Trusted medical advice from the
American Academy of Family Physicians.

Take Care of Yourself Before Pregnancy

Whether you’re actively planning to become pregnant or not thinking about it, preconception care during your childbearing years is essential. One reason is because about half of all pregnancies in this country are unplanned. And unplanned pregnancies are at higher risk for preterm birth and low-birth-weight babies.

Preconception care means taking good care of your body and mind during the period when you can have a child. Everybody can benefit from this healthy living lifestyle. So if you’re trying to have a baby or just have an inkling you might want to in the near future, here are some things you should focus on.

Path to improved well being

The following are important steps to help you get ready for the healthiest pregnancy possible.

Up your folic acid. Folic acid is a B vitamin that our bodies use to make new cells. Folic acid is especially important during times when the cells are dividing and growing rapidly, such as during pregnancy. Getting adequate folic acid can help prevent two common and very serious neural tube defects (NTDs): spina bifida and anencephaly. Both occur very early in pregnancy (as early as 3 to 4 weeks after conception), which is before many women even know they’re pregnant.

  • Anencephalyis when a baby is born without the front part of the brain (forebrain) and the thinking and coordinating part of the brain (cerebrum). The remaining parts of the brain are often not covered by bone or skin.
  • Spina bifidacan happen anywhere along the spine if the backbone that protects the spinal cord does not form and close properly. This often results in damage to the spinal cord and nerves. Spina bifida might cause physical and intellectual disabilities that range from mild to severe.

The U.S. Public Health Service and Centers for Disease Control and Prevention recommend that all women of childbearing age (between 15 and 45 years of age) consume 0.4 mg (400 micrograms) of folic acid every day.

Schedule a preconception checkup. It’s important to get any chronic conditions under control before you become pregnant. Identifying them now can help up your chances of having a healthy pregnancy for both you and your baby. Your visit should include discussions of:

  • Your medical and family history.If you have certain conditions, such as diabetes, hypertension, asthma, seizure disorders, or maternal phenylketonuria, you’ll need to learn how to manage them during your pregnancy.
  • Any vaccines or boosters you may need.Some vaccines can be given during pregnancy, but the rubella (German measles) and varicella (chicken pox) vaccines should be given before you get pregnant.
  • All over-the-counter and prescription medicines you take,including vitamins, dietary and herbal supplements. Certain medications can cause serious birth defects, so be sure to mention everything you’re taking.

Stop smoking and drinking alcohol. Both can increase the risk for preterm birth, NTDs, fetal alcohol spectrum disorders, and sudden infant death syndrome (SIDS). If you need help to stop, speak to your healthcare provider about what types of support is in your area. You can also call 1-800-QUIT-NOW to be connected to your state’s “quitline.” For help with drug abuse, 1-800-662-HELP (4357) provides referrals to local treatment facilities, support groups, and community-based organizations. Having supports in place will increase your chances of quitting successfully.

Get to a healthy weight. Being overweight can make it more difficult to conceive. It also increases your risk of certain issues during pregnancy, including high blood pressure, gestational diabetes, having a stillbirth, and increasing the chances of needing a cesarean delivery. Shedding the weight before becoming pregnant can help improve your chances of conceiving and delivering a healthy baby.

The Centers for Disease Control and Prevention’s adult body mass index (BMI) calculator can help you determine your BMI and figure out whether you’re in the healthy range. Always talk with your doctor about the best way to achieve your weight loss goals.

Stay away from certain fish. Some fish, including swordfish, tilefish, king mackerel, and shark, contain a metal called methylmercury. Exposure to this metal can be harmful to a developing fetus. If you regularly eat these fish, methylmercury can build up in your bloodstream. Since it may take a while to drop to a safe level, stay away from these four fish while you’re thinking of getting pregnant.

Other cooked fish and seafood are fine as long as you eat a variety of different kinds of fish. Choose up to 12 ounces (2 average meals) a week of an assortment of fish and shellfish that are lower in methylmercury. These include shrimp, canned light tuna, salmon, pollock, and catfish. Keep in mind, albacore (“white”) tuna has more methylmercury than canned “light” tuna. So, when choosing your 2 meals, you may eat up to 6 ounces of albacore tuna per week.

Things to consider

Genetic counseling may be something you want to think about if certain conditions run in your family or your partner’s family. You also will want to know if a member of your family was born with a genetic condition, birth defect, chromosomal disorder, or cancer. Other reasons to see a genetic counselor include having had trouble getting pregnant, experiencing several miscarriages, infant deaths, or a birth defect with a previous pregnancy. Or if you or your partner are older than age 35.

A genetic counselor can meet with you to discuss potential genetic risks. At your appointment, you’ll discuss your medical, family, and pregnancy history. The counselor will explain what genetic conditions your future children may be at risk for depending on your history and recommend tests that can help diagnose any conditions. Once you gather all the information, you and your partner can make an informed decision about whether or not genetic testing is right for you.

Questions for your doctor

  • What kinds of vitamins should I take that include enough folic acid?
  • Are there any foods I shouldn’t be eating while trying to get pregnant?
  • Are there any activities I shouldn’t be doing while trying to get pregnant?
  • Could any of my current health conditions affect my pregnancy?
  • Could any of my past history (STDs, miscarriages, abortions) affect my future pregnancy?
  • When should I stop using birth control?

Resources

Centers for Disease Control and Prevention: Planning for Pregnancy

National Institutes of Health, MedlinePlus: Steps to Take Before You Get Pregnant

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