Are you hoping to start a family? Now is the perfect time to plan for a healthy pregnancy and baby by starting a proper diet and learning what factors may adversely affect your body.
Are you thinking about conception? Taking the time to get healthy now will give your baby a fighting chance against birth defects, according to Dr. F. Sessions Cole, MD, director of the division of newborn medicine and head of the Neonatal Intensive Care Unit (NICU) at St. Louis Children’s Hospital in St. Louis, Missouri.
“The most important time in a pregnancy is the first four to eight weeks when most of a fetus’s organs are being formed,” says Dr. Cole, who is also a professor of pediatrics, cell biology, and physiology at Washington University in St. Louis School of Medicine. “[Waiting] to stop smoking or drinking, taking some prescription medications, or [waiting to add] nutrients to your diet until you find out you’re pregnant means you’re weeks or months late.”
Watch Your Weight
Come as close to your ideal weight as possible. Being seriously overweight or underweight can influence birth defects such as cleft palate and diabetes.
“While many substances from smoke that could be harmful to a fetus are cleansed from the body in days, some are stored in fat and take longer to eliminate,” says Dr. Cole. “Smoking is associated with prematurity and low birth weights, an increased risk of sudden infant death syndrome (SIDS) and asthma.”
As with smoking, some harmful substances are stored in fat and can take a month or more to eliminate. Fetal alcohol syndrome can cause serious defects and learning disabilities—some of which might not show up for several years.
Don’t Do Drugs
Stop using recreational drugs. “All have an adverse effect on the fetus,” says Dr. Cole.
Plan checkups for both parents-to-be. This is the time to talk about your medical history, ask questions, and find out whether any tests are recommended. This preconception visit is especially important if you have preexisting conditions, such as thyroid disease or diabetes, or if you have had problems with a previous pregnancy. Note that the father’s health and habits also play a role in the health of your baby. “Most men don’t think they need to do anything,” says Dr. Cole. “[But] sperm are the unindicted co-conspirators when it comes to birth defects. Sperm are as affected by tobacco, alcohol, and recreational and prescription drugs as eggs.”
No More Pill or IUD
If you have been using birth control pills, your healthcare provider can tell you how long to wait before trying to conceive. However, birth control pills will not cause birth defects, no matter how close to conception you stop using them, according to the March of Dimes. If you have been using an IUD, be sure to have it removed before trying to conceive. (If pregnancy occurs with an IUD in place, it can be harmful.)
Ask about Prescriptions
Discuss any prescription medications you are taking with your physician, especially drugs for depression, anxiety, and other common disorders, advises Dr. Cole. These medications can be very damaging to a fetus. “You may need to stop or change medication, and you want give your body time to adjust before trying to conceive,” he says.
Take a Prenatal Vitamin
Start taking prenatal vitamins at least two months before conception. A good prenatal vitamin should include folic acid and calcium, among other nutrients that are important to a healthy pregnancy and baby. The March of Dimes reports that birth defects of the spine and brain, such as spina bifida and anencephaly, can occur if the mother does not get sufficient folic acid during the first few weeks of her pregnancy. According to the March of Dimes, the suggested dosage for folic acid for a non-pregnant woman is 0.4 mg and for a pregnant woman it is 0.8 to 1.0 mg. Folic acid is also found in many foods, including leafy greens, oranges and grapefruits, and whole grain breads.
Check to see if you’ve had or been vaccinated against rubella and varicella. “Your immunity to both childhood diseases can be easily checked with a blood test and save you from concern if you are exposed to them during pregnancy,” says Dr. Cole. “Even if you were vaccinated as a child or think you had them, it is better to check.”
Take an HIV Test
If you don’t know your HIV status, most obstetricians routinely offer the test shortly after verifying pregnancy—yet HIV-positive women have a much better chance of sparing their babies from contracting the disease if they are aware of their HIV status before conception. If you learn you are HIV positive, find an OB-GYN who is well-educated about HIV care and can explain your options for safe conception and pregnancy. Modern medicines can be highly effective at preventing HIV transmission from a woman to her unborn child.
Know Your Blood Types
If you don’t already have this information, it’s helpful to learn your and your partner’s blood types before conception (though they don’t actually come into play until pregnancy). “If they are not compatible, you run the risk of the mother being incompatible with her fetus, leading to anemia or more serious problems for the infant at birth,” says Dr. Cole, adding that Rh disease, the result of the incompatibility, can be easily treated during pregnancy.
Build a Family History
Create a prenatal family history to identify possible genetic birth defects.
See Your Dentist
Periodontal inflammation may play a role in the development of preeclampsia, the potentially deadly condition that affects approximately 5 percent of pregnancies in the United States, according to a recent study in The Journal of Periodontology. It may be implicated in other pregnancy complications as well.
Most periodontal diseases are chronic inflammatory conditions caused by the body’s response to bacterial gum infections that can destroy the gum tissue and supporting bone that hold teeth in the mouth. The main cause of this disease is bacterial plaque, a sticky, colorless film that constantly forms on the teeth.
Dr. Vincent J. Iacono, DMD, who is president of the American Academy of Periodontology, notes that for prevention women should floss daily to break up the bacterial colonies between the teeth. Proper daily brushing will help prevent plaque buildup, and professional cleanings at least twice a year can remove calculus from places the toothbrush and floss may have missed. “A periodontal evaluation by your dentist or periodontist is the best way to know if you have any periodontal disease,” he adds.
Women should monitor their stress levels. “An anxious day or two at work probably won’t do you in, but prolonged stress can cause real problems. There are no magic rules for a when a woman should stop working during pregnancy. A woman’s decision should be based on her level of fatigue, the type of work involved, her pregnancy history, and her doctor’s opinion,” says Dr. Jonathan Scher, MD, author of Preventing Miscarriage: The Good News.
“Stress creates mental tension that can quickly rise to a boil,” adds Kerstin Sjoquist, a certified hypnotherapist. “Stress wreaks havoc on our bodies, lowering our ability to fight illness and disease. Lingering anxiety can make sleep difficult, which leads to more stress, creating an endless vicious cycle.”
Sjoquist emphasizes that women should also make themselves a priority and schedule down time. “That 15-minute mini-vacation on a daily basis can quite literally save your mental health before you head home to the house, your kids, and your partner and everything they all demand of you,” she says. “And keeping your mental health in check [prevents] your stress from showing up in your skin, eyes, and even your hair.”
Dr. Abdulla Al-Khan, MD, assistant attending in the department of obstetrics and gynecology at Hackensack University Medical Center, agrees stress should be kept in check. “High stress levels lead to higher endorphin and cortisol levels in the mother, and this could lead to possible adverse pregnancy outcome,” he says. “Even though the data on this subject is poor, I strongly believe that a healthy mind-set leads to excellent outcomes.”
Watch Out for Toxins
Dr. Scher notes that while environmental factors are often a great concern and cause of guilt for parents when they suffer a miscarriage, studies are inconclusive about the connection between specific environmental factors and pregnancy loss or recurrent miscarriage. “We cannot control many factors, other than doing our best to curb certain social habits and known toxins,” Dr. Scher says. He recommends avoiding toxins from cigarette smoking, alcohol, illicit drugs, extreme heat (from saunas and hot tubs), and caffeine. He also notes women should be aware of workplace pollutants and avoid them whenever possible.
Dr. Cole points out the importance of seeing prenatal and postnatal risks from the baby’s point of view. “When a child comes to us it is because there is a problem,” he says. “The NICU doesn’t represent a normal outcome. The best strategy for parents is to prevent the problem to the degree possible, and that takes some planning.”