What is Preconception Care?

Preconception Care is the medical care given to a couple  planning to conceive before conception happens.

Not many patients know of it and therefore only a few walk into facilities or clinics to seek care before they conceive, at least on our setting

Preconception care is important to optimize the health of the woman before conception by identifying certain risks which may interfere with fertility and affect pregnancy outcomes with the aim of reducing or eliminating the risks altogether. The end goal once one conceives is to have a healthy and safe baby and mother.

The risks may be physical, environmental, psychosocial, behavioural or genetic risks

You will be educated on the risks and counselled on what to do. In addition, you will be given interventions way before you get pregnant.

Why is Preconception Care Important?

  • The fetal organ development occurs early in pregnancy. With most organ development including the neural tube-brain and spine-occuring in the embryonic period before 10 weeks gestation. This is why you need to start for instance,  folic acid supplementation at least 3 months before conception. Folic acid is important for neural tube development and also prevents some congenital malformations
  • Most pregnancies are unplanned and you might be caught unaware and unprepared
  • Some interventions can take long before reaping the benefits . For example, weight reduction may not happen overnight yet it helps to improve fertility in some cases.

What Does Preconception Care Entail?


There are several discussion points with different risks mentioned to optimize your health.

  1. Healthy (not underweight or overweight) -physically and nutritionally. Optimized weight and nutrition serves to improve ovarian function by improving ovulation. It also helps to ensure adequate stores for different micronutrients for you and your baby when conception happens.
  2. Medications. Some medications are not safe for the embryo and fetus. They are said to be teratogenic and can harm the baby once conceived and therefore need to be changed with safer ones to manage the reason for which the medications are taken -medical conditions or otherwise.
  3. Excessive intake of coffee (>300mg/day) is not recommended
  4. Cigarettes are a health hazard to your body. Stop smoking cigarettes or smoking other substances-bhang, heroin-name it. This includes second hand smoking These substances affect the sperm and egg quality and are also teratogenic
  5. Keep your system free of alcohol since alcohol-beers/spirits/wine-is harmful to the fetus. No studies have been done to find out the safe alcohol limit for the unborn fetus and you do not want to be the guinea pig if such a study were to pass ethical approval.
  6. Stress from whichever quarters has a negative impact on pregnancy. Financial stress, social stress-lack of social support, intimate partner violence and mental health concerns.
  7. Folic Acid supplementation. Folic acid is a very important vitamin for neural tube development and closure which happens very early on before 6 weeks of pregnancy. You will need to build adequate stores starting 3 months before conception. About 0.4mg-0.8mg is required in patients who do not have additional requirements for folic acid. Patients who have a previous baby born with neural tube defects like spina bifida or other anomalies, those with diabetes or on antiepileptic medications, users of alcohol and other substances et cetra need up to 5mg daily doses of folic acid.
  8. Chronic Medical Conditions. Patients with chronic conditions need to have the conditions optimized (well controlled) before they can conceive. Some of the conditions are high blood pressure (hypertension), diabetes, HIV, heart disease, asthma, thyroid disease, SLE, SCD.
  9. Screening for various health conditions-anaemia, syphilis, HIV, Hepatitis, mental health issues such as depression and anxiety. Blood group and rhesus antigen typing is done during this visit and management of the conditions if diagnosis is confirmed. Some of the conditions can be transmitted from mother to baby.
  10. Counselling on safe sexual practices like condom usage.
  11. You will be asked if you are up to date with vaccinations.
  12. Environmental risks include chemicals such as lead.
Partner Support & Pregnancy

Reduce risk of preterm births, fetal growth restriction, low birth weight or infant death.

Smoking & Pregnancy

Affects the lung and brain tissue of the baby. Linked with miscarriages, placenta previa and early placental separation (abruptio placenta)

Stress and Fertility

Stress hormones dysregulates the HPO axis which is key in fertility matters.

Alcohol and Pregnancy

Causes mental retardation. No safe  limit or trimester of pregnancy

What is the Way Forward?

1. Start taking oral folic acid supplements on a daily basis for three months and continue beyond conception.

2. A balanced diet and moderate physical exercises can be instituted to ensure you and your partner attain a normal Body mass index (BMI)-18.5-24.9.

3. Ask your doctor about preconception care when:

    • During premarital visit
    • During contraception counselling
    • During postdelivery visit

4. Quit Smoking.

5. Stop alcohol consumption and use of all other substances of abuse

6. Reduce your coffee intake to less than 300mg/day

7. Avoid unnecessary exposure to environmental toxins at work and at home-pesticides, lead, mercury, radiation, some cleaning detergents .

8. Have adequate sleep and reduce stress for your mental well being

9. See your gynecologist for preconception care and counselling for counselling, education on the risks and some interventions where necessary.


We at Nyalife Women’s Health clinic do offer preconception care services to couples way before they conceive. Call us to request an appointment with our obgyn-obstetrician and gynecologist on 0746516514.


1. CDC


2. Alcohol and Pregnancy outcomes

Addila, A.E., Azale, T., Gete, Y.K. et al. The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study. Subst Abuse Treat Prev Policy 16, 64 (2021). https://doi.org/10.1186/s13011-021-00401-x


Lifestyle and fertility: the influence of stress and quality of life

Palomba, S., Daolio, J., Romeo, S. et al. Lifestyle and fertility: the influence of stress and quality of life on female fertility. Reprod Biol Endocrinol 16, 113 (2018). https://doi.org/10.1186/s12958-018-0434-y

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