Part 2 of 6 in the "Can I see a TCM practitioner while preparing for pregnancy" series. Part 1 covers what this stage is and how long before you see a doctor; part 3, what three of these checks are looking for.
"Which pre-pregnancy checks do we actually need?" It is the most practical question once the decision is made, and in Malaysia there is an existing framework for the answer.
Malaysia's Ministry of Health Perinatal Care Manual sets out a pre-pregnancy visit as three parts: history taking, physical examination, and clinical laboratory tests. This part puts what each usually includes, and where it belongs, into one table.
The short version
- The manual sets out a pre-pregnancy visit as three parts: history taking, physical examination, clinical laboratory tests.
- In Malaysia, pre-pregnancy care at a government health clinic (Klinik Kesihatan) is integrated into the existing maternal and child health and outpatient services; at hospital level it is coordinated by the O&G specialist clinic — that is the manual.
- Six items on the table: history and examination, blood tests, thalassaemia, rubella and vaccination, folic acid, and the medication and supplement list.
- The table is "what is usually included", not "what you need". Which items apply to you is the decision of the doctor you see. The same goes for dose — this article states none.
- Severe abdominal pain, heavy bleeding, or fever with lower abdominal pain: call 999 now, or go to the nearest hospital emergency department.
I. In one table: what pre-pregnancy checks usually include, and where each belongs
In Malaysia, pre-pregnancy care at a government health clinic (Klinik Kesihatan) is integrated into the existing maternal and child health (MCH) and outpatient services; at hospital level it is coordinated by the O&G specialist clinic — that is how the manual divides it.
| Item | What it usually includes | Where it belongs | When to see a doctor first |
|---|---|---|---|
| History and examination | History taking and physical examination; the manual's first-assessment form records height, weight, BMI and blood pressure | Government health clinic or family doctor | Women with chronic conditions such as diabetes, hypertension, thyroid disease, epilepsy and asthma are listed in the manual as target groups for pre-pregnancy assessment |
| Blood tests | The manual's first-assessment form lists haemoglobin (Hb) and a Pap smear; the manual also states that diabetes and hypertension screening should be offered at least annually | Government health clinic or family doctor | An abnormal result is followed up by the doctor |
| Thalassaemia | What it checks is whether each partner is a carrier: the Ministry of Health's Family Health Development Division explains that a carrier shows none of the features of a person with the disease, and that status is known only through screening. The manual's pre-pregnancy arrangement is that if either partner is a carrier, there is referral to a family medicine specialist or O&G for counselling, and screening of the untested partner | Government health clinic | A family history, or a previous child with a genetic disorder, places you in the manual's genetic-counselling group |
| Rubella and vaccination | What it checks is immunity: the NHS says rubella caught during pregnancy could harm the baby, and that the vaccine is not suitable in pregnancy. The manual's arrangement is that if you are not immune, vaccination is offered together with contraception, because pregnancy is contraindicated for three months after vaccination; hepatitis B vaccination history is also asked | Government health clinic or family doctor | If you are unsure of your immunity, the manual says a Rubella IgG test confirms it |
| Folic acid | The purpose is to prevent neural tube defects, as the manual puts it — a problem with the brain or spine, or both, such as spina bifida, as the NHS explains it. The manual says folic acid supplementation should be emphasised to all women at least 3 months prior to a pregnancy | Available at a pharmacy counter (Guardian, Watsons and the like); ask your doctor which dose | The manual sets different doses for specific medical histories — so the dose is your doctor's decision for your situation |
| Medication and supplement list | The manual's antenatal history explicitly asks for "drug history (traditional medication and other self-prescribed medicines)" | Both sides: one copy for the doctor, one for the practitioner | If you take prescribed medication (including hormone-related medication), never stop it on your own |
This table is "what is usually included", not "what you need". Which items apply to you is the decision of the doctor you see.
The last item on the table is the only one that goes to both sides: one copy for the doctor, one for the practitioner. How detailed that list needs to be, and how to read the registration number on the packaging, are in part 4.
Three of the six have a logic worth knowing — why thalassaemia screens both of you, why rubella is tested then waited out, why folic acid starts ahead of time. That is part 3.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
First, the things that cannot wait
Severe abdominal pain, heavy bleeding, or fever with lower abdominal pain — call 999 now, or go to the nearest hospital emergency department. The NHS's pelvic inflammatory disease page puts pelvic pain that is severe or getting worse, pelvic pain with heavy bleeding from the vagina, and a very high temperature at the call-999 tier; the same page describes pelvic inflammatory disease as an infection that affects the womb, fallopian tubes and ovaries.
