Preconception care

​Note: this is a non-exhaustive guideline. Clinical judgement needs to be used when assessing clinical urgency with consideration to clinician, parental and/or family concerns

​​​​​​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • ​Nil

When public outpatient services are not routinely provided

  • Already being seen in a model of care (i.e. engaged with health care provider providing preconception care)
  • Already receiving treatment with a fertility specialist

  • Routine preconception care​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • ​​Actively trying for pregnancy and have any of the following features without previous follow-up or preconception care or planning:
    • ​cardiac concerns (e.g. prosthetic heart valve, rheumatic heart disease, congenital heart disease, cardiomyopathy, Marfan syndrome, dilated aortic root, ischaemic heart disease)
    • medical concerns:
      • ​​​​​any stage renal failure
      • child with genetic condition and not known to any genetic service
      • congenital uterine anomalies
      • wpilepsy
      • family history of genetic condition
      • hepatitis B and C
      • human immunodeficiency virus (HIV)
      • parent or partner with a known or carrier of a genetic condition
      • previous child affected by anti-platelet antibodies (i.e. Neonatal Alloimmune Thrombocytopenia – NAIT)
      • previously treated cervical cancer
      • red cell antibody
      • spina bifida, previous baby affected with spina bifida or immediate family history of spina bifida
      • type 1 diabetes
      • type 2 diabetes​
    • ​​medications with a high risk of teratogenicity or other embryo–fetal risk
      Note: if any concerns with medication, consider contacting MotherSafe
    • pregnancy related history
      • eclampsia
      • fetal growth restriction (FGR) requiring birth <34 weeks of gestation
      • history of perinatal loss
      • history of recurrent miscarriage, stillbirth and/or neonatal loss
      • hypertensive disorders of pregnancy requiring birth < 34 weeks of gestation
      • previous failure of vaginal cervical cerclage​
    • ​​solid organ transplant recipients 
    • substance use (e.g. alcohol, smoking, vaping, recreational drugs)
​Category 2
Recommended to be seen within 90 calendar days.
  • ​Planning pregnancy and currently on contraception with any of the medical conditions specified in Category 1
  • Previous adverse birth experience
  • Seeking preconception care outside the scope of practice of a general practitioner​

Category 3
Recommended to be seen within 365 calendar d​ays.

  • ​Nil

Information to include within a referral

Required

  • Reason for referral​
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically current contraception use

If available

  • Obstetric history
    • ​previous pregnancies
      • date of birth, gestation, mode of birth, birth weight, place of birth
      • any pregnancy complications (e.g. gestational diabetes mellitus, fetal growth restriction, hypertensive disorders of pregnancy, antepartum haemorrhage)
      • any birth complications (e.g. postpartum haemorrhage, preterm birth, perinatal loss, pre-existing adverse birth experience)
    • previous neonatal admission to a special care nursery or neonatal intensive care unit (NICU), and reason
    • miscarriage​
    • ectopic pregnancy
    • termination of pregnancy
    • gynaecology history
    • previous diagnosis of cervical cancer and treatments
    • uterine anomalies
    • polycystic ovary syndrome (PCOS)
    • endometriosis
    • recurrent miscarriage
  • medical, oncology, surgical and psychological history
    • include details of any risk factors or co-morbidities (e.g. cardiac, renal or liver disease, diabetes, hypertension, venous thromboembolism, autoimmune disease, asthma, epilepsy, obesity, bariatric surgery, eating disorders, mental health concerns)
  • ​medication history
    • psychotropic drugs (e.g. sodium valproate, lithium)
    • other medications with recognised fetal implications
  • family history
    • ​carrier screening
    • genetic screening
​​Note: parents who are at an increased risk of having children with a genetic condition after genetic carrier screening or who are at an increased risk of having children with a genetic condition due to a personal and/or family history (i.e. blood relatives) should also be referred to a genetics service
  • ​investigations
    • pathology relevant to any medical history (i.e. known cardiac, renal or liver disease)
    • imaging relevant to any medical history (i.e. known cardiac, renal or liver disease)
  • social history
    • drug, alcohol, and smoking history
    • victim of domestic violence
    • living situation
    • sexual orientation
    • gender diversity
    • environmental exposure

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

Additional maternity services

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing