Preconception counseling promotes healthy pregnancy and should be included for all women of childbearing age. The focus should be on factors that have an impact on organogenesis. Discuss the following:
- Family planning and genetic history
- Effects of ↑ maternal age on chromosomal abnormalities
- Adverse effects of obesity on pregnancy outcome and make a plan for maintaining optimal weight
- Encourage 400 mcg of folic acid daily for at least one month before pregnancy to prevent neural tube defects
- Encourage intake of foods rich in folic acid
- Enriched grain products
- Fortified cereals
- Leafy green vegetables
- Beans
- Discourage use of alcohol, smoking, and drugs
- Teach about protection from sexually transmitted infections
- Update adult immunizations and investigate titers
- Review exposure to environmental risk factors
- Screen for intimate partner violence
- Discuss control of chronic medical conditions
- Teratogens
- Safety of prescribed and over-the-counter (OTC) medications and herbs