Periods absent for a long stretch or a marked change in the cycle, bleeding between periods or after sex — get this checked. Vaginal bleeding that is unusual for you, including bleeding between periods and during or after sex, is listed among the symptoms of cervical cancer by the NHS.
The full list, and the reason for four of them, are in part 6. TCM and Western medicine complement each other; it is not a choice between them.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
In Malaysia, where these start
- Government health clinic (Klinik Kesihatan). The manual states that pre-pregnancy care is integrated into the MCH and outpatient services there; most of the items in the table above can start here.
- Pharmacy counter (Guardian, Watsons and the like). Folic acid is available over the counter; ask your doctor or the pharmacist about the dose. Over-the-counter medicine and supplements bought there go on the list too.
Frequently asked
Which pre-pregnancy checks should we do? The Ministry of Health manual's frame is history, examination and laboratory tests; the form carries BMI, blood pressure, haemoglobin and a Pap smear. Rubella immunity, thalassaemia (if one partner is a carrier, the other is screened) and folic acid at least 3 months ahead sit alongside — all of those are the manual's. Which apply to you is your doctor's decision. The full table is above, and part 3 explains what three of the items are looking for.
The words in this part
- BMI (身体质量指数) — a figure worked out from weight and height. The manual's first pre-pregnancy assessment form has a field for it, beside height, weight and blood pressure.
- Pap smear (子宫颈抹片) — a test on a sample taken from the cervix. The manual's first pre-pregnancy assessment form lists it beside haemoglobin under laboratory investigations.
- Haemoglobin (Hb, 血红蛋白) — the oxygen-carrying protein in blood, written Hb on a report, in g/dL. The manual's first pre-pregnancy assessment form lists it.
- Genetic counselling (遗传咨询) — professional counselling about genetic questions. The manual lists couples with a family history of a genetic disorder, or a previous child with one, as those who should be counselled for possible genetic problems.
The other five parts
- Part 1: Can I see a TCM practitioner while preparing for pregnancy — what this stage is, and how long before you see a doctor
- Part 3: What three of those checks are looking for — thalassaemia, rubella, folic acid
- Part 4: The advice that applies to both partners, and the options a consultation raises
- Part 5: How TCM theory reads this stage — 天癸 and 冲任
- Part 6: When to see a doctor first
👉 If you are not sure which item on this table to arrange first, the pre-pregnancy checks themselves should be arranged by a family doctor or an O&G; for the routine-and-general-state side, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you.
Sit with a licensed TCM practitioner from wherever you are.
HansMed Modern TCM
For general wellness education only — not medical advice. Consult a registered TCM practitioner for personal guidance.
Sources
- Ministry of Health Malaysia, Perinatal Care Manual 4th Edition (released May 2023), Chapter 1: Processes and Procedures of Pre Pregnancy Care; Appendix 1-3 Pre Pregnancy Risk Factors; Appendix 1-4 First Assessment of Pre Pregnancy Care; Appendix 1-8 Pre Pregnancy Health Education; Chapter 2 booking history; Section 5.1.2 Thalassaemia in Pregnancy — https://hq.moh.gov.my/bpkk/images/PERINATAL_CARE_MANUAL_4th_Edition_2020_11Mei2023.pdf
- Kementerian Kesihatan Malaysia, Bahagian Pembangunan Kesihatan Keluarga (Family Health Development Division), Soalan Lazim — Topik Thalassaemia (BM; site footer © 2023) — https://hq.moh.gov.my/bpkk/index.php/soalan-lazim.html
- NHS (UK), Rubella (german measles), page last reviewed 13 March 2026 — https://www.nhs.uk/conditions/rubella/
- NHS (UK), Pregnancy vitamins and supplements, page last reviewed 3 June 2026 — https://www.nhs.uk/pregnancy/keeping-well/pregnancy-vitamins-and-supplements/
- NHS (UK), Pelvic inflammatory disease, page last reviewed 17 December 2025 — https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
- NHS (UK), Cervical cancer — Symptoms, page last reviewed 4 September 2024 — https://www.nhs.uk/conditions/cervical-cancer/symptoms/
