Preparing for Pregnancy (part 3) : Genetic Counseling, Pregnancy after 35, Weight Management before Pregnancy

- 7 Kinds Of Fruit That Pregnant Women Shouldn’t Eat
- How to have natural miscarriage
- Foods That Cause Miscarriage
- Signs Proving You Have Boy Pregnancy

Genetic Counseling

If you’re planning your first pregnancy, you are probably not considering genetic counseling. However, there may be circumstances in which genetic counseling could help you and your partner make informed decisions about having children.

Genetics is the study of how traits and characteristics are passed from parent to child through chromosomes and genes. Genetic counseling is an information session between you and your partner and a genetic counselor or group of counselors.

In actuality, the occurrence of birth defects is very low—they occur in about 0.04% of all births. The primary goal in genetic counseling is prevention and/or early diagnosis of these problems. Certain groups have a higher incidence of problems, and certain medications, chemicals and pesticides can put a couple at risk.

Genetic disorders may be caused in various ways. If you have an inherited disorder, it comes from your parents. A chromosomal disorder can happen even when parents don’t have any risk factors. Multifactorial disorders can occur from more than one source; the cause is generally unknown.

Genetic counseling aims to help you and your partner understand what might happen in your particular situation. A counselor won’t make decisions for you. He or she will give you information on tests you might take and what test results may mean. So don’t hide information you feel is embarrassing or hard to talk about. It’s important to tell a counselor what he or she needs to know.

Most couples who need genetic counseling do not find out they needed it until after they have a child born with a birth defect. You might consider genetic counseling if any of the following apply to you.

• You will be at least 35 years old at the time of delivery.

• You have delivered a child with a birth defect.

• You or your partner have a birth defect.

• You or your partner have a family history of Down syndrome, mental retardation, cystic fibrosis, spina bifida, muscular dystrophy, bleeding disorders, skeletal or bone problems, dwarfism, epilepsy, congenital heart defects or blindness.

• You or your partner have a family history of inherited deafness.

• You and your partner are related (consanguinity).

• You have had recurrent miscarriages (usually three or more).

• You and your partner are descended from Ashkenazi Jews. There is an increased risk of Tay-Sachs disease, Canavan disease and other problems. 

• You or your partner are Black/African American (risk of sickle-cell disease).

• Your partner is at least 40 years old.

Some information may be difficult to gather, especially if you or your partner are adopted. You may know little about your family’s medical history. Discuss this with your healthcare provider before you get pregnant. If you learn about the chances of problems before pregnancy, you won’t have to make difficult decisions after you get pregnant.

Genetic Testing

Your genetic counselor may talk about various tests with you. More than 1000 disorders can be detected using genetic tests, but most are rare. The conditions regularly tested for include cystic fibrosis, Down syndrome, neural-tube defects, thalassemia, Tay-Sachs and sickle-cell disease.

There are three types of tests that may be done—carrier testing, screening tests and diagnostic tests. Carrier testing involves testing both partners to determine if either or both is a carrier of a particular genetic defect. Screening tests may be done during pregnancy to determine whether there is an increased risk of a problem; it does not positively identify the problem. Diagnostic tests often determine whether a problem is present.

Pregnancy after 35

More women are choosing to marry after they have established a career, and more couples are choosing to start their families at a later age. Today, healthcare providers are seeing more older first-time mothers; many have safe, healthy pregnancies. 

An older woman considering pregnancy often has two major concerns. She wants to know how the pregnancy will affect her and how her age will affect her pregnancy. A pregnant woman older than 35 may face increased risks of:

• a baby born with Down syndrome

• high blood pressure

• pelvic pressure or pelvic pain

• pre-eclampsia

• Cesarean delivery

• multiple births

• placental abruption

• bleeding and other complications

• premature labor

You may find it easier to be pregnant when you’re 20 than it is when you’re 40. You may have a job or other children making demands on your time. You may find it harder to rest, exercise and eat right. But these concerns shouldn’t dissuade you from having children when you’re older.

Through medical research, we know older women are at higher risk of giving birth to a child with Down syndrome. Various tests may be offered to an older woman during pregnancy to determine whether a baby will have Down syndrome. It’s the most common chromosomal defect detected by amniocentesis.

The risk of delivering a baby with Down syndrome increases as you get older. But there’s a positive way to look at these statistics. If you’re 45, you have a 97% chance of not having a baby with Down syndrome. If you’re 49, you have a 92% chance of delivering a child without Down syndrome. If you’re concerned about the risk of Down syndrome because of your age or family history, discuss it with your healthcare provider.

Research shows a father’s age may be important. Chromosomal abnormalities that cause birth defects occur more often in older women and in men over 40. Some researchers recommend men father children before age 40, but there’s still some controversy about this.

If you’re older, you can maximize your chances of having a successful pregnancy by being as healthy as possible before you become pregnant. Most experts recommend a baseline mammogram be done at age 40. Have this test before you become pregnant. Paying attention to general recommendations for your diet and your health care is also important in preparing for pregnancy.

Weight Management before Pregnancy

Most people feel better and work better when they eat a well-balanced diet. Planning and following a healthy eating plan before pregnancy helps provide your growing baby good nutrition during the first few weeks or months of pregnancy.

Usually a woman takes good care of herself once she knows she’s pregnant. By planning ahead, you can be sure baby has a healthy environment for the entire 9 months of pregnancy, not for just the 6 or 7 months after you find out you’re pregnant.

Weight Management

Some researchers believe your weight may affect your chances of getting pregnant. Being underweight or overweight can alter sex hormones, your menstrual cycle, ovulation and may even affect the lining of your uterus. Any of these can make it harder for you to get pregnant.

If you’re underweight, your body may not produce enough hormones for you to ovulate every month. You may also have problems getting the best nutrition for your baby.

If you’re overweight, don’t diet while you’re trying to conceive, and don’t take diet pills. You may have a harder time getting pregnant if you’re overweight or obese. Overweight is defined as having a body-mass index (BMI) between 26 and 30. Obesity is defined as having a BMI over 30. 

Examine your eating habits. Determine what you need to work on to make your food intake healthy for you and baby. It may be very helpful to lose weight before trying to get pregnant, which may help reduce pregnancy complications and birth defects.

Consult your healthcare provider if you’re thinking about starting a special diet to lose or gain weight before you try to get pregnant. Dieting may cause a drop in vitamins and minerals that both you and your developing baby need.

If You’ve Had Weight-Loss Surgery

Some women have weight-loss surgery to help them lose weight. Bariatric surgery is defined as surgery related to the prevention and control of obesity and related diseases. Women who have had bariatric surgery have been shown to have less-complicated pregnancies than obese women who don’t have surgery, and their children are also less likely to be obese.

If you had gastric-bypass surgery to lose weight, you may be at increased risk of getting pregnant after the procedure. This happens because you lose weight, which may lead to more-regular ovulation. This could result in pregnancy.

If you plan to become pregnant soon, having lap-band surgery may be your best choice. Unlike gastric-bypass surgery, lap banding is fully reversible. It’s possible to have your stomach outlet size opened so you can meet the increased nutritional needs of pregnancy.

You should probably delay getting pregnant for 12 to 18 months following surgery because this is the time you will be losing weight very rapidly. You may not have sufficient nutrients available for you and your growing baby.

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