 I am Dr. Yashika Gudesar, head of department at Manipal Hospital, Dwaka. Today we will be talking about pre-conceptional counseling. The main aim of the pre-conceptional counseling is to have a healthy mother and a healthy baby. So, when we start the pre-conceptional counseling, it should be done whenever the patient is going to plan for a pregnancy. Ideally it should be at least three to six months before they have started planning because there are lots of things which should be done ideally before time. If we have not decided yet, but you are just about to get pregnant and you are just left with one month, still go for the pre-conceptional counseling, at least you will be aware of a few more facts which if you miss out, maybe there might be some issues during the pregnancy. So, the most important thing in the pre-conceptional counseling which your doctor will take care is whether you have some history, old history of taking some drugs, you have some history of smoking, alcohol intake and which all should be stopped, what is important which might not harm the baby during the antinatal period and postpartum period. All those people who are on drugs should carry their own previous papers, surgery reports and investigations and all the drugs which they are taking and send your doctor can let you know which drugs can be stopped. There are few drugs which are terepogenic, not all of them and some drugs can be changed to simpler drugs like somebody who has a history of fits can be shifted over to a less terepogenic drug so that during pregnancy the baby is not harmed and some people who have taken some acne treatment and they should stop the medications even six months before they are planning. So, those things should be mentioned to the doctor if you have a strong history of family, history of diabetes and you yourself are little obese then you should be taking care that you should get yourself investigated because sometimes as soon as you get pregnant, your sugars might shoot up and somebody who has an HBAvenC of more than seven they have high chance of becoming diabetic during the pregnancy. So, those things should be ruled out. In our country most of the pregnancies are unplanned, half of the pregnancies are unplanned and sometimes when we have unplanned pregnancies and the most important problem which the patient faces is then when she comes to know that she has diabetes, she has thyroid and then they have lots of stress that whether my baby will be malformed and these are not indications in which you should abort but you should be careful there might be a chance of abortion in this pregnancy and somebody who has had a previous history of multiple abortions they should obviously be going to the doctor as soon as possible and before even they are planning because then these multiple abortions the causes for that should be ruled out and you should be on prior medications and the doctor should be knowing about this and you should not have a second abortion after that after you have had previous multiple abortions now the family history is there and the past history is there now you have taken the drugs and you have to stop your drugs the other things is the vaccines like you should be aware that whether you have taken a MMR vaccines that is for the rubella because if you have not been vaccinated with the rubella vaccine and your ITG is still negative you should better get vaccinated and we ask the patients to not to conceive for next three months then there is varicella varicella is for chickenpox if you have not been immune with the varicella antibody you should better take a vaccine people who are sexually active earlier also they should go for a cervical cancer vaccine if you have taken a cervical cancer vaccine you should not go for pregnancy for the next six months and the hepatitis B immunization should be complete so before you are planning these things should be completed sometimes people come to us very late and we don't have time to give them vaccines because asking them to wait again for three to six months is a long time so it is better that you take the vaccine little early so go to the doctor by maybe six months before you have started planning so that will be very good and some people even have some genetic diseases in their families so that should be seriously discussed and should take a genetic opinion so that your baby does not have this issue or even if there is a chai chance of your baby having the disease you can be prevented from it and we can have a healthy baby if your age is less than 20, if your age is more than 40 you have a high risk of having a malformation but it is not that that we cannot prevent it nowadays we have good amount of tests available which are done at 11 weeks and the early scanning and the early double marker tests they will prevent you from malformation so nothing to be worried about just go for the preconceptional counseling so that you are not anxious when you are pregnant and as we told smoking and alcohol should be stopped and all those people who are working in a medical setup like the sister, the OT technicians they should know that they are about to conceive so they should not go in an area where there is a radiation there can be some radiation to that because radiation should be avoided X-rays should be avoided just before you are pregnant see in the last 15 days just before your periods anybody who is positive for hepatitis B, HIV and if their partners are also positive they should be aware that disease should they should talk to their doctor so that we can prevent the infections coming to their baby and the buffering of the infections during the pregnancy so everybody should go for a preconceptional counseling as we have discussed in detail so if you have any doubts, any clarity required please come and consult me or any of your gynecologist near your place and before even you have started planning to just give a very beautiful and healthy baby and prevent from all the type of any malformations