Published: May 27, 2014

Renee M. Bender, DO, Obstetrician/Gynecologist
Chester County Hospital

Once they become pregnant, many women ask, "What should I be doing differently now that I am pregnant?" That question, however, is better asked BEFORE a woman conceives. The answer is simple, yet complex. The simple part of the answer is to avoid tobacco and alcohol, eat a well balanced diet, exercise, and receive early, regular prenatal care. The more complex part of the answer involves lifestyle changes and optimizing good health before pregnancy.

A woman who is considering becoming pregnant should optimally see her doctor several months before attempting pregnancy. This allows time for screening for immunity to such diseases as varicella (chicken pox) and Rubella (German measles). Checking for immunity to these diseases in advance allows time for a woman to be immunized prior to becoming pregnant. Also, after review of her health history, her doctor can address other medical problems such as thyroid disease, diabetes, and high blood pressure that can affect both mother and baby during pregnancy.

If you have thyroid disease, you should have your thyroid levels checked. If you have diabetes, it is important to control you blood sugars before pregnancy. Uncontrolled diabetes can increase your risk of having a baby with a heart defect. If you have high blood pressure, it is important to control your blood pressure prior to pregnancy as well. Your family history can also be reviewed, and screening for certain genetic diseases, such as cystic fibrosis, prior to your pregnancy should also be considered.

Your doctor can also review your medication list to make sure you aren't taking any medications that can affect your pregnancy. While most medications do not cause any problems in pregnancy, a few, such as certain medications to treat seizures and high blood pressure should be avoided. Your doctor can identify these, and often, suggest an alternative.

Folic acid is an important supplement before and during pregnancy. Adequate folic acid can help prevent neural tube defects such as spina bifida. A woman needs at least .4mg of folic acid daily to help prevent this. If she has a higher risk of having a baby with spina bifida, such as having had a child in the past with spina bifida, have a family history of, or are on certain medications, you may need more folic acid- 4mg instead of .4mg a day. Folic acid is found in foods such as citrus fruits, beans, dark green leafy vegetables and enriched breads and cereals. However, since it can be hard to get enough folic acid in your diet, it is recommended you take either a folic acid supplement, or a multivitamin with folic acid. Since more than half of pregnancies are unplanned, it is recommended that any woman of child bearing age take folic acid, since, just like the heart and the other fetal organs, the spine is often formed before a woman even realizes she is pregnant.

So think about it, plan for it - and do your best to optimize your health before you become pregnant!

This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.

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