Prenatal Care Planning a Pregnancy

Planning a pregnancy soon?  There are several steps you can take before trying to get pregnant to get you and your baby off to a healthy start:

    * Begin taking a prenatal vitamin with at least 400 mcg of folic acid daily several months before you plan to get pregnant.  Folic acid lowers the risk of some birth defects of the brain and spine.  There is some evidence that taking higher doses of folic acid (800 mcg) may be beneficial, but this is not totally clear.

    * Stop smoking and drinking alcohol.  Many women are easily able to quit drinking alcohol as soon as there is a chance of pregnancy.  Smoking may be more difficult, so quitting should be planned before pregnancy.  Also, smoking adversely affects fertility.

    * If you have a medical condition, be sure it is under control.  Pregnancy can be affected by many chronic diseases including diabetes, high blood pressure, asthma, depression, and seizures.  Make an appointment with your doctor to discuss optimal management and the medication changes needed for pregnancy.

    * Discuss all medications with your doctor to determine their safety in pregnancy. Even discuss over-the-counter medicines, vitamins, and herbal supplements.

    * Be sure your vaccinations are up to date.  Many vaccine-preventable infections can be devastating in pregnancy.  You may need a booster of tetanus, pertussis, chicken pox or other vaccines.  Your doctor may do a blood test to see if you need a rubella booster. A flu shot may be recommended.

    * Avoid contact with toxic substances at work and at home. Stay away from chemicals and cat or rodent feces.

    * Do not eat raw or undercooked meat or seafood.  The risk of food-bourne infections are greater in pregnancy.

    * Monitor your seafood intake.  Large amounts of seafood in the diet increase your exposure to mercury, especially if you eat certain types of fish.  Women who are planning pregnancy should avoid shark, swordfish, king mackerel, tilefish, and golden bass.  The effects of mercury from eating seafood are not fully understood, but doctors recommend this limit as a precaution.

    * But make sure you get enough seafood! Mercury concerns have caused some women to believe that they should avoid all seafood during pregnancy.  Wrong!  Be sure to get 2-3 servings of fish per week.  If you eat less than that, you will not be getting essential fatty acids for you and your baby's development.  Some studies suggest that the health benefits of seafood for unborn babies outweigh the risks of mercury exposure.  Healthy fish for pregnant women are salmon and canned light tuna.  If you do not eat seafood, your doctor may recommend a supplement with DHA (important fatty acid found in fish).

    * Know your family history and that of your partner.  This is important for everyone, but especially for couples planning to start a family.  Genetic disease such as cystic fibrosis, sickle cell disease, and mental retardation may be in the family, but not frequently discussed.  A family history of some medical conditions (such as a propensity to form blood clots), are important to women because it may increase the risk of pregnancy complications.

    * Maintain a healthy weight.  Overweight women have more pregnancy complications.  Work to get your weight under control and continue or start to exercise regularly before the pregnancy, so you have established healthy habits that can be maintained during your pregnancy.