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Need For A Healthy Child - The Advantages Of Pre Pregnancy Planning

One third to one half of live-born infants in the United States are the result of unintended pregnancy; however, studies have consistently shown that planned pregnancies generally have better outcomes than unplanned ones. Women who plan their pregnancies are more likely to make healthy changes in their lifestyles that give them a better chance for a healthy pregnancy, delivery, and baby. They are also more likely to have stable finances, health insurance, and an understanding of and desire for the extra responsibilities of motherhood.

It is advisable for all sexually active women of child-bearing potential to undergo a simple preconception review of medical history, a physical exam, and possibly life-style counseling or vaccinations to ensure the best possible outcome if pregnancy should occur. It is even more important for women planning a pregnancy or who have a high-risk life-style.

Review of Medical History: Your doctor will ask you about current medical conditions and medications. Some medical conditions could complicate pregnancy, especially if they are not well-controlled. For example, if you have hypothyroidism, your doctor will want to make sure your current dose of medication is maintaining adequate thyroid function before you get pregnant. (Poor thyroid function can also inhibit fertility, so fixing the problem, if there is one, could actually help you get pregnant faster). Other conditions like diabetes, hypertension, seizure disorders, sexually transmitted diseases, and urinary tract infections can also have implications for pregnancy, so your doctor will want to discuss them with you.

Medication Review: many medications are contraindicated in pregnancy, so your doctor will want to switch you to a safer alternative. Even more medications are considered borderline, meaning there is not enough data to say whether they are safe or not. In this case, you and your doctor will weigh the potential benefits compared to the potential risks to decide whether you should continue to take them.

Family History: if anyone in your family has a genetic disorder, you may be offered preconception genetic testing and/or genetic counseling to assess the risk that your baby would have the disorder.

Age: depending on your age, your doctor may discuss it with you. Teenagers are not ideal candidates for pregnancy because they are rarely in a loving, long-term, stable relationship. They have often not completed their education and are not typically financially stable. They may even still be growing themselves, which is an additional stress for a body attempting to grow a baby. Women over the age of 35 have declining fertility and are at greater risk for Down’s Syndrome and other chromosomal disorders.

Vaccination Status: your doctor may draw blood to assess your status for rubella and hepatitis B. If you have not been vaccinated or your titers of antibodies appear to be insufficient, your doctor will recommend that you receive these vaccinations now to protect the baby once you