Pre-Pregnancy Planning

An assessment of any medical problems and a discussion of how they may affect, or be affected by, a pregnancy should be undertaken.

Stabilisation of pre-existing medical conditions and assessment of mental health status prior to a pregnancy is necessary to optimise pregnancy outcomes.

All women and couples planning pregnancy should be offered reproductive carrier screening. If there is an increased risk of a heritable disorder, based on the family history or ethnic background, then pre-pregnancy genetic counselling should be offered to assist in determining the couple’s risk of an affected child and to provide information about options for carrier screening, preimplantation genetic diagnosis, prenatal diagnosis and postnatal management.

Vaccination history for covid, measles, mumps, rubella, varicella zoster, diphtheria, tetanus and pertussis should be checked and maintained as per recommendations published by the relevant Australian and New Zealand Government bodies. Hepatitis B, rubella and varicella immunisation should be considered for women with incomplete immunity.

Steps to correct high BMI (dietary, exercise and where appropriate consideration of bariatric surgery) prior to a pregnancy should be recommended.

Folic acid should be taken for a minimum of one month before conception and for the first 3 months of pregnancy. The recommended dose is at least 0.4mg daily. Where there is an increased risk of Neural Tube Defects  (anti-convulsant medication, pre-pregnancy diabetes mellitus, previous child or family history of NTD, BMI >30), a 5mg daily dose should be used.