In this episode of The Care Circle by Motherhood Hospitals, host Sneha sits down with Dr. Teji Dawane, Consultant Obstetrician & Gynaecologist, Motherhood Hospitals, Whitefield, Bangalore, to talk about something most couples overlook which is the “preconception counseling”. Dr. Dawane explains how many women in their late 20s and early 30s may have hidden health concerns like PCOS, thyroid issues which often go unnoticed until they start trying to conceive. She shares that instead of waiting months and dealing with stress and uncertainty, couples can take a proactive approach by meeting with a doctor a few months before planning a pregnancy. She also highlights the fact that preconception counseling isn’t just about medical tests, it’s about understanding your body, improving lifestyle habits, checking for nutritional gaps and making sure both partners are on the same page emotionally and physically. This warm, insightful conversation packed with real-life examples from Dr. Dawane’s experience, makes it a helpful guide for anyone thinking about starting their journey to parenthood.

Here are the key takeaways you shouldn’t miss from this episode:

• Preconception counseling is most effective when started a few months before planning a pregnancy
• Men also need to be emotionally and physically involved throughout the fertility process.
• Preconception guidance varies according to age of the couple.
• Relying solely on Google or lab packages without proper medical guidance can lead to unnecessary stress and confusion.
• Counseling goes beyond tests with a full check-in on mental health, stress, and overall well-being before conception.

Dr. Teji Dawane – Consultant Obstetrician & Gynaecologist, Motherhood Hospitals, Whitefield, Bangalore

Dr. Teji Dawane is working as a Gynaecologist and Obstetrician. Dr. Teji Dawane has a specialization in the field of Gynaecology and Obstetrics. Dr. Teji Dawane is a qualified MBBS from Bangalore Medical College, Bangalore, and an MD in Obstetrics & Gynaecology from Gauhati Medical College, Assam. Dr. Teji Dawane then completed her senior residency at the Jawaharlal Institute of Postgraduate Education & Research (JIPMER) in Pondicherry.

Dr. Teji Dawane is a member of the Federation of Obstetrics & Gynaecology Societies of India and the Indian Medical Association. Dr. Teji Dawane has been associated with Narayana Hospitals before joining us at Motherhood Hospitals, Whitefield, Bangalore. With over 14 years of experience in Obstetrics, she manages a range of complex and high-risk pregnancies and complications like diabetes, hypertension, preterm labor, and multiple pregnancies with the most ease. Dr. Teji Dawane also has received vigorous training in handling various Gynaecological problems like ovarian disorders, menstrual problems, and uterine fibroids. Dr. Teji Dawane has a keen interest in academic research and has various awards and publications to her credit.

0:00 – Introduction
0:50 – Guest’s Introduction
1:09 – Lack of Awareness about preconception counselling
2:03 – What is preconception counselling?
3:23 – Right time to book a preconception appointment
4:26 – Surprising findings in preconception counselling
4:53 – Preconception advice for men
7:48 – A real life story of preconception counselling
11:28 – Drawbacks of home collection of samples
12:35 – Rapid fire round
14:52 – Take-home message

(0:00) Snehaa : Almost one in four Indian women aged 25 to 35 may have an undetected issue, thyroid imbalance, PCOS, endometriosis that can make it harder to conceive naturally. Yet most couples wait until months of trying or until serious problems appear before seeking help. The smarter first step is preconception counseling. In one appointment, both partners meet a gynecologist, review their health, run a few basic tests, talk through everyday habits, and leave with a clear plan to improve their chances of an easy, healthy pregnancy. Welcome to The Care Circle, a podcast series by Motherhood Hospitals. I’m your host, Sneha.

(0:45) Snehaa : And today we are diving into something that’s a step for every parent to be. Joining me is someone who has guided hundreds of aspiring parents through this early chapter, Dr. Teji Davani, a gynecologist who specializes in maternal health. Welcome, Dr. Teji.

(1:03) Dr. Teji Dawane : Hello, Sneha. It’s fantastic to be here. Thank you for having me.

(1:07) Snehaa : Thank you so much, doctor. So, doctor, a while back, I was talking to a friend who has been wanting to start a family. And I asked her if she’s gotten her preconception counseling done.

