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Preparing for Pregnancy (part 2) : Your Health before Pregnancy, Current Medications

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Discontinuing Contraception

It’s important to continue some form of contraception until you’re ready to get pregnant. If you’re in the middle of treatment for a medical problem or if you’re having tests, finish the treatment or tests before trying to conceive. (If you’re not using some form of birth control, you’re basically trying to get pregnant.)

After stopping your regular contraceptive, use some other birth-control method until your periods become normal. You can choose from condoms, spermicides, the sponge or a diaphragm.

If you use birth-control pills, patches or rings, most healthcare providers recommend you have two or three normal periods after you stop using them before trying to get pregnant. If you get pregnant immediately, it may be hard to determine when you conceived. This can make it harder to figure out your due date. It may not seem important now, but it’ll be very important during pregnancy and before you deliver.

If you have an IUD (intrauterine device), have it taken out before you try to conceive. However, pregnancy can occur while an IUD is in place. The best time to remove an IUD is during a menstrual period.

If you use Implanon or other implantable contraception, have at least two or three normal menstrual cycles after it’s removed before trying to get pregnant. It may take a few months for your periods to return to normal. If you get pregnant immediately, it may be difficult to determine when you got pregnant and what your due date is.

Depoprovera should be discontinued for at least 3 to 6 months before trying to conceive. Wait until you have had at least two or three normal periods.

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.

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