I. Contents of pre-pregnancy health care services (1) Health education and counseling Warmly receive couples, explain the importance of pre-pregnancy health care, and introduce the contents and procedures of pre-pregnancy health care services. Through inquiries, lectures and the distribution of health information, health education services are provided to couples preparing for pregnancy. The main contents include knowledge about physiological and psychological health care; basic knowledge about fertility (such as the process of conception of life, etc.); the effects of lifestyle, pre-pregnancy and pregnancy exercise patterns, diet and nutrition, and environmental factors on fertility; and the prevention and treatment of birth defects and hereditary diseases. (ii) Health status examination Through counseling and pre-pregnancy medical examination, a preliminary assessment of the health status of the couple preparing for pregnancy is made. Advice is given on the existence of health problems that may affect fertility. Pre-pregnancy medical examination (including physical examination, laboratory and imaging and other auxiliary examinations) should be carried out on the basis of informed choice, and the privacy of the service users should be protected at the same time. 1. Understanding the general situation. Understand the health status of the couple preparing for pregnancy and both family members, focusing on inquiries about fertility-related pregnancy and childbirth history, disease history, family history, lifestyle, diet and nutrition, occupational status and working environment, exercise (labor), psychosocial and interpersonal relationships, etc. (see Annex 1). 2. Pre-pregnancy medical examination. On the basis of health education, counseling and understanding of the general situation, with the consent of both husband and wife, medical examinations are conducted to grasp the basic health status of the couple preparing for pregnancy. At the same time, special examinations are conducted for diseases that may affect fertility. Physical examination: carried out in accordance with routine operations, including specialized gynecological and male examinations of the reproductive systems of both men and women. Auxiliary examination: It includes routine blood test, blood type, routine urine test, blood sugar or urine sugar, liver function, secretion of reproductive tract, electrocardiogram, chest X-ray and gynecological ultrasound. Hormone examination and semen examination if necessary. Specialized examination: including serious hereditary diseases, such as thalassemia in Guangdong, Guangxi and Hainan; infectious diseases and sexually transmitted diseases that may cause fetal infections, such as hepatitis B and tuberculosis; infections of toxoplasmosis, rubella virus, cytomegalovirus, herpes simplex virus, syphilis spirochete, HIV and so on; psychiatric disorders; and other illnesses affecting pregnancy such as hypertension and heart disease, diabetes mellitus, thyroid disease, etc. (iii) Health guidance A comprehensive assessment of the health status of pre-pregnancy health care recipients is made on the basis of general information and the results of pre-pregnancy medical examinations. Following the principle of combining universal guidance and personalized guidance, couples planning to become pregnant are given guidance on pre-pregnancy, early pregnancy and prevention of birth defects. The main contents include: 1. Prepared and planned pregnancy, avoiding older births; 2. Reasonable nutrition, dietary control, supplementation of folic acid, iodine, iron, calcium and other nutrients and trace elements; 3. Inoculation against rubella, hepatitis B, influenza and other vaccines; timely measures against viruses and infectious diseases that have already been infected; 4. Actively preventing, screening and treating chronic and infectious diseases; 5. Reasonable use of medication, avoiding the use of medications that may Avoid contact with toxic and harmful substances in the living and occupational environment (e.g. radiation, high temperature, lead, mercury, benzene, pesticides, etc.), and avoid close contact with pets; 7, change bad habits (e.g. smoking, drinking, drug use, etc.) and lifestyles; 8, maintain mental health, relieve mental stress, and prevent the occurrence of psychological problems during pregnancy and postpartum; 9, reasonably choose the mode of exercise; 10, for those with high hereditary risk, the use of medication should be reasonable, avoiding the use of medication that might affect the normal development of the fetus For couples with a high genetic risk, guidance is given to them to make the relevant preparations and remind them of what may happen during pregnancy and prenatal checkups. II. Implementation of pre-pregnancy health care services (a) Strengthening organizational leadership Health administrative departments should strive for the attention of government leaders, cooperate with relevant departments such as population and family planning, civil affairs, women’s federations, federations of the handicapped, education, culture and radio and television, and actively support health care institutions to carry out pre-pregnancy health care services. Areas with the means to do so can actively cooperate with departments of civil affairs and population and family planning, and widely contact newlyweds to publicize preconception health care to every couple preparing to become pregnant, through community health-service institutions or residents’ committees. Health administrative departments at all levels may, in the light of the actual situation, formulate measures for the implementation of preconception health-care services and service specifications, and establish relevant management systems and service assessment standards; organize technical steering groups consisting of business leaders in obstetrics and gynaecology, paediatrics, maternity and child health care, health education and other relevant disciplines, to provide technical training and guidance to preconception health-care service personnel, and to assess preconception health-care service institutions, in order to continually improve the service level. (b) Strengthening management and standardizing pre-pregnancy health care services Health care institutions at all levels shall fully implement and carry out pre-pregnancy health care services in accordance with these Norms. 1. Healthcare institutions may, according to their own actual situation, open preconception healthcare service clinics, and take professionals with good interpersonal communication skills and comprehensive service capabilities as the operational backbone of preconception healthcare services; at the same time, they shall reasonably utilize the existing houses and equipment, and formulate specific preconception healthcare service processes and rules and regulations (see Annex 2). Health-care institutions that are in a position to do so may attempt to provide systematic reproductive health services, such as premarital, pre-pregnancy, pregnancy, childbirth and post-natal health care in a “one-stop shop”. On the basis of the management of health care during pregnancy and childbirth, the management of reproductive health services is being strengthened. 2. Pre-pregnancy health-care data files are being established, and data are being summarized, counted and analysed in a timely manner. Where conditions exist, electronic management should be gradually implemented and linked to the current systematic management of the pregnancy and childbirth period. (3) Maternal and child health-care institutions at all levels should, under the leadership of the health administrative departments, actively explore pre-pregnancy health-care service models that conform to local realities; at the same time, they should effectively undertake technical guidance, training, data collection and summarization of pre-pregnancy health-care services under their own jurisdictions. (iii) Preconception health care publicity The necessity and main content of preconception health care are widely publicized through the use of radio, television, newspapers and magazines, arousing the active participation of the whole society, especially newlyweds and couples preparing to give birth. At the same time, in forms that are pleasing to the public, the “Health Education Action for Hundreds of Millions of Farmers”, the “Healthy Community Tour”, and the “Three Visits to the Countryside with Science, Technology, Culture and Hygiene” have been utilized to bring scientific knowledge about birth defects prevention to rural areas. (c) Utilizing activities such as the “Hundreds of Millions of Farmers’ Health Education Action”, the “Healthy Community Walk” and the “Three Visits to the Countryside in Science, Technology, Culture and Health” to send popular scientific knowledge about birth defects to rural and urban communities, and to guide the public in setting up the concept of “starting before pregnancy to have healthy children”.