Preconception Planning - It's more than stopping birth control

By Dr. Rhonda Miller, MD, OB/GYN

We plan our vacations. We plan weddings, family reunions and dinner parties.

 

Why do we sometimes fail to plan pregnancies better than our social calendars?

 

This is a very important part of life, and much happens in the early phase before a woman even knows she is pregnant. It is more difficult to provide a cozy place for the new life to grow after it is has been already occupied. 

 

Factors affecting the intrauterine environment include lifestyle, genetics, medications and past pregnancies. Successfully addressing these factors is one reason why couples should consider seeing a provider as part of prepregnancy care.

 

Nutrition, exercise and optimizing health are key planning elements. Dietary likes and dislikes may leave vitamin and nutrition gaps that can seriously affect the fetus. Folate deficiencies, for example, have been associated with increase risk of certain birth defects, such as cleft lip and cleft palate. 

 

There are also studies that suggest an increased risk for miscarriage. Vegetarian diets and diet fads need to be reviewed to look for additional nutrition gaps that may be amenable to some adjustments. Large doses of vitamins can cause problems for the developing embryo and periods of fasting increases certain chemicals in the blood that can impact development of the fetal brain. 

 

Tobacco use should be addressed prior to conception. Smoking is associated with an increased risk of placental problems that can result in loss of the pregnancy or growth problems for the fetus. It is estimated that mortality rates for newborns would decrease by up to 5 percent if smoking was eliminated in pregnancy. Medical providers have resources to assist women who are thinking about conceiving or those who are already pregnant to reduce or quit smoking. 

 

Women with medical conditions who are trying to conceive should have their medications reviewed for safe use. There may be options more suitable for expecting mothers.

 

Making sure chronic conditions are stable prior to pregnancy is also crucial. Diabetes, for example, should be in control in order to reduce the risk of heart problems, spinal cord problems and growth issues.  

 

Family genetics should also be discussed. Certain genetic disorders can be tested prior to pregnancy, and others can be addressed through a review of family origination.

 

All women are encouraged to have a discussion with a health care provider. After all, what is more important than the health of your baby?