Planning Your Pregnancy — Preconception Planning

Get a Medical Checkup

It is important to find a clinician who specializes in pregnancy health and delivers babies. It's also important to find someone who will help you feel comfortable. You may want to continue to see your current gynecological clinician. Or, you may want to find a new clinician to visit during pregnancy. You can ask for recommendations from your current clinician, family doctor, family members, or friends who have been pregnant.

A doctor who practices gynecology and obstetrics is commonly called an OB/GYN. Some women choose a midwife to deliver their babies. Certified nurse-midwives are registered nurses. Licensed midwives may be self-taught or trained by a licensed state agency.

It's important to research and interview any professional you may want to help with your pregnancy and delivery. You may also want to consider where you want to deliver the baby. Where do you want to deliver?

• in a hospital
  
• in your home
  
• in a birthing center

The Preconception Visit
Certain factors are associated with difficult pregnancy. Some may be treated or controlled. Be sure to have a preconception visit if you

• have had only brief times between earlier pregnancies or just had a baby
  
• have a history of unexplained stillbirths or miscarriages, or babies born premature or low birth weight
  
• know you are at personal risk of having a child with birth defects, mental retardation, or a genetic disorder
  
• are at risk for rubella (German measles) or other infectious diseases
  
• have heart or kidney disease, hypertension, or other chronic conditions such as lupus
  
• have or had a sexually transmitted infection, cytomegalovirus, streptococcal infections, or toxoplasmosis
  
• have psychological stress, such as family or financial problems
  
• were exposed to environmental hazards, such as X-rays or toxic chemicals
  
• smoke, drink alcohol, or use over-the-counter, prescription, or illegal drugs
  
• have a weight problem or a history of eating disorders
  
• are younger than 15, or older than 35

Your clinician may ask you questions about your family, and their medical histories, and the potential father and his family's medical histories. It is important to be honest about both families' medical histories. This preliminary screening may reveal possible risks for the pregnancy and for the health of your child.

This checkup may also include a physical exam, a pelvic exam, and blood and urine tests.

Change Old Habits That Affect Your Health

It's important to change unhealthy habits as soon as you know that you want to become pregnant. You will be dealing with many changes once you become pregnant. Changing certain habits can be stressful, so it may be easier to start now.

The first 12 weeks of pregnancy are very important for fetal health and development. Many women do not even know that they are pregnant during this time. If you are trying to become pregnant, make healthy decisions as if you already were pregnant!

Don't smoke. The dangerous chemicals in cigarettes can cut off oxygen to the developing fetus. Smoking can also cause complications from low birth weight to infant death.

Women who need help to stop smoking should speak with their clinicians or contact the American Cancer Society — 1-800-227-2345, www.cancer.org; the National Cancer Institute - 1-800-422-6237, www.cancer.gov; or the National Heart, Lung, and Blood Institute's Smoking Education Program - 1-301-592-8573, http://www.nhlbi.nih.gov/index.htm.

It is also believed that "passive smoking" (breathing secondhand smoke) can have negative effects on pregnancy. Make sure that you are in smoke-free environments.

Don't drink alcohol. Even a little alcohol may harm a fetus — no matter what kind of alcohol it is. Beer and wine are just as dangerous as hard liquor.

No one is sure how much it takes to cause harm. Most clinicians tell women not to drink at all during pregnancy.

We know for sure that more than five drinks a day can cause FAS (fetal alcohol syndrome). FAS causes birth defects and affects a child's ability to learn, think, and move.

Women who need help to stop drinking should speak with their clinicians or contact a local self-help program such as Alcoholics Anonymous.

Don't use drugs. Addictive, habit-forming, or trippy drugs such as heroin, cocaine, codeine, crystal meth, uppers, downers, marijuana, PCP, or LSD can cause serious problems for the fetus and for the baby when it is born. Many babies go through painful withdrawal in the first few days of life. Many don't survive.

Using other illegal drugs during pregnancy — marijuana, for example — may harm a child's ability to

• pay attention
  
• make decisions
  
• remember things

Women who need help to stop using drugs should talk with a clinician or contact a local self-help program such as Narcotics Anonymous.

A Man's Role in Pregnancy Planning
It can be difficult to get pregnant if a man has a low sperm count. Some habits that can affect sperm badly include

• drinking alcohol
  
• smoking cigarettes
  
• using anabolic steroids
  
• using illegal drugs, such as marijuana, cocaine, or heroin
  
• taking certain antibiotics, prescription drugs, or over-the-counter medicine
  
• using saunas, whirlpools, or hot tubs at more than 102ºF
  
• unhealthy diet

Stress, certain bacterial and viral infections, some medical conditions, and exposure to pesticides may also reduce sperm count or the quality of semen.

Eat Well and Exercise
A healthy diet is vital for a healthy pregnancy. It's the best thing you can do for your baby's mind and body. It will also make you strong and ready for labor, delivery, and breastfeeding.

Talk with your clinician about your diet if you

• cannot eat certain foods or are a vegetarian
  
• vomit frequently
  
• cannot take prenatal vitamins
  
• have too much or too little weight gain

You will need about 100-300 more calories a day than you usually do. Talk with your clinician about how many will be right for you. Also talk about any problems with eating or keeping a healthy weight.

It's important to eat a balanced diet of carbohydrates, fat, protein, and fiber. Drink when you are thirsty, but avoid caffeine — coffee, tea, and soda. Also avoid sugary drinks.

Most women need to take extra vitamins during pregnancy — even if they eat well. Your clinician may advise you to take "prenatal" vitamins. They are especially for pregnant women.

The most important ones to take during pregnancy are calcium, iron, and folic acid — a type of vitamin B. Folic acid helps reduce the risk of very harmful brain and spine defects. It is possible to get too much of some vitamins and minerals. Too much Vitamin A, for example, can cause birth defects. Talk with your clinician about the right vitamins to take.

Regular exercise can help strengthen a woman's body and prepare it for pregnancy. Some women with certain health problems may not be able to increase their physical activity, especially once they are pregnant.

Reduce Stress and Avoid Dangers
Get plenty of sleep and don't exert yourself. Be sure to take the time to do things that you enjoy and that relax you. Enjoy your sexuality, too. Having sex can help reduce stress and the tensions that can build up during pregnancy. Most women who want to are able to enjoy sex throughout pregnancy.

Beware of dangers on the job. Some jobs may be harmful before and during pregnancy. Talk with your boss and clinician to figure out how you can avoid dangerous substances and situations, such as standing too long or working too many hours in a row. Try to find ways to reduce job stress, too.