A 3-month guide to preparing yourself for pregnancy
IF YOU'RE READING THIS COLUMN, chances are good that you're thinking about having a
baby soon. But before the serious baby-making begins, check out this get-ready-to-get-pregnant
guide. Already started trying? No problem. It's never too late to make lifestyle changes that will
improve your health … and your child's.
Three months before
Check yourselves out Since it takes two to do the reproductive tango, you should schedule a preconception checkup for yourself and your partner. During this exam, your health care provider will
go over issues such as your and your families' health histories. "Understanding patients'
gynecological history and past pregnancy experiences can be very important in helping them plan
healthy pregnancies," says John R. Sussman, M.D., associate professor in the department of
obstetrics and gynecology at University of Connecticut School of Medicine.
At this exam, your caregiver also should check that your immunizations are up-to-date.
Chickenpox and rubella are the two main ones to concern yourself with now. If you're not immune
to both diseases, you should ideally be vaccinated three months before trying to conceive. Both are
"live" vaccines, so they're not recommended during pregnancy.
Special cases, special advice Women with chronic health conditions such as high blood pressure,
thyroid disease, diabetes, epilepsy, heart disease or lupus will need to have them carefully
managed. For women with diabetes, the odds of having a healthy pregnancy and baby increase if
they are able to get their blood sugar under control before they become pregnant. A pre-conception
checkup should include a test for diabetes if a physician suspects you may be at risk. Women who
are being treated for depression or anxiety, or who've struggled with mood disorders in the past,
also should get special care.
Clean out your cabinets Your medicine chest is probably filled with over-the-counter
medications you take for headaches, allergies or constipation, and perhaps a variety of herbal
products, too. Now is the time to start thinking about what's in there. Some of these products
contain ingredients that could affect fertility or harm your baby-to-be. Ask your doctor about
what's safe once you start trying to conceive.
Pick a date If you're using a barrier birth control method, such as condoms or a diaphragm, you
can continue to use it until the day you start "trying." But if you're on the birth control pill, you
might want to switch to another method of contraception now. Even though some women begin
ovulating almost immediately after stopping oral contraceptives, for others it may take several
months.
Put your money where your mouth is Gum disease is associated with preterm delivery, so see a
dentist to make sure you're in good dental health before getting pregnant. If you need dental
treatments, X-rays or medications, take care of that before you start trying to conceive.
On-the-job safety If you're concerned about anything you're exposed to at work-such as harmful
chemicals, prolonged standing or even intense stress-talk to your employer, and do some research.
Your partner also should do some digging, even though it can be difficult to get some employers to
acknowledge that reproductive health issues are important for men, too.
Two months before
Vitamins and veggies Start eating a variety of whole grains, fruits and vegetables every day, and
reduce your unhealthy-fat intake. Boost your consumption of foods that are rich in iron and
calcium, and consider taking a multivitamin supplement, too. Just make sure you don't overdo it
with vitamins A or D. (Recommended: vitamin A, 770 micrograms, up to 3,000 mcg; vitamin D, 5
mcg, up to 50 mcg.)
One of the most important ingredients in your multivitamin supplement is folic acid. A minimum
of 400 mcg daily is recommended to reduce the risk of neural-tube defects such as spina bifida in
babies. (Note: If you are at increased risk, you may need approximately 10 times that amount, or 4
milligrams.)
Would-be dads also should get plenty of folic acid, zinc and vitamin C, nutrients that are vital for
optimal sperm production and quality.
Weight matters If you're heavier than you should be, try to get to within 15 pounds of your goal
weight before becoming pregnant, then switch to a maintenance diet of 1,800 calories per day
while trying to conceive. Obese mothers face an increased risk of high blood pressure, gestational
diabetes, oversize babies and Cesarean section.
Of course, it's not healthy to be seriously underweight either. Women who are too thin are at risk
of experiencing fertility problems, going into preterm labor, having a low-birth-weight baby or
becoming anemic.
Get with the (fitness) program If you already have a regular fitness routine, by all means
continue it (unless you are 'into marathons or extreme sports, in which case you should consult a
physician to make sure your activities don't affect your fertility). And if you've been more into the
couch than cardio, consider starting a program now--one you can continue throughout your
pregnancy. Being physically active when you're pregnant can help relieve pregnancy aches and
pains. It also boosts your energy, helps you sleep, improves your mood and helps you cope with
stress.
One month before
Kick some butts "There are so many things you don't have the ability to change to maximize your
chances of having a healthy baby. Smoking is one thing you can change," says Arlene Cullum,
M.P.H., of the Sutter Medical Center in Sacramento, Calif. A woman who smokes is less fertile
and faces an increased risk of miscarriage, stillbirth, preterm delivery and having a low-birthweight baby. Children of mothers who smoke are at higher risk for many health problems,
including sudden infant death syndrome (SIDS).
If you're a nonsmoker but your partner isn't, tell him it's time he quit. Recent studies conclude that
for a fetus, there's no big difference between having a mother who smokes or having one who's
exposed to secondhand smoke.
Don't party hearty No one has ever been able to determine a safe level of alcohol consumption
during pregnancy, so the March of Dimes and the Centers for Disease Control and Prevention
recommend that you stop drinking entirely once you start trying to conceive. Moms who drink
during pregnancy face an increased risk of miscarriage, stillbirth and having a low-birth-weight
baby or one with potentially severe birth defects.
Alcohol also can bring down sperm counts, and marijuana use decreases sperm density and
motility and increases the number of abnormal sperm.
Go slow with the joe You don't have to cut out caffeine entirely, but because excessive intake
(more than 300 mg daily) has been linked to fertility problems as well as to an increased risk of
miscarriage, preterm delivery and a low-birth-weight baby, moderation is key.
Start your engines!
Once you're actively trying to conceive, take a few more steps to stack the odds of a healthy
pregnancy in your favor.
Find out which foods are safe Experts recommend that pregnant women--and women who are
trying to get pregnant--steer clear of raw fish and fish that are high in mercury; undercooked meat
or seafood; dell meats; all foods made with raw or lightly cooked eggs; unpasteurized soft cheeses,
milk and juices; raw vegetable sprouts; and herbal teas.
Delegate the dirty work Let others handle unsafe chores (e.g., using paints, solvents or pesticides;
cleaning the cat box or rodent cage).
Help him keep his cool Men who wear boxers have a tower scrotal temperature (and hence a more
sperm-friendly environment) than those who wear briefs. Your guy also should keep the laptop off
his lap and avoid cycling more than two hours a day, six days a week.
By Ann Douglas
Ann Douglas is the mother of four children and author of The Mother of All Pregnancy Books
(Wiley Books, 2002).
Fit Pregnancy ; Oct/Nov2006