Importance of preparing for pregnancy

and pre-conception counseling:

Preconception care (WHO)

Kanadi Sumapradja

Department of Obstetrics and Gynecology

Faculty of Medicine Universitas Indonesia
Preconception care

A set of interventions aimed at identifying and modifying

biomedical, behavioral and social risks to a woman’s health or
pregnancy outcome through prevention and management

The centers for disease control and prevention

Farahi N, Zolotor A. Am Fam Physician 2013;88:499-506

Preconception care

The provision of biomedical, behavioral and social health

interventions to women and couples before conception occurs.
The goals of preconception care
To ensure that the woman is as healthy as possible before
conception to promote her health and the health of her future
children

It aims at improving their health status, and reducing behaviors

and individual and environmental factors that contribute to
poor maternal and child health outcomes.

Its ultimate aim is to improve maternal and child health, in

both the short and long term

Farahi N, Zolotor A. Am Fam Physician 2013;88:499-506

Preconception care
Facts
4 out of 10 women report that their pregnancies are unplanned

Maternal under nutrition and iron-deficiency anemia – 20% maternal mortality

In 2010, 58 000 newborn babies died from neonatal tetanus

Female genital mutilation increases the risk of neonatal death (including stillbirths)
by 15% to 55%

Perinatal deaths are 50% higher among children born to mothers under 20 years
of age
Facts
Up to 35% of pregnancies among women with untreated gonococci infections result
in low birth weight infants and premature deliveries, and up to 10% result in
perinatal death

Rates of HIV transmission from mother to child are between 15 and 45%

Violence against girls and women results in adverse physical, psychological

and reproductive consequences, as well as increased risk for premature delivery
and low-birth-weight infants
Facts
Women with epilepsy are at increased risk of having babies with congenital
anomalies

Estimates indicate that eliminating smoking before or during pregnancy could

avoid 5–7% of preterm related deaths and 23–24% of cases of sudden infant death
syndrome
Why preconception care?
Farahi N, Zolotor A. Am Fam Physician 2013;88:499-506
Farahi N, Zolotor A. Am Fam Physician 2013;88:499-506
 Take home messages
Complications related to pregnancy still high – associated
with high maternal and perinatal mortality and morbidity

Preconception care will ensure the woman is in healthy

condition before conception – to promote her health and
her future children

To improve maternal and perinatal health outcome

Design your own preconception program based upon local

problem and local capacity