Your Health before Pregnancy
Discuss any
chronic medical problems you have with your healthcare provider. You may
need extra care before and during pregnancy. Some common chronic
medical problems are discussed below.
Anemia
Anemia
means you do not have enough hemoglobin in your blood to carry oxygen to
your body’s cells. Symptoms include weakness, fatigue, shortness of
breath and pale skin.
Iron plays an
important part in anemia. It’s possible to develop anemia during
pregnancy because the baby makes great demands on your body for iron. If
you have low iron levels, pregnancy can tip the balance and make you
anemic.
If you have a family history of anemia (such as sickle-cell disease or thalassemia), discuss it with your healthcare provider before
you get pregnant. If you take hydroxyurea, discuss whether you should
continue using it. We don’t know whether this medication is safe during
pregnancy.
Asthma
Most asthma
medications are safe to take during pregnancy, but talk to your
healthcare provider about your medication. Try to get asthma under good
control before trying to get pregnant.
Bladder or Kidney Problems
Bladder
infections, such as urinary-tract infections or UTIs, may occur more
often during pregnancy. If a urinary-tract infection is not treated, it can cause an infection of the kidneys, called pyelonephritis. Kidney stones may also cause problems during pregnancy.
If you’ve had
kidney or bladder surgery, major kidney problems or if your kidney
function is less than normal, tell your healthcare provider. It may be
necessary to evaluate your kidney function with tests before you become
pregnant.
If you have an
occasional bladder infection, don’t be alarmed. Your healthcare provider
will decide whether further testing is necessary before you become
pregnant.
Celiac Disease
Celiac disease
affects the small intestine and interferes with nutrient absorption. It
occurs when you eat gluten, which is found in foods made from white
flour, wheat, barley, rye and oats. If you have celiac disease, discuss
any intestinal problems you have.
It’s best to
have the disease under control for 1 to 2 years before pregnancy to help
heal your digestive tract. Better nutrient absorption helps ensure the
good health of you and your baby. If you can manage your celiac disease
and take in enough of the nutrients your body needs before pregnancy,
you decrease your risks of problems.
Diabetes
It may be harder for you to become pregnant if you have diabetes. If your diabetes is not under control when you get pregnant, the risk increases of having a child with a birth defect.
Most healthcare
providers recommend having diabetes under control for at least 2 to 3
months before pregnancy begins. Get your blood sugar under control,
manage blood pressure, reach a healthy weight and take care of any other
problems you may have. When it isn’t under control, you increase the
chance of problems. Many problems occur during the first trimester (the
first 13 weeks of pregnancy).
Pregnancy may
increase your need for insulin. Being pregnant increases your body’s
resistance to insulin; some oral antidiabetes medications can cause
problems for your baby. You may have to check your blood sugar several
times a day.
If
you’re diabetic, you may have more prenatal visits and more testing
during pregnancy. Your healthcare provider may have to work very closely
with the healthcare provider who treats your diabetes.
Epilepsy and Seizures
Before you become
pregnant, talk to your healthcare provider about therapies for treating
epilepsy. Some anticonvulsant medicine shouldn’t be used during
pregnancy. If you take several medications in combination, you may be
advised to take only one.
Seizures can be
dangerous to a mother and baby. It’s important for you to take your
medication regularly and as prescribed by your healthcare provider. Do
not decrease or discontinue any medication on your own!
Heart Disease
Consult your
physician about any heart condition before you become pregnant. Some
heart problems may be serious during pregnancy and may require
antibiotics at the time of delivery. Other heart problems may seriously
affect your health. Your healthcare provider will advise you.
High Blood Pressure (Hypertension)
High blood
pressure, or hypertension, can cause problems for a pregnant woman and
her growing baby. If you have high blood pressure before pregnancy,
you’ll need to work with your healthcare provider(s) to lower your blood
pressure. If necessary, start exercising now and lose any extra weight.
Take blood-pressure medication as prescribed.
