Tamar Antelava

Tamar Antelava

Obstetrician-Gynecologist, Coordinator of the Obstetrical-Gynecological Service at Evex Clinics.

One Step Before Pregnancy – A Visit to the Gynecologist

Planning a pregnancy does not start with a positive test; it begins much earlier, the moment a woman decides to take charge of her reproductive health.

A visit to the gynecologist is the first and one of the most critical stages in this process. Its goal is not solely to detect existing problems, but to assess overall health, identify potential risk factors, and manage them in a timely manner. It is exactly this approach that lays the foundation for a safe pregnancy and a healthy newborn.

Modern guidelines emphasize that consulting a gynecologist is important for all women of reproductive age, regardless of whether they are currently planning a pregnancy. However, its significance increases dramatically when pregnancy is actively being considered or when there are factors that could affect conception and the course of the pregnancy.

Preconception counseling with a gynecologist is a key component of a woman’s healthcare (Source: ACOG, ASRM).

For Whom and When is a Gynecologist Visit Important

A routine gynecological consultation is recommended for all women of reproductive age, regardless of whether they wish to conceive at this stage. This visit is particularly important for those using contraception, planning a pregnancy, or facing fertility issues—in these cases, the consultation should not be postponed.

Regular visits are essential because health status and risk factors can change over time.

A visit to the gynecologist is recommended:

Before marriage — for health assessment and preventive measures

For the selection and management of contraception

During the pregnancy planning stage

In the event of repeated negative pregnancy tests

For the evaluation of sexually transmitted infections or vaginal issues

In the presence of chronic conditions (e.g., diabetes mellitus, hypertension, psychological disorders), when treatment adjustment is needed

After childbirth

After pregnancy loss or termination

Why a Pre-Pregnancy Visit is Important

A woman’s health status before pregnancy directly impacts both the course of the pregnancy and the health of the fetus and newborn. That is why, before planning a pregnancy, it is crucial to fully evaluate her health status, identify potential risk factors, and implement appropriate preventive or therapeutic measures. Only after this is it recommended to proceed with planning the pregnancy.

In the case of an unplanned pregnancy, the risk of complications increases. For example, observing an optimal interpregnancy interval (18–24 months) significantly reduces the incidence of preterm birth and hypertensive disorders of pregnancy. During this process, the gynecologist has the opportunity to offer the patient effective contraceptive methods and help her make an informed decision.

Assessing Risk Factors

Consulting a gynecologist is primarily a preventive measure. Its objective is to uncover factors that might influence conception, the progression of the pregnancy, or fetal development. Timely identification of risks allows for treatment or monitoring to begin if necessary, which substantially reduces the likelihood of complications. At this stage, gathering a detailed medical history is crucial, as it provides the doctor with a complete picture of the patient’s health.

Nutritional Status – An Often Underestimated but Critical Factor

A woman’s nutritional status is a significant factor that affects both conception and the course of pregnancy. Therefore, a nutritional assessment should be conducted prior to pregnancy, and if necessary, adjustments should be made in advance with the involvement of a gynecologist and a dietitian.

Women at high nutritional risk require special attention, including those:

With obesity (BMI ≥30 kg/m²)

With diabetes mellitus

At risk for a multiple pregnancy

Prone to severe nausea and vomiting

During the assessment, it is important to determine whether the patient is receiving adequate amounts of calcium, iron, and vitamins (A, B12, D). It is especially critical to begin taking folic acid at least one month prior to conception (0.4 mg per day), which significantly reduces the risk of neural tube defects and fetal developmental abnormalities.

Quick Self-Assessment – What Are Your Eating Habits Like?

For a preliminary assessment of nutritional status, a simple self-assessment questionnaire can be used to help patients analyze their own dietary habits.

The score ranges from 0 to 16 points; the lower the score, the healthier the eating habits.

Rapid Nutritional Status Self-Assessment Questionnaire

Over the past few months: