Incorporating preconception care into primary care of young women enhances the preventive aspects of care and may improve pregnancy outcomes. The preconception approach to medical care includes optimization of chronic health problems and risks that may impact negatively on pregnancy. Specific preconception issues regarding common chronic disorders are addressed along with antepartum medical care in this chapter. Preconception care of type I diabetic women results in earlier prenatal care, lower glycosylated hemoglobin levels, fewer antepartum hospitalizations and fewer hospital days, and decreased intensity and length of stay for newborns. Perinatal consultation may be helpful as a preconception event in a number of high risk medical conditions and in women with an unexplained history of poor reproductive outcomes. A growing list of metabolic problems and hematological disorders are associated with preeclampsia, growth retardation, abruption, and other complications in late pregnancy.