Bringing a new life into the world can feel daunting at any age. Yet when pregnancies are planned, there are more opportunities to give a baby the best possible start, beginning well before conception.

“Before conception, couples should know a few things that could profoundly influence the future of the child they are planning for,” says Dr Mokgohloe Phasha, an obstetrician-gynaecologist practising at Netcare Park Lane Hospital.

pre-conception visit

“A pre-conception visit offers women the chance to enter pregnancy as their healthiest self, laying the optimal foundation for their future baby. Pre-conception appointments play a crucial role in ensuring a healthy pregnancy. However, few people fully appreciate the value this holds for mother and baby and for managing potential risks before falling pregnant,” she says.

In addition to a physical examination, the specialist asks questions to establish if there are any risk factors for your pregnancy and assesses and discusses any potential risks.

assessing potential medical risks

“While many women have healthy babies well into their 40s, pregnancy after the age of 35 is associated with increased risk for genetic abnormalities.

“We are born with all our eggs, so our eggs are as old as we are. Over time, the number and viability of a woman’s eggs wane, which may also increase the risk of miscarriage.

“Advanced maternal age during pregnancy may pose some extra health risks for the woman. The good news is that pre-conception assessments allow us to identify and mitigate risks wherever possible before the baby is even conceived,” Dr Phasha says.

For parents of any age, pre-conception assessments determine whether the couple are known carriers of certain genetic abnormalities. If so, the couple and specialist discuss the risks of passing the condition to the next generation and explore options to mitigate those risks.

Other tests are also performed to ascertain whether the mother-to-be has new health conditions, such as type 2 diabetes, that could  impact the pregnancy. “If the woman has a known medical condition, we assess if it is well controlled and check whether her medication is suitable for pregnancy. We will advise on adjustments if necessary, with multidisciplinary collaboration to ensure her medical condition is well managed in preparation for pregnancy,” Dr Phasa explains.

vaccinations

“We also assess the need for vaccinations. “German measles is especially of concern. When contracted in pregnancy it may result in minor symptoms for the mother, but can lead to foetal abnormalities. Being vaccinated before pregnancy can prevent these serious risks to the baby. We recommend not falling pregnant for 6–12 weeks after vaccination, so continuing contraception is imperative around that time.”

Read more about preparing for a new baby.

child spacing, maternal health and bonding

Another important aspect of pre-conception consultations is discussing child spacing as pregnancy takes a toll on a woman’s body. Child spacing means the time, in months or years, between a woman’s pregnancies. In general, we recommend pregnancies are spaced at least 18 months to 2 years apart. This allows the woman’s body sufficient time to recover and replenish stores before the next baby’s gestation period begins,” Dr Phasa explains.

“Spacing pregnancies also allows sufficient bonding time with the older child., making for a more harmonious home dynamic when the new sibling arrives,” Dr Phasha says.

Read our article on introducing a new baby to an older sibling.

golden window of opportunity

A healthy lifestyle underpins wellness before and after pregnancy. “The first three months of pregnancy are crucial for organ development,” says Dr Phasa.  “Women planning to conceive should avoid alcohol and quit smoking well in advance of conception.”

Folic acid supplementation during pregnancy is vital.  Still, many women only realise they are pregnant after their first trimester, missing a golden window of opportunity to prevent neural tube defects. “The mom-to-be’s folic acid requirements must be met ahead of conception. It’s an inexpensive intervention that has proven to significantly reduce the risk of spina bifida, which can lead to paralysis of the baby’s legs,” Dr Phasha advises.

“Our children are our legacy to the world. Taking the time to prepare before the patter of tiny feet is an extremely worthwhile investment in your family’s future,” Dr Phasha concludes.