HEALTHY PARENTS, HEALTHY CHILDREN

PRE-CONCEPTION CARE

• Many women are aware about care during pregnancy, but

preconception care is also important to deliver a healthy baby
Healthy baby
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 Healthy baby
• Every couple (woman and her husband) desires a
healthy and live long baby
• Baby is generally born full term (completion of 9
months 9 days). But birth can occur 15 days earlier or
15 days later to EDD
• Healthy baby cries immediately after birth
• It weighs about 2.5 to 3.0 kg.
• Its length is about 45 to 50 cm.
• There is absence of congenital anomalies
• What should we do to have such healthy baby? When
to do?
• What are does and don’ts?
 Care should be taken before conception!
How and what, that is what we will now learn....
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It is necessary to plan parenting
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 Planning parenting
It is necessary that both partners (wife and husband)
are healthy and happy before conception
Physical capacity Psychological capacity
• Age of woman should be above 20
years
• Child’s responsibility should
• Her BMI should be between 18.5 and be accepted happily
25.0 • Hence, they should be
• Her Hb should be more than 12 gm % prepared psychologically for
• There should be minimum 3 years gap
between two children
before conception
• They should not have any addiction of • They should think of
tobacco, Mishri, snuff (Nus), alcohol etc conception only after being
• They should eat balanced diet prepared
• They should not be suffering from any
illness. If present, it should be treated
•Every pregnancy should be planned
•After you have planned about conception, contact nurse or doctor and get
information
•Woman should register immediately after she conceives and take proper
care. She should also enquire about the nearest place for ANC services 5
It is likely that a preterm baby may die
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 Probable risks
Following adverse events may occur due to
unplanned parenting or if proper care is not taken
• Spontaneous abortion
• Preterm baby is born (weight, length of such baby is less,
baby is likely to die)
• Low birth weight baby (such baby is also likely to die)
• Still birth (baby doesn’t cry after birth, no movement;
born dead)
• Baby is likely to have congenital structural or
physiological anomalies
• Baby is likely to die within four weeks. This is called as
neonatal death. Baby is more likely to die in first week of
life
 Such unfortunate incidences can be averted through
proper pre-conception care 7
Examination of women before
conception 8
Examination of women before conception
• Examination should be done through doctor or nurse and all necessary
investigations suggested by them should be done
• Weight, height and blood pressure are simple standards. It should be
assured that they are normal
• Besides, tests like blood group, haemoglobin, initial test for sickle cell
anaemia, blood glucose should be done
• Husband’s blood group when wife is Rh negative, diagnostic test for sickle
cell anaemia, blood glucose level should be done if needed. Eg. Oral
Glucose Tolerance test for diabetes, electrophoresis for sickle cell anaemia
• Thyroid function test should also be done
• HIV and VDRL test after counselling for STD and if needed, husbands
testing and treatment of both partners should be done
• Besides any investigations advised by doctor should be done (eg blood test
for malaria)
• The results of the test should be communicated and understood by
women
 Treatment as per the advice of doctor or nurse should be taken.
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 All these test and treatment will be done free of cost.
 Contraceptive
pills and condoms

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 Woman’s age
• Physical and mental growth of the woman should be
complete before she conceives
• Avoid conception before 20 years age of a woman
• Probability of abortion is more if a woman conceives
before 20 years of age
• It is likely that such woman may have hypertension/ PIH
and be fatal for her life
• Baby may be preterm birth, low birth weight. So chances of
neonatal death increase
• Chances of still birth are more
 Hence such women should use contraceptive pills,
injectable or males should use condoms regularly
 Other women should use contraceptives like Cu-T
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 Woman’s under nutrition or
overweight may be at risk for baby
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 Ratio of weight and height (BMI)
There is a specific ratio of weight and height; weight of a woman
is proportional to her height. This is called as Body Mass Index
(BMI)
BMI is calculated as follows
Weight in kg. ÷ square of height in m. = BMI
Meaning of BMI
BMI <18 Low weight
BMI 18.5-24.9 Normal
BMI >25.0 Overweight
• If BMI of woman is low, baby born may have low birth weight and length
• Sometimes preterm baby may be born
• Obviously probability of neonatal death may increase
• Overweight women also have risk of delivering preterm and low birth baby. She may get
diabetes, hypertension etc.
• Complications during pregnancy/ delivery or later may occur and be at risk for mother
and baby
• Baby born to such mother may also acquire diabetes, hypertension in future 13
 Fats:
sparingly Oil, ghee, butter, sweets etc
Non-veg :
Mutton, fish, eggs etc
2 parts/ servings
Milk and milk products:
milk, curd, cheese etc
3 parts/ servings Millets and legumes : Chana,
kidney beans, pigeon pea, green
gram, black gram
3-4 parts/ servings Fruits and vegetables:
banana, chickoo, guava,
fenugreek, spinach etc
4 parts/ servings Cereals: chapati, rice,
bhakari etc.

