Before You Get Pregnant

It's exciting to plan to have a baby. To improve your chance of having a problem-free pregnancy and a healthy baby, be sure you are ready ahead of time. It helps if the mother and father are both healthy before the pregnancy begins. You want to lower your chances of having a problem pregnancy.

Not all problems are preventable, but you can increase your chances of having a healthy baby by identifying risks you or your partner might have and changing those risks, if possible.

Preconceptual counseling, or health information you get before you become pregnant, is an important part of prenatal care. You can talk about your pregnancy plans with your doctor as part of general preventive care or during office visits for other medical conditions.

The fetus is most open to harm from 17 to 56 days after conception. Changing your risks before you become pregnant can ensure that your baby is safe during this important time.

Risks Due to Age, Family and Ethnic Origin

Women under age 15 or over age 40 have higher risks when they become pregnant. Your doctor can talk with you about your risks for genetic problems and the benefits of genetic testing. Some ethnic groups may have special risks. Genetic screening for sickle cell disease may be important in people of black and southeast Asian descent, for Tay-Sachs disease in people of Jewish descent and for blood disorders called thalassemias in people of Mediterranean or Asian descent.

If you, your baby's father or a close relative has a genetic disorder like muscular dystrophy, Down syndrome or open spine (also called spina bifida), talk to your doctor about genetic counseling before you get pregnant, so you will know the risks you face.

Diet, Exercise and Sleep

Being at an ideal weight when you get pregnant can improve your chance of having a healthy baby. Both very thin women who do not gain weight during pregnancy and very heavy women may have more problems. Pregnancy is not the time to try to lose weight. It's best to have good eating habits and be at the right weight before becoming pregnant.

Multivitamins containing folic acid may decrease the chance of your baby being born with spina bifida or anencephaly (without a brain), if the vitamin is taken before you become pregnant and during the first six weeks of pregnancy. Ask your doctor to prescribe this vitamin for you.

Healthy sleep habits and exercise are important to your general health. Exercise can continue during pregnancy if you are used to it and if your body temperature doesn't get too high. Fevers and high body temperatures should be avoided in the first 14 weeks of pregnancy, because they can lead to an increased chance of birth defects. You should avoid getting overheated through vigorous exercise or the use of hot tubs.

Medical Diseases

All chronic diseases such as high blood pressure, diabetes, seizures, heart problems, thyroid disease, rheumatoid arthritis and kidney disease should be discussed with your doctor. With good planning, many of the risks to your baby (and you) can be greatly reduced. Ask your doctor about all of the drugs you take and their safety during pregnancy-should you switch medicines or stop taking them? How long should you stop taking them before you become pregnant?

Discuss sexually transmitted diseases (STDs) with your doctor. If you have an STD, it's good to treat it before you are pregnant. To have a healthy baby, it's best to learn how to avoid STDs. Women with HIV infection (human immunodeficiency virus infection, or AIDS) are advised not to become pregnant because they can pass the AIDS virus on to their babies. AIDS testing is available to all pregnant women, women in high-risk groups or women who plan to get pregnant.

Many infectious diseases can affect your baby. It is helpful to get a German measles (rubella) test before becoming pregnant. If you get rubella during your pregnancy, your baby might have birth defects. You can protect yourself by having a rubella vaccination at least three months before you become pregnant. In general, pregnant women, especially in the early months of pregnancy, should stay away from children who are sick with rashes and fevers.

Toxoplasmosis is an infection that also causes birth defects. You can avoid exposure to toxoplasmosis by having someone else clean the cat's litter box, by avoiding contact with kittens or garden soil, and by not eating raw or undercooked meat.

Workplace and Home Exposures

Ask your boss about exposures at your workplace to chemicals or inhaled substances. Your workplace is required to keep on hand written information on all chemicals used at that location, and this information can be given to your doctor. Don't forget that some

hobbies carry a risk to your unborn baby-for example, the lead used in making stained glass. You might have your house tested for lead in water pipes and paint to guard your health and the health of your growing child.

Smoking, Drug and Alcohol Use

Smoking, illicit drug use and alcohol use are never safe during pregnancy. Treatment programs to help you stop using these substances before pregnancy are important. These substances increase your risk of having a miscarriage, a baby with birth defects or a premature baby.

Children whose parents smoke have a greater chance of dying from sudden infant death syndrome (SIDS), and they also have more colds and ear infections while they are growing up. If you use alcohol and drugs during pregnancy, it can affect your child's ability to learn and can even result in mental retardation.

Social Concerns

Your doctor can give you information about social programs like WlC (Aid to Women, Infants and Children) and ADC (Aid to Dependent Children). You and your partner should talk about your readiness for parenting, to see if you have problem areas that could be improved before you get pregnant. Domestic violence often increases during pregnancy, and this abuse should always be recognized. Many communities offer parenting classes.

Summary

Fortunately, most women have healthy babies. By seeing your doctor often during your pregnancy, and by discussing and changing risks before you get pregnant and during the early months of pregnancy, you can increase your chances of having a healthy baby. Prepregnancy check-ups are now routine with many doctors. For your own health and your baby's, take advantage of this important education opportunity.


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