Article produced in association with London Pregnancy Clinic and Jeen Health

For many years, formal clinical involvement in a pregnancy began at the point of confirmation, typically around eight to ten weeks.

The concept of the ‘0th trimester’ represents a shift in thinking: that the period before conception is itself a clinically significant window, during which health optimisation, risk identification and informed planning can meaningfully improve pregnancy outcomes.

Guidance from Tommy’s and the NHS both recommend pre-conception care as part of responsible reproductive health management.

What Pre-Conception Care Involves

Pre-conception care is not a single test or appointment. It is a structured approach to assessing and optimising a woman’s health before she attempts to conceive.

The NHS guidance on planning a pregnancy recommends a range of measures including taking folic acid, reviewing medications for safety in pregnancy, ensuring immunity to rubella and chickenpox, and addressing pre-existing conditions such as thyroid disorders, diabetes or high blood pressure before conception occurs.

General pre-conception assessments typically include blood pressure and BMI review, full blood count and iron levels, thyroid function, immunity screening (rubella, varicella), vitamin D status and cervical screening if overdue.

For women with existing conditions, specialist review before pregnancy is often more valuable than specialist referral during it.

Fertility Investigations as Part of the 0th Trimester

For women who are planning a pregnancy but have concerns about fertility, pre-conception investigations provide information that informs planning rather than leaving uncertainty unaddressed.

Clinics offering 0th trimester services, including London Pregnancy Clinic, provide investigations including hysterosalpingo-contrast-sonography (HyCoSy) to assess tubal patency, follicle tracking scans, anti-Mullerian hormone (AMH) testing to estimate ovarian reserve, and endometrial assessment.

These tests do not guarantee conception but they provide a clinical foundation from which fertility decisions can be made with better information.

Genetic Assessment in Pre-Conception Care

The genetic dimension of pre-conception care is increasingly central to a thorough 0th trimester assessment.

Genetic carrier screening before pregnancy allows couples to identify their carrier status for conditions such as cystic fibrosis, SMA and a range of other inherited disorders before conception, giving them time to consider their options with appropriate clinical support.

At-home carrier testing offered by Jeen Health provides access to comprehensive carrier screening without the need for a clinical referral.

Couples collect their sample at home and receive results within a defined timeframe.

When both partners carry a variant in the same gene, the result can be followed up with genetic counselling via clinics such as London Pregnancy Clinic, where clinical specialists can contextualise the findings and explain the available options.

Lifestyle and Nutritional Factors

Pre-conception health is not limited to clinical testing.

Lifestyle factors including physical activity levels, nutritional status, alcohol consumption and smoking all influence fertility and early fetal development.

Pre-conception care provides an opportunity to address these factors proactively rather than as an afterthought following a positive test.

Folic acid supplementation, recommended at 400 micrograms per day in the pre-conception period and the first trimester, is one of the most evidence-supported interventions available.

Why Timing Matters

Many of the interventions that benefit pregnancy are most effective when started before conception rather than after.

Addressing thyroid dysfunction, normalising blood pressure, treating iron deficiency anaemia, and identifying genetic risks all have a higher potential impact when managed from the outset rather than detected at the first antenatal appointment.

The 0th trimester framework provides a way of thinking about pre-conception care as a structured medical period with its own clinical agenda, rather than simply a waiting room for the first trimester.

What a Pre-Conception Appointment Might Look Like

A comprehensive pre-conception assessment with a specialist provider would typically cover a clinical consultation reviewing medical and family history, a pelvic ultrasound scan, blood tests for general health markers and fertility hormones, cervical health review if indicated, and a discussion of genetic risk including a recommendation for carrier screening if appropriate.

For couples with specific concerns about fertility or genetic history, specialist investigations can be added to this baseline assessment.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment.

Clinical guidance referenced reflects published NHS, NICE and RCOG standards as at March 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article.

This piece was produced in association with London Pregnancy Clinic and Jeen Health, which provided background clinical information for editorial purposes.

Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

Article produced in association with London Pregnancy Clinic and Pouch Health

A woman attending a private pregnancy scan will often leave her appointment with a printed photograph and a verbal summary of findings.

The detailed report, together with the full image set, may follow by email days later, or may require a login to a clinical portal that is not accessible from a mobile device.

For women managing their antenatal care across multiple providers, including both private clinics and NHS community midwifery, accessing a coherent record of their pregnancy health has historically required considerable effort.

Pouch Health is a digital health platform that was developed specifically to address this problem.

Where Pouch Health Came From

The idea for Pouch Health emerged from direct clinical experience at London Pregnancy Clinic, a private fetal medicine and pregnancy scanning centre that sees hundreds of patients per month across its City of London and West London sites.

The clinical team identified a recurring pattern: patients arriving without their previous scan reports, results being held in disconnected systems, and families unable to share imaging with other members of their care team at key moments.

The app was built as a practical response to these observed gaps, not as a standalone consumer product.

What the Platform Does

Pouch Health is an all-in-one pregnancy companion app.

Its central feature is the Digital Pouch, a personal health record where users can store and access their scan reports, blood test results, appointment summaries and clinical correspondence from any internet-connected device.

The platform is designed to be the single place where a woman’s complete antenatal record lives, accessible to her and shareable with whoever is involved in her care.