It is necessary that all people have

balance diet as per above figure
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 Diet
• BMI is based on our diet
• It is necessary that all have balance diet as per the food pyramid
• Fruits and vegetables should washed properly in salt / plane
water and then chopped
• Use iodized salt for cooking
•Avoid cold drinks like coke, pepsi and eating maggie, pizza etc
• Women who have low weight (BMI <18), they should have one
meal extra. They should include fish, eggs, chicken, mutton as well
as fats like oil, ghee in their diet. Besides, milk, curd, various pulses
i.e. dals should be included in their diet in larger quantity. Such
women should avoid fasting, or eat different food items stomachful
• Women who are overweight (BMI >25) should include fruits, leafy
vegetables in their diet. Their main diet should be chapati or
bhakari of sorghum (jowar) or ragi, dals pulses. Avoid eating sweet,
spicy and oily food. Exercises like circumambulation, walking,
working in farms should be performed 15
Take deworming
tablets every six
months before
conception 16
 Treatment on abdominal worms
• Different bacteria and viruses are present in our body.
Few bacteria/ virus cause disease
• Different worms are also present in human intestine
• Generally worms are present in children
• But many times, worms may also be present in women
• Worms absorb nutrients from our body and grow
• Because of these worms, women may show symptoms
like weakness due to anaemia
• Hence deworming tablets should be consumed every six
months before conception to avoid above symptoms
• Tablets should also be taken even during pregnancy as
per mentioned above
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Haemorrhage during pregnancy or postnatal can
be fatal in an anaemic woman
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 Anaemia
• Hb below 12 gm% is called as anaemia
• Commonest cause of preterm and low birth weight baby is anaemia
• Haemorrhage during pregnancy or postnatal can be fatal in an
anaemic woman
• It is easy to prevent or treat anaemia
• Sickle cell anaemia is another type of anaemia, for which treatment
as per doctor’s consultation is necessary
• Parents should plan pregnancy only when haemoglobin is higher
than 12 gm%
• Take deworming tablets once in every six months
• Take iron tablets for minimum 3 months daily after dinner
• Include ragi, leafy vegetables, drumstick leaves vegetable, jaggery,
dates, fruits, mutton, chicken
• Use iron utensils like frying pan, griddle, spatula etc. for cooking
• Use lemon, tomato or Amla daily in diet
• Do not consume tea/ coffee after meal. Avoid over-consumption of
tea coffee
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Anomalies of brain and spinal cord in
infant
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 Folic acid
• Folic acid is very essential vitamin for foetal
development of brain and spinal cord
• Anomalies of brain and spinal cord may develop due to
deficiency of folic acid before conception
• In order to avoid this, women should consume folic
acid tables three months before conception and three
months during pregnancy in first trimester
• Tablets given to women having anaemia also contains
folic acid
• Leafy vegetables, especially spinach should be included
in diet. Pulses also contain folic acid in some amount.
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It is essential to test blood group
before first pregnancy
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 Importance of blood group
• Blood group is commonly determined by two systems
• Four groups A, B, AB and O are there in first system
• Two groups Rh positive and negative are there in second
system
• It is essential to test blood group before first pregnancy
• It is very essential to test husband’s blood group if wife is
Rh negative. If husband’s blood group of such woman is Rh
positive, antibodies from mother pass to foetus and can be
fatal to baby
• The risk due to Rh group incompatibility is low during first
pregnancy and increases with parity
• Such women should be given injection before and after
delivery to reduce the risk to baby
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Tobacco causes cancer

If a woman is addicted to use of tobacco

substances, it may have effect on foetus
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 Tobacco
• Smoking bidi/ cigarette, chewing tobacco/
gutkha, mishri, snuff are lethal. Many diseases
are caused due to them. There are about seven
thousand types of lethal chemicals in tobacco
substances
• If a woman is addicted to use of tobacco
substances in any form, it may have effect on
foetus
• Risk like abortion, preterm or low birth weight
baby, congenital anomalies or still birth may
occur
• It is necessary for a woman to refrain from these
addictions before pregnancy
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Normal eyes
Normal lips

Anomalies due to alcohol consumption

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 Adverse effects of alcohol consumption
• Alcohol consumption has severe effect on growth of women and
her baby
• It may cause problems in women like menstrual irregularity,
infertility etc
• It may cause congenital anomalies in baby or affect growth of brain
and spinal cord
• Baby may be have less length, low birth weight and small head
circumference
• Baby may have cognitive impairment and may affect sight and
hearing, or organs like heart and kidney
• Face may be unusual especially eyes and philtrum
• May have behavioural problems (eg hyperactivity, instability etc)
• May have problems in child’s school progress or psychological
problems (eg mental retardation)
• Hence women should avoid alcohol consumption (Tadi, Madi, 27
country/ branded) before conception
 Wife-husband both should undergo
investigations and treatment as per the advice
of a doctor for a healthy baby
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 Sexually transmitted infections
• Sexual diseases are infectious. They may be present in
both partners (wife and husband)
• Symptoms like frequent lower abdominal pain, white
discharge, groin nodule, burning sensation while
urinating, itching etc. may occur
• This may lead to problems like infertility or abortion,
ectopic pregnancy (foetus outside uterus) etc.
• Baby may be preterm or low birth weight
• It is more likely that still birth or neonatal death may
occur
Hence it is necessary that wife-husband both undergo
HIV and VDRL investigations and treatment as per the
advice of a doctor
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 HEALTHY PARENTS, HEALTHY CHILDREN

Future parents should take care as per the

information about preconception services

We can definitely achieve our goal

through this