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Planning for Pregnancy | Preconception Care

If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Preconception health and health care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby. For some people, getting their bodies ready for pregnancy takes a few months. For other people, it might take longer. Whether this is your first, second, or sixth baby, the following are important steps to help you get ready for the healthiest pregnancy possible.

1. Make a Plan and Take Action

Whether or not you’ve written them down, you’ve probably thought about your goals for having or not having children, and how to achieve those goals. For example, when you didn’t want to have a baby, you used effective birth control methods to achieve your goals. Now that you’re thinking about getting pregnant, it’s really important to take steps to achieve your goal [PDF – 764 KB]—getting pregnant and having a healthy baby!

Preventive health care can help you stay healthier throughout your life.

2. See Your Doctor

Before getting pregnant, talk to your doctor about preconception health care. Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy. They may want to discuss any previous pregnancy problems, medicines you currently are taking, vaccinations you might need, and steps you can take before pregnancy to help prevent certain birth defects.

Take a list of talking points so you don’t forget anything. Be sure to talk to your doctor about:

Medical Conditions

If you currently have any medical conditions, be sure they are under control and being treated. Some of these conditions include: sexually transmitted diseases (STDs), diabetes, thyroid disease, high blood pressure, and other chronic diseases.

Lifestyle and Behaviors

Talk with your doctor or another health professional if you smoke, drink alcohol, or use certain drugs; live in a stressful or abusive environment; or work with or live around toxic substances. Health care professionals can help you with counseling, treatment, and other support services.

Medications

Almost every pregnant person will face a decision about taking medicines before and during pregnancy. Talk to your healthcare providers before starting or stopping any medicines. Be sure to discuss the following with your healthcare providers:

• All medicines you take, including prescriptions, over-the-counter medicines, herbal and dietary supplements, and vitamins
• Best ways to keep any health conditions you have under control
• Your personal goals and preferences for the health of you and your baby

Vaccinations (shots)

Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having lifelong health problems.

3. Take 400 Micrograms of Folic Acid Every Day

Folic acid is a B vitamin. CDC urges all people who can become pregnant to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).

Learn more about folic acid »

4. Stop Drinking Alcohol, Smoking, and Using Certain Drugs

Smoking, drinking alcohol, and using certain drugs can cause many problems during pregnancy, such as premature birth, birth defects, and infant death.

If you are trying to get pregnant and cannot stop drinking, smoking, or using drugs, contact your healthcare provider, local Alcoholics Anonymous, or local alcohol treatment center.

Alcohol and Drug Resources

Substance Abuse Treatment Facility Locator
The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment facility locator. This locator helps people find drug and alcohol treatment programs in their area.

Alcoholics Anonymous (A.A.)
Alcoholics Anonymous® is a fellowship of men and women who share their experiences, strengths, and hopes with each other so that they can solve their common problem and help others to recover from alcoholism. Locate an A.A. program near you.

Learn more about alcohol and pregnancy »

Smoking Resources

1-800-QUIT-NOW (1-800-784-8669)

Learn more about smoking during pregnancy »

5. Avoid Toxic Substances and Environmental Contaminants

Avoid harmful chemicals, environmental contaminants, and other toxic substances such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces around the home and in the workplace. These substances can hurt the reproductive systems of men and women. They can make it more difficult to get pregnant. Exposure to even small amounts during pregnancy, infancy, childhood, or puberty can lead to diseases. Learn how to protect yourself and your loved ones from toxic substances at work and at home.

Learn about the effects of toxic substances on reproductive health »

Learn how CDC tracks Children’s Environmental Health »

6. Reach and Maintain a Healthy Weight

People who are overweight or obese have a higher risk for many serious conditions, including complications during pregnancy, heart disease, type 2 diabetes, and certain cancers (endometrial, breast, and colon).¹ People who are underweight are also at risk for serious health problems.²

The key to achieving and maintaining a healthy weight isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating and regular physical activity.

If you are underweight, overweight, or obese, talk with your doctor about ways to reach and maintain a healthy weight before you get pregnant.

Learn more about healthy weight »

7. Learn Your Family History

Collecting your family’s health history can be important for your child’s health. You might not realize that your sister’s heart defect or your cousin’s sickle cell disease could affect your child, but sharing this family history information with your doctor can be important.

Other reasons people go for genetic counseling include having had several miscarriages, infant deaths, trouble getting pregnant (infertility), or a genetic condition or birth defect that occurred during a previous pregnancy.

Learn more about family history »

Learn more about genetic counseling »

8. Get Mentally Healthy

Mental health is how we think, feel, and act as we cope with life. To be at your best, you need to feel good about your life and value yourself. Everyone feels worried, anxious, sad, or stressed sometimes. However, if these feelings do not go away and they interfere with your daily life, get help. Talk with your doctor or another health professional about your feelings and treatment options.

