If you've decided the time is right to
get pregnant, you've likely already begun
emotionally preparing yourself for a lifelong
commitment to your child. But before you try to
conceive, take time to ensure that your body is
equally well prepared for the task ahead.
The preconception visit: An important first step
Begin your preparations for pregnancy by
scheduling a preconception appointment with your
doctor, your nurse-midwife or another medical
doctor. This allows him or her to assess your
overall health and helps you map out lifestyle
changes that may improve your chances for a
healthy pregnancy and baby. This visit also
gives you and your partner a chance to ask
questions and discuss any concerns you may have.
A preconception checkup typically includes a
complete physical examination. You have blood
tests to check your immunity to infections —
such as chickenpox (varicella) and German
measles (rubella) — that can cause serious birth
defects or illness in your baby. If you aren't
immune to these infections, your doctor may
vaccinate you. The American College of
Obstetricians and Gynecologists recommends that
after being vaccinated you wait at least one
month before
trying to get pregnant.
Also be prepared to talk with your doctor about:
Current and past health issues. If you have an
ongoing medical condition such as diabetes,
asthma or high blood pressure, it's best to have
it under control before you get pregnant. This
reduces the risks for both you and your baby.
You and your doctor can determine what changes,
if any, are necessary to bring your condition
under control before you attempt to become
pregnant. Even if you've had no problem
maintaining your health for some time, you may
require special care during
pregnancy. A growing baby can put new
demands on your body.
Medications. Some prescription, over-the-counter
and herbal medications can harm a growing baby.
Tell your doctor about all the medications,
herbs or supplements you're taking. He or she
may recommend you stop taking certain
medications or change doses before you become
pregnant.
Family history. Some health conditions, such as
diabetes, high blood pressure and seizure
disorders, tend to run in families. If a close
relative has a certain condition, you or your
baby could be at greater risk of having it. To
assess your risk, your doctor asks you and your
partner a number of questions about your family
medical history.
Certain medical conditions are genetic
disorders, meaning that they're passed from
parent to child through DNA. Examples include
sickle cell anemia, cystic fibrosis and Duchenne
muscular dystrophy. Even if you don't have the
disorder yourself, you may carry the defect in
your genes and can pass it along to your baby.
Your ethnicity or family history can affect the
risk of passing on a genetic disorder. If it's a
concern, your doctor may refer you to a genetic
counselor — a health care professional trained
to assess the risk of inherited disorders. For
some conditions, genetic screening can provide
important information about the risk of disease
in a child. If you or your partner is of
Ashkenazi Jewish heritage, for example, you may
benefit from screening for Tay-Sachs, Canavan
and Gaucher diseases. If you're
African-American, consider screening for sickle
cell anemia. If you're of Asian descent, you may
want to think about screening for
alpha-thalassemia. If you're of European
descent, consider screening for cystic fibrosis.
Age. If you're age 35 or older, you're at
increased risk of fertility problems,
miscarriage and certain chromosomal disorders in
your child, such as Down syndrome. Some
pregnancy-related problems, such as high blood
pressure and gestational diabetes, also occur
more frequently among mothers who are age 35 and
older. Discuss these risks with your doctor and
develop a plan for avoiding complications.
Previous pregnancies. Your doctor may ask you
about previous pregnancies, including any
problems you might have had. This discussion is
especially important if a prior pregnancy was
complicated by high blood pressure or diabetes
or if you had premature labor, if you had a
preterm birth or if your baby was born with a
birth defect. In some cases, your doctor can
help you take preventive steps that increase the
likelihood that future pregnancies will be
healthy. At the very least, the discussion
allows you to air any of your existing concerns
or fears.
Adopt a healthy lifestyle
Preparing for pregnancy is an excellent reason
to improve your health. To give your future baby
the best possible start in life:
Don't smoke. Smoking decreases a woman's chance
of conceiving and can reduce a man's sperm
count. Women who smoke during pregnancy tend to
have babies with lower birth weights than
nonsmokers, and these babies may have
developmental problems. Their babies are also
three times as likely to die from sudden infant
death syndrome (SIDS) as are the babies of
nonsmokers. In addition, smokers have a higher
incidence of tubal (ectopic) pregnancy and
stillbirths.
It's very important that both of you stop
smoking. Regular exposure to secondhand smoke
may reduce fetal growth and therefore increase
your chances of having a low-birth-weight baby.
