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Planning to get Pregnant?

Our goal is healthy moms and healthy babies. Meeting with our providers prior to pregnancy can help achieve that goal. You can have a big impact on your ability to conceive a baby (your fertility), as well as creating a healthy start to your pregnancy, simply by making healthy choices.

Folate

Folate, or folic acid, is a B vitamin that is in many foods and most all multivitamin supplements. It is recommended that every reproductive-age woman take a minimum of 400 micrograms (0.4 mg) of folate daily—ideally for 3 months but a minimum of 1 month before becoming pregnant. Many obstetricians prefer more than the minimum amount of folate: 800 to 1000 mcg (0.8 to 1mg). This folate needs to be a vitamin supplement in addition to any amount you may get in your diet in an effort to lower the risk of neural tube defects or spina bifida, as well as lessen the risk of cleft lip and palate and heart defects. Some women need much more than the minimum 400 mcg of folate, especially those with a family history of neural tube defects and those with diabetes, as well as obese women.

Tobacco, Alcohol, Substance Use

Smoking tobacco and e-cigarettes is associated with preterm delivery, stillbirth, and birth defects. Smoking also increases the risk of low birth weight and a higher risk of sudden infant death syndrome (SIDS). Stopping before pregnancy is your best option. Call 800-quit-now for help or talk with your Women First Care Team.

Even today, alcohol use during pregnancy is one of the most common preventable causes of developmental delay. You should stop all alcohol once you have a positive pregnancy test, and avoid heavy drinking (more than 2 drinks per day) or binge drinking (more than 5 drinks per day) while you are trying to get pregnant. Even moderate drinking (1-2 drinks per day) has been associated with attention deficit and memory problems in children, so no amount of alcohol is considered safe during pregnancy.

Oxycodone, hydrocodone, Xanax, Valium, marijuana, cocaine, heroin, methamphetamines, and illicit drugs must be avoided before and during pregnancy. They can cause premature birth and low birth weight, in addition to causing your baby to become addicted to the drug during pregnancy. After birth, your baby may go through withdrawal—neonatal abstinence syndrome (NAS)—and require prolonged medical stay.

Pregnancy is an opportunity to adopt healthy habits and make lifestyle changes that can last a lifetime, benefiting you and your entire family.

Read more about the impact of any of these substances during pregnancy here.

Ideal Body Weight

It is important to maintain your ideal body weight (body mass index 18.5-25) when you are trying to get pregnant. Obesity (body mass index greater than 30) is associated with problems getting pregnant and first trimester miscarriage, as well as birth defects and pregnancy complications. It’s best to optimize your weight before getting pregnant—for your health as well as that of your baby.

Medical Conditions

Many medical conditions need to be addressed and controlled before pregnancy for the best chance of a healthy mom and baby. See your doctor or health care provider before you get pregnant if you have diabetes, high blood pressure, thyroid problems, heart or kidney disease, or depression or anxiety that requires treatment.

Thyroid disease can cause problems getting pregnant, miscarriage, and lower intellectual functioning in your baby. If you are taking thyroid replacement for low thyroid, your needs increase very early in pregnancy. If you are taking thyroid medicines (including synthroid), call the Women First office once you have a positive pregnancy test so we can tell you what you need to do.

Medications

There are many medicines you should avoid and many medicines you need to continue taking when you are trying to become pregnant. You should address any prescription, over-the-counter, or herbal medicines you take with your doctor or Care Team before you get pregnant.

Past Obstetrical Problems

Discuss with your doctor if you have had a prior complicated pregnancy, especially if you have had a prior stillbirth or preterm delivery. You should also discuss any blood pressure or preeclampsia problems in the past.

Zika Travel

The Zika virus is spread primarily through infected mosquitos or unprotected sex with someone who is infected by Zika. Even if they show no symptoms, it can be passed from a woman to the fetus during pregnancy. Becoming infected during pregnancy can pass the virus to your fetus, resulting in potentially severe fetal birth defects such as microcephaly (small head).

Therefore, pregnant women or women trying to become pregnant should not travel to areas with risk of Zika. The Centers for Disease Control and Prevention (CDC) guidelines are for any man or woman who has recently traveled to a place with a CDC Zika travel notice to delay getting pregnant. Women need to wait 8 weeks and men need to wait 6 months after the last possible exposure or after any symptoms started before trying to conceive. During this waiting period, couples should use condoms or not have sex.

Zika travel recommendations change frequently so visit the CDC to keep up with the most current recommendations.

Fish Intake

Mercury is a metal that builds up in your body, and you can pass the metal to your baby during pregnancy. High mercury levels can cause brain damage, hearing and vision problems, and developmental delay. People cannot clear mercury so it builds up over time. A common source of mercury for people is eating certain types of fish. Fish get mercury from the water they swim in and from eating other fish that have mercury in them. There are only a few types of fish that reproductive-age women and children should avoid. The fish to avoid are tuna, swordfish, shark, tilefish, king mackerel, marlin, and orange roughy. You can have 3 cans per week of canned tuna (tuna salad).

Visit Your Dentist

Dental problems are associated with pregnancy complications, so stay up-to-date with your dental visits and teeth cleanings before you become pregnant.

Genetic Family History

If there is a family history of any birth defect, chromosomal disorder, developmental delay, or congenital anomaly for you or your partner, see if you can get a diagnosis or details from your family to discuss with your Women First doctor or health care provider. Certain ethnicities or groups of people are at a higher risk of carrying a gene that may put their baby at risk of an inherited genetic disease. The most common genetic disease in Caucasians is cystic fibrosis and, in African Americans, it is sickle cell. Also, people of Jewish ancestry are at risk of several genetic diseases. We now have several inexpensive blood tests that can screen you for a carrier of many different diseases. We also have the technology to prevent a couple from having a baby with a specific disease when both parents are carriers.

Learn more about our genetic screening.

Foresight Carrier Screen (Counsyl) or HerediT (Sequenom) Carrier Screening

There are thousands of genes on our chromosomes, and many of us are carriers of a specific gene defect without being aware of it. When your partner carries the same recessive gene, your child has a 25% chance of receiving both genes and getting the disease. Examples of these types of recessive genetic diseases, which affect one in 400 births, include cystic fibrosis and sickle cell anemia.

A simple blood test can screen you and your partner to see if you are a carrier of almost 200 genetic diseases that are relevant to pregnancy and babies. When we only screen based on ethnicity and family history, we miss 80% of carriers. An expanded genetic carrier blood test can be done at any time, pre-conceptually or during pregnancy.

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