Hough, Amy;
Kavanagh, Jayne;
Pathak, Neha;
(2024)
Sexual and reproductive health clinical consultations: preconception care.
BMJ Sexual and Reproductive Health
10.1136/bmjsrh-2024-202361.
(In press).
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Abstract
Scenario: Sofia, aged 32 years, wants another child. She has used a contraceptive implant for contraception for 2 years and attends her local sexual health clinic to have it removed. Before starting the removal the healthcare professional (HCP) asks about her general health and obstetric history. She is well and does not take regular medication. Her body mass index (BMI) is 33 kg/m2 and her last cervical screening test was 6 years ago. She drinks socially and does not smoke or use recreational drugs. She has two children aged 7 and 4 years. Her first pregnancy was uncomplicated, and she had a vaginal birth. She had gestational diabetes in her second pregnancy and opted for an elective caesarean for fetal macrosomia. She cannot recall if she had testing for diabetes after birth. She has a palpable implant. Before starting the implant removal, the HCP discusses pregnancy planning with Sofia. They advise her to consult her general practitioner (GP) to start 5 mg/day folic acid (table 1), have a cervical screening test and be tested for diabetes. The HCP sensitively brings up Sofia’s weight and alcohol intake. They explain that she could reduce her risk of complications during pregnancy and delivery by aiming for 5–10% weight loss and signposts her to the National Health Service (NHS) ‘Live Well’ website. The HCP also discusses the benefits of not drinking alcohol before and during the pregnancy, and encourages her to discuss these lifestyle changes with her partner as well, as men can also optimise their health to improve fertility. The HCP also uses the opportunity to screen for reproductive coercion and domestic abuse as pregnancy is associated with an increased risk.
| Type: | Article |
|---|---|
| Title: | Sexual and reproductive health clinical consultations: preconception care |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjsrh-2024-202361 |
| Publisher version: | http://dx.doi.org/10.1136/bmjsrh-2024-202361 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10196400 |
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