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Feature Article

Preconception counselling: optimising reproductive health and wellbeing

Greg Duncombe

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Abstract

The preconception counselling consultation is one of the best opportunities to initiate effective preventative medicine.

Key Points

  • Preconception counselling forms the basis of a preconception care program and is one of the most potent opportunities to practise preventative medicine.
  • Topics that may be covered in preconception counselling are conception, contraception, sexually transmitted infections, cervical screening, dietary advice (preconception folate, iron and vitamin C supplementation), weight optimisation, smoking cessation, and alcohol use and risk behaviour modifications.
  • Lifestyle modifications should involve both the woman and her partner; if they do not, success is likely to be limited or at least only short term.
  • Some patients will ask directly about preconception care but usually the GP will have to broach the subject during consultations for other reasons.
  • Patients with certain medical diseases or personal or family histories implying specific disease risks and/or inheritable genetic disorders should be prepared for pregnancy well before it occurs, with a plan of action formulated using a multidisciplinary approach.

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