Good Health Before Pregnancy: Prepregnancy Care
- What is a prepregnancy care checkup?
This is the first step in planning a healthy pregnancy. The purpose of this checkup is to look for anything that could have an impact on your pregnancy. Because significant organs develop in a fetus during the first 8 weeks of pregnancy, identifying these factors is essential.
- What happens during a prepregnancy care checkup?
During this visit, your obstetric care provider will make sure you have gotten all the vaccines recommended for your age group, talk about the risk of STIs and how to protect yourself and they will also talk about your diet and lifestyle, medical and family history, medications you take and past pregnancies
- How can I try to be healthier before pregnancy?
The months leading up to your pregnancy are the best time to take steps to be healthier. These steps may include taking prenatal vitamin, keeping your environment safe, stopping the use of unhealthy substances (tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reason), eating a healthy diet, exercising regularly, and reaching and maintaining a healthy weight (Being underweight or overweight may cause problems during pregnancy).
Cutting back on your daily calories intake and exercising more are great steps to reach a health body weight if you are overweight. It’s recommended at least 150 minutes of moderate exercises a week and 2 days of muscle- strengthening activities. An easy way to cut calories is to avoid sugary drinks and pay attention to the amount of food you eat. Portion control is key.
Being underweight raises the chances of having a low-birth-weight baby. Low-birth-weight babies are more likely to have complications during labor and childbirth. Preterm birth is also increased by being underweight. If you need to gain weight, ingest more calories than you burn during the day. Some healthy snack options include yogurts, granola bars, fruit smoothies and nuts.
You can check your body mass index (BMI), which is a number calculated from height and weight used to determine whether a person is underweight, normal weight, overweight, or obese. Use the online calculator at https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm to find your BMI. There are four categories of weight that are based on BMI:
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- Underweight—BMI of less than 18.5
- Normal weight—BMI of 18.5 to 24.9
- Overweight—BMI of 25 to 29.9
- Obese—BMI of 30 or greater
Excess weight during pregnancy is associated with several pregnancy and childbirth complications, including:
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- High blood pressure
- Preeclampsia
- Preterm birth
- Gestational diabetes
Obesity during pregnancy also increases the risk of:
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- Macrosomia
- Birth injury
- Cesarean birth
- Birth defects, especially neural tube defects (NTDs)
.
- Should I start taking vitamins?
You should start taking a daily prenatal vitamin before getting pregnant and continue to do so while you’re expecting. Prenatal vitamins provide all the essential daily vitamins and minerals, including folic acid and iron, that you’ll need before and during your pregnancy. If you start taking prenatal vitamins before becoming pregnant, you may be able to prevent nausea and vomiting.
- How much folic acid should I take?
You should start taking a prenatal vitamin with at least 400 micrograms of folic acid at least 1 month before conception and continue for the first 12 weeks of pregnancy. Some women, such as those who have previously had a child with an NTD, should take 4 milligrams (mg) of folic acid per day as a separate supplement at least 3 months before pregnancy and for the first 3 months of pregnancy. Based on your health history, you and your ob-gyn can consider whether you require this dose of folic acid or not.
- Why is iron important during pregnancy?
Your body uses iron to produce the extra blood that you and your fetus require during pregnancy. Non-pregnant women require 18 mg of iron per day. Pregnant women require a higher dose, 27 mg per day. Most prenatal supplements contain this increased quantity.
You should eat iron-rich foods such beans, lentils, enriched breakfast cereals, beef, turkey, liver, and shrimp in addition to taking an iron-fortified prenatal vitamin. Orange juice, grapefruit, strawberries, broccoli, and peppers are examples of foods that help iron absorption.
- Why is it important to stop using substances before getting pregnant?
The use of tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reason—can cause serious problems for your pregnancy and your fetus, including:
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- Birth defects
- Low birth weight
- Preterm birth
- Stillbirth
Using narcotics like heroin, cocaine, or methamphetamines is considered substance abuse. It also includes utilizing oxycodone or other opioids for purposes other than those for which they were prescribed. Now is the moment to stop using any of these substances. Stopping before becoming pregnant can also allow you time to get help if you have substance abuse or dependence concerns.
Quitting harmful behavior takes support. It’s okay to ask for help. Your obstetric care provider can suggest ways to get through the early stages and refer you to support groups.
During pregnancy, neither your partner nor anyone else in your household should smoke. Toxic substances can be passed on to your fetus through secondhand smoke. Slight exposure to secondhand smoke has also been related to an increased incidence of sudden infant death syndrome (SIDS).
If you have a male partner, he should abstain from using dangerous substances before you try to conceive. Tobacco, alcohol, and drug use can impair a man’s sperm cells and have negative consequences for the fetus.
- What should I know about my environment?
You may come into contact with chemicals at work, at home, or in your neighborhood before becoming pregnant and during your pregnancy. Contact with a few substances can make it harder for you to conceive and can be dangerous to a fetus. Lead, mercury, solvents, radiation, and some pesticides are among them. Radiation, a form of energy sent out in invisible waves, is used in certain medical and industrial jobs. If you are not sure if you are exposed to harmful substances at work, talk to your employer.
- Will I be asked about intimate partner violence?
