A woman’s health in the preconception period is important to ensure a healthy pregnancy and to support the wellbeing of her child. Encouraging positive behaviour change can help to establish a balanced lifestyle for a woman and her family. The first half of this article will cover the initial assessment and general advice that applies to all women who are planning a pregnancy. The second half will explore the preconceptual management of long-term health conditions, and will describe the relevance of genetic risk assessment in pre-pregnancy counselling.