Every woman aged 15–49 years should be considered for preconception care.

Preconception care is a set of interventions that aim to identify and modify biomedical, behavioral and social risks to a woman’s health or pregnancy outcome through prevention and management.

This should include smoking cessation and advice to consider abstinence from alcohol (especially in the early stages of pregnancy), folic acid supplementation, review of immunisation status medications and chronic medical conditions, especially glucose control in patients with diabetes. 

There is evidence to show improved birth outcomes with preconception health care in women with diabetes, phenylketonuria and nutritional deficiency, as well as benefit from the use of folate supplementation and a reduction in maternal anxiety.

Vaccinations

Testing may be undertaken to determine immunity to varicella and rubella, so that vaccination can be provided to nonimmune women. Women

receiving live viral vaccines such as measles/mumps/rubella (MMR) and varicella should be advised against falling pregnant within 28 days of vaccination.

• If indicated, MMR and varicella (nonimmune on testing) should be given at least 28 days before conception

• Influenza is recommended during pregnancy to protect against infection (if in second or third trimester during influenza season)

• Diphtheria/tetanus/pertussis (to protect the newborn from tetanus or pertussis) should be considered before conception