Your ob-gyn or other health care provider may ask about your relationship during your prepregnancy care visit. You may not think of your home environment as harmful, but if you are dealing with intimate partner violence (also known as domestic violence), it can be harmful for you and your children.
- How can I get help if I’m in an abusive relationship?
- Your ob-gyn or other obstetric care provider can help you find resources in your state that offer aid.
- You also can call the toll-free, 24-hour National Domestic Violence hotline at 800-799-SAFE (7233) and 1-800-787-3224 (TTY).
- Can chronic medical conditions cause problems during pregnancy?
Yes, some medical conditions may cause problems during pregnancy. Some of these conditions include:
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- Depression
- Diabetes mellitus
- Eating disorders
- High blood pressure
- Seizure disorders
Some health issues, such as diabetes, can raise the chance of birth abnormalities in the fetus. Other factors may raise your chances of developing health problems. You can still have a healthy pregnancy and baby if you have one of these disorders. Prenatal care may help to lessen pregnancy-related complications.
- What should I do if I have a chronic medical condition?
If you have a medical issue, you may need to make some changes to get it under control before trying to get pregnant. Even if a health problem is controlled, the demands of pregnancy may exacerbate it. You may need to make some lifestyle changes, see your doctor more often, and get specialized care during your pregnancy to keep your health concerns in check.
- Can I take medications, herbal remedies, or supplements?
Some medications, vitamins, and herbal remedies can be harmful to a fetus and should not be taken while you are pregnant. Bring everything you take to your prenatal appointment in their original packaging, even if you think is a safe intake. Your obstetric care provider can determine their safety when used during pregnancy and guide you.
Do not discontinue taking prescription medications without first consulting your obstetrician. Although some medications may increase the chance of birth problems, the benefits of continuing to take them while pregnant may exceed the dangers to your fetus.
- Should I be tested for HIV?
All women should be tested for human immunodeficiency virus (HIV). There is no cure for HIV, but knowing your HIV status allows you to make vital pregnancy decisions. You can also read about treatment options that may reduce your chances of passing the infection on to your fetus. See Testing for HIV to learn more.
- What should I know about vaccination before pregnancy?
Vaccination can prevent a lot of infections. Because some vaccines cannot be given during pregnancy, it’s ideal to get all the immunizations advised for your age group before trying to conceive. Certain infections might cause birth abnormalities or pregnancy problems.
The influenza (flu) vaccine and the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine are two immunizations that are essential for pregnant women. The flu shot and the Tdap vaccine are both safe to take while pregnant.
- I had a problem in a past pregnancy—will I have the same problem again?
Some pregnancy problems may raise the chances of having the same issue in a subsequent pregnancy. Preterm birth, high blood pressure, preeclampsia, and gestational diabetes are among these problems. However, just because you had an issue with a previous pregnancy doesn’t imply you’ll have one again—especially if you get good treatment before and during your pregnancy. Any previous pregnancy issues will be asked about by your obstetric care provider.
- Glossary
Birth Defects: Physical problems that are present at birth.
Body Mass Index (BMI): A number calculated from height and weight. BMI is used to determine whether a person is underweight, normal weight, overweight, or obese.
Calories: Units of heat used to express the fuel or energy value of food.
Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the woman’s abdomen.
Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor.
Depression: Feelings of sadness for periods of at least 2 weeks.
Diabetes Mellitus: A condition in which the levels of sugar in the blood are too high.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Gestational Diabetes: Diabetes that starts during pregnancy.
High Blood Pressure: Blood pressure above the normal level. Also called hypertension.
Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system. If left untreated, HIV can cause acquired immunodeficiency syndrome (AIDS).
Influenza (Flu) Vaccine: A shot given to protect against the flu.
Low Birth Weight: Weighing less than 5 ½ pounds (2,500 grams) at birth.
Macrosomia: A condition in which a fetus grows more than expected, often weighing more than 8 pounds and 13 ounces (4,000 grams).
Neural Tube Defects (NTDs): Birth defects that result from a problem in development of the brain, spinal cord, or their coverings.
Obstetric Care Provider: A health care professional who cares for a woman during pregnancy, labor, and delivery. These professionals include obstetrician–gynecologists (ob-gyns), certified nurse–midwives (CNMs), maternal–fetal medicine specialists (MFMs), and family practice doctors with experience in maternal care.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Opioids: Drugs that decrease the ability to feel pain.
Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.
Prepregnancy Care: Medical care that is given before pregnancy to improve the chances of a healthy pregnancy. This care includes a physical exam; counseling about nutrition, exercise, and medications; and treatment of certain medical conditions.
Preterm: Less than 37 weeks of pregnancy.
Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact. Infections include chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).
Sperm A cell made in the male testicles that can fertilize a female egg.
Stillbirth Birth of a dead fetus.
Sudden Infant Death Syndrome (SIDS) The unexpected death of an infant in which the cause is unknown.
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine A shot that protects again tetanus, diphtheria, and pertussis (whooping cough).
Vaccination: Giving a vaccine to help the body’s natural immune system develop protection from a disease.
Vaccines: Substances that help the body fight disease. Vaccines are made from very small amounts of weak or dead agents that cause disease (bacteria, toxins, and viruses).
SOURCE: Good Health Before Pregnancy: Prepregnancy Care | ACOG
BUTTON FOR LINK: Getting Pregnant | ACOG
