Planning a pregnancy is, to a large extent, an oxymoron. It's difficult to predict exactly when one will get pregnant, let alone the week-to-week changes of pregnancy and the sometimes roller-coaster of emotional and physical developments that come with a new pregnancy.
Despite the unknowns, being prepared is always a good idea. We at Women's Healthcare Associates are happy to review your history and make recommendations for future pregnancy during a preconception counseling visit. Often, this is when new patients first meet their obstetric provider. Some of the things that may be covered during this visit include diet and lifestyle, family and medical history, medications you are taking and your past pregnancy history.
1. Establish Healthy Diet and Exercise Habits
Pregnancy can place a great deal of stress on your body, and eating a healthy diet and exercising regularly is one way to give yourself and your baby a head start. Being overweight can predispose you to pregnancy and childbirth complications, such as gestational diabetes, preeclampsia or high blood pressure during pregnancy; preterm birth; neural tube defects; and increased risk of cesarean section. Being underweight is also associated with an increased risk of having a low birth weight baby and preterm birth. Talk to your obstetric provider about your weight and whether or not it’s a concern.
2. Make Healthy Lifestyle Choices
Other lifestyle behaviors, choices and issues, such as smoking and alcohol and drug use can have harmful effects on fetal and child development. They can also contribute to pregnancy complications, such as intrauterine growth restriction and placental abruption. You should stop using tobacco, alcohol and recreational drugs before trying to get pregnant. If necessary, your obstetric provider can refer you to someone for help with this. If you have significant exposure to environmental toxins, such as lead, mercury or radiation at your workplace, you may also want to address this before getting pregnant.
3. Supplement Smartly
It is important to begin taking folic acid daily before you get pregnant. While folic acid is plentiful in a healthy diet that includes leafy green vegetables, a daily supplement of 400 mcg is recommended in women prior to and during early pregnancy. This can decrease the risk of neural tube defects or spina bifida. Some women may need more than 400 mcg of folic acid, or an iron supplement, as well. In contrast, some vitamins can be harmful if taken in excess. Talk to your obstetric provider if you are taking other supplements or herbal products.
4. Discuss Any Medical Issues or Medications
Discuss any medical problems or prescription or over-the-counter medications you are taking with obstetric provider. Certain medical problems can either be affected by or can affect a pregnancy. These include (but are not limited to) asthma, diabetes, heart disease, thyroid disease and autoimmune disorders. Don’t stop taking any prescription medications without consulting with your doctor, as some medications are actually important to continue taking while you are pregnant. Others, such as anti-seizure medications, blood thinners and acne medications, may need to be discontinued before getting pregnant, as some are known to cause birth defects or miscarriage.
5. Review Your Family, Genetic and Pregnancy History
Your family history and genetic history may also play a role in your pregnancy. You may want to consider genetic screening prior to pregnancy. Previous pregnancy history should also be reviewed, including miscarriages, especially if you had any complications, such as preeclampsia or diabetes, or if you had a previous cesarean section.
6. Assess Your Infection Risk
Finally, some infections can contribute to birth defects. If you are at risk for sexually transmitted diseases, you may need testing and treatment. Other infections, such as rubella or chicken pox, can cause birth defects if you are newly infected while pregnant. If you are not up to date on your vaccinations, the best time to do so is before becoming pregnant as some vaccinations may not recommended during pregnancy.
While you can’t script your pregnancy any more than you can accurately predict what your child is going to be like, you can certainly try to give yourself and your pregnancy the best chance possible for a healthy outcome. We are here to help to achieve that. Contact one of our offices to schedule a preconception counseling visit >
Dr. Laura Morrison is a board-certified OB/GYN physician and surgeon who sees patients at the Peterkort South office of Women’s Healthcare Associates in Portland, Oregon. She received her master’s and medical degrees from the University of Michigan in Ann Arbor, where she also completed her OB/GYN residency. Dr. Morrison is particularly interested in vulvar health, adolescent gynecology, preventive women's health and delivering babies.
Sources: Image - Pregnancy and Baby