time.”

Studies show unintended pregnancies are also associated more with adverse maternal and infant outcomes than intended pregnancies. Some interventions, such as managing medical conditions or achieving substantial weight loss, can also take several months to achieve.

As many as 30% of women begin traditional prenatal care in the second trimester, or after 14 weeks of gestation. However, prenatal care should begin in the first trimester, ideally by 10 weeks of gestation since early initiation of care can establish important baseline measurements in the mother, including blood pressure, weight and laboratory evaluations of patients who have chronic diseases. Prenatal screening in the first trimester can also provide an early window into providing social service support and other interventions when needed.

When women receive preconception care before becoming pregnant, the potential benefits are even greater. For example, steps taken to help prevent congenital anomalies can begin before conception occurs, such as taking folic acid supplements and avoiding alcohol and some medications.

“Preconception care visits not only include identifying potential risks to the mother and fetus, but also include components like health advice and interventions like birth control if they aren’t yet ready to conceive,” Dr. Font said. “Ideally, an OB/GYN physician will meet with a patient and develop a plan based on when the patient intends to become pregnant. They can work together to review and revise that plan at each subsequent visit.”

Dr. Font advises individuals, especially those who plan to become pregnant, to ask their OB/GYN providers about preconception health care. To learn more about the maternity services at Northwest Health, visit NWHealthin.com

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