Why do we need preconception care?

  • Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. 99 percent of all maternal deaths occur in developing countries. 
  • Women die in pregnancy and childbirth for 5 main reasons. These are severe bleeding, infections, unsafe abortion, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications like cardiac disease, diabetes, or HIV/AIDS complicating or complicated by pregnancy.
  • Four out of ten women report that their pregnancies are unplanned. As a result, essential health interventions provided once a woman and her partner decide to have a child will be too late in 40 percent of pregnancies. 
  • About 50 percent conceptions are unplanned and almost 25 percent of the pregnancies are unwanted in Bangladesh. 
  • Infant mortality 45.67 deaths/1,000 live births in Bangladesh.
  • Rate of congenital malformations 2-4 percent and low birth weight baby 40 percent in Bangladesh.

About Preconception Care:


What is preconception care?

Preconception care is the provision of biomedical, behavioral and social health interventions to couples of reproductive age planning for conception.  

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What are the positive effects of preconception care?

Preconception care has a positive effect on a range of health outcomes. Preconception care can:

  • Prevent unplanned pregnancies
  • Prevent complications during pregnancy and delivery
  • Reduce maternal and child mortality
  • Prevent pregnancy loss like abortion, miscarriage, stillbirths, preterm birth and low birth weight
  • Prevent birth defects, and neonatal infections
  • Give opportunity to identify and provide appropriate management related to reversible medical condition like under/over nutrition, anemia, diabetes, hypertension, urinary tract infections, sexually transmitted infections etc.
  • Lower the risk of type 2 diabetes, gestational diabetes, and cardiovascular disease later in life
  • Improve knowledge about contraception, pregnancy, lactation etc.

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What are the barriers to preconception care?

  • Unplanned pregnancy - Incidence of unplanned pregnancy is 40 percent
  • Usual entry into prenatal care in the 3rd month after LMP
  • Planned pregnancies are seldom planned with a health care provider
  • Unpreparedness of health care providers
  • Ignorance about the importance of good health habits prior to conception
  • Limited access to health services

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What are the general components of preconception counseling?

  • Family planning, pregnancy spacing
  • Exercise
  • Nutrition - healthy eating
  • Weight management before pregnancy -  if overweight/obese or underweight
  • Abstinence from tobacco, tobacco product, alcohol, and illicit drugs
  • Advise administration of daily iron and folic acid supplement if required
  • Identifying reversible medical condition like under/over nutrition, anemia, diabetes, hypertension, urinary tract infections, sexually transmitted infections etc.
  • Maintaining good control of any preexisting medical conditions (e.g., diabetes, hypertension, anemia, urinary infection, asthma, seizures, thyroid disorders, and inflammatory bowel. Disease etc.)
  • Determining the time of conception by obtaining an accurate menstrual history, and providing instruction by using a menstrual calendar.

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What kinds of assessment will be done during preconception counseling?

  • Blood grouping (to identify Rh-negative women)
  • Hemoglobin (to screen anemia)
  • Blood glucose test including fasting and 2 hours after 75 gm glucose (to identify diabetes and prediabetes)
  • Routine urine examination (proteinuria and urinary tract infection)
  • Blood pressure measurement (to screen hypertension)
  • Anthropometric measurement including weight, height, waist, hip (to screen nutritional status including under nutrition and over nutrition/ obesity)

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Who are the eligible candidates for preconception care?

  • Every woman of reproductive age who is potential candidate to become pregnant
  • Every couple

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Benefits for registered members

  • To increase knowledge, and improve attitudes and value for health care prior to conception
  • To assure that women of childbearing age receive evidenced-based risk screening, health promotion, and intervention that will enable them to enter a safe pregnancy.
  • To identify reversible health risks to pregnancy outcome, emphasizing factors that must be acted on before conception or to achieve optimal pregnancy outcomes.
  • To educate women about risk prevention before pregnancy. Education regarding exercise, nutrition, obesity, family support, and financial issues related to pregnancy contribute to a better-prepared patient, whose prospects are good for a healthy outcome

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