Preparing for Pregnancy

Having a healthy baby is a joy. Happily, there are ways to prepare for pregnancy that can help assure your baby's health. Even before you conceive, there are things you can learn from your doctor and things you can do yourself that will help you have a healthy baby. It's called "preconception planning," and it's part of a healthy approach to pregnancy.

By working with your doctor before conception and planning ahead for your pregnancy, you can take control of many factors that might otherwise put your pregnancy at risk and could lead to problems with your baby's health. Click here for a list of recommended books to read during your pregnancy, Reading List.

Preconception planning should begin at least three months before you stop birth control or begin trying to conceive, so you'll have time to take control and make health changes, if necessary. Even if this is not your first pregnancy, it is important to plan ahead. This information discusses some of the areas where problems can begin and what you can do to reduce the risk of these problems. As you read through it, make notes about areas that concern you, then use this information as a basis for discussion with your doctor. He or she will play an important role in preconception planning and will always be your best source for information and help before and during your pregnancy.

When a woman misses her period, she may already be two weeks pregnant. If she waits before calling her doctor, she may not get medical advice on pregnancy until eight to ten weeks after she has conceived. It may be several weeks before a doctor can see her and start advising her on how to provide a healthy start for a new baby.

Studies have shown that the first 12 weeks after conception are critical for the fetus. The period of greatest sensitivity for the developing fetus is between the 17th and 56th day (2 to 8 weeks) after conception, when the fertilized egg attached itself to the uterine wall and begins to grow. It is during this period that the fetus' cells organize and differentiate themselves, and vital organs begin to form.

The fetus is extremely vulnerable during this time - a time when you may not even know you're pregnant. That's why it's important to start planning before you conceive, so that even during the first weeks of your pregnancy you'll be giving your baby the best care.

Take Control

Preconception planning gives you the opportunity to prepare yourself mentally as well as physically for the challenges and the joys that having a child will bring. Of course, you can't anticipate everything that may happen during pregnancy or after you give birth. But by taking time to prepare yourself, you can take control as much as possible and increase your chances for a healthy pregnancy.

See your doctor before you start trying to conceive. Don't wait - schedule a preconception planning session with you about 3 to 6 months before you begin trying to conceive.

To help you start thinking about areas of importance, contact us to receive a checklist of questions you can ask yourself. It will help you and your doctor to review all aspects of your lifestyle, eating habits, medical history, and family background. Your partner should do this same, wither with your doctor or with his own doctor. Than you both should discuss with you doctor factors that may present risks to your baby's health - and what you can do about them.

Lifestyle Choices

There are a number of lifestyle behaviors that are harmful to a fetus. These behaviors include smoking, drinking alcohol, and using illicit drugs like cocaine, marijuana, and heroin.

Alcohol - Fetal alcohol syndrome (FAS) is the most common preventable cause of mental retardation in the United States. It is not known exactly what quantity of alcohol consumption results in FAS, or at what stage of pregnancy that consumption is the most dangerous. The best choice is to avoid alcohol entirely; not only while you are pregnant but also while you are trying to become pregnant.

Smoking - The adverse effects of cigarette smoking on pregnancy outcomes have also been documented. They include an increased incident of low birth weight, miscarriage, stillbirth, increased vaginal bleeding during pregnancy, and as increased chance of sudden infant death syndrome (SIDS).

Smoking should be avoided while you are trying to conceive. Secondary smoke from the people around you may also affect your health and the health of your baby. If you or your partner would like to quit, preconception planning gives you a perfect opportunity to ask your doctor about safe, available methods.

Drugs - Illegal "street" drugs also have known effects on pregnancy. Cocaine and heroin use increases your chance of a miscarriage or premature labor, as well as the chance of stillbirth or death among newborns. The use of illicit drugs in general is associated with low birth weight, which can cause mental and physical handicaps.

Exercise - Regular exercise is a lifestyle choice that not only will make you feel better but also will be a big help as your pregnancy progresses. Building muscles in the lower back, stomach, and legs will be especially helpful in making yours a more comfortable and active pregnancy.

