The primary goals of preconception counselling are to provide women with specialist information, offer interventions, and optimise medical care prior to pregnancy to support their health and the health of their future baby. If a woman receives preconceptual counselling within a year of getting pregnant, the likelihood of experiencing a complication in her pregnancy is significantly reduced. As approximately half of pregnancies are unplanned, it is important that women who will benefit most from preconceptual counselling are referred early enough so that, should they fall pregnant, are adequately prepared.
The following link provides general advice that all women preparing for pregnancy should consider. For those with underlying medical conditions, separate specialist advice should be sought.
Planning your pregnancy – NHS (www.nhs.uk)
- Women with pre-existing health conditions: pre-existing health conditions are categorised into A, B and C according to the impact the condition might have on a pregnancy and vice versa. Category C health conditions are considered the most complex with the highest inherent risk.Please refer to the NCL Maternal Medicine network service specification under the relevant specialty for further information on the health condition categories.Women with category A health conditions should receive pre-conceptual counselling from their GP, practice nurse or community pharmacist.Women with category B or C health conditions should receive pre-conceptual counselling from a multi-disciplinary team including a specialist doctor and nurse, Obstetric physician, and Obstetrician. Please see below for further information on how to refer for this consultation.
- Women with mental health conditions: women with a current or past severe mental health condition should be referred to their local specialist perinatal mental health service for pre-conceptual care.
- Women with a history of adverse pregnancy outcomes: those with a history of recurrent miscarriages, fetal anomalies, late stillbirth, or severe preterm labour should be referred as per local guidance for pre-conceptual care. Unless associated with a medical condition outlined above or specific to pregnancy, these adverse pregnancy outcomes lie outside the remit of the maternal medicine network.There are medical conditions that are specific to pregnancy, which can have associated complications in both the short and long-term. These include pre-eclampsia and acute fatty liver of pregnancy. Women with a history of severe pregnancy associated medical conditions should receive pre-conceptual counselling from a multi-disciplinary team that includes an Obstetric physician, Obstetrician, and midwife.
- Biannual multidisciplinary workshops:Twice a year, the NCL maternal medicine network holds a pre-conceptual care workshop for women with the following conditions:
- Epilepsy
- Inflammatory rheumatoid conditions including lupus
- Inflammatory bowel disease (Crohn’s and ulcerative colitis)The workshops, which alternate between being held in person or virtually, are attended by the relevant specialty doctors and nurses, Obstetrician, Obstetric physicians, and midwives.They provide an open forum to ask questions, receive information, and, importantly, put faces to the healthcare professionals who may be looking after them in a future pregnancy! In addition, these workshops help to circumvent the waiting times for an individual appointment to enable, for some, to have earlier preparation for pregnancy.The workshops are for the woman and her families to attend and the upcoming dates along with information on how to register can be found here.
- Refer a patient: we understand that for some women, individual counselling may be more appropriate than a group workshop. The following contact form can be completed by healthcare professionals to refer a patient with:
- a pre-existing medical condition (category B or C as specified here)
- history of a medical condition associated with pregnancy.
- Available online resources:Online resources providing pre-conceptual information have been listed under the individual conditions.