Pre-pregnancy Counselling or Planning is a good idea. It is conducted before you conceive. While many women have normal pregnancies, pre-planning with Dr Cook improves the chances of a smooth pregnancy and a healthy baby.
By discussing your plans with Dr Cook prior to becoming pregnant you can optimise both the health of the mother as well as the baby during the term of pregnancy.
Pregnancy planning will
Assess the mother for any illness
Allow time to resolve any medical issues before you become pregnant
Help to create a healthy environment for the fetus
Help in checking for possible risk factors or pre-existing diseases
Can help to prevent birth defects as well as other pregnancy related problems
Counselling and care will help you to become emotionally and physically healthy and strong before you enter into the phase of pregnancy.
What is Pregnancy Planning
Pregnancy planning involves talking to Dr Cook prior to becoming pregnant.
Some of the issues addressed by Dr Cook in pregnancy planning include:
Medical conditions: A thorough medical examination before pregnancy helps in diagnosing any medical conditions that may affect the mother and baby such as diabetes, high blood pressure, anaemia, kidney disorders, thyroid diseases, and heart problems. You will be advised on certain measures to control them.
Infections and vaccinations: During pregnancy, the mother will be more susceptible to infections that can cause serious birth defects or illness in the baby. Tests are done to determine immunity against diseases such as rubella and chickenpox. If the expecting mother lacks antibodies against these diseases, then the Dr Cook will advise vaccination before pregnancy.
Immunisation: If the mother is a carrier of hepatitis-B virus, blood tests will be done to identify the virus and the child will be vaccinated at birth. Vaccination protects the foetus from hepatitis-B infections.
Hereditary disorders: In women with a family history of hereditary disorders such as haemophilia, sickle cell anaemia, cystic fibrosis, and thalassemia, the chances of a child developing these conditions is increased. Therefore, before planning for pregnancy, Dr Cook may suggest both mother and father undergo certain tests to identify these diseases.
Diet: A healthy diet is very important before pregnancy. Fruit and vegetables and protein (in lean meat, fish and eggs) are recommended. Calcium containing foods in low fat dairy is important, as are whole grains. Fish oil has been shown to be good for fertility and pregnancy, and can reduce the risk of postnatal depression. Additives including food colours, flavours and preservatives should be avoided. Avoid eating foods during pregnancy which may contain listeria which can cause serious problems for the unborn child. These foods include: soft cheeses, pate, cold meats, pre-prepared salads and raw seafood.
Supplements - Dr Cook will suggest supplements such as prenatal vitamins and folic acid. Folic acid should be taken at least one month prior to pregnancy and for three months into the pregnancy as this reduces the chance of the baby having a defect in the neural tube, such as spina bifida.
Family health history: Inform Dr Cook about the presence of hereditary medical conditions and multiple births in the family.
Reproductive history: Dr Cook will discuss your menstrual history, use of contraceptives, any previous sexually transmitted diseases, vaginal infections and Pap test results.
Weight: It is always better to have an ideal weight before you conceive.Reducing weight if you are overweight will prevent the risk of high blood pressure during pregnancy.
Workplace and home environment: Dr Cook will discuss potential hazards to conception or maintaining a pregnancy, such as exposure to lead or certain toxic solvents, radiation, lead and mercury. Avoid exposure to cat faeces by asking someone to empty the litter box.
Lifestyle: The deleterious effect of certain habits like alcohol consumption, smoking and use of recreational drugs on pregnancy will be discussed. Smoking is hazardous to general health, fertility and the pregnancy. Smoking can have adverse effects on sperm function in men. There are no accepted safe levels of alcohol consumption whilst attempting conception and during pregnancy. It is recommended that alcohol is avoided altogether. (recommendation of the Royal College of Australian & New Zealand College of Obstetricians and Gynaecologists)
Caffeine - both men and women should consume no more than 1 to 2 coffees or 2-3 teas per day
Exercise: Inform Dr Cook about the type of exercises you perform or if you don't exercise. Based on this, you may be advised to continue normal exercises during pregnancy until Dr Cook suggests otherwise. You will benefit from being fit prior to pregnancy. A moderate level of fitness is recommended - perhaps 45 minutes of brisk walking on five days per week. No more than four hours of high intensity exercise per week is recommended. Men should also have a reasonable level of fitness.
Dr Cook's Recommendations
Physical examination of your abdomen, heart, breasts, thyroid and lungs
Pap smear and pelvic examination
Lab tests to screen for hepatitis, HIV, rubella immunity, syphilis, chicken pox immunity and other conditions
Chart menstrual cycles to monitor ovulation and determine the most favourable time to achieve pregnancy
Advise appropriate vaccinations against rubella or chickenpox, and recommend delay in conception for a month
Organise genetic counselling for older mothers or those with a risk of hereditary diseases to help you understand the risks to the fetus
Prenatal vitamins: You should start taking folic acid supplements before you conceive, as folic acid reduces the chances of neural tube defects in your baby.
Preconception Genetic Screening
A preconception carrier test lets you know whether you and/or your partner are carriers of a disease, and helps you to make important pregnancy-related decisions.
An important step in such tests is identification of a carrier (a person with either mild or no symptoms of the disorder, but capable of passing on the disorder to his or her child through a particular gene).
Genetic Carrier Screening
If you are a carrier, you may decide to get pregnant with the option of considering prenatal diagnosis (diagnosis of abnormalities), use In Vitro Fertilization or even choose not to become pregnant.
Preconception Carrier Screening is a screening option, available for a woman planning to become pregnant, that allows her doctor to identify conditions that have the potential to adversely impact the health of her fetus (developing baby) in the future.
This is done at a point in time when the woman can have the widest range of personal and reproductive choices and helps to predict the possibility of having a child with a genetic disorder.
In genetic counseling, a genetic counsellor goes through your family medical history, which helps him to determine if your baby is likely to have a genetic disorder based on the following:
If there is a history of genetic disorders in your family
If you have a genetic disorder
If you already have a child with a genetic disorder
Your race or ethnicity
Blood and saliva samples are collected. They can be analysed for hundreds of genetic disorders using DNA Analysis.