(1:18) Snehaa : And she looked at me completely blank. She had no idea that this was a thing. Six months later, she was diagnosed with a thyroid issue that needed to be addressed first. She told me that this conversation probably saved her months of frustration and worry. So, doctor, I know couples might not be aware of it. What are your thoughts? And do you observe something similar in your daily OPDs? What are your thoughts around it? Yes, yes, absolutely.

(1:45) Dr. Teji Dawane : You know, Sneha, that’s exactly what we see all the time. Most couples think that they only need to see a doctor after six months of trying without any results. But that’s a very reactive approach. We want couples to be a little more proactive when they are planning their pregnancy.

(2:03) Snehaa : So, doctor, what exactly is preconception counseling? If you can define it in a common man’s term, and why should couples consider before they even start trying?

(2:14) Dr. Teji Dawane : It’s a very important question. So, preconceptional counseling is a very proactive approach, is a very proactive step that you would take to plan your pregnancy. You see, it is all about checking your physical, of course, emotional and reproductive readiness before even pregnancy happens. So, we screen for multiple hidden issues, you know, because sometimes with life, you may not always have clinical symptoms related to thyroid disorders, or polycystic ovarian syndromes, or diabetes, or simple nutrient deficiencies, but have an impact, and a huge impact on conception, and also pregnancy outcomes later. So, it is extremely important that we give couples clarity and the confidence, also very much at an emotional level.

(3:02) Snehaa : So, in a way, doctor, you’re saying that it’s like laying the foundation before you start building.

(3:06) Dr. Teji Dawane : Exactly. It’s that one appointment, which helps you plan smarter, and avoid any kind of surprises that you would be completely unexpecting. And it’s always better to be one step ahead of, you know, any problems that you could possibly face.

(3:22) Snehaa : So, doctor, when is the right time to book a preconception appointment? Should couples start right after marriage or wait till they are ready to try?

(3:30) Dr. Teji Dawane : See, honestly, Sneha, the earlier the better, because it’s especially if you’re planning to, you know, thinking of starting a family in a year or two, it’s just not about age. It’s also about giving yourself time to optimize your health, because these lifestyle changes don’t happen in a day, right? You need some time to get into a proper routine, to get into, you know, to get acclimatized to the food changes, and whatever you’re going to, whatever we expect.

(3:57) Dr. Teji Dawane : So, guidance changes age group wise. So, a couple, if you see who are in their late 20s, who are just getting started, might just need a simple, you know, lifestyle tweaks, and simple changes here and there. But if you’re post mid 30s, or early 40s, you may also have to look at some advanced tests, we may have to prior itself, you know, try to look at ovarian reserves, egg quality, or any chronic conditions, which may impact pregnancy and its outcome.

(4:26) Snehaa : So, doctor, do you think people get surprised in these sessions or what kind of, you know, to-do list they have to do, you know, before they’re trying a baby?

(4:45) Dr. Teji Dawane : All the time, Sneha, all the time, you know, people are not expecting to land up in problems or having troubles. But we do see a range of problems from very mild insulin resistance to low folic acid levels. And even these small nutritional deficiencies make a big difference later, if caught early.

(4:52) Snehaa : So, doctor, we have spoken about the women’s perspective of staying healthy and fit. What advice would you like to give the men there when it comes to preconception counseling?

(5:02) Dr. Teji Dawane : Very important, Sneha. Actually, the role of men, if you see, has evolved, you know, like my father really never knew when my mother went for her tests and what happened and, you know, we were just born. But now the times have changed. Men are also very aware, they are very involved in the whole process. And because, and it’s very nice because, you know, when a couple says that we are pregnant, now it’s no longer that the lady is pregnant.

(5:28) Dr. Teji Dawane : So, it brings about a bonding between them too. So, men also play a very important role because nowadays, you know, the roles are almost equal and both of them are sharing responsibilities and both of them are sharing, you know, the whole journey of the pregnancy. So, preparation also likewise has to be shared, you know, both of them have to be equally on the same page emotionally.

(5:53) Dr. Teji Dawane : You know, it shouldn’t be that, you know, she’s ready, he’s not or he’s maybe or things like that because it’s a very beautiful journey and this journey really is going to impact even the pregnancy outcomes, you know, how they are welcoming the baby. So, emotional aspect is definitely something we want to look at nowadays with the extreme level of stress, maybe at work, of travel, maybe, you know, because the lady is possibly closer to home but the husband has to travel with all the traffic. So, all of that definitely adds. So, emotional preparation is very important.

