 I am the head of department at Manipal Hospital in Dwarka. Today we will be talking about pre-marital counseling. Pre-marital counseling will relate to two types of counseling that will be psychological counseling and the medical counseling. So, I will be dealing with the medical counseling part. Psychological counseling will be leading a counselor. If there are some issues related to some emotional bonding or you want to have a counseling before your married life should be healthy in that way. So, you can take a psychological counseling with the counselor. For the medical part, what the most important thing is that we want that both the partners should be healthy after marriage. As we go for horoscope checking for all before marriage, we know that horoscope will not lead us to have a healthy married life. What needs to a healthy married life is having getting ourselves checked. Both the female and the male should go to a gynecologist or some doctor and get all the investigations done, especially the infected diseases like STDs, HIV, hepatitis, HCV, VDRL, syphilis. These diseases should be checked. We don't know whether our partners, though he might be a very good person, he might be from a very good background, he might be very healthy to look at, might be suffering from some disease which he himself doesn't do. So, better both get those tests done. You can discuss with the gynecologist and then get your test done and your partner's test done. If you do this beforehand, you will be more sure that your partner is more healthy and whenever you are going into a sexual relationship with your partner, you will be much safer. So, the other aims of pre-marital counseling will be the sexual education. The most important thing the female suffers is she is very anxious about the first night. They are not aware the couple is going for the sexual relationship the first time. So, they are not aware of any type of contraception. So, contraception is also a second part. So, you should talk to your partner before you are getting married, that whether you are going for a family or you are not going for a family. You don't want the pregnancy for a year or two years or six months or you just want to, most of our couples who come to us are conceiving and they are not blind. They are not aware that they will be conceiving or not conceiving. And then they conceive and then there are problems, then they have an issue whether they want to abort or when they want to continue their pregnancy. So, aborting is also not right and continuing the pregnancy without a proper planning. And the mother is not, maybe her education is not completed, maybe her education is still to be completed and she doesn't want to have a baby right now. But then the family pressure is there and she conceives and then continues the pregnancy. Half of the pregnancy goes in lot of vomiting, anxiety and then she is not taking care of herself. There is chances of having a pre-term delivery, the morbidity of the baby will be more, the weight of the baby will be less. So, we should avoid such issues. So, in that case, the sexual education, contraception education and the discussion with the partner has already happened. So, these things will be avoided. So, and many times you are hesitant to talk to your partner. If you come to the doctor with your partner or you can have a one-to-one discussion with your doctor, nor meet to sit together, but if you sit together it will be a very good thing. So, these things are taken care of in the pre-marital counseling. And then the education for the infections. If you are already suffering from some infection, you should talk to your doctor, you should get it treated so that both of them don't have the same infection. Many people have warts, then they are transferred to their partners and then the disease flares up in both the partners and then they get treated after that. I have had many patients who have, both the partners had the warts after their first sexual contact and they had to treat both of them. That would have come with the same problem before they had a sexual relationship. We could have prevented that thing to flare up in both the partners. And then actually after you suffer from such a disease, there is always an anxiety before you go for a relationship. You go for the next time you are into the relationship. You are very anxious. So, to prevent these, you should meet your doctor. And if you are a doctor and you have planned that you are going for your pregnancy right after you are married. So, then you should take the pre-conceptional counseling course. Because pre-conceptional counseling, we go for investigations. We take your history, we stop any drugs you are taking which can be map for the map, which can cause map formation to the baby. So, these things should be catered and there will be a full pre-conceptional counseling. Even your vaccine history, it should be taken. And all those who are going for pre-marital counseling, they can even also go for a cervical cancer vaccine if they have not taken it before. And you can get your investigations and your partner's investigations to be done. And you should know about condensers, you should know about contraceptives, you should know about emergency contraception. What is emergency contraception? Many times people come to me very late and they have gone over the time when they can have taken a emergency contraception also. If you take an emergency contraception in time, you can prevent yourself from pregnancy. Because once you have conceived, you have to go through the abortion process. And that is very heartening for both the partners. It's not an easy thing. You go through emotional challenge and a medical challenge. And before ending, I would like to tell you one case in my history in which by both the partners, they became a serious antigen positive. And one of the partners, they became HIV positive just after conceiving. And then they had to go for a divorce because of that, because they thought that the other partner had not told the history to that. And there was one of my couples who conceived and they came to me for termination at 10 weeks. And they terminated, but she came to me after 2 years and she had not disclosed the history. And then she came and told me that she had been HIV positive and she terminated the baby. But now because her husband was not well, she wanted to have another baby. But right now it was not the time. So I just want you all to know that if you are a hepatitis B positive or HIV positive, the times have come that we can prevent the baby from getting that malformation. In HIV positive, you can go for an IUI or an IVF and you can have a healthy baby. And in case of hepatitis B, there are lots of medications by which your baby can be prevented from having the saline infection. So please disclose these to your doctors. Meet your doctor beforehand. Talk to your partner. You should not need to disclose it to every relative but you can always disclose this to your partner and to the doctor. And please all of those people best of luck for their marriage and they should go for a premarital counseling and we have this facility at Manipal. So please come over and take this before you are getting married and get yourself investigated.