Pre-Pregnancy Planning

Pre-Pregnancy Visit

Choosing to get pregnant and becoming a mother is a big decision that requires lots of thought and planning. Talking to your health care provider before trying to get pregnant is a great idea! You can get expert advice on what you can do to improve your overall health so you can give your new baby the best start at life that is possible. A pre-pregnancy visit with your provider is one of the most important things you can do, especially if you are over age 30. At this visit, you can discuss any nutritional needs or health concerns, including mental health concerns that you may have before becoming pregnant.

Be sure to talk with your provider about your diet, physical activity, smoking, alcohol or drug use, and sexual history. Don't forget to let him/her know if you are being treated by other health care providers, including mental health providers. Review all your medications with your provider, including over-the-counter and prescription medications and ask if it is safe to keep taking them while you are trying to conceive and during pregnancy. If you have diabetes, high blood pressure, an eating disorder, depression, or other chronic or long-term health conditions, talk with your health care provider about how your condition(s) might affect your health and your pregnancy. Don't think that because you have a health condition you will have serious problems with pregnancy. There are things both you and your health care provider can do to help you have a healthy pregnancy and a healthy baby.

Another important thing to discuss with your health care provider is your family health history. You can get genetic counseling before becoming pregnant and possibly be tested for certain genetic conditions, such as Tay-Sachs disease or blood disorders like sickle-cell anemia or thalassemia. Your provider also will talk with you about whether you've had all of your immunizations, especially for Rubella (German measles). If you haven't had chickenpox or Rubella, make sure you are vaccinated at least 3 months before becoming pregnant. You also may want to be screened for Hepatitis B, sexually transmitted diseases (STDs) and toxoplasmosis since these can harm your baby, as well as yourself.

Your health care provider will recommend that you get 400 micrograms or .4 mg of folic acid daily in your diet. Folic acid is the synthetic (man made) form of folate, one of the B vitamins. Research shows that getting enough folate before becoming pregnant and during pregnancy, especially during the first trimester, can greatly reduce the risk of certain birth defects. Because it is hard to get the amount of folate you need daily through diet alone, your provider can prescribe a daily prenatal vitamin that contains 400 micrograms of folic acid. You can also increase foods rich in folate in your diet, like leafy green vegetables, kidney beans, orange juice and other citrus fruits, peanuts, broccoli, asparagus, peas, lentils, and whole grain products. When synthetic folic acid is added to certain grain products, including flour, rice, pasta, cornmeal, bread, and other cereals, these foods are considered "fortified" with folic acid.

Lifestyle Changes

It is very important to have a healthy lifestyle when you are thinking about becoming pregnant and when you are pregnant. Here are some things you can do to improve your overall health:

• Eat a healthy diet that includes fruits, vegetables, grains, and calcium-rich foods. Choose foods low in saturated fat.

• Unless your health care provider tells you not to, try to be physically active for 30 minutes, most days of the week. If you are pressed for time, you can get your activity in through 10-minute segments, three times a day.

• If you have a cat, do not handle the cat litter. It can carry toxoplasmosis, a parasitic infection that can cause birth defects. Wear gloves while gardening in areas where cats may visit.

• Don't eat uncooked or undercooked meats or fish.

• If you smoke, drink alcohol, or use drugs, STOP. These can cause long-term damage to your baby. Talk with your health care provider about steps to take to stop smoking. Talk with a member of your faith community, a counselor, a trusted friend, or your health care provider if you are concerned about your alcohol or drug use.

• Stay away from toxic chemicals like insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Most dangerous household products will have pregnancy warnings on their labels.

• Avoid hot tubs, saunas, and x-rays.

• Limit or eliminate your caffeine intake from coffee, tea, sodas, medications, and chocolate.

• Get informed. Read books, watch videos, go to a childbirth class, and talk with experienced moms.

Planning Conception

While planning to conceive, you may choose natural planning methods such as the ovulation method (intercourse takes place just before or after ovulation) or the symptothermal method (evaluating fertility based on your daily temperature). Remember: women are more likely to become pregnant if intercourse takes place just before or just after ovulation. This is because the unfertilized egg can live for only 12-24 hours in your body. If you have been trying for a few months with no results, don't get discouraged. Only 20% of women who are trying to get pregnant are successful on the first attempt, so don't lose hope or assume something is wrong.

Infertility

It is important to note that women today are often delaying having children until later in life, when they are in their 30s and 40s. While many women in their 30s and 40s have no difficulty getting pregnant, fertility does decline with age. For women over 40 who cannot achieve pregnancy after six months of trying, it is recommended that they see their health care provider for a fertility evaluation.

It is not uncommon to have trouble becoming pregnant or experiencing infertility (inability to become pregnant after trying for one year). Overall, there are about 2.1 million married couples in America experiencing infertility, and some 9 million women have used fertility treatments. If you think that you or your partner may be infertile, you can discuss this with a health care provider who can recommend treatments such as drugs, surgery, or assisted reproductive technology.

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