McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

It is important to prepare yourself for pregnancy before you try to conceive. During the early weeks of pregnancy the baby's body and internal organs are formed. Your health can affect this early development.

Talking to your health care provider about your medical history can help protect your baby from potentially harmful situations, such as infections or birth defects. Also, having a healthy lifestyle can help your body deal better with the stresses of pregnancy, labor, delivery, and breast-feeding.

Talking with Your Health Care Provider

Before you become pregnant, have an appointment with your health care provider to talk about your pregnancy plans and have a complete physical exam, including a Pap smear. This is called a preconception visit. Your provider will ask you questions about your medical history, lifestyle, and any past pregnancies. The answers to these questions will help identify any risks or problems you may have.

Your provider may also discuss social, financial, and psychological issues related to having children. You may talk about the number of children you would like to have.

Your Medical History
It is important to know if you have or have had certain diseases or medical conditions. Some conditions cause fewer problems during pregnancy if they are under control before pregnancy.

Your health care provider will want to know if you have had any of the following diseases or conditions:

• diabetes
• thyroid problems
• asthma
• high blood pressure
• epilepsy
• lupus
• herpes
• heart disease
• sickle cell trait or disease
• urinary tract infections
• deep vein thrombosis
• kidney disease
• arthritis
• cancer
• hepatitis.

Tell your health care provider about any medicines you are taking, including prescribed drugs, nonprescription , and herbal medicines.

Information about any past pregnancies or gynecologic problems helps your health care provider predict problems that might occur during pregnancy or when you are trying to conceive. Such information includes:

• menstrual history
• birth control methods you have used
• whether your mother used the drug diethylstilbestrol (DES), a hormone that was given to pregnant women a generation ago to prevent miscarriage
• abnormalities of the uterus
• problems getting pregnant or during past pregnancies
• abortions, stillbirths, or miscarriages
• births of babies weighing more than 9 pounds or less than 5 and 1/2 pounds
• births by cesarean section
• newborn deaths or sudden infant death syndrome (SIDS).

Some infectious diseases can harm a baby before or after the baby is born. They may affect your ability to get pregnant or affect the delivery. Some of these diseases are:

• toxoplasmosis
• chickenpox or rubella
• syphilis, chlamydia, gonorrhea, herpes, or genital warts
• AIDS.

If you have a sexually transmitted diseases (such as chlamydia or gonorrhea), you and your partner should finish treatment for the disease before you try to get pregnant.

It is also important to check for immunity to rubella, measles, or mumps (for example, by exposure or vaccination). Your health care provider can look at your past medical records or may test you for immunity. You may need shots against these diseases before you try to get pregnant. Be sure to avoid getting pregnant for at least 3 months after you get the shots.

Your Family History
Some families have a history of inherited diseases or birth defects. Discuss your family medical history, including your partner's family history, with your health care provider. If there is a chance that your baby will inherit a disease or other problem, your provider may refer you to a genetic counselor. A genetic counselor can help determine your chances of having a child with birth defects or inherited diseases. You may have tests of your chromosomes and your partner's chromosomes. Examples of inherited diseases are:

• blood diseases such as hemophilia, thalassemia, and sickle cell anemia
• Tay-Sachs disease, a brain disorder
• cystic fibrosis, a disease that affects the lungs and digestive system
• Down syndrome, which causes mental retardation and other problems.

Birth defects are abnormalities seen in infants at birth. They may affect the bones, organs, or any part of the body. Examples of birth defects are cleft lip or palate, heart disease, and an opening in the spine called spina bifida.

A Healthy Lifestyle

Diet
A balanced diet is always important for good health. Make sure you have a healthy diet before pregnancy puts more demands on your body. Following a healthy diet before you get pregnant ensures that you and your baby start with the nutrients you need. Discuss your diet with your health care provider to determine whether there are any changes you should make before you get pregnant. It is wise take a multivitamin supplement and at least 4 mg of folic acid daily. (Folic acid lowers the risk of problems with the baby's spine.)

Your weight before you get pregnant is also important. If you are underweight, you are more likely to have a small baby. Small babies have more problems during labor and just after birth. Being overweight is also a health hazard for you and your baby. You have a greater chance of having high blood pressure and diabetes if you are overweight when you are pregnant. Once you are pregnant, you should not try to lose weight because you may deprive your baby of needed nutrients. If you are underweight or overweight, try to reach an ideal weight before you become pregnant.

Exercise
Good health depends not only on a balanced diet, but also on getting enough exercise. Starting or continuing a regular exercise program before you get pregnant helps prepare your body for the stresses of pregnancy and labor. It will also affect how much you can exercise during pregnancy. If you are starting an exercise program and are not used to being active, begin gradually.

Lifestyle
Your habits and exposure to toxic chemicals or radiation can affect your ability to conceive or the well-being of your baby.

Tobacco, alcohol, and drugs such as marijuana, crack, cocaine, and heroin are dangerous for both you and the unborn baby. If you are planning to get pregnant and you use any of these substances, now more than ever is the time to quit. Don't be afraid to ask your health care provider to help you quit. He or she can offer support and medical advice.

Tell your provider if you have been exposed to radiation, lead, chemicals, or pesticides.

Let your health care provider know if there is violence or abuse in your home. Never get pregnant to try to help a troubled marriage. Having a child can make things worse.

It is also important to plan ahead and think about the many aspects of your life that will change, such as your budget, work situation, daily schedule, health, and relationships with family and friends.

Conceiving and Early Pregnancy

If you have had a physical exam and are maintaining a healthy lifestyle, and you feel it is the right time to try to conceive, you are on your way to having a healthy baby.

During a normal 28-day menstrual cycle, the egg is released around day 14 (day 1 being the first day of your period). Therefore, you are more likely to conceive if you have intercourse on days 10 through 16.

Do not expect to become pregnant right away. It takes an average couple 6 months to conceive. However, 80% of couples conceive after 1 year of trying. If you still are not pregnant after 1 year, make an appointment with your health care provider. Your provider may be able to help find the reason why you are having trouble conceiving.

Normally, women suspect they are pregnant if they miss a period, though this is not always the case. Some women have spotting that may lure them into thinking they are not pregnant when they really are. With the use of pregnancy tests, you will be able to confirm your suspicions. These tests of your urine or blood measure the level of a hormone produced by the placenta called human chorionic gonadotropin (HCG).

With a blood test at your health care provider's office you can find out if you are pregnant as early as 9 days after conception. Home pregnancy tests are also very reliable. With some home tests you can find out if you are pregnant on the day your period should have started. If you think you are pregnant, call your health care provider. Tell the provider when your last period started. This information is helpful for figuring out your due date.

During the time you are trying to get pregnant, try to relax and not let it become a stressful experience. Stress may make it harder for you to become pregnant. And remember that because there is time between when you become pregnant and when you know that you are pregnant, it is important to maintain a healthy lifestyle. That way you can find comfort in knowing that you are providing the healthiest environment possible for your baby no matter when he or she is conceived.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.