Use the time before you conceive to start an exercise program that suits your lifestyle. If you already exercise regularly, most exercise can be continued. Talk to your doctor about how much of the exercise you can be continued throughout your pregnancy.

If you don't exercise already, walking and swimming are excellent choices. You may also wish to learn about prenatal exercise classes in your area. Ask your doctor about the exercise programs they offer.

Nutritional Status How well you eat during pregnancy determines how well your baby is nourished as it develops. But an adequate diet is just as important prior to conception. A mother's pre-pregnancy weight has been shown to affect her baby's birth weight. Therefore, it is important to eat well before pregnancy, and try to attain a weight that is appropriate for your height. What can you do?

Eat well before you conceive. It's best to start a pregnancy as physically healthy as you can be. Go over your diet with your doctor and determine any nutritional deficiencies you may have. Be honest about your eating habits and make as many healthy changes as you can. If you are overweight or underweight, it's best to change that before you start trying to conceive. Special diets may not be appropriate for the first few months of pregnancy. Talk to your doctor about a plan that's right for you.

As with many aspects of pregnancy, common sense is your best guide to determining a healthy diet. Use the four food groups as a basis for putting together a balances meal plan. You should have something from each of the following food groups every day:

• Milk and dairy products
• Meat, poultry, fish, eggs, nuts, and beans
• Whole-grain or enriched bread and cereal
• Fruits and vegetables

Eating sensibly can usually supply all the nutrients needed for a healthy pregnancy. Your doctor, however, may suggest vitamin or mineral supplements, it is important not to take more vitamins than your doctor directs, as large doses of some vitamins can be dangerous. Megadoses of vitamins A and D, for example, have been associated with abnormal fetal development. For a detailed list of foods high in protein and iron please click here, Protein and Iron Rich Foods

Chemical and other toxic exposures Some mothers may not be aware of their exposure to harmful chemicals and toxins that could affect their baby. You should evaluate your workplace and home to determine if you are being exposed to anything that may affect your baby's health. For example, if you work regularly with chemicals or around X-rays, you should take extra precautions to avoid exposure before and during your pregnancy. If you work with chemicals or lead in a hobby, like gardening or ceramics, you could also expose your baby to toxins during pregnancy.

If you have a cat, you may also be at risk for something known as toxoplasmosisa disease caused by parasites that live in certain mammals. You can become infected by coming in contact with cat feces, either in a litter box or in the soil, as well as by eating some raw meats. Have someone else change litter boxes for you, or wear gloves. Infection during pregnancy may cause premature birth or low birth weight.

What can you do?

As part of your preconception planning, you can clean up the prenatal environment. you may decide which hobbies are safe to continue during pregnancy and which ones should be avoided. you can also make a note about house-hold items that should always be handled with caution, like household pesticides.

You and your doctor may also discuss hazards that are of concern to you, like exposure to lead, chemicals, or other toxins. Planning ahead gives you time to clean up your daily environment and evaluate what you should avoid. Remember: the earlier, the better.

Some women have medical conditions that will require special attention and may increase the rise of problems during pregnancy. You should review with your doctor your full medical history in order to identify possible sources of complications. These conditions will be much easier to manage and will pose less of a risk if they are brought well under control before conception.

Studies have shown, for instance, that when careful diabetic control is started before conception and maintained throughout pregnancy, risks to the baby are greatly reduced. Babies born to diabetic women are at an increased risk of being born with certain congenital malformations. Again, the time of greatest risk is the first 12 weeks of pregnancy. If you have a personal history of medical problems, such as asthma, hypertension, heart or kidney disease, you may also wish to discuss how they might affect your pregnancy and how pregnancy might affect you.

Risks can be lowered if you take special care of yourself before becoming pregnant, and during your pregnancy. Talk to your doctor before hand about how you can best reduce the risks to your baby.

What can you do?

Take a moment to review your medical history yourself before you see your doctor. Be prepared to ask questions and answer some. With the right planning, your chance of having a healthy baby will be greatly increased.

