Planning for pregnancy

Preparing your body for pregnancy

By Jennifer Newton Reents

So, you want to have a baby? While it may seem easy just letting nature take its course, most doctors recommend that you take a little control over Mother Nature, and see a doctor before you conceive to make sure you and your baby get a healthy start.

Importance of early detection

Dr. M Kelly Shanahan, MD, FACOG, who has a private practice in South Lake Tahoe, California, is the author of Your Over-35 Week-by-Week Pregnancy Guide: All the Answers to All Your Questions About Pregnancy, Birth, and Your Developing Baby. She says that prior to conceiving, women should have a check up and consultation with their obstetricians to discuss general health and how it may affect a pregnancy.

"The organs of the baby begin forming around 17 days after conception when most people don't know they are pregnant," says Dr. Tara Scott, MD, of the Ob/Gyn department at Summa Health System in Akron, Ohio, about the need to see a doctor before conception takes place.

Dr. Shanahan says doctors will also want to review any medications, vitamins and herbs you may be taking as some may be harmful to a developing baby and should be changed or stopped before getting pregnant. Dr. Shanahan says women should, however, take a vitamin supplement containing 0.4 mg (400 mcg) of folic acid at least three months before they try to conceive. Folic acid in your diet lowers the chance of having a child with a neural tube defect such as spina bifida.

Trish Thackston of Alexandria, Virginia, followed her doctor's advice. "He told me that it was a good idea to start taking a multi-vitamin, to get plenty of folic acid through my diet, keep up my regular exercise routine and limit caffeine and alcohol consumption," she says.

Dr. Shanahan says women also need to meet with their doctor to address lifestyle issues—such as smoking or drinking alcohol—that may affect your chances of conceiving or affect the health of the baby.

"I quit smoking cold turkey," says Margo Trueman-Roche of Ridgecrest, California.

Dr. Scott says alcohol causes fetal alcohol syndrome that involves facial deformities and mental retardation, and drugs such as cocaine can cause premature labor, low birth weight or placental abruption.

Get your vaccinations

You need to be sure you are up-to-date on your vaccinations, both doctors say. "Certain illness, like rubella, can cause birth defects if contracted at certain stages of a pregnancy. Vaccines prior to pregnancy can eliminate this worry," Dr. Shanahan says.

Dr. Scott notes that those who work in the health care field or in child care facilities may be at risk for Hepatitis B or cytomegalovirus (CMV). Cat owners or those who handle raw meat may be at risk for toxoplasmosis. All of these diseases can be tested for by a blood test before pregnancy. These infections have the potential to be harmful, she says.

Your history matters

Dr. Scott says when meeting with your obstetrician, you will want to evaluate your own obstetric history: Have you had a miscarriage? Did you have a previous complicated pregnancy? "These are questions to discuss with your doctor to prevent recurrences," she says. You should also be aware of your family medical history as well as your own, Dr Scott says. "Cystic fibrosis and blood disorders such as sickle cell anemia and thalassemia are inherited. Genetic counseling and prenatal testing is available to detect some of these diseases," she says. "Know your own medical history. Congenital heart disease, hypertension and diabetes may cause problems in pregnancy. Diabetics with high blood sugars could have a baby with defects."

Prescription and over-the-counter medications

If you are taking prescription drugs, ask your OB/GYN about them before you become pregnant. Some blood pressure medications are not safe in pregnancy. Seizure medications can be switched to a safer choice. Even some allergy medications are safe, Dr. Scott says.

She says you should also ask your doctor about over-the-counter medications. "Tylenol is safe, but ibuprofen isn't. Ibuprofen interferes with implantation and causes other problems in pregnancy," she says.

So when and how should you stop taking birth control pills and how long should you wait before getting pregnant? Dr Shanahan says to stop taking them three months before you actually try to get pregnant. "She and her partner should use a barrier method of contraception—condoms, diaphragm, cervical cap—until she starts having normal cycles," says Dr. Shanahan.

This is not so much to prevent any ill effects from the medication as it is to allow her time to begin cycling on her own. She says if a woman gets pregnant immediately after stopping the Pill, she may chalk up a missing period to the effects of stopping the Pill, and may not realize she is pregnant for a few months.

Once you've tried to conceive and you miss a period, you can try one of the many pregnancy tests sold at drug stores or see your doctor for a test. If your home test is positive, you should see your caregiver to confirm that you are indeed pregnant.

Getting the timing right

Ovulation predictor kits (OPKs) can also be helpful in determining when you are ovulating and when is the right time for conception to occur. Dr. Shanahan says if your menstrual cycle is normally 28 days, you can start using an OPK on day 11, which is 11 days from the first day of bleeding of your last period. "We conceived the second month that we used an OPK," says Thackston, who tried to get pregnant for eight months before using the device.

You and your partner should give yourselves a few months to prepare for pregnancy. With a little planning, some common sense and by following the advice of your caregiver, you will be able to start your new family in the happiest, healthiest way possible.