Preconception care: What every mother should know before conceiving
Stella Walker* has had epilepsy since childhood. She has managed the condition by having frequent visits to her doctor and taking medication and therapy sessions.
She thought her condition wouldn’t interfere with her normal life until she got a mild attack while on holiday in London over a decade ago.
“My husband and I were on a holiday at his home country and during our stay, I experienced an attack and was rushed to hospital.
When the doctor ensured I was fine and ready to leave, he questioned me about trying to get a baby and he gave me a warning because of the medication he had administered. He said it would interfere with the conception process,” she says.
Stella adds that according to her doctor, women with epilepsy are at increased risk of having babies with congenital anomalies because both epilepsy and the medications given for its control may have adverse effects on the baby.
“As much as we were still newlyweds and had not planned on having children that soon, I was glad that I was made aware of that.
By the time we had already settled on when to conceive, I had already started visiting my doctor here at home to advice on the steps and changes I needed to take,” says Stella.
Late intervention can be fatal
Stella is now a mother of three aged between 16 and 11. “Medication for epilepsy is not cast on stone.
There are many variants depending on the patient and dosage. Also, medication can be changed depending on trimester.
The doctor can decide to give a different medication or reduce dosage. One of the medication I used to take was valporoate sodium, used to treat migraine headaches in epileptic people, which was changed to levetiracetam when I got pregnant,” she explains.
It is a fallacy to think that all women who have given birth were well prepared to carry their babies.
In fact, four out of 10 women report that their pregnancies are unplanned. As a result, essential health interventions provided once a woman and her partner decide to have a child will be too late in 40 per cent of pregnancies.
The few who are prepared are not all that informed about what is needed to make the pre-conception period safe and healthy for the baby.
World Health Organisation (WHO) defines preconception care as the provision of biomedical, behavioural and social health interventions to women and couples before conception occurs.
It aims at improving their health status, and reducing behaviours and individual and environmental factors that contribute to poor maternal and child health outcomes.
Nerea Ojanga, childbirth education specialist and doula advises women to ensure that they are healthy and in the right frame of mind even as they plan to conceive.
All in all, the optimum health of a mother is what is needed for every woman.
“It is important to check all genetic predispositions that you or your partner may have as this may prevent diseases in the child,” she adds.
Nerea emphasises that when a woman wants to conceive, it is also important to ensure that her blood levels are normal and that there are no infections or any deviations in vital signs from normal, which could signify underlying conditions such as HIV, elevated blood pressure or kidney problems. .
According to Nerea, the other important thing to consider is the mother’s rhesus factor.
Knowing your blood group helps to know what other additional supplements can be taken if need be.
It is dangerous for a mother to have a rhesus negative as the baby is detected as a foreign body and is usually detached from the placenta either causing a miscarriage or the birth of a deformed baby.
If a mother is discovered to have a rhesus negative, she is required to take the AntiD vaccine given in three doses.
“The first dose is given at 28 weeks of the pregnancy, then the second dose is given between week 34 and 36 of the pregnancy, and the final dose is usually given for second success pregnancy within 72 hours after delivery of a baby,” she says.