Preconceptional Care - Planning for Pregnancy

Good health is always important, but it’s especially so if you are planning on becoming pregnant.   Making healthy choices can help to improve your quality of life, reduce some risks to you and your baby, and help you feel your best before, during and after your pregnancy.  It’s important to let your physician or midwife know if you are planning a pregnancy.   Schedule an office visit to help identify any risk factors you may have.  At that point, you can discuss your current lifestyle choices and medical history so that everyone is working together for the greatest benefit to you and your baby.

Your Daily Lifestyle

There are many things that you do every day that can have an effect on your pregnancy.  Diet and exercise, your habits, and your home and work environments are some of the things your physician or midwife will discuss during your appointment. 

Your Diet

Since it’s best to be at a healthy weight before your pregnancy, your physician or midwife may suggest changes in your diet to achieve your maximum wellness.  Whether you need to lose or gain weight, the physician or midwife can give you the best information on how to do so.  Most women need about 2500 calories per day during pregnancy.The USDA Food Guide Pyramid is a good resource to help you choose a balanced diet.  Your physician or midwife may recommend that you go online at http://www.mypyramid.gov/mypyramidmoms/ and follow the My Pyramid Plan for Moms link to get a personalized plan for nutrition during your pregnancy.The physician or midwife will also need to know about the vitamins, herbs and supplements, if any, that you are currently taking.   You may need to make some temporary changes as your body’s needs change.  The provider may recommend that you take a folic acid supplement.  Folic acid has been proven to help reduce the risk of neural tube defects, a birth defect of the central nervous system, including the spinal cord and brain, which results from the failure of the neural tube to properly close during the development of the fetus.  Folic acid occurs naturally in many foods, including citrus fruits, dark leafy greens, peas, beans, whole grains, and organ meats.

Your Fitness Level

Exercise is an important part of a healthy lifestyle.  The more physically fit you are before conception, the more likely you will be able to sustain an active life comfortably during your pregnancy.   Walking and swimming are the most recommended forms of exercise during pregnancy, but if you are physically fit and used to more strenuous sports, your physician or midwife may give you the green light to continue those workouts. 

Your Habits

Most of us have habits we would like to break.  However, some habits are addictions in disguise that are harmful to you and can be especially harmful to your baby.  These include smoking, drinking alcohol, and taking illegal drugs.   Smoking can cause many problems for you and your baby. Among those problems are premature birth, which can result in many future health problems for your child, and the premature rupturing of the membranes that hold the amniotic fluid.  There is also an increased risk of SIDS (Sudden Infant Death Syndrome) for the children of smokers. Alcohol and illegal drug use can result in irreparable damage to your baby, including mental retardation and many other birth defects.  It’s best to be honest with your physician or midwife if you have a problem with either. Right now is the time to end those habits, or at least cut down on your use.  If you need help doing so, tell your physician or midwife.  There are often programs and treatments available to help you.

Your Environment

Your provider needs to know about anything in your home or work environment that may affect your fetus.   This can be anything from domestic violence to exposure to harmful chemicals at work.  If you are experiencing abuse at home, you need to know that an abuser generally will not stop just because you are pregnant.  Injuries that may be minor to you under normal circumstances could result in great harm to your baby.  For the sake of your baby, tell your physician or midwife or someone you trust if you are being abused; they will help you contact the many support services that are available.You should also tell the physician or midwife about your exposure to chemicals at home and at work.  It will be necessary to limit your exposure to such things as paint, pesticides, cleaning solvents and others once you become pregnant. 

Other Important Information

There are several other very important factors that you and the physician or midwife must discuss.  These include your family health history as well as any current medical concerns.

Health History

If your provider doesn’t already know your family history, you will be asked about diseases that may run in your family, such as diabetes, heart disease, high blood pressure, and others.  If your history suggests that genetic testing would be helpful, you may be referred to a genetic counselor.  The counselor will help to assess the possibility of birth defects in your child by:

• evaluating your family history and medical records
• ordering genetic tests if necessary
• evaluating the results of this investigation
• helping you to understand and reach decisions about what to do next

Genetic tests are done by analyzing small samples of blood or body tissues. They determine whether you, your partner, or your baby carry genes for certain inherited disorders.If you have had a pregnancy resulting in more than one miscarriage, or a child born with a birth defect, genetic counseling is highly recommended. 

Current Medical Concerns

There are many medical issues that can pose a health risk to your baby and must be resolved or controlled before you attempt to become pregnant.  Be sure that the physician or midwife knows about:

• Any health problems, such as high blood pressure, diabetes, asthma or cardiovascular disease. The provider can help you to get them under control before you become pregnant.  These conditions will have to be carefully monitored during your pregnancy.
• Any medicine you are currently taking, either prescription or over-the-counter.
• Your immunizations and vaccinations history.  If you have not been vaccinated for childhood diseases such things as rubella, measles, mumps and chicken pox, your physician or midwife needs to know.  You should also be up-to-date on your tetanus and flu shots, and there may be others based on your risk factors.
• Any possibility of a sexually transmitted disease.  Since some types of birth control protect you from certain STDs, if you are attempting to become pregnant, you may increase your risk.  These diseases, besides possibly harming your baby, can also affect your ability to become pregnant.   If you have more than one sexual partner, or if you think you may have been exposed to an STD, the physician or midwife will have recommend the proper testing and necessary treatment.  You should not be sexually active until the disease has been treated. 

For more information on STDs, including symptoms, go online to http://www.mayoclinic.com/health/std-symptoms/ID00053.     

Last But Not Least, Be Certain That You Are Ready!

Parenting can be joyful, rewarding, and demanding. As you watch your child grow, you may also grow to understand yourself better. Parenting not only takes a lot of love, it also takes a lot of energy and patience. The needs of your child will constantly change. Your job will be to figure out what those needs are and do your best to meet them.

Here are some questions to think about:

• Am I ready to make any needed changes in my diet and lifestyle in order to have a healthy pregnancy and healthy child?
• Am I ready to cope with a tighter budget, less time for myself, and more stress?
• Do I have the support of family and friends?
• Am I ready to accept responsibility for all my child's needs?

If you can answer yes to all of these questions, you are probably ready to become a parent!  We at Smoky Mountain OB/GYN are looking forward to sharing this wonderful and joyous time of your life with you.