Download Pregnancy Planning Your health and habits affect a baby from the

Pregnancy Planning
Your health and habits affect a baby from the earliest days of a pregnancy. Before you
find out for sure that you are pregnant, a great deal has already happened. Your baby's
major organs (like the heart and kidneys) form during the first eight weeks.
Before you try to get pregnant, therefore, make sure you are as healthy as you can be.
Call your clinician to schedule a pre-pregnancy counseling visit to discuss your personal
health needs and possible risks. Consider taking a class at a hospital or health care site
about planning and having a healthy pregnancy. Following the tips in this list will help,
too.
Eat a nutritious, well-balanced diet
Eat a well-balanced diet for your health and the baby's:
 Fruit, vegetables, and grains (such as rice or grains found in bread, tortillas, or
cereal)
 Dairy foods like low-fat milk, cheese, and yogurt
 Protein-rich foods like lean meat, poultry, fish eggs, beans, or tofu
 Avoid junk food!
Talk with your clinician if you eat a vegetarian, macrobiotic, or non-dairy diet, or if you
need help bringing your weight into a healthy range.
Take a daily vitamin
Vitamins are very important to your baby's health and growth. The vitamin folic acid is
especially important because it helps prevent one kind of birth defect. Take one
multivitamin or prenatal vitamin a day (more than that could harm you and the baby).
Check the label to be sure the vitamin has at least “0.4 to 0.8” (400mcg to 800mcg) of
folic acid.
If you smoke, quit
If you smoke, ask your clinician about ways to quit. Smoking (and second-hand smoke)
is bad for you and your baby. It can even make it harder to get pregnant and increase
your risk for miscarriage and other health problems during pregnancy.
Avoid drinking alcohol
Experts aren't sure if it's safe to drink any alcohol during pregnancy. But they do know
that too much alcohol can cause birth defects, learning problems, and mental
retardation. It is safest to stop drinking alcohol before you try to get pregnant. If you need
help stopping, talk with your clinician or call Alcoholics Anonymous (listed online or in the
phone book).
Limit Caffeine intake
It is best to limit daily caffeine intake to 250mg a day or less. (Amounts of caffeine in
various types of coffee and caffeinated beverages vary greatly so you should be aware
of the portions that you typically intake.) There have been studies suggesting excessive
caffeine intake can decrease fertility and increase the risk of miscarriage.
Don't take any illegal drugs
If you use illegal drugs, stop before you try to get pregnant. Drugs harm you and may
cause your baby to be born very sick or addicted to drugs. Even occasional use of illegal
drugs can hurt. If you need help ending drug use, ask your clinician to refer you to
counseling or call Narcotics Anonymous (listed in the phone book).
Make sure you are safe
Being slapped, kicked, or beaten is never right. When you're pregnant, it puts your baby
in danger, too. If this ever happens to you, tell someone who can help you, like your
clinician, religious leader, or a social worker. You can also call a crisis hotline number in
your state for help:
 In Massachusetts, call (800) 992-2600
 In Rhode Island, call (800) 494-8100
Discuss any medicines you take with your clinician
Talk with your clinician about any medicines you take (even those you take occasionally,
like asthma medicine). Some medicines can harm your baby. This includes prescription
drugs and any over-the-counter medicines including herbal supplements you buy in a
drug store or supermarket. If a medicine you use is not safe, your clinician often can
suggest safer ones. In general, avoid all medicines except acetaminophen (Tylenol®).
However, never discontinue prescription medications that you need without consulting
your clinician.
Discuss any health problems with your clinician
If you have diabetes, talk with your clinician about having a special blood test to make
sure your diabetes is under control before you try to get pregnant. When diabetes is not
well controlled, it can cause birth defects and other health problems. Your clinician can
tell you if you need to change the way you eat or exercise. You may also need to change
your dose of insulin or type of medicine and test your blood sugar more often.
If you have high blood pressure, ask your clinician about the best way to lower it. If it's
not under control, high blood pressure can cause serious problems for you and the baby.
If you're already on blood pressure medicine, ask about the safety of the one you are
taking. You may need to take a different one while you are pregnant.
If you have epilepsy, talk with your clinician about the medicine you are taking. Some
drugs for epilepsy can harm your baby. You may need to switch to another one or take
extra folic acid before you get pregnant.
If you have any other health problem, discuss it with your clinician. You may need to try
a medicine that's safer for your baby or make changes in your diet.
Make sure you have all your vaccines
At least three months before you try to get pregnant, ask your clinician if all your
vaccines are up-to-date. This is important because some diseases, especially German
measles (rubella), can be serious for your baby if you get them while you are pregnant. If
you have not had chickenpox, you can now get a vaccine for that, too.
Make sure you don't have an STD
Sexually transmitted diseases (STDs) can infect a baby during pregnancy or birth, and
can cause health problems for you. STDs include herpes, chlamydia, gonorrhea, and
other diseases. Since many STDs cause no symptoms, it's best to ask your clinician if
you should be tested. Some STDs can be cured or controlled with medicine.
