For many women, preparing for a pregnancy can be exciting. But for women who have certain health conditions or who have had a difficult pregnancy before, the prospect of a pregnancy can be downright scary.
Preconception care can help.
“Preconception care is care provided by a physician to a woman planning or considering pregnancy, before she is pregnant,” said Dr. Teresa Harper, a UCHealth maternal and fetal medicine specialist. Harper also is a professor of clinical practice in obstetrics, gynecology and maternal-fetal medicine at the University of Colorado Anschutz School of Medicine.
Harper explains what preconception care is and how it can make a big difference in pregnancy.
Preconception care vs prenatal care
Preconception care is medical care that helps women prepare for pregnancy and improve outcomes for both mother and baby.
Prenatal care begins as soon as a woman thinks she could be pregnant.
A preconception visit may be as simple as getting recommendations for prenatal vitamins and avoiding household toxins. Or the visit can be more involved, with the doctor creating a plan to help manage health conditions or prevent pregnancy complications.
Harper most often sees women who have a medical condition such as diabetes or high blood pressure; women who have had challenges conceiving; women who take multiple medications; and women who have had an issue with prior pregnancies, such as preterm delivery or stillbirth. That said, any woman can see a maternal and fetal medicine specialist for preconception care.
“Laying out a plan of care for these women is amazing,” Harper said. “They go from a lack of confidence that they’ll be able to have a successful pregnancy, to having a reassuring plan.”
When should you schedule preconception care?
Ideally, women should schedule a preconception appointment several months before trying to conceive to give providers enough time to review medications, manage health conditions and recommend lifestyle changes.
How does preconception care help?
Preconception care can have a big impact on a variety of health conditions.
For instance, women with uncontrolled diabetes can have up to a 25% risk of having a baby with a serious birth defect.
“If we can get their diabetes under control, that birth defect risk can drop down to baseline level,” Harper said.
Similarly, certain medications used for anxiety, depression or bipolar disorder may carry a risk of birth defects. A maternal and fetal medicine doctor can work with a psychiatrist to recommend alternative medications that are also effective, but without that risk.
For women who have had a preterm birth, steps such as taking a progesterone supplement or putting a stitch in the cervix if it begins to shorten can reduce risks of a second preterm birth by 30%.
And for women who previously had a stillbirth, Harper can look for ways to lower the risk of it happening again.
“There are just so many things we can do,” Harper said. “We provide a sense of hope and control, and a plan.”
Who qualifies for preconception care?
Anyone thinking about getting pregnant should consider preconception care. In most cases, it is covered by insurance.
Women who think it may be helpful to see a maternal and fetal medicine specialist can make an appointment or call for more information.
What if the recommended changes seem difficult?
Lifestyle changes that support a successful pregnancy can feel overwhelming. Harper provides tools to make losing weight or quitting smoking easier.
“This is one time in people’s life that lifestyle modifications are relatively effective,” Harper said. “People will do things for their future babies that they won’t do for their future selves.”
She reminds women that nothing has to be perfect.
“Even if you don’t follow every single guideline perfectly, everything you do to take a step towards improved health can improve a pregnancy outcome,” Harper said.