Bachelor of Midwifery Program
Brawijaya University
Preconception Care:
Optimizing Maternal &
Neonatal Health
Dr. Linda Ratna Wati, S.ST, M.Kes
Learning Objectives
By the end of this session, students will be able to:
1. Define preconception care and explain its importance.
2. Identify key components of Preconception care.
3. Recognize risk factors that may affect pregnancy outcomes.
4. Discuss the role of midwives in the Preconception care implementation.
Definition of Preconception Care
WHO (2013) Definition:
"The provision of biomedical, behavioral, and social health interventions to
women and couples before conception occurs to improve maternal and
child health outcomes."
Why is Preconception Care Important?
• Reduces maternal and infant morbidity & mortality.
• Prevents birth defects & pregnancy complications.
• Improves pregnancy readiness and maternal well-being.
Goals of
Preconception Care
Optimize maternal health before pregnancy.
Reduce the risk of pregnancy complications.
Improve neonatal health and development.
Enhance reproductive planning and family
health.
1️⃣ Risk Factor Identification
2️⃣ Nutritional Assessment & Supplementation
Key 3️⃣ Lifestyle & Behavioral Modifications
Components of
4️⃣ Infectious Disease Screening & Vaccination
Preconception
Care 5️⃣ Psychological & Mental Health Considerations
6️⃣ Environmental & Occupational Exposure
7️⃣ Family Planning & Contraception Counseling
Conceptual framework for preconception care. Source: Born Too Soon: The global action report on preterm
birth, 2012.
Identifying Risk Factors
Medical History:
Previous
Diabetes, Genetic Risks:
Pregnancy Outcomes:
hypertension, heart Family history of
Miscarriage, preterm
disease, thyroid congenital disorders.
birth, stillbirth.
disorders.
The components of
Preconception care
Nutritional Assessment
& Supplementation
Assessment: BMI, dietary habits
before pregnancy, Screening anemia &
diabetes.
Key Nutrients:
• Folic Acid (400-800 mcg/day): Prevents
neural tube defects.
• Iron: Reduces anemia risk.
• Calcium & Vitamin D: Supports bone health.
• Iodine: Essential for fetal brain
development.
Avoid Teratogens: Smoking,
alcohol, drugs.
Lifestyle and Physical Activity: Moderate
exercise to maintain a healthy BMI.
Behavioral
Modifications Adequate Sleep & Stress
Management.
Midwife’s Role: Educate and
counsel women on healthier
choices.
Maternal lifestyle prior to and during pregnancy is, therefore, of
paramount importance for the epigenetic mapping of the offspring [5]
and underpins the intergenerational cycle of obesity, insulin
resistance, and associated disorders (Figure 1). Moholdt, Trine et al. Trends in Endocrinology & Metabolism, Volume 31, Issue 8, 561-569
Genetic
Condition
• Family History taking to identify
the risk factor
• Carrier screening and testing
• Genetic Counseling
• Appropriate treatment of
genetic conditions
• Community-wide or national
screening among population at
high risk
Environmental Health
1 2 3 4
Providing Protecting from Avoiding Avoiding heavy
guidance & unnecessary unnecessary metal, such as:
information on radiation exposure pesticide use Lead, Cadmium,
environmental in occupational, Mercury etc
hazard and dan medical
prevention settings
Love, C., Sominsky, L., O’Hely, M. et al. Prenatal environmental risk factors for autism spectrum disorder and their
potential mechanisms. BMC Med 22, 393 (2024). https://doi.org/10.1186/s12916-024-03617-3
Infertility/ Sub-Fertility
1 2 3 4
Creating awareness Defusing stigmatization Screening and Counseling for
and understanding of of infertility diagnosis of couples individual or couples
fertility and infertility following 6-12 moths of
and their preventable attempting pregnancy,
and unpreventable ang management the
causes. underlying causes
Interpersonal Violance
• Providing age-appropriate
comprehensive sexual education for
gender equality, human rights and sexual
relations.
• Health promotion to prevent dating
violence
• Recognizing signs of violence against
women
• Referral and psychosocial support to
violence victims
• Keeping girls in school
Too early, • Influencing cultural norms that
unwanted support early marriage
• Providing age-appropriate
and rapid comprehensive sexuality education
• Empowering girls to resist coerced
successive sex
pregnancies • Educating women and couples about
the effect of short birth intervals
Screening for STIs
Increasing access to treatment and
Sexually other relevant health service
Promoting safe sex practices
transmitted
Infections Provider-initiated HIV counseling and
testing, including male partner testing
Providing Antiretroviral prophylaxis
beside antiretroviral therapy for PMTCT
Mental Health
• Assessing psychosocial problems
• Psychosocial counselling before and
during pregnancy
• Counselling, treating and managing
depression in women planning
pregnancy
• Stregtening community networks and
promoting women empowerment
• Reducing economic insecurity of women
of childbearing age
Birth Spacing Recommendations:
Family At least 2 years between pregnancies
to reduce risks.
Planning &
Contraception Safe contraceptive methods before
Counseling planned conception.
Midwife’s Role: Guide couples in
choosing appropriate contraception.
ICM Essential Competencies
for Midwifery Practice
2024
Thank you, let's discuss
