Pregnancy Planning

What is Pregnancy Planning?

Pregnancy Planning involves checking for possible risk factors during pregnancy and can offer ways to resolve any medical issues you may have before you become pregnant.

It generally includes steps such as ensuring you are in good health before becoming pregnant, managing any pre-existing health conditions, taking prenatal vitamins, and making lifestyle changes such as quitting smoking or limiting alcohol consumption.

What is Pre-Pregnancy Counselling?

Pre-pregnancy counselling is a counselling session conducted before you conceive and is beneficial for the mother and baby during pregnancy. Pre-pregnancy counselling aims to prepare for pregnancy by discussing potential risks and providing information on optimising your health before, during and after pregnancy.

Pre-pregnancy counselling and care will help you become physically healthy and emotionally strong before you enter the pregnancy phase.

It's good to have pre-pregnancy counselling to understand any risks and how to optimise the health of the mother and baby before, during and after pregnancy. This counselling can help to identify and address any potential issues before they become problems, and it can also provide peace of mind and help to prepare for the journey ahead.

Preconception Health Session?

You can discuss and clarify with your doctor everything that concerns you before you get pregnant, like starting prenatal vitamins, diet or any hereditary health issues. Many important points will be discussed during your pre-pregnancy counselling session. These include:

Reproductive history: Your doctor will discuss your menstrual history, use of contraceptives, previous sexually transmitted diseases, vaginal infections and Pap test results.
Medical and surgical history: You should inform the doctor about any past health problems so they can be controlled while you plan your pregnancy. Any past surgeries or hospitalisations should also be brought to the doctor's notice.
Current medications: Discuss with your doctor any prescription, over-the-counter medications, or herbal supplements you may be taking. This can help the doctor plan your medications to prevent potential pregnancy problems.
Weight: It is always better to have an ideal weight before conception. Gaining weight if you are underweight will reduce the risk of having a low birth-weight baby, and reducing weight if you are overweight will prevent the risk of high blood pressure during pregnancy.
Workplace and home environment: Your doctor will discuss potential hazards to the conception or maintaining a pregnancy, such as exposure to lead or certain toxic solvents, radiation and cat faeces.
Lifestyle: The effect of certain habits like alcohol consumption, smoking and recreational drugs on pregnancy will be discussed. You and your partner may be advised to stop these habits for a healthy pregnancy.
Exercise: Inform your doctor about your activities or if you don't exercise. You may be advised to continue regular exercises during pregnancy until your doctor suggests otherwise.
Diet: Having good dietary habits is beneficial during pregnancy. You will be advised to consume food rich in folic acid, calcium, fibre and other nutrients and reduce the intake of caffeine, which is present in coffee, chocolates, soft drinks and medications, before getting pregnant.
Family health history: Inform your doctor about hereditary medical conditions and multiple births in the family.
Prenatal vitamins: You should take folic acid supplements before you conceive, as folic acid reduces the chances of neural tube defects in your baby.

What are the Benefits of Pregnancy Planning?

Pregnancy planning is important for couples or women planning to become pregnant. It has many benefits, including:

Improved maternal and foetal health: Pregnancy planning allows couples or women to optimise their health before conception, leading to better outcomes for both the mother and the baby.
Reduced risk of complications: Pregnancy planning can help to identify and address any potential risks or complications before they become problems. This can include identifying and managing pre-existing medical conditions, such as diabetes or hypertension, or addressing lifestyle habits, such as smoking or substance use, that could affect the pregnancy.
Increased chances of a successful pregnancy: Preparing for pregnancy can increase the chances of a successful pregnancy by identifying and addressing any fertility issues early on, as well as identifying and addressing any potential risks that could negatively impact the pregnancy.
Better prenatal care: Pregnancy planning allows couples or women to get an early start on prenatal care, which can benefit both the mother and the baby. This includes identifying and addressing any potential issues early on, as well as providing education and support to help couples or women prepare for the birth of their child.
Emotional and psychological benefits: Pregnancy planning can help couples or women feel more in control of their pregnancy and provide peace of mind. It can also help couples or women to feel more prepared and confident as they embark on the journey of parenthood.
Financial benefits: Pregnancy planning can help couples or women budget and plan for the costs associated with pregnancy and childbirth, including medical expenses and time off work.