Some high-blood-pressure medications are safe to take during pregnancy; others are not. Do not stop or decrease any medication on your own! If you’re planning pregnancy, ask your healthcare provider about your medication.
Lupus
Lupus
treatment is individual and may involve taking steroids. There is an
increased risk of problems in women with lupus, which requires extra
care during pregnancy.
If
you take methotrexate, discontinue it before you try to get pregnant.
But don’t just stop taking it. Talk to your healthcare provider so you
can plan alternative treatment.
Migraine Headaches
About 15 to
20% of all pregnant women suffer from migraine headaches. Many women
notice fewer or less-intense headaches while they’re pregnant. If you
take medication for headaches, check with your healthcare provider now
so you’ll know whether the one you take is safe to use during pregnancy.
Rheumatoid Arthritis (RA)
If you have
rheumatoid arthritis, talk to your healthcare provider about the
medicine you take to treat your disease. Some medication can be
dangerous to a pregnant woman. Methotrexate should not be used during pregnancy because it may cause miscarriage and birth defects.
Thyroid Problems
Thyroid
problems can appear as either too much or too little thyroid hormone.
Pregnancy can change medication requirements, so you should be tested
before pregnancy to determine the correct amount of medication for you.
You will also need to be checked during pregnancy.
Back Surgery
If you’ve
had back surgery, discuss pregnancy plans with your surgeon. If you had
surgery on your lower back, you may be advised to wait 3 to 6 months
before trying to become pregnant. If you had fusion surgery, the wait is
often 6 months to a year.
Why
wait? Waiting lets your back heal before taking on the stress of
pregnancy. You may have fewer problems or complications. Be sure to
check with your surgeon before you plan to become pregnant.
Current Medications
It’s important
for you and your healthcare providers to consider the possibility of
pregnancy each time you are given a prescription or advised to take a
medicine. When you’re pregnant, many things change with regard to
medication usage.
Medicine that is
safe when you aren’t pregnant may have harmful effects during pregnancy.
Most organ development in the baby occurs in the first 13 weeks of
pregnancy. This is an important time to avoid exposing baby to
unnecessary or harmful substances. You’ll feel better and do better
during pregnancy if you have medication use under control before you try
to get pregnant.
Be Careful with Medications
Before pregnancy, play it safe with medicines. Keep in mind the following.
• If you use birth control, don’t stop unless you want to get pregnant.
• Take prescriptions exactly as they are prescribed.
• Tell
your healthcare provider if you think you might be pregnant or if you
are not using birth control when a medication is prescribed.
• Don’t self-treat or use medicine you were given for other problems.
• Never use someone else’s medication.
• If you’re unsure about taking something, call your healthcare provider before you use it!
Some medicine is
intended for short-term use, such as antibiotics for infections. Others
are for chronic or long-lasting problems, such as high blood pressure or
diabetes. Some medications are OK to take while you’re pregnant and may
help make your pregnancy successful. Other medications may not be safe
to take during pregnancy.
Vaccinations
When you have a
vaccination, use reliable contraception. Research shows it’s better to
receive vaccinations for various diseases before you get pregnant than during pregnancy. Some vaccinations cannot be given to pregnant women; others can.
At your
prepregnancy visit, ask your healthcare provider if you’re up to date on
your vaccinations. A good rule of thumb is to complete vaccinations at
least 3 months before trying to get pregnant.
Vaccinations are
usually most harmful in the first trimester. If you need a vaccination
for rubella, MMR (measles, mumps, rubella) or chicken pox before you get
pregnant, experts recommend you wait at least 4 weeks after receiving
it before you try to get pregnant.
An
exception to this rule is the flu vaccine; you can get it at any time
during pregnancy. However, don’t get the nasal mist type of flu
vaccine—it’s not advised for pregnant women. If you’re advised to take
the flu vaccine because of your job or for some other reason, go ahead.
It will help protect you and baby.
