Preparing for pregnancy is a positive step towards enhancing pregnancy outcomes and provide prospective parents options that may not be available once a pregnancy is confirmed.In many regions mostly Africa women are confirmed to be fertile if they are able to deliver after marriage, but if she is not able to conceive she is been tagged a barren woman even when the problem is not her fault . In Africa the pressure to bear children especially the male children are high, so the couple will do anything possible to have children that will carry on their family name after their demise. Families should not be in a hurry to persuade their children into having babies but should encourage them to take necessary measures for the safety of both the baby and the parents . In Africa procreation is one of the reasons for marriage, failure to conceive can bring problem to the family thereby making the family to source for help from external hands which can bring disaster to the family later on. There are various means to prepare the couple for early conception which we will discuss later.




            Preconception care.

    Unlike antenatal care the concept of Preconception care has been around for less than 30 years, it has now been identified as a key area of health care. The aim of Preconception care is to ensure that the woman and her partner are in optimal state of physical and emotional health at the onset of pregnancy . It also provides some prospective parents with a series of options that may not be available once the pregnancy is confirmed . Although pregnancy for some couples will be unplanned, the majority of couples who do plan a pregnancy could benefit from the Preconception care whether they want to do the best for their baby or an effort to mitigate against condition that can adversely affect the outcome of pregnancy .
     Preconception advices are readily available particularly in the mass media and through the World wide Web. However the provision of Preconception care is still not yet universal with the majority of service been provided by  family planning clinics , well woman clinics, general practitioners (GPS), practice nurses and mid wives most of them opportunitist. The Preconception periods refer to to a time span of anything from three month to one year before conception  but ideally should include the time when both the ova and sperms are matured, which is usually 1oo days before conception .
      The problem with conceptual care is that the people who most need it rarely attend for such counselling. The people who do seek out such care are usually well motivated educated people. Even then people find it hard to change their lifestyle and habits. A Preconception programme takes time to complete therefore adequate time needs to  be allowed for the initial consultation and the subsequent follow up where result, advice and treatment may be given .   

      Information and investigation in Preconception programme.

    *family history  
     *medical history. 
     *menstrual history 
      *method of contraception . 
       *occupation 
        *diet
          *alcohol and smoking  

     Observations.

        *Height and weight  
         * Urinalysis  
         *Blood pressure  
         * Stool sample  
          *Blood tests  
          *Haemoglobin  
            *Male semen analysis .
      A woman nutritional status before pregnancy and during the first week before realising that she is pregnant may be more important than the diet she eat once her pregnancy is confirmed . By this time much of the cell organisation, differentiation and ganigenesis  will have taken place  poor feeding can result in fetal   damage and stunted growth  

    ORAL contraception 

    Oral contraception should be stopped at least 3 months and preferably 5 months prior to planning a pregnancy to allow for the resumption of natural hormone regulations and ovulation . Also the oral contraceptive pill is associated with vitamin and minerals imbalances that may need correcting .

     Drugs abuse.

       The number of drugs users is rising and the most frequently reported main drug of use is heroine followed by methadon, ecstasy and  amphetamine causes disruption of menstrual cycle, heavy drugs use during pregnancy is associated with miscarriage, preterm labour, low birth weight,  still birth and abnormalities 

     Environmental factors.

    Smoking

   The evidence is substantial that pregnancy is adversely affected by smoking,  In terms of fertility in women smoking can cause early menopause and menstrual problems. In men it can cause abnormality in sperm morphology and motility. New evidence shows that women who smokes during pregnancy pass out harmful carcinogen unto their baby.

   Alcohol 

   Alcohol when drank occasionally or in moderation is a very acceptable social activity,  but when consumed in large quantities it can become problematic reduce appetite and affect nutritional status.  High alcohol intake in women  have been associated with menstrual disorder and decrease fertility, even in women who have five or fewer drinks. Special Preconception advices should be given to women who drinks even when pregnant to minimise the risk factors .   


 

    Exercise.

    Moderate exercise is known to be beneficial for health and the benefits of regular exercise for the healthy pregnant women appears to outweighs the risk. Exercise by physically fit women with uncomplicated pregnancy has no effect on fetal growth . However, exercise intensity should be modified according to maternal symptoms and should not continue on  fatigue or exhaustion.
       Pregnancy is mostly valued by family, so proper care and precautions should be taken to avoid poor delivery and miscarriage in most cases . The first pregnancy can be hectic and tiresome as the woman is without experience , but as time goes on she will get used to it. Pregnancy when cared for  will save some time,energy  and resources that will result from poor delivery. Get more information on our page female health forum .