Learn about mental health »

Learn about depression »

References

1. NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online:
   http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)
2. Moos, Merry-K, et al. Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. AJOG Volume 199, Issue 6, Supplement B , Pages S280-S289, December 2008.

How to prepare for conception?

Pregnancy planning is really necessary, especially in our time, when a healthy woman is the exception rather than the rule. Not to mention the fact that pregnancy is a serious test for the body of even a perfectly healthy woman.

It can be said that entering into pregnancy without prior preparation for it is the same as flying on an airplane that has not been checked in advance: maybe it will cost, or maybe not. Of course, aircraft are tested before each flight. So why does a woman, ready to give birth to a new human being, not always conduct a similar check of her body? After all, the price of her neglect of herself and her health can be the life of an unborn child.

The process of preparing for pregnancy is quite complex and includes several stages. It is worth starting planning a few months (at least three) before the time when the couple intends to conceive a baby.

And at the stage of pregnancy planning , it is necessary to understand that the bearing and birth of a baby is not a woman's business, but a married couple's. Therefore, the active participation of the father in planning pregnancy is extremely necessary and important for himself, and for his wife, and for the unborn baby.

Without the help of doctors, it will not be possible to manage even at this stage. A visit to the gynecologist will allow you to identify possible diseases and treat them in a timely manner. After the first appeal, future parents undergo several examinations and pass certain tests in order to find out how ready their bodies are for conceiving a baby, as well as to prevent possible problems when carrying a child. The gynecologist will tell you what to do if, before planning a pregnancy, a woman was protected with hormonal contraceptives. It is necessary to stop taking hormonal contraceptives 3 months before the planned pregnancy.

It is important for a future mother to understand that only a healthy woman can bear and give birth to a healthy baby. In this regard, you need to start taking care of your own health long before conception. Good physical shape, the absence of diseases, proper nutrition and the rejection of bad habits, hygiene and a measured lifestyle - all this has a beneficial effect on the female body and subsequently makes it easier to endure pregnancy. However, not all vitamins can be obtained from food. For example, the body can only obtain folic acid in an artificial form, since its counterpart (folate), found in green vegetables, beans, asparagus, and citrus fruits, is much less absorbed. Folic acid is very important for the development of the baby to take place correctly, and the need for its intake exists throughout pregnancy. If the mother's body during the bearing of the child receives a sufficient amount of this substance, then the risk of pathology from the nervous system is minimized.

What tests should a married couple undergo

before planning a pregnancy?

1. Gynecological examination, colposcopy for women.
2. Blood type, Rh factor for both spouses. If a woman has a positive Rh factor, there is no problem. If a woman has a negative Rh factor - antibodies to the Rh factor (even if a man is also negative). If they are positive, pregnancy is not currently possible and needs to be corrected. If negative - repeat this analysis once a month, starting from 8 weeks of pregnancy. If a woman has 1 group, and a man has any other group, incompatibility by blood types is possible. An analysis for group antibodies, as well as an analysis for antibodies to the Rh factor, is carried out once a month, starting from 8 weeks of pregnancy.
3. Tests for infections: routine smear, PCR for latent infections - both spouses.
4. Blood test for TORCH-complex. Antibodies to rubella, toxoplasma, herpes, CMV, chlamydia - quantitative analysis (with titer). The presence of IgG antibodies means immunity to these infections, and is not an obstacle to pregnancy. The presence of IgM means an acute stage, planning in this case must be postponed until recovery. If there are no IgG antibodies to rubella, it is necessary to be vaccinated and protected for another 3 months after it.
5. A trip to the dentist, a therapist, chest x-ray is a must for both spouses. By appointment of the therapist - consultation of narrow specialists (ENT doctor, urologist, endocrinologist, cardiologist, gastroenterologist).
6. Spermogram. Desirable, but not required. It is done to determine the quality of spermatozoa and identify a hidden inflammatory process (a much more informative analysis than any smears and PCR).
7. Ultrasound of the pelvic organs - at least 2 times per cycle: after menstruation and before menstruation. For the first time, the general condition of the pelvic organs is assessed, in the second, the presence of a corpus luteum and endometrial transformation, indicating that ovulation has occurred. Ideally, an intermediate third ultrasound on the eve of the expected ovulation is to detect the dominant follicle.
8. Blood test for hormones of the reproductive system, thyroid gland, adrenal glands - according to indications.
9. Ultrasound of the thyroid gland, mammary glands - according to indications.
10. Hemostasiogram, coagulogram. - according to indications.
11. General clinical blood test (hemoglobin, erythrocytes, leukocytes, platelets, ESR, color index, leukocyte formula). Finger blood. General urinalysis (morning portion of urine - completely collected, it is important that the analysis does not include discharge from neighboring organs).
12. Blood tests for syphilis, HIV, hepatitis B and C - for both spouses.
13. If there was a case of hereditary diseases in the family, miscarriages, spontaneous miscarriages, seek advice from a medical genetic consultation (Krasnoyarsk Regional Consultative and Diagnostic Center for Medical Genetics, Krasnoyarsk, Molokova St. 7, t. 55-99-20).

how and when to plan a pregnancy

Is it necessary to plan a pregnancy in advance? Most often, future parents visit a doctor when it has already come. Well, if they are in good health. But what to do when they do not suspect the presence of disorders in the body or genetic inheritance? In many cases, an elementary examination and treatment before conception could prevent the development of pathologies in the unborn child. Therefore, pregnancy planning is now beginning to be taken quite seriously.

