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With many pregnancies unplanned, a general practice consultation can address needs that arise opportunistically, and advice should be tailored to individual personal and cultural views of health, sexuality, fertility, and pregnancy. Guidance covers asking about pregnancy risk or intent, reviewing fertility-relevant health factors, updating contraception, and supporting planning through education on modifiable risks, timing of intercourse, folic acid, immunity checks, and referral criteria based on age and time to conception.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pre-conception-care-in-general-practice-education-and-pre-conception-check/403416/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pre-conception-care-in-general-practice-education-and-pre-conception-check/403416.png","ImageObject",300,407,{"name":92,"@type":93},"jayni","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How can pre-conception care be integrated into general practice consultations?","Question",{"text":112,"@type":113},"Education to improve pre-conception health should be treated as a routine part of primary care. Because many pregnancies are unplanned, the general practice consultation can improve future pregnancy outcomes even when the topic arises opportunistically.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What question should clinicians consider asking to identify pregnancy risk or intent?",{"text":117,"@type":113},"Consider asking all women of reproductive age a single question about pregnancy risk or intent, encouraging them to think about the right time and circumstances to consider pregnancy.",{"name":119,"@type":110,"acceptedAnswer":120},"What guidance is given on when couples should have intercourse to maximize conception?",{"text":121,"@type":113},"Highest rates of pregnancy occur with intercourse every one to two days during the fertile phase. The fertile phase begins about five to six days prior to ovulation and ends on the day of ovulation, with conception more likely when timed within the three days prior to ovulation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},403416,1790762774,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747859343,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","in general practice  \nIntegrating pre-conception care into general practice  \nEducation to improve pre-conception health should be viewed as a routine part of primary care for all women of reproductive age. Many pregnancies are unplanned, so integration of pre-conception care into a general practice consultation can improve future pregnancy outcomes.  \nSome woman may consult specifically for pre-conception advice but in the majority of cases, the topic of preconception care is likely to arise opportunistically, e.g. at a consultation for a repeat prescription for contraception, a visit for a routine smear or a sexually transmitted infection (STI) check. Personal and cultural concepts of health, sexuality, fertility and pregnancy vary widely and therefore advice should be tailored specifically to the needs of the individual woman.  \nAsk about pregnancy risk or intent  \nConsider asking all women of reproductive age a single question about pregnancy risk or intent.1 Encourage women to think about the right time and circumstances to  \nconsider pregnancy and prescribe effective contraception until this is desired. Provide education about modifiable risks during pregnancy such as smoking and alcohol intake and also provide education on how a pregnancy may be best achieved.  \n GPs and practice nurses should be aware of patients who, because of their obstetric or medical history, may have complications during pregnancy or delivery. The Ministry of Health Guidelines for referral in maternity care is a useful resource highlighting conditions which may require more complex management. This resource can be found [at: www. moh.govt. nz/moh. nsf/pagesmh/6257/$File/](at: www. moh.govt. nz/moh. nsf/pagesmh/6257/$File/)[ ](at: www. moh.govt. nz/moh. nsf/pagesmh/6257/$File/)[maternity-referral-guidelines-may07.pdf](maternity-referral-guidelines-may07.pdf)  \nThe pre-conception check  \nIt is well established that the state of a woman’s health has a direct effect on the health of the foetus. While populationlevel interventions exist, e.g. folic acid fortification of bread (although not yet implemented in New Zealand), targeted individual changes are needed to optimise the wellbeing of a woman and her child.  \nBPJ | Issue 35 | 9  \nWhat is normal fertility?  \nApproximately 85% of couples should conceive after 12 months of unprotected intercourse during the fertile phase. Of the remaining couples, a further 50% will conceive over the next 36 months.4  \nHighest rates of pregnancy occur if couples have intercourse every one to two days during the fertile phase of the woman’s menstrual cycle.5 The fertile phase of the menstrual cycle begins approximately five to six days prior to ovulation and ends on the day of ovulation, although conception is more likely to occur if intercourse is timed within the three days prior to ovulation.5 In a woman with a regular 28 day cycle, ovulation will usually occur on day 14 of the cycle (or 14 days before the expected date of the next menstrual period), so the best practical advice for couples is to have regular intercourse (every two to three days) starting at the end of menstruation, until about ten days before the woman’s next menstrual period is due.  \n10 | BPJ | Issue 35  \nGeneral guidance should be offered to all women of reproductive age because:  \n▪ It is estimated that 30–50% of pregnancies are unplanned2  \n▪ It is estimated that 51 per 1000 girls aged between  \n15 and 19 years become pregnant each year in New Zealand3  \n▪ Fertility begins to significantly decrease for women after age 35 years  \n▪ The risks during pregnancy for both mother and foetus rise after age 40 years  \nWomen who have already had a child may need an update on pre-conception and pregnancy information that has changed, e.g. the use of iodine supplements in pregnancy.  \nSuggested format of a pre-conception consultation A pre-conception discussion could include:  \n▪ An initial question about pregnancy risk or intent, i.e. do they wish to be","cbCaibBJVPQID5eI","https://ap.wps.com/l/cbCaibBJVPQID5eI","pdf",262741,"English","# Integrating pre-conception care into general practice\n## Education for pre-conception health\n## Ask about pregnancy risk or intent\n## The pre-conception check\n## What is normal fertility?\n## Suggested format of a pre-conception consultation\n## Referral and evaluation of fertility","[{\"question\":\"How can pre-conception care be integrated into general practice consultations?\",\"answer\":\"Education to improve pre-conception health should be treated as a routine part of primary care. Because many pregnancies are unplanned, the general practice consultation can improve future pregnancy outcomes even when the topic arises opportunistically.\"},{\"question\":\"What question should clinicians consider asking to identify pregnancy risk or intent?\",\"answer\":\"Consider asking all women of reproductive age a single question about pregnancy risk or intent, encouraging them to think about the right time and circumstances to consider pregnancy.\"},{\"question\":\"What guidance is given on when couples should have intercourse to maximize conception?\",\"answer\":\"Highest rates of pregnancy occur with intercourse every one to two days during the fertile phase. The fertile phase begins about five to six days prior to ovulation and ends on the day of ovulation, with conception more likely when timed within the three days prior to ovulation.\"}]","Pre-conception Care in General Practice - Education and Pre-conception Check | PDF",1790540282,15]