Most women have heard about the importance of having folic acid in their diets, especially when they are of child-bearing age. Among other benefits, folic acid can lower the risk for certain neurological birth defects. It's important to remember, however, that women should be getting this essential nutrient before they conceive.
"It's been estimated that as many as 50 percent of pregnancies in the United States are unplanned. That's why it’s so important to always be at the ready," says Xavier Pombar, DO, a high-risk obstetrician at Rush University Medical Center.
"All women of child-bearing age should receive preconception counseling at every visit to their health care provider. Ideally, this type of counseling should begin with the first visit after a woman begins to menstruate."
The basics
Besides folic acid, there are other things that women should consider when thinking about becoming pregnant:
Good nutrition
Good nutrition is the cornerstone of a successful conception and pregnancy. Taking a multivitamin is a good way to ensure that you are getting some of the basic daily requirements.
- Avoid fish that may have high levels of methylmercury
- Avoid raw fish, like sushi or ceviche
- Avoid soft cheeses
- Reduce amounts of caffeine (usually from beverages like coffee, teas and some sodas)
Exercise
Exercise can improve labor outcomes and reduce the risk of gestational diabetes, a type of diabetes that occurs during pregnancy.
Quitting smoking
Quitting smoking can reduce the risk of spontaneous miscarriages, fetal death, infants with lower than normal birth weight infants and sudden infant death syndrome (SIDS).
Stop using alcohol and other recreational drugs
"No one has ever identified a safe amount of alcohol use," says Pombar. "And fetal alcohol syndrome is the leading cause of preventable mental defects. Therefore, you should limit use of alcohol significantly or quit altogether if you are trying to conceive and, once you realize you’re pregnant, you need to abstain from alcohol altogether.
"Of course, it goes without saying that you should stop any recreational drug use, whether you thinking of conceiving or not," Pombar adds. Talk to your physician if you think that you have a problem with alcohol or other drugs.
Family history
Another thing that people sometimes forget to consider is their family history. A review of your family history with your physician can help show if you may be predisposed to certain disorders or complications. You may have a family history of heart and vascular disease, diabetes, miscarriages or fetal death.
"If you are a woman with a family history of diabetes, for instance, I would recommend that your blood sugar levels be tested before conception," says Pombar.
The newborn of a mother with diabetes is seven times higher risk for birth defects. "That's why it's so important to have control of the blood sugar before conception and throughout the pregnancy," says Pombar.
"Many of these issues must be addressed and managed before conception," he says. "It may be too late if we wait, especially since the organs develop around six to eight weeks into the pregnancy, and the first visit to the gynecologist or obstetrician is usually at the eight to 10 week mark. The fetus may have already developed problems before the mother comes in for her first prenatal visit."
All women of child-bearing age should receive preconception counseling at every visit to their health care provider.
Your environment
You should be aware of possible toxins in your environment that can affect the health of a developing fetus. Some things seem more obvious than others for instance, if you work somewhere where you are exposed to toxic chemicals or radiation. Other things are not as obvious.
One example is toxoplasmosis from your cat. Toxoplasmosis can lead to fetal infections. You should also be careful about exposure to mercury and other heavy metals in fish and other seafood, as well as foodborne illnesses, including from unpasteurized cheeses and juices.
Talk to your doctor for more details and to discuss those things that may be of particular risk to you.
Medication
Women of child-bearing age should also consider the effects of any medications they are taking. A clear relationship has been established with birth defects and some anti-seizure medications and antidepressants, says Pombar. You can talk to your physician about the possibility of changing medications or dosage.
Being prepared
If you are of child-bearing age you should always be prepared for the possibility of having a child.
"In my opinion, they are very few women who would not benefit from preconception counseling," Pombar says. "If nothing else they can have the confidence that they did everything possible to optimize the first stages of the pregnancy."