Why should pregnancy be planned? However, according to some statistics, only about 30% of babies are born absolutely healthy. The same number already have a definite diagnosis. The remaining children are at risk. The situation is explained by the fact that as a result of exposure to adverse factors (poor nutrition, radiation, drug use, air pollution, smoking, and others), the cells of the human body continuously mutate. Mutations that have occurred in germ cells can be passed on to subsequent generations.

A person may not be aware of what changes are taking place in his body, especially if he is in excellent health and looks absolutely healthy. The older a person is, the more mutations accumulate in his cells. All this is transmitted as a result of inheritance, so it is very important to undergo a thorough examination before conception.

It is necessary to plan a pregnancy for those couples who have hereditary diseases, problems with bearing a child. The risk group also includes future parents living in environmentally polluted areas or working in hazardous industries. But this does not mean that the rest should not worry, because pregnancy planning, or conscious parenthood, is the key to the health and well-being of the unborn child.

When to plan a baby

In the process of planning pregnancy, it is necessary to carefully analyze the situation at the moment and look a little into the future. Of course, it will not be possible to foresee everything that can happen, but some points can still be thought through. Experts recommend starting preparation for conception six months or at least 3 months before pregnancy. But this is provided that outwardly no signs of illness are observed in both parents. In the case when at least one of them has current or hereditary disorders, the period is extended.

Pregnancy and age

When can I start planning a pregnancy? What age is considered the best for conception and bearing? In fact, each couple decides for themselves when they are ready to become parents. In modern times, more and more often the birth of the first child is postponed for a period after 30 years. And the task of gynecologists is to prepare a woman for pregnancy at any age.

Doctors should warn a woman that with age, the quality of eggs deteriorates, and the number of follicles begins to decrease faster. In addition, the task of the gynecologist is also to talk about the possibility of banking - freezing eggs or embryos.

What else does planning mean

Specialist consultation. At the stage of pregnancy planning, first of all, a woman should visit a gynecologist. The doctor may recommend, in addition to the main examinations, when planning, to do additional examinations if necessary. For example, to determine the presence of antibodies to such viral diseases as measles, rubella and chicken pox. In the absence of antibodies, vaccination is recommended, followed by protection for 1 month.

Correction of medication intake. If a woman is prescribed any drugs for permanent use, then she should definitely tell the doctor that she plans to conceive and become pregnant. The doctor will select a suitable, safer analogue. The drug may have a teratogenic and mutagenic effect, therefore, before using any of them, even at the stage of pregnancy planning, it is best to consult first.

Collection of information. It is worth asking parents and relatives if they have had cases of miscarriage or manifestations of hereditary disorders. If at least one such episode is found, you need to visit a geneticist.

Refusal of bad habits. Smoking and drinking alcohol can provoke hypoxia, miscarriage or lead to abnormalities in the development of organs in the fetus, so you should completely abandon these habits.

Power correction. Expectant mother needs to monitor body weight, maintaining it at an optimal level. Obesity, as well as underweight, can cause complications in both the child and the woman. However, it is also not recommended to drastically lose or gain weight, as this entails a restructuring of the hormonal background. A good way out is moderate food intake with a properly designed regimen, which a specialist can advise. It is not recommended to choose a diet on your own.

Caring for a healthy lifestyle. Good rest, hardening and physical activity are factors that contribute to the easy passage of a future pregnancy and the birth of a healthy baby.

Vitamins

When planning pregnancy, vitamin complexes are recommended. Mandatory intake:

1. Vitamin D. It is desirable for all women preparing to conceive to receive vitamin D at a dose of 600-800 IU / day. The decision to prescribe higher doses of vitamin D should be made on the basis of determining its concentration in the blood. Hypovitaminosis D is subject to mandatory correction.
2. Folic acid (vitamin B9). The need for folic acid in an adult and a child over 11 years of age is 200 mcg / day. During pregnancy, it increases by another 200 micrograms, so women during this period are recommended to take folic acid at a dosage of 400 micrograms / day.
3. Potassium iodide. Assign according to indications in cases where the intake of iodine with food is less than 150-300 mcg / day. The drug crosses the placenta well and, when taken at a dose of more than 500 mcg / day, can cause the development of hypothyroidism and goiter in the fetus.

Admission of additional drugs is decided individually.

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