(6:27) Dr. Teji Dawane : That also said, we also have to prepare men physically because there are various ways, you know, men usually have various ways to de-stress. So, it could be, you know, men may be turning to smoking, men may be turning to alcohol, men may be, you know, other habits or maybe even… So, even passive smoking, Sneha, is something which will really impact. So, maybe but they don’t realize, you know, men don’t realize that these things actually would have an impact. So, it is possibly good that they listen from us, you know, what are the things that they need to change in their day-to-day lifestyle which would actually impact because it’s not that they’re doing it knowingly, they may also do it unknowingly.

(7:07) Dr. Teji Dawane : So, that is also extremely important and along with that, the nutritional deficiencies, you know, because we are seeing a surge of diabetes in men also. It’s a huge surge. Hypertension and due to stress and blood pressure issues in men. So, all of this has an impact on the quality of the sperms and it’s also about performance, you know.
It’s also about, you know, men not being able to haveintercourse properly. So, all these aspects have to be looked up on and we also give a very… we have a very holistic approach here at Motherhood and we make sure that, you know, both couples are looked after and they are on the same page when they are planning pregnancy.

(7:48) Snehaa : So, doctor, do you have any personal stories to share while, you know, you are seeing a lot of couples who are coming for preconception counseling? Any such instances where, you know, you have changed a couple’s perspective of, you know, getting pregnant? Would you like to share some? Yeah, definitely Sneha.

(8:06) Dr. Teji Dawane : Many instances, but what really comes up at the top of my head is, a very recently, very young couple came to the OPD, maybe early 30s, 33-34 year olds, both of them working IT professionals and they came for preconception counseling. They’ve been married a couple of years and they want to have a baby, low risk. And then, so when, you know, we finished the examination and then I was advising some tests and all of that, the basic ones, of course, because they were low risk.

(8:38) Dr. Teji Dawane : And then is when the wife told me that, you know, doctor, we have already done some tests. So, I said, okay, good. So, if you’ve done your basic workup, so I already have the report, so maybe follow-ups may not be required. So, I started going through the reports and then when I looked at all the reports, I realized that the basic tests were not there, you know, the minimum thyroid, the sugars and all of that, but they had done an advanced fertility panel. And that is something we, you know, recommend for couples who have been trying or maybe, you know, 40 years of age and, you know, or high risk group, you know. And so, I was really surprised. I said, okay, I mean, why was the advanced fertility panel asked for?

(9:21) Dr. Teji Dawane : And did somebody advise it? And have you already met somebody? So, they said no. I mean, we looked up a little bit online at Google and then we also looked up, you know, the tests that the lab was offering and there was a panel which said advanced fertility panel and we did the test. And then she started saying that, but doctor, if you see all my reports are, you know, out of the charts and all my hormones are majorly, you know, imbalanced and what do I do? I’m completely, you know, I don’t know what to do.

(9:56) Dr. Teji Dawane : How do I go ahead? So, I simply asked her this. So,I said, see what time of the period, what time of your menstrual cycle the tests were done, what time. So, you know Sneha, these things are so important because, you know, the knowledge that is offered by labs and all of that is up to a certain extent, you know, up to Google also is going to offer you and that actually unnecessarily gives you a lot of stress because these hormonal panels, all the other tests have a particular timing of your menstrual cycle that you need to be doing it because the hormones are going to vary accordingly.

(10:29) Dr. Teji Dawane : So, just before your periods the hormones are going to be, you know, different during your ovulation cycle, it’s going to be different just following your periods. So, they vary according to the timeline, you know. So,and if you randomly do it, it’s definitely going to be haywire, it’s definitely going to be out of, so it is very difficult for me, I mean, to sit there and I was trying to undo the stress that the tests have caused the couple because following the test they were so stressed.

(10:55) Dr. Teji Dawane : They were like I have major imbalances, I need a lot of treatment and all of that. So, this is something I really wanted to put forward because I would always suggest that, you know, you visit the doctor before doing any kind of advanced fertility test because if you really would require it, we will be suggesting it. But then there are certain timelines to when to do the test, duration, you know, even when you’re doing it in the early morning, when you’re doing it in the evening.

