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:

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

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.

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.

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)

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