Chapter 2 Fact sheet: Optimizing preconception health

Information for health care providers

  • Encourage women considering pregnancy to schedule a visit to discuss preconception health and the optimization of maternal and fetal outcomes.
  • Take advantage of episodic visits to identify health risks, offer related interventions and encourage positive health behaviours prior to conception.
  • Encourage all women and men of reproductive age to develop a reproductive-life plan, whether they intend to have children or not.
  • Recommend a daily multivitamin containing 400 mcg (0.4 mg) of folic acid for all women of reproductive age who could become pregnant, and discuss risk factors that may warrant a higher dose.
  • Ensure that immunizations are complete and up-to-date, using immunization history or serological testing for routinely recommended adult vaccines and those for which pregnancy requires specific screening.
  • Review all medications for their potential teratogenicity and counsel women about the potential impact on a pregnancy, regardless of their plans to conceive.
  • Discuss the effects of alcohol in pregnancy and encourage abstinence leading up to and during pregnancy.
  • Promote smoking cessation. Prepregnancy is the ideal time to stop smoking in order to prevent adverse perinatal outcomes associated with maternal smoking.
  • Encourage progress towards healthier weights in women who are underweight, overweight or obese. Adverse perinatal and maternal outcomes can be reduced with appropriate preconception weight gain or loss.
  • Screen for elevated sexually transmitted infection (STI) risk factors. Identifying an infection before conception allows for timely treatment and prevention of transmission during pregnancy and birth.
  • Optimize chronic medical conditions prior to conception to improve perinatal and maternal outcomes.
  • For women who have previously given birth, discuss interpregnancy interval (IPI) - the time between a live birth and the beginning of the following pregnancy. Both short and long IPIs have been associated with an increased risk of adverse maternal and newborn outcomes.

For references, consult Chapter 2: Preconception Care in Public Health Agency of Canada. Family-Centred Maternity and Newborn Care: National Guidelines. Ottawa (ON): PHAC; 2017.

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