The app also includes a week-by-week pregnancy development tracker and a moderated community forum where users can connect with other expectant parents.

These features extend its role beyond records management into broader pregnancy support, though its clinical records function is the most significant from a healthcare perspective.

Tricefy Integration and Real-Time Image Access

London Pregnancy Clinic uses Pouch Health in conjunction with Tricefy, a secure cloud-based imaging platform, to deliver scan images and reports to patients immediately after their appointment.

When a scan is completed at the clinic, images are transferred to Tricefy and made accessible to the patient through Pouch Health, typically within minutes.

This means that patients leave their appointment with their full image set already accessible on their phone rather than waiting for a physical copy or a delayed digital delivery.

The clinical significance of this goes beyond convenience.

When a patient attends a subsequent appointment at a different provider, such as an NHS community midwife or a hospital consultant, having immediate access to their imaging enables more productive clinical conversations and reduces the risk of information being lost at care transitions.

Patient Data Ownership in Antenatal Care

The shift towards patient-held records in the NHS has been a stated goal of digital health policy for some years. NHS England’s digital health commitments include expanded access to patient records through the NHS App.

In the private sector, Pouch Health represents a parallel development: a patient-first approach to data that does not depend on institutional systems granting access, but gives patients control of their own record as a default rather than an exception.

For women receiving care across private and NHS settings simultaneously, this has practical value.

Rather than each provider holding a fragment of the clinical picture, the patient holds the whole record and shares it selectively with whoever needs it.

This model reduces duplication, improves continuity and aligns with the direction of travel in both NHS and private digital health.

A Reported Gap in the Care Experience

An article published by Future Female Health described Pouch Health as a direct response to the fragmented nature of the pregnancy care journey, noting that the app was developed by a team with first-hand clinical experience of the problem it was designed to solve.

This grounding in clinical reality distinguishes Pouch Health from technology products developed without a primary care context.

What This Means for Patients at London Pregnancy Clinic

Patients attending London Pregnancy Clinic receive access to Pouch Health as part of their clinical experience. 3D scan images, anomaly scan reports, NIPT results and fetal wellbeing assessments are all made available through the platform.

For patients who also access care through NHS pathways, the ability to present a complete and current clinical record at every appointment improves care coordination and reduces the administrative burden that typically falls on the patient.

For the wider FemTech sector, Pouch Health illustrates a broader trend: the most effective digital health tools are frequently those built by practitioners who have experienced the clinical problem they are trying to solve.

Technology that emerges from the consultation room rather than the conference room tends to address the right problems.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS, NICE and RCOG standards as at March 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with London Pregnancy Clinic and Pouch Health, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

Women with diabetes are less likely to get preventive care than those without the condition, a UCLA-led study suggests.

The findings are based on an analysis of more than 40 studies from several countries.

They highlight how physicians largely overlook the importance of these routine services for women who have diabetes mellitus, or DM, putting them at risk of preventable medical conditions such as pregnancy complications.

Lauren Wisk is associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and senior author on the study.

She said: “These findings are important because they identify that women with diabetes are not receiving recommended well-woman care, which is essential to support both managing their diabetes and their overall health.

“Providers need to be aware that they should not forget to provide these essential services for women with diabetes.”

The researchers sifted through thousands of studies, focusing on the concepts of women, diabetes and women’s health services, and settled on 44 that addressed treatment services for women aged 15 to 49 with type 1 or type 2 diabetes, excluding those with diabetes insipidus or gestational diabetes.

They looked at four preventive health service categories: contraceptive counselling and use, breast and cervical cancer screening, pre-conception counselling, and screening for sexually transmitted infections.

One study found that 48 per cent of women with diabetes received contraceptive services compared with 62 per cent of women without the disease.

Nine papers showed cervical cancer screening rates ranging from 38 to 79 per cent for women with diabetes compared with 46 to 86 per cent for those without diabetes.

Four studies found that breast cancer screening rates for women with diabetes ranged between 38 and 69 per cent compared with 54 and 82 per cent for those without diabetes.

Fourteen studies found pre-conception counselling rates of just over 1 per cent compared with 46 per cent for women with diabetes who are planning to get pregnant.

The researchers did not identify any studies on screening for sexually transmitted infections, which they said represents “a substantial gap in the literature.”

The researchers wrote: “One of the more striking findings of this review is the importance of robust coordinated care teams in ensuring access to appropriate services for women with DM.

“Several of the identified studies provide support that a co-management model, or the concept of involving endocrinology, primary care, and other specialty care providers in the care of individuals with DM, as recommended by the American Diabetes Association, is associated with greater receipt of services.”

Within the time constraints of an office visit, primary care physicians are expected to address preventative health needs as well as chronic disease management, said Dr Lisa Kransdorf, an associate clinical professor of medicine at the Geffen School and a study co-author.

She said chronic disease management will often take priority.

“In cases where the patient has other providers such as specialists and clinical pharmacists actively involved in their chronic disease management, there is opportunity for primary care physicians to attend to preventative care gaps,” the researcher added:

There are some limitations to the findings.

The search yielded only 44 studies, many of which relied on patient recall, which can be unreliable, highlighting the need for further research.

In addition, most of the studies analysed had small sample sizes or were conducted at a single site, limiting how applicable the findings might be in other settings.