At birth, low-birth-weight babies are more
likely to have low blood sugar (hypoglycemia)
and trouble maintaining their body temperature
(hypothermia). Low birth weight also increases a
baby's risk of chronic disabilities, such as
cerebral palsy, mental retardation and learning
problems.
Smoking is an addiction and can be difficult to
stop. If you're ready to stop, ask your doctor
for help. This is especially important if you're
interested in using products such as nicotine
patches or gum. Your doctor will be eager to
help you stop smoking anytime, but there are
more tools available before you get pregnant.
Avoid alcohol. No level of alcohol consumption
has been proven safe during pregnancy. In fact,
prenatal alcohol exposure can cause birth
defects in the early weeks of your pregnancy,
before you even know you're carrying a child.
Drinking alcohol may also decrease a woman's
ability to conceive and increase the risk of
miscarriage.
In the most extreme cases, excessive drinking
during pregnancy results in fetal alcohol
syndrome. Babies born with this condition can
have severe long-term problems including mental
retardation, learning disabilities and
behavioral problems.
It's important for men to resolve any problem
drinking before pregnancy begins. There's
increasing evidence that heavy drinking can lead
to low sperm counts. But more importantly, your
baby's safety, security and happiness require
that you and your partner are free of alcohol
problems.
Eat a healthy diet based on a variety of foods.
All of your growing baby's nutritional
requirements come from you. If you're eating too
few calories or too few nutrients, cell
development may be less than ideal and your baby
may be underweight at birth, increasing his or
her risk of short- and long-term health
problems.
If your diet is lacking in iron, calcium, folic
acid or other essential vitamins and nutrients
or you often skip meals, make some changes now.
Reduce your intake of foods with little
nutritional value, artificial sweeteners and
caffeine. Drinking more than two caffeinated
beverages a day, in fact, may make it more
difficult for you to get pregnant. Opt instead
for protein-rich foods, fruits, vegetables,
whole grains and dairy products. If you're
overweight and want to shed some pounds, do so
before you become pregnant. Pregnancy isn't the
time to start a weight-reduction diet.
Before trying to conceive, begin taking a daily
vitamin that contains at least 400 micrograms of
folic acid. Studies show that folic acid in this
quantity offers significant protection against
neural tube birth defects, such as incomplete
closure of the spine (spina bifida) or a
partially or completely missing brain
(anencephaly). If you begin taking folic acid
after you find out you're pregnant, the
protection may not come soon enough. Neural tube
defects occur in the first four weeks of
pregnancy, before you may realize you're
pregnant.
Exercise. Moderate exercise can increase your
fitness, reduce stress and help prevent health
problems, such as heart disease and high blood
pressure. And if you get in the habit of
exercising now, you're more likely to enjoy its
benefits during pregnancy. Many women find that
exercise eases the constipation, backaches,
fatigue and varicose veins common with
pregnancy.
If you're not used to exercising, work with your
doctor to develop a plan that's right for you.
Trying to conceive
Once you've prepared your body to provide a
baby-friendly environment, you're ready to begin
the pursuit of pregnancy. The first step: Stop
using birth control. If you've been using birth
control pills, it may take several months for
your menstrual periods to return to a regular
pattern. If you use injectable contraception,
such as Depo-Provera, this delay is quite
probable. Until regular periods begin, it's more
difficult to pinpoint when ovulation — the time
in which your ovaries release an egg into your
fallopian tubes — occurs or to estimate a due
date if you do become pregnant. If conception
occurs before your regular
menstrual period have started again, your
doctor should use ultrasound to establish the
dating of the pregnancy.
In order for you to become pregnant, you and
your partner must have sexual intercourse within
three days (72 hours) of the egg entering the
fallopian tube. Your partner's sperm can
fertilize your egg hours after ejaculation, but
your egg is fertile for only a very brief period
of time. Your best chance of becoming pregnant
is generally 12 to 14 days before your next
menstrual period is due.
Between 80 percent and 90 percent of couples who
are trying to conceive become pregnant within a
year. But about 10 percent to 20 percent of
couples won't. If you're unable to become
pregnant after a year of unprotected
intercourse, you, your partner or both of you
may have a
fertility problem. Your gynecologist, your
partner's urologist or your family doctor may be
able to help. In some cases, your doctor may
recommend a specialist or clinic that treats
infertility problems.
Preconception planning: A smart choice
In pregnancy, as in life, some things are out of
your control. But you can reduce the risk of
complications — both for you and for your future
baby. Seek preconception care from your doctor
and make healthy lifestyle changes. By doing so,
you're one step closer to your ultimate goal —
delivering a healthy baby.
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