Individual health counseling before the onset of pregnancy (synonym: preconceptional counseling) including lifestyle counseling helps to avoid risks for mother and child.
Education or counseling should be provided on the following topics:
- Preconceptional nutritional improvement: education about risks of being underweight or overweight; referral of the patient to a physician-led program for the underweight or overweight.
- Counseling on addictive substances: This must be done regardless of the social position of the pregnant woman. Education about the risks of:
- Alcohol: risk of fetal alcohol syndrome (FAS; synonym: alcohol embryopathy, AE), which is prenatal damage to a child caused by alcohol ingested by the pregnant mother.
- Tobacco (smoking): fetal retardation (fetal growth retardation), low birth weight, stillbirth, among others.
In the case of substance abuse, motivation of pregnant women to change their behavior. See also at www.rauchfrei-info.de and www.schwanger-null-promille.de
- Folic acid supplementation (folic acid intake; 400 µg per day): risk reduction for neural tube defects (eg, spina bifida aperta / malformation in the spine); furthermore, protective effects for child development.
- Consultation and update of vaccination status: taking into account diphtheria, hepatitis B (form of hepatitis), influenza (flu), measles, mumps, rubella, tetanus (tetanus), varicella (chickenpox); pre-conceptional vaccination, if necessary vaccination of the environment.
- Consideration of psychosocial risks: recognize women at risk (address the family and partnership living situation). As far as necessary, referral to family counseling centers and pro familia. Use of the nationwide help hotline (08000116016).
- Advice on chronic diseases including long-term medication: especially older pregnant women need advice, if necessary, also the internal clarification or genetic counseling. Regarding counseling and change of medication: see www.embryotox.de (Pharmacovigilance and Counseling Center for Embryonic Toxicology. Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum. Augustenburger Platz 1, 13353 Berlin).
