Preconception planning: Is your body ready for pregnancy?
December 8, 2010
If you've decided to get pregnant, you may already be emotionally prepared to have a baby. Now it's time to find out if your body is ready for the task ahead.
Depending on your health, immunizations and method of contraception, preconception planning up to a year in advance may be helpful. To help ensure a healthy pregnancy, schedule a preconception appointment with your health care provider as soon as you begin thinking about pregnancy. Be ready to answer the following questions.
What type of birth control have you been using?
If you've been taking birth control pills, your health care provider may recommend a pill-free break before trying to conceive. This will allow your reproductive system to go through several normal cycles before you conceive, which will make it easier to determine when ovulation occurred and establish an expected due date. During the pill-free break, you may want to use condoms or another barrier method of contraception. Your fertility may return to normal two weeks after you stop taking the pill.
If you've been using a long-term method of birth control, such as contraceptive injection (Depo-Provera), you can try to conceive as soon as you stop using birth control — but it may take several months for fertility to return.
Are your vaccines current?
Infections such as chickenpox (varicella), German measles (rubella) and hepatitis B can be dangerous for an unborn baby. If your immunizations aren't complete or you're not sure if you're immune to certain infections, your preconception care may include one or more vaccines — preferably at least one month before you try to conceive.
Do you have any chronic medical conditions?
If you have a chronic medical condition — such as diabetes, asthma or high blood pressure — make sure it's under control before you conceive. In some cases, your health care provider may recommend adjusting your medication or other treatments before pregnancy. Your health care provider also will explain any special care you may need during pregnancy.
Are you taking any medications or supplements?
Tell your health care provider about any medications, herbs or supplements you're taking. He or she may recommend changing doses or stopping them completely before you conceive.
This is also the time to start taking prenatal vitamins. Why so early? The baby's neural tube — which becomes the brain and spinal cord — develops during the first month of pregnancy, possibly before you even know that you're pregnant. Taking prenatal vitamins before conception is the best way to help prevent neural tube defects.
Are you at risk of a sexually transmitted infection?
Sexually transmitted infections can increase the risk of infertility, ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube — and other pregnancy complications. If you're at risk of a sexually transmitted infection, your health care provider may recommend preconception screening and treatment.
Do you have a family history of any specific medical conditions?
Sometimes family medical history — either your history or your partner's — increases the risk of having a child who has certain medical conditions or birth defects. If genetic disorders are a concern, your health care provider may refer you to a genetic counselor for a preconception assessment.
How old are you?
After age 35, the risk of fertility problems, miscarriage and certain chromosomal disorders increases. Some pregnancy-related problems, such as gestational diabetes, are more common in older mothers as well. Your health care provider can help you put these risks into perspective, as well as develop a plan to give your baby the best start.
Have you been pregnant before?
Your health care provider will ask about previous pregnancies. Be sure to mention any complications you may have had, such as high blood pressure, gestational diabetes, preterm labor, premature birth or birth defects. If you had a previous pregnancy involving a neural tube defect, your health care provider may recommend a higher daily dose of folic acid than what's found in most prenatal vitamins for at least one month before conception.
If you have any concerns or fears about another pregnancy, share them with your health care provider. He or she will help you identify the best ways to boost your chances of a healthy pregnancy.
Would your current lifestyle support a healthy pregnancy?
Healthy lifestyle choices during pregnancy are essential. Your health care provider will likely discuss the importance of a healthy diet, regular physical activity and keeping stress under control. If you're underweight or overweight, your health care provider may recommend addressing your weight before you conceive. It's also important to avoid alcohol, illegal drugs and exposure to toxic substances. If you smoke, ask your health care provider about resources to help you quit.
What about your partner's lifestyle?
If possible, have your partner attend the preconception visit with you. Your partner's health and lifestyle — including family medical history and risk factors for infections or birth defects — are important because they can affect you and your baby.
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