Preconception care: C-Care IHK's Dr. Nsubuga answers key questions

Below Dr. Mushin Nsubuga, an obstetrician and gynaecologist from C-Care IHK, responds to common questions about preconception care.

Dr. Nsubuga was interviewed by the actress Eleanor Nabwiso, who also spoke to Mitchelle Bithum and Joanitah Nandi (mothers) and Gordon Mungurick, a father -- who shared their experiences.

Nabwiso herself is a mother of four -- two boys and two girls.

Nabwiso: Tell us more about preconception, Dr. Nsubuga.

Dr. Nsubuga: Many mothers, about 4/10, conceive when they are not prepared and this can be a very scary experience.

[For good outcomes, he said, it's important to visit a doctor before conceiving.]

The journey starts when a person is still young. A woman planning to have kids in the future should be able to feed well to have their bodies grow such their bodies can carry these babies and this should facilitate them with childbirth. So, nutrition is a very important aspect.

Both partners need to screen for congenital diseases like sickle cell disease before conception so that doctors offer advice.

Diseases like diabetes and high blood pressure need to be optimised before conception because they may affect the ability of a mother to successfully carry the pregnancy if they are not controlled. [He said it could lead to the death of the mother.]

Some diseases like Hepatitis B need to be vaccinated against.

Those using drugs and alcohol also need to consult a doctor before conceiving.

There are also medications like that for epilepsy and thyroid diseases that need to be changed once someone conceives.

Couples need to also be educated on expectations like preterm births and male partners on how to support pregnant mothers.

Nabwiso: How do I know it's not safe to have a child with my partner?

Dr. Nsubuga: Preconception care is broad but it can be personalised depending on someone's history. But there are basics that are crucial like checking for HIV, Hepatitis, sickle cells and blood group.

Nabwiso: Are you encouraging people who have sickle cell disease to have children?

Dr. Nsubuga: People with sickle cell disease should have children. But it's advisable they have children with partners who are not sickle cell carriers or have sickle cell disease.

That's why preconception care is important because you make well-informed decisions and you're prepared both mentally and physically.

Nabwiso: I would like to know, was it easy for you to conceive?

Bithum: Yes.

Nabwiso: What happens to a couple that conceived before consulting a doctor?

Dr. Nsubuga: Like I said, 4/10 pregnancies are not planned. But anytime you find out you are pregnant, immediately walk to the doctor even if sometimes doctors may not be able to change much. For instance, if both partners have sickle cell disease. But there is medical support we can offer to ensure a safe pregnancy.

Nabwiso: Tell me the myths you had before conception.

Bithum: The only myth I had... I wanted a baby girl because I wanted her to enroll into modeling, I wanted to be her role model, I wanted her to join all these beautiful pageants. Then I asked someone and they told me to keep touching the left part of my stomach and that if I feel something hard, that's a girl.

[She said her mind was suddenly convinced into believing it was a girl until she went for a checkup and found out it was a boy.]

It kinda broke me down but I no longer believe in myths.

Nabwiso: Should we believe in myths?

Dr. Nsubuga: The myths exist and some can affect the pregnancy negatively. For instance, some people are encouraged to take herbs to, say have twins, and this may harm the pregnancy.

Nabwiso: How do you fathers get involved in preconception?

Mungurick: Before my wife conceived, we discussed the tests we were to do. I also found out it's more than just blood tests and there is a lot to learn about the journey leading to having a baby.

Nabwiso: What is so important that a man should be involved in preconception?

Dr. Nsubuga: Ideally, the man is the head of the 'project' of having a baby, so he should take charge. And I encourage men to avoid having unplanned babies. We should plan and be deliberate about having children.

[He said men should be the ones to initiate medical visits and this should be done even if they already have kids because their health state keeps changing.]

Men need to be part of the journey because women need support and we need to have healthy children. For instance, if a man is a heavy drinker or smoker, it affects the sperm quality.

Nabwiso: What tests are done on a man preconception?

Dr. Nsubuga: There are those tests that are similar between a man and a woman, for instance, screening for STIs, congenital diseases, lifestyle modification, blood group tests, etc.

Then others like sperm checks and semen analysis are exclusive to men.

We encourage men to be part of the conception journey.

Nabwiso: Tell me about your preconception journey; did you ever think about testing?

Nandi: No

Nabwiso: Did you get any complications with the child after that?

Nandi: No... the baby is healthy.

Nabwiso: What did you try to check preconception?

Nandi: I didn't try to check for anything. Like I said, the baby just came. When the baby came, of course, you are worried -- is he sick, is he safe? I was also scared of tests like that of HIV. I was very scared, by the way.

Nabwiso: Did you ever think my partner could have had sickle cell disease?

Nandi: All those things run through your head. I kept saying what if he is sick. If he is not sick, what if it's me, I don't even know my blood group. I started my antenatal care at five months because all that time I was stalling to avoid tests.

[She said sometimes she would check Google for information before visiting doctors and this scared her more.]

Nabwiso: What advice would you have for a mother out there who would like to conceive?

Nandi: If you have a partner who is willing, talk to them and go to the hospital together. Most of us don't have that chance with partners who are willing to go for tests.

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