Preparing for Pregnancy (part 1) : Your General Health, See Your Healthcare Provider before Pregnancy

Your General Health

In the past, the emphasis was to be healthy during pregnancy. Today, most experts suggest looking at pregnancy as lasting 12 months or more instead of just 9 months; this includes a 3-month preparation period.

Some medical experts now suggest all women of childbearing age should live their lives as if they were trying to get pregnant. Why? Because 50% of all pregnancies are unplanned. That means half of all mothers-to-be may not have been taking the best care of themselves, which could impact the baby. Live every day as if this is the day you get pregnant, and you’ll help make certain any child you give birth to has a good start in life.

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Prepare for Pregnancy

There are a lot of things you can do to get ready for pregnancy. Reach your ideal weight. Overweight women often have more pregnancy complications. Underweight women may have a harder time getting pregnant.

Eat lots of fruits and vegetables. Choose foods low in saturated fat to help keep your metabolism healthy.

Begin exercising regularly, and stick with it. Exercise 30 minutes a day, at least 5 days a week. Exercising before and during pregnancy can help you feel good for the entire 9 months.

See your healthcare provider to talk about any medicine you take regularly. If you have medical problems, get them under control. Schedule medical tests before you stop contraception. Be sure you’re up to date on vaccinations. Have your immunity to rubella and chicken pox checked. If you need vaccinations, find out how long you have to wait after you have them before you try to get pregnant.

Find out your HIV status. Know your blood type and the blood type of your baby’s father. Together with your partner, write down your family medical histories.

Ask your healthcare provider to check your iron level. Iron deficiency before pregnancy could make you feel more tired. Get a thyroid test.

Check your cholesterol level; reduce high levels by eating foods high in fiber and low in saturated fat. High cholesterol may contribute to high blood pressure during pregnancy.

Take time off the pill—at least 3 months. Keep a record of your fertility cycle by using charts. Or check your fertility cycle with ovulation-predictor devices.

Start taking prenatal vitamins, and stop taking your daily multivitamin. More is not better in this situation. Take folic acid—400mcg/day is recommended—to help prevent some types of birth defects. Taking folic acid before pregnancy gives you protection during the first 28 days of pregnancy, which is very important.

Stop taking aspirin and ibuprofen. Instead, use acetaminophen (Tylenol)—this may help reduce chances of miscarriage. Be careful about taking some herbs, such as St. John’s wort, saw palmetto and echinacea; they may interfere with conception.

Have a dental checkup, and have any treatments you need. Get gum disease under control; if you have it during pregnancy, it may increase your risk of problems.

Stop smoking. Avoid secondhand and third-hand smoke. Stop drinking alcohol. Stay away from hazardous chemicals at work and at home. Reduce stress in your life.

Tip for Prepregnancy

Even though you aren’t pregnant, treat your body as if you were. When you do get pregnant, you’ll be on the right track for eating, exercising and avoiding harmful substances.

Some of the above actions may be hard to begin during pregnancy. If you know you’re healthy, you won’t have to worry about the risks they may pose while you’re pregnant.

See Your Healthcare Provider before Pregnancy

See your healthcare provider before you get pregnant. Have a checkup and discuss pregnancy plans. You’ll know when you do get pregnant, you’re in good health.

Your general medical history will be covered. You may be asked many things about your health and lifestyle. Your answers provide clues as to what needs to be done once you do get pregnant to keep you healthy.

Your healthcare provider will ask you about your gynecologic history. Answer all questions as clearly and honestly as you can. Answers help him or her understand how pregnancy may affect you. Areas often covered include date of your last menstrual period, how long your cycle lasts, the age at which menstruation began, questions about Pap smears and any STDs you may have had. A pregnancy history will also be taken.

If you have had any type of surgery in the past, you’ll be asked about it. Previous Cesarean delivery or other surgeries may affect your pregnancy, so be sure to share this information.

The Father-to-Be

A father-to-be can have an impact on his partner’s ability to get pregnant and to have a healthy pregnancy.

Your healthcare provider will also want to know about your family’s medical history, especially on your side of the family. Talk to your mother, aunts and sisters about pregnancy complications they may have had. It’s good to know if anyone in the family had twins, triplets or more. If birth defects occurred, get as much information as possible about them. If there is a history of any inherited problems in your family or your partner’s family, let your healthcare provider know.