(11:20) Dr. Teji Dawane : So,there is a certain time to do the test and, you know, and whether you need to do it empty stomach, whether full stomach, all of those simple changes. Even I’ll tell you, Sneha, home collection is the biggest, I know everyone’s looking after convenience, everyone wants to not to travel and all of that, but hormones are the, see now the person who is going to come to collect your sample, he’s not coming only for you, he’s going to have 10 other houses. Now, hormones are all heat sensitive.So, with the weather here in Bangalore, with the temperatures going up, do you think they have maintained the cold chain? They might have not even maintained it properly and if he’s going to roam around in the heat with your samples, aren’t they going to change? Absolutely, doctor. So, hormones are extremely heat sensitive. They have to be done in a lab.

(12:08) Dr. Teji Dawane : Do not do home collection. Yeah, your simple sugar you want to check, you want to check your hemoglobin level, blood group, all that is fine. So, this home collection, this matter of convenience has now become a problem for us because then we have to redo the tests and we have to and then undo the stress also that the couple has faced following all of this. So, simple things, but they really go a long way in impacting your mental health when you’re planning a baby.

(12:35) Snehaa : So, doctor, let’s do a quick rapid fire round. Are you ready for it? Yes, let’s go ahead.
Snehaa :If the couple is healthy, they don’t need a preconception counseling. Is it a myth or a fact?
Dr. Teji Dawane : Definitely a myth, Sneha. See, even healthy women can have many undetected issues.
There is always an entity called a subclinical issues, you know, where you may not have clinical major symptoms. Simple things like vitamin B deficiencies or any kind of minor hormonal imbalances, but go a huge impact, you know, go a long way in planning pregnancy.

(13:07) Snehaa : Only women with fertility issues need this.
Dr. Teji Dawane : No, no, definitely a myth. So, it’s about preparation. It’s not about, you know, problems per se. It’s about how you can be better prepared and how you can optimize your health before getting pregnant.

(13:22) Snehaa : Men don’t have to change anything for conception.

Dr. Teji Dawane : Huge myths. So, when we look at couples, when I have patients who have come alone, I actually send them back saying, you know, it’s always better to come as a couple because men also have to undergo a lot of changes. They also have to undergo a lot of, you know, it’s about sperm health. It’s about diet. It’s about stress management. It’s about alcohol, simple things like that. And of course, it’s also about, you know, emotional well-being, you know, where pregnancy is a phase where you’re going to bond over a baby. So, you have to establish that bond well in advance and both of you. So, nowadays couples say, we are pregnant. It’s no longer that I am pregnant. So, it’s about bringing a newborn. So, it’s about being together as a family. So, it’s always has to be done as a unit.

(14:08) Snehaa : One appointment is enough for preconception preparation. D

Dr. Teji Dawane : Definitely a myth again. Follow-ups, extremely important. We may have to, you know, order some tests, some basic examinations that we may require and if that needs to be corrected, then you have to come back for a follow-up and we need to, you know, do simple changes which can adequately optimize your health.

(14:29) Snehaa : And the final statement, doctor, is preconception care is only for older women.

Dr. Teji Dawane : No, definitely not true. Nowadays, thanks to all the lifestyle changes, the dietary changes, we are seeing quite a few of issues even in young women, even in adolescent age group and starting from then. For example, women with PCOS or even irregular cycles, they benefit so much from preconception counseling.

(14: 52) Snehaa : So, Dr. Teji, one key message you want to share with the couples who are wondering if preconception care is really worth it?

(14:59) Dr. Teji Dawane : Definitely, So, our take-home message would be that one consultation can really save you months of stress and avoidable complications and it helps you to give the best start possible because we want to do the best for our baby, right? So, we want to make sure that you give best health emotionally and physically and just think of it as starting your GPS before you hit the road.

(15: 22) Snehaa : Love that analogy. Thank you so much, Dr. Teji.

(15:24) If today’s episode brought you clarity, subscribe to The Care Circle for your very own expert-led safe space. Follow us on social media for updates and exclusive content. Until next time, stay healthy and take care.