Consider a test for HIV
You and your partner should consider being tested for HIV (the virus that causes AIDS)
before you try to get pregnant. HIV can be passed from an infected mother to her unborn
baby. (If you are pregnant and you have AIDS or HIV, there is medicine that will improve
your health and lessen the chance that your baby will get the virus.)
Discuss any problems with earlier pregnancies with your clinician
If you've had problems with earlier pregnancies, get your medical records from other
health care institutions and talk with your primary or obstetric clinician.. S/he will try to
find out what caused the problem and how likely it is to happen again. Your next
pregnancy may be watched carefully or special tests will be done, if needed.
Consider the risk of birth defects and genetic disorders
Your age during pregnancy, family health history, and racial or ethnic background can
affect the health of your baby. Before you try to get pregnant, talk with your clinician
about the information below. S/he can explain tests that can be done before or during
pregnancy to help find out if your baby could have certain birth defects or genetic
disorders. Your clinician may also refer you to a genetic counselor to help review your
family history.
Age Women over age 35 have a greater chance than younger women of having a child
with chromosome problems and a higher risk of early miscarriage. Tests during
pregnancy (prenatal testing) can determine whether your baby has a chromosome
problem that could cause mental retardation or birth defects.
Family History If you or a family member have any of the following conditions, you may
have an increased chance of having a child with the same condition:
 Birth defects such as a heart, spine, or kidney problem present at birth
 Mental retardation including Fragile X syndrome and Down's syndrome
 Genetic disorders such as muscular dystrophy, hemophilia, Huntington's disease,
and cystic fibrosis
Racial and Ethnic Background Some genetic disorders are more common in certain
racial and ethnic groups. Healthy people can carry an abnormal gene that can cause
diseases in their children if both parents have the same abnormal gene. Tests can
screen parents for the gene and the fetus for the disease. Listed below are several
groups and some genetic disorders that are more common in them.
Background
Genetic Disorder
Mediterranean and Asian
Thalassemia
African-American, Latino
Sickle cell anemia
E European Jewish (Ashkenazi)
Tay-Sachs disease,
Canavan's disease
French-Canadian
Tay-Sachs disease
N European Caucasian (incl Ashkenazi Jewish)
Cystic fibrosis
For more information on birth defects and genetic disorders, call the March Dimes
Resource Center at 1-888-MODIMES (1-888-663-4637).
Avoid lead paint and dangerous chemicals
Lead paint and some chemicals may harm a baby during pregnancy by causing mental
retardation and health problems. This includes some household cleaners, garden
products, and chemicals used at work. Avoid using them, or wear gloves and wash your
hands carefully afterward. If you use paints and solvents, keep windows open and get a
special mask at the hardware store that will prevent you from breathing in fumes.
Ask your clinician what chemicals to avoid, or call the Pregnancy/Environmental Hotline
at 781-466-8474 (or 800-322-5014 in Massachusetts).
Most states also have groups that oversee safety and health in the workplace. In
Massachusetts the Department of Health and Human Services Website about work
safety can be accessed on line here.
Your local health department can tell you how to find out if your home has lead paint and
how to safely remove or cover it.
Avoid infection
Washing your hands frequently helps prevent many kinds of infection. If you eat meat,
have a cat, or spend time working in a garden, take the additional steps below to avoid
getting the disease called toxoplasmosis. It is passed on in raw or undercooked meat,
cat droppings, and soil where there are cat droppings. This disease can seriously harm
your baby if you get it while you're pregnant.
Cook meat until it is medium to well-done
Ask someone else to clean the litter box, or wear gloves and a mask.
Wear gloves when gardening
Wash your hands especially carefully after handling meat, cleaning a litter box, or
gardening.
Get in shape
Get in shape ideally before you try to get pregnant. Regular exercise will make you
healthier and tone and stretch muscles you'll need during pregnancy and birth. Being
very overweight can make it harder to get pregnant as well as increase complications of
pregnancy and risk of some birth defects.
Don't get overheated
Avoid saunas and hot tubs while trying to get pregnant. They can raise the temperature
inside your body, which can harm a developing baby. If you have a fever of more than
100.4°F, take acetaminophen (such as Tylenol®) to bring the fever down.
See your dentist
Have a dental checkup. If you need an x-ray or work on your teeth, have it done before
you try to get pregnant.
Record your periods
Keep a written record of your periods to help your clinician estimate your due date if you
do get pregnant.
Take these healthy steps
By taking these steps, you'll improve your health. And if you do become pregnant, you'll
know you've given your baby the best possible start in life.
If you have been trying to get pregnant for a year (or six months if you are over 35) and
haven't been successful, ask your clinician if you should be checked for fertility
problems.
Want more information about early pregnancy?
Websites
the Center for Disease control has lots of information, a Q and A and other links.
http://www.cdc.gov/ncbddd/preconception/links.htm
Birth defect prevention is the mission of the March of Dimes.
http://www.marchofdimes.com/pnhec/173.asp
Book
Planning for Pregnancy, Birth, and Beyond, 4th Edition by The American College of
Obstetricians and Gynecologists. ACOG (Washington, DC: 2005).