Be prepared to talk about any medicine you take and any tests you may be having. Cover all medical problems you’re being treated for. Include all over-the-counter medicines, herbs, supplements and vitamins you may use. It’s easier to answer questions about these things before you get pregnant rather than after you are pregnant.

Don’t be surprised if you’re asked about your lifestyle and any substances you take or use. These include cigarettes, alcohol, illicit drugs, legal drugs you may be using, your exercise program, your job and chemical substances you may be exposed to at work or at home. Domestic violence may also be addressed because it can often appear for the first time, or it can escalate, during pregnancy.

Be honest in your answers; your healthcare provider is trying to evaluate your situation. Concealing facts because you’re embarrassed or scared doesn’t help you or the baby you hope to conceive.

You may have heard a couple shouldn’t have sex too often when they’re trying to conceive. A new study states having sex several times in one week may actually increase a man’s sperm production by as much as 30%.

If You Have Problems

The odds of getting pregnant in any menstrual cycle are about 20 to 25%; nearly 60% of all couples conceive within 6 months. But if you have trouble getting pregnant, talk to your healthcare provider. If you’re over 35 and have had trouble getting pregnant, your healthcare provider may be able to advise you about lifestyle changes and other factors that could increase your chances.

If your menstrual cycle is longer than 36 days or shorter than 23 days, ovulation may be an issue. Your healthcare provider can advise you of various ways to determine whether you are ovulating and when you ovulate.

Tests for You

Have a physical exam before you get pregnant. A Pap smear and a breast exam should be included in this physical. Lab tests may include tests for rubella, blood type and Rh-factor. If you’re 40 or older, a mammogram is also a good idea.

If you think you may have been exposed to HIV or hepatitis, ask about testing. If you have a family history of other medical problems, such as diabetes, ask about tests to rule them out. If you have a chronic medical problem, such as anemia, your healthcare provider may suggest other tests.

Ask for a pregnancy test before having any test involving radiation, including dental work. Tests involving radiation include X-rays, CT scans and MRIs. Use reliable contraception before these tests to make sure you’re not pregnant. Schedule a test right after the end of your period. If you need a series of tests, continue birth control.

Possible Prepregnancy Tests

Your healthcare provider may do a lot of tests to identify any problems that could affect your pregnancy. You can deal with them now instead of later. The following tests may be done at a prepregnancy visit. You may have had some of them in the past, and they may not need to be repeated:

• a physical exam

• pelvic exam and a Pap smear

• breast exam (mammogram if you are at least 40)

• rubella (German measles) and varicella (chicken pox)

• blood type and Rh-factor

• HIV/AIDS (if you have risk factors)

• hepatitis screen (if you have risk factors)

• vaccination and immunization screens

• screening for sexually transmitted diseases (if you have risk factors)

• screening for genetic disorders based on racial and ethnic background, including cystic fibrosis, sickle-cell disease, thalassemia, Tay-Sachs disease, Gaucher disease, Canavan disease, Niemann-Pick disease

• screening for other genetic disorders, based on family history, including fragile-X syndrome, hemophilia, Duchenne muscular dystrophy

Tests for Women of Color and Jewish Women

If you are a woman of color (Black/African American, Latina/Hispanic, Native American/Alaska Native, Asian/Pacific Islander or Mediterranean) or of Jewish descent, you may be advised to have some tests to help determine if you could pass a particular disease or condition to your baby. For example, if you are of Mediterranean descent, you may be told a screening test for beta-thalassemia is a good idea. Asian/Pacific Islanders might be screened for alpha-thalassemia. If you’re Black/African American, your healthcare provider may suggest screening for sickle-cell disease.

Although a woman of Jewish descent may not be a woman of color, there are diseases that might affect her. These conditions usually affect women who are Ashkenazi or Sephardi Jews.

The American College of Obstetricians and Gynecologists recommends Tay-Sachs carrier screening be offered before pregnancy to women who are at high risk. This includes those of Ashkenazi Jewish, French-Canadian or Cajun descent, and those with a family history of Tay-Sachs disease.

If you have any questions about these conditions, discuss them with your healthcare provider. He or she can give you information and guidance.