Preconception planning can also help eliminate the risk of exposing your fetus to potentially dangerous drugs you may be taking to treat a condition. For example, if you are epileptic, see your doctor before you begin trying to conceive, to discuss your medications and how you can reduce the risks. Babies exposed to anticonvulsant medications used to treat epilepsy may be born with birth defects.

You should also be cautious of any over the counter medication you may take regularly. Acne medicine, aspirin, headache medicine, nasal spray, and cough medicine that may seem harmless to you could be dangerous to your fetus.

What can you do?

Talk to your doctor before you conceive. He or she can help you put together a list of medicines to avoid and advise you on your medication safely.

For additional information, you may download our free informational guide.

Women can also pass along to their babies certain diseases during pregnancy. If a woman is infected, for example, with rubella (German measles) during the first month of pregnancy, there is a 50% chance her baby will be infected as well. If this happens, her baby may develop problems including cataracs (possible leading to blindness), heart defects, and deafness - known together as congenital rubella syndrome.

What can you do?

You can eliminate the risk of passing along some diseases by making sure you are immunized against them before conception. These diseases include rubella, measles, mumps, and hepatitis. Before you become pregnant, discuss your immunization status with your doctor.

It is important to immunize early because some immunizations shots cannot be taken once you are pregnant. Others take time to administer. So plan ahead. Talk to your doctor before you conceive so he or she can schedule appropriate tests and help you map out an immunization plan.

There are a number of diseases transmitted through sexual contact that can be harmful to your fetus. These include syphilis, gonorrhea, herpes, chlamydia, condyloma, and infection with HIV, the virus that causes AIDS.

All of these diseases are prevalent in all population groups, including women. HIV infection is transmitted primarily through sexual intercourse (vaginal, anal, and oral) and the sharing of intravenous (IV) needles for drug injection. It can also be passed through a blood transfusion or from an infected mother to her fetus during pregnancy.

What can you do?

If you have questions about sexually transmitted diseases, HIV infection, or AIDS, talk to your doctor before you conceive. Let your doctor know about any sexually transmitted disease you have had in the past. If you suspect any infection, the only way to be sure you are not infected is to ask your doctor for counseling and testing.

You should also review with your doctor the outcomes of past pregnancies, if you have had any. Do you have a history of miscarriages, cesarean sections, or other complications that might threaten you or a new baby? Your doctor can advise you on precautions you should take.

You should also consider your age before conceiving. If you are over 35 and are planning to conceive, you are not alone. Today, more and more women are delaying childbirth until later in life and having normal, health pregnancies.

Statistically speaking, however, the risk of problems begins to increase after age 35, which is why preconception planning can be particularly helpful. It gives you the chance to review your personal health with your doctor and make your decision accordingly.

What can you do?

Talk to your doctor before you conceive. He or she can best advise you on your personal health and history.

Finally, you should consider genetic disorders that you or your partner may be carrying. You are at risk for disorders of this type if they have appeared anywhere in your family's medical history. In some cases, these disorders are related to specific ethnic groups. Tay-Sachs disease, for instance, is found predominantly among the Jewish population of Eastern European decent and sickle-cell disease among African-Americans. It is important that both you and your partner review your family histories of birth defects or mental retardation.

What can you do?

If you are among a population group at risk, or have a family history of birth defects or mental retardation, talk to your doctor before conception about screening procedures for you and your partner.

If either of you is diagnosed with a genetic disorder, you can discuss with your doctor the chances of you having a healthy baby before deciding whether to conceive. You can also learn about various methods of testing for genetic problems during your pregnancy. These include:

• Amniocentesis - a procedure in which a small amount of fluid is taken from the sac around the fetus and tested.
• Alpha-fetoprotein testing (AFP) - a test using a protein produced by the fetus that can be found in amniotic fluid and in the mother's blood.
• Chronic villi sampling (CVS) - a test involving the small sprouts that develop on the wall of a fertilized egg and become the placenta.
• Ultrasonography - a test using sound waves to produce an image of the fetus in the mother's uterus.

