Planning a Pregnancy

If you're planning to become pregnant, taking certain steps can help reduce risks for both you and your baby. Good health before deciding to become pregnant is almost as important as a healthy lifestyle during pregnancy.

The first few weeks of pregnancy are crucial in a child's development. But many women don't know they're pregnant until several weeks after conception. Planning ahead and taking care of yourself before becoming pregnant is the best thing you can do for you and your baby.

One of the most important steps in helping you prepare for a healthy pregnancy is a prepregnancy exam. This is often called preconception care. It is done by your healthcare provider before you become pregnant. This exam may include:

• Family health history. The healthcare provider will ask about your family health history, as well as your partner's. This helps find out if any family members have had any health problems, like high blood pressure, diabetes, or intellectual disability.

• Genetic testing. This type of testing looks for any possible genetic disorders. Several genetic disorders may be inherited. One example is sickle cell anemia. It's a serious blood disorder that mainly happens in African Americans. Another is Tay-Sachs disease. It's a nerve breakdown disorder marked by worsening intellectual and developmental disabilities. It mainly occurs in people of Eastern European Jewish origin. Some genetic disorders can be found by blood tests before pregnancy.

• Personal health history. The healthcare provider will ask about your personal health history to determine if there are any:

  • Health conditions that may need special care during pregnancy—like epilepsy, diabetes, high blood pressure, anemia, or allergies

  • Previous surgeries

  • Past pregnancies

• Vaccine status. The healthcare provider will ask you about the vaccines you've had to assess your immunity to certain diseases, such as rubella (German measles). Getting rubella during pregnancy can cause miscarriage or birth defects. If you aren't immune to it, you may be given a vaccine at least 1 month before conception.

• Infection screening. The healthcare provider will screen you for any sexually transmitted infections. These can be harmful to you and your baby.

You can take other steps to help reduce your risk of complications and to prepare for a healthy pregnancy. These include:

• Smoking cessation. If you're a smoker, stop smoking now. Studies have shown that babies born to mothers who smoke tend to be born prematurely and to be lower in birth weight. They are also more likely to die of sudden infant death syndrome (SIDS). Plus, women exposed to secondhand smoke are more likely to have low-birth-weight babies. There may also be dangers from thirdhand smoke. These are the chemicals, particles, and gases of tobacco that are left on hair, clothing, and furnishings.

• Healthy diet. Eating a balanced diet before and during pregnancy isn't only good for your overall health, but it's essential for nourishing your baby.

• Healthy weight and exercise. It's important to exercise regularly and maintain a healthy weight before and during pregnancy. Women who are overweight may have health problems, like high blood pressure and diabetes. Women who are underweight may have babies with low birth weight.

• Management of pre-existing conditions. Before getting pregnant, take control of any current or pre-existing health problems, like diabetes or high blood pressure.

• Preventing birth defects. Take 400 micrograms (0.4 mg) of folic acid each day. This nutrient is found in some green leafy vegetables, nuts, beans, citrus fruits, fortified breakfast cereals, and some vitamin supplements. Folic acid can help reduce the risk of birth defects of the brain and spinal cord (also called neural tube defects).

  Don't drink alcohol or take drugs during pregnancy. Also tell your healthcare provider about any medicines (prescription and over-the-counter) you're currently taking. All may have negative effects on the developing fetus.

• Exposure to harmful substances. Stay away from toxic and chemical substances (like lead and pesticides) and radiation (like X-rays). Exposure to high levels of some types of radiation and some chemical and toxic substances may negatively affect the developing fetus.

• Infection control. Don't eat undercooked meat and raw eggs. You should also stay away from cat feces and cat litter. These may contain a parasite called Toxoplasma gondii that causes toxoplasmosis. Other sources of infection include insects (for instance, flies) that have been in contact with cat feces. Toxoplasmosis can cause a serious illness in, or death of, the fetus. You can reduce your risk for infection by staying away from all potential sources of the infection. A blood test before or during pregnancy can determine if you have been exposed to the Toxoplasma gondii parasite.

• Daily vitamins. Start taking a prenatal vitamin every day, as your healthcare provider directs. Your body will then get all the nutrients and vitamins needed to nourish a healthy baby.

• Identifying domestic violence. Women who are abused before pregnancy may be at risk for increased abuse during pregnancy. Your healthcare provider can help you find community, social, and legal resources to help you deal with domestic violence.