Morris - improving preconception care

I think the way you could improve preconception counselling is by asking that question more often, “Do you want to get pregnant?” And the other area where we could greatly improve preconception counselling is for adolescents with chronic diseases. So for example, the diabetes clinic has a number of adolescents that are in the process of becoming sexually active and just taking the time with them to help them understand what the challenges are of a diabetic pregnancy and what kind of work they’ll have to do. And giving them that information ahead of time before they get into something where they realize they didn’t quite want to get all that involved. So any clinic that cares for teenagers, you always have to ask that question, “Do you want to be pregnant? Do you want to avoid a pregnancy?” And for kids with chronic illnesses, don’t wait until they come and tell you they are sexually active and they’ve missed a period. Talk to them before that happens because some of the chronic illnesses that kids carry into adulthood pose really serious risks for pregnancy and they need to value that and time it and do it when they can do the best job at it. Those are opportunities we can take and you have to be comfortable doing preconception counselling. There’s part of you that wants to say, “No, don’t get pregnant” and you can’t do that. If they, you know; seize the chance, do it, give them the information and they’ll choose to use it if they want to. So it doesn’t work to say, “No, don’t get pregnant, it’s a bad idea.” Just find out if they’re at risk and tell them what they need to do to have a healthy pregnancy and a healthy baby before it happens. And they might think, “Oh, that’s too much work. I think I’ll wait.”