These methods can be used to assure you of your baby's health or prepare you for problems. Ask your doctor to explain how each works.

Your baby's father also directly to the baby's health and can help avoid problems by taking part in your preconception planning. He, too, should review his lifestyle, medical history, and family history, and learn about how his health might affect the outcome of a pregnancy. Genetic factors should be considered, as well as his susceptibility to diseases that might be passed on to you or the fetus. In fact, he needs to learn everything you learn during preconception planning, so he can be supportive once you start trying to conceive.

If he smokes, he should know that smoking may decrease his sperm count and make conception more difficult. he should be aware of the dangers of secondary smoke to you and the fetus. He should also realize that if he smokes during your pregnancy, he could be making it hard for you to quit. Through preconception planning, he can become an even better partner for you before and during your pregnancy, so you can share the challenges and the joys of becoming a mother and father together.

Becoming pregnant is likely to take some time. On average, only about half the couple who are trying to conceive will do so within 6 months. So, have patience. If you think it is taking too long, there are a number of fertility tests that can be performed on you or your partner, and most problems can be overcome.

While you are trying to conceive, your doctor is your best source for information and guidance. However, it's up to you to maintain control and stick to the plans you made with your doctor during preconception planning.

Once you suspect you may be pregnant, the earlier you find out, the better. Knowing you're pregnant means you can take extra care during those important first 12 weeks, when the baby's cells are being organized and a new human life is being formed inside you. There are several ways for you to detect possible pregnancy early, but only your doctor can diagnose pregnancy for sure. He or she will most likely want you to come in for a test as soon after you suspect pregnancy as possible.

The earliest way to find out yourself is with a home pregnancy test that can be used the day you miss your period. A positive test at that time means the fetus is about two weeks old form the time of conception. If you haven't started planning for a healthy pregnancy, now's a good time. See your doctor right away so he or she can begin working with you. If you choose to use a home pregnancy kit, it is important that you use a test both you and your doctor trust. Not all tests are foolproof, so you should talk with your doctor about a test that's right for you.

Long waiting time (2 to 5 minutes) between test steps causes more errors in the reading of home pregnancy tests than any other factor. You should look for a test that requires little or no waiting time before results appear.

The test you choose should also produce unmistakably clear results that you understand. A major source of error is the "half-clear" result, when you're not sure if a reaction has taken place at all.

Read the labels, or ask your doctor or pharmacist to suggest a test that meets all these criteria. Tests are now available that use the same technology found in doctors' offices and laboratories - and confidence in your results at home means you can begin caring for your baby as soon as possible.

Once you get a positive result at home, set up an appointment with your doctor right away. With preconception planning, you'll both be prepared for the news. Then your doctor, along with other health care professionals, can continue to counsel you through the rest of your pregnancy, from preconception to birth, helping you deliver your baby as healthy as can be.

Travel Travel during pregnancy is generally safe, but there are some important guidleines to follow when plannning a trip. As a general rule, don't schedule trips out of town after 32 weeks gestation (ie. 8 weeks before your due date). If you're planning on flying, check on any restrictions the airlines have on flying and whether a letter will be necessary to board the plane. Plan ahead by getting to the airport in plenty of time and have someone help you with your luggage. Airline flight is in itself quite safe in pregnancy, but troubles arise with the stress of travel. Be sure to get plenty of rest during your trip.

If you are traveling by car, make plans to get out of the car every 2-3 hours, since pregnancy is a condition that makes women susceptible to blood clots in the legs. Always wear a seat belt and bring extra fluids to keep yourself hydrated during the trip.

If you are planning on foreign travel during pregnancy, make every effort to do this early in the pregnancy. Check with your travel agent about illnesses endemic to the countries that you are planning on traveling in and what vaccines are necessary. Ideally, vaccines should be given before you become pregnant, however your doctor and you may need to decide whether the risks of a disease are greater than the risk of the vaccine. When traveling to Mexico, avoid contaminated water by drinking bottled water or soft drinks without ice.