Pregnancy Planning Steps

Pregnancy planning includes several steps couples or women can take to prepare for a healthy pregnancy and childbirth. The specific steps will vary depending on the individual, but some standard measures include the following:

Optimising health includes achieving and maintaining a healthy weight, eating a balanced diet, and quitting smoking and alcohol.
Discussing family medical history includes discussing any genetic disorders, chronic health conditions, or other health concerns that may affect the pregnancy.
Identifying and addressing potential risks or complications: This can include identifying and managing pre-existing medical conditions, such as diabetes or hypertension, or addressing lifestyle habits, such as smoking or substance use, that could affect the pregnancy.
Fertility testing and treatment: This can include ovulation monitoring, fertility testing, and treatments such as fertility drugs or assisted reproductive technologies (ART) if needed.
Choosing a healthcare provider: This includes selecting a healthcare provider who is experienced in prenatal care and childbirth and will provide continuity of care throughout the pregnancy.
Preparing for prenatal visits: This includes scheduling regular prenatal visits and discussing any potential concerns or complications with the healthcare provider.
Preparing for childbirth: This includes researching different options for labour and delivery, such as natural childbirth or caesarean section, and taking childbirth education classes.
Planning for postpartum care: This includes preparing for the baby's arrival, discussing breastfeeding options, and identifying support systems for the new mother.
Making a birth plan includes outlining preferences and expectations for labour, delivery, and postpartum care and discussing them with your doctor.

Pre-genetic Testing (PGT)

Preimplantation Genetic Testing (PGT) is a type of genetic testing done on embryos before they are implanted into the uterus. PGT can be performed on embryos created through in vitro fertilisation (IVF) and can be used to identify genetic disorders or chromosomal abnormalities in the embryos.

PGT is typically recommended for couples or individuals with a known risk of having a baby with a genetic disorder or couples or individuals who have had multiple pregnancies with chromosomal abnormalities or miscarriages. PGT can help couples or individuals to select an embryo that is free of genetic disorders or chromosomal abnormalities, which can increase the chances of a successful pregnancy.

Pre-genetic pregnancy testing can help detect various genetic conditions or diseases that may affect the developing foetus. Some examples include:

Chromosomal abnormalities: Chorionic villus sampling (CVS) and amniocentesis can detect chromosomal abnormalities like Down syndrome, trisomy 18, and Turner syndrome.
Genetic disorders: Tests such as carrier screening can identify if the parents are carriers of genetic conditions like cystic fibrosis, sickle cell anaemia, and Tay-Sachs disease.
Neural tube defects: Tests such as maternal serum screening can detect neural tube defects like spina bifida.
Other genetic diseases: Other genetic disorders detected by pre-genetic testing in pregnancy include Tay-Sachs disease, Niemann-Pick disease, and Canavan disease.

Samples for testing can be taken from blood, cheek swabs, and amniotic fluid (protective liquid in which the unborn child develops).

Genetic testing provides vital information for diagnosing, treating and preventing various diseases.

Types of Genetic Tests

Molecular genetic testing is used to study short lengths of DNA to identify mutations. Chromosomal genetic testing to study changes in chromosomes like duplication or reduction in number; and
Biochemical genetic testing is used to study the amount of protein activity. Although genetic testing may give you an insight into the diseases you may develop, it is not always that you will develop a specific condition if your genetic test is positive.

Abnormal Genetic Test Results

Abnormal genetic test results can indicate a genetic disorder or increased risk of developing a particular condition. The implications of abnormal results will depend on the type of test performed and the specific genetic variations identified.

Abnormal results may indicate a diagnosis of a genetic disorder. For example, a positive result on a diagnostic test for cystic fibrosis would confirm the diagnosis.

In other cases, abnormal results may indicate an increased risk of developing a condition but do not confirm a diagnosis. For example, a positive result on a predictive test for a genetic mutation associated with breast cancer would indicate an increased risk of developing the disease. Further testing, such as mammography, would be needed to confirm a diagnosis.

Chance of Having High-Risk Pregnancy

High-risk pregnancies are those that involve potential complications for the mother or baby. These include diabetes, high blood pressure, certain infections, age, and obesity. In some cases, the mother may have a pre-existing health condition that can increase the risk of complications.

The most important step you can take to protect your and your baby's health is to be informed. Speak with your doctor about any existing health conditions and other factors that may increase your risk of complications. Discuss any medications you are taking, as some may also pose a risk.

Advice for Older Women

Women older than 35 will be advised on the risks of infertility, abnormalities in the child and pregnancy complications, such as miscarriage and labour problems.

Your doctor may also recommend the following:

Physical exam of your abdomen, heart, breasts, thyroid and lungs
Pap smear and pelvic examination
Lab tests to screen for hepatitis, HIV, rubella, syphilis and other conditions
Chart menstrual cycles to monitor ovulation and determine the most favourable time to get pregnant
Advise appropriate vaccinations against rubella or chickenpox, and recommend delay in conception for a month
Conduct genetic counselling for older mothers or those with a risk of hereditary diseases to help you understand the chances of congenital disabilities or intellectual disability in the child.