Preparing for Pregnancy

by Arthur L. Wisot, M. D. of Reproductive Partners Medical Group

One of the most important steps in life is making the decision to have a child. Of course, in many cases a pregnancy is not the result of a conscious decision and therefore the baby might not be conceived under even close to ideal circumstances. Parents and child may suffer consequences from that lack of preparation or activities engaged in during an early unintended pregnancy. If you are planning to become pregnant here are some steps you should take in advance.

Make sure you want to have a baby. This may sound foolish, but many couples attempt to get pregnant without giving enough thought to the effects on their life of having a child. They say “Let’s get pregnant” instead of “Let’s have a baby.” Creating a child and being pregnant sound glamorous. It may be glamorous, but you must really want to have a child. Don’t get me wrong—having a baby is great. But is it great for you? You may think this never happens, but I do see new mothers who say, “If I had known what this would do to my life…” Make sure your relationship is strong. It’s generally a serious mistake to have a baby to try to patch up a shaky marriage. You just compound your problems and it’s certainly not the ideal way to bring a new life into the world.

Learn all you can about your genetic history. If there is a significant history of genetic problems in the family, you may want to investigate it before attempting to get pregnant. This could include a relative with Down syndrome or other genetically-related disability, muscular dystrophy, cystic fibrosis, hemophilia, or other inherited diseases. You may belong to a population group that carries an increased risk of diseases specific to that group, such as Tay-Sachs disease in Ashkenazi Jews or certain types of anemia in blacks or people whose ancestors came from Mediterranean countries. This applies to both partners. Your own doctor can help you with advice in this area, or will refer you to a place where you can get more information. There are now blood tests available to see if you are a carrier of the gene that causes many of these diseases such as Tay-Sachs and cystic fibrosis.

Clean up your act! Both of you should get into the best physical shape possible. Stop all medically unnecessary drugs, especially recreational drugs, including marijuana. These can have an effect on fertility as well as on the baby. Avoid smoking, alcohol and caffeine. Caffeine and smoking have been implicated in infertility. One study comparing smokers and nonsmokers going through in vitro fertilization found that the smokers had lower fertilization rates, lower estrogen levels, required greater amounts of fertility drugs, and had lower pregnancy rates. Another study showed that a cup of brewed coffee daily was associated with a 50 percent reduction in the chance of conceiving each month. If you are overweight, it is a good idea to lose the weight before you get pregnant, and do it in a manner consistent with good nutrition. Then continue on a nutritionally sound weight-maintenance program. If your weight is normal or you are underweight, make sure that you are eating a well-balanced diet. If strenuous exercise has made your periods irregular, you might want to modify your routine while trying to conceive. Check at work for any environmental hazards to conception or pregnancy. Finally, if your level of stress is a problem, you can try to avoid stress or use stress-reduction techniques. Your doctor can help with this type of planning.

Take prenatal vitamins daily. In preparation for pregnancy, authorities are recommending the use of vitamins containing the daily requirement for pregnant women. Do they help? Studies have suggested a much lower incidence of neural tube and heart defects in infants whose mothers took vitamins containing 0.4 milligrams (mg) of folic acid before conception. In any event, they can’t hurt if taken as directed. These are easily obtained over the counter at any pharmacy and are fairly inexpensive. In order to obtain the dose of 1 mg of folic acid utilized in prescription prenatal vitamins, you will need to get a prescription from your physician. There are many different brands, but all contain about the same formula.

Take care of existing medical problems. If there is any question of a medical problem, it is a good idea to have this evaluated and treated before getting pregnant. This is especially true if diabetes is present or suspected. Fertility will be greatest, and the chance of fetal abnormalities will be minimized, by starting the pregnancy with normal blood sugars. We recommend that all diabetics be checked and receive an okay from their doctor before even attempting to get pregnant. You should also be sure that other medical conditions are under control and that medications to control them are appropriate for pregnancy, since some medications could increase the chance of fetal abnormalities.

If you follow these few simple rules you will go a long way toward assuring your future child’s well-being.