World Library  
Flag as Inappropriate
Email this Article

Pre-conception counseling in the United States

Article Id: WHEBN0036130807
Reproduction Date:

Title: Pre-conception counseling in the United States  
Author: World Heritage Encyclopedia
Language: English
Subject: Maternal health
Publisher: World Heritage Encyclopedia

Pre-conception counseling in the United States

Pre-conception counseling in the United States allows for optimization of US prenatal care. Pre-conception counseling is a meeting with a health-care professional (generally a physician) by a woman before attempting to become pregnant. It generally includes a pre-conception risk assessment for any potential complications of pregnancy.

Obstacles to pre-conception counseling in the United States

Obstacles to pre-conception counseling in the United States include:

  • It is too late in unintended pregnancies. The rate of Unintended pregnancy in the United States is approximately 49%.[1][2] Half of unintended pregnancies result from not using birth control, and 45% of them from using birth control inconsistently or incorrectly.[3]
  • Women not knowing, realizing, or understanding the benefits of visiting their physician before trying to become pregnant.
  • Another common obstacle to pre-conception counseling and assessment may be the lack of health insurance. However, most insurances will cover this as a screening visit. Also, many physicians will do the pre-conception screening during a regular office visit or gynecological visit if the woman just informs the doctor of her desire to become pregnant. Most gynecologists will inquire about child-bearing intentions anyway.

Screening and monitoring in the United States

Screening and monitoring of women prior to conception is recommended to include the following:[4]

However, the overall lack of evidence precludes a recommendation for universal screening for thyroid disease in pregnancy.[5]

Rubella screening

Screening for rubella susceptibility by history of vaccination or by serology is recommended in the US for all women of childbearing age at their first preconception counseling visit to reduce incidence of congenital rubella syndrome (CRS).[4] It is recommended that all susceptible non-pregnant women of childbearing age should be offered rubella vaccination.[4]

Varicella screening

Immunity status of varicella should be performed at the pre-conception counseling session, in order to prevent the occurrence of congenital varicella syndrome and other adverse effects of varicella in pregnancy.[4] Generally, a person with a positive medical history of varicella infection can be considered immune.[4] Among adults in the United States having a negative or uncertain history of varicella, approximately 85%-90% will be immune.[4] Therefore, an effective method is that people with a negative or uncertain history of varicella infection have a serology to check antibody production before receiving the vaccine.[4] The CDC recommends that all adults be immunized if seronegative.[4]

Domestic violence

It is recommended to screen for domestic violence at a preconception visit, because domestic violence during pregnancy a risk factor for miscarriage, late entry into prenatal care, stillbirth, premature labor and birth, fetal injury and low birth weight, and detection can avail for specific counseling and intervention.[4]

There is evidence that direct interview screening result in a higher rate of reporting prenatal domestic abuse than a written, self-report questionnaire method.[4]


Education of women intending to be pregnant is recommended to include:[4]

Vaccination and prophylaxis

Vaccination and other prophylaxis of women intending to become pregnant is recommended to include:[4]


  1. ^
  2. ^
  3. ^
  4. ^ a b c d e f g h i j k l m Health Care Guideline: Routine Prenatal Care. Fourteenth Edition. By the Institute for Clinical Systems Improvement July 2010.
  5. ^
  6. ^
  7. ^
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.