Preconception Counselling in Delhi
Getting your health, medication and nutrition right before you start trying.
What preconception counselling involves
The first few weeks of pregnancy, often before you know you are pregnant, are when the neural tube forms and the placenta implants. Folic acid, controlled blood sugar, corrected thyroid function and the right medication need to be in place before conception, not after.
A preconception visit takes half an hour and can prevent problems that are far harder to manage later. It is particularly important with diabetes, thyroid disease, epilepsy, hypertension or a previous complicated pregnancy.
Who this is for
- Planning a pregnancy in the next six to twelve months
- Diabetes, thyroid disease, hypertension or epilepsy
- Previous miscarriage, preterm birth or a baby with an anomaly
- Family history of a genetic condition
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Health review
Medical history, current medication, immunisation status and BMI.
Investigations
Haemoglobin, thyroid, blood sugar, vitamin D, rubella immunity and blood group.
Optimisation
Folic acid started, medication switched where needed, chronic conditions brought under control.
Genetic screening
Carrier screening for thalassaemia and other conditions where the history suggests it.
Your results, in writing
Whatever the outcome of preconception counselling, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: A medication changed three months before conception
28, Rohini · epilepsy · planning pregnancy
What she came in with
Well-controlled epilepsy on sodium valproate for six years, seizure-free for four. She and her husband wanted to start a family and had come for a routine 'pre-pregnancy check'.
What the workup showed
Sodium valproate carries a roughly 10% risk of major congenital malformation and a significant risk of neurodevelopmental impairment — by far the highest of the common antiepileptics. She had never been told this. Her folate level was also low.
What we did
Joint management with her neurologist to switch to lamotrigine, with a three-month overlap and monitoring to confirm seizure control was maintained. High-dose folic acid at 5 mg daily started immediately. Conception deliberately deferred until the switch was stable.
Outcome
Seizure-free on lamotrigine. She conceived five months later, had a normal anomaly scan and fetal echocardiogram, and delivered a healthy baby at term.
The point of this case
The neural tube closes by 28 days, often before a woman knows she is pregnant. A medication switch that takes three months has to happen before conception, not after the positive test.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Medication safety reviewed before conception, not after
Thalassaemia carrier screening, which matters a great deal in India
Rubella vaccination given with adequate time before conception
Realistic nutrition and weight advice
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about preconception counselling
When should I start folic acid?
At least one month before trying, at 400 mcg daily, or 4 mg if there is a history of neural tube defect, diabetes or certain medications.
Do I need to stop my regular medication?
Some medications need changing, some do not, and stopping abruptly can be more dangerous than continuing. That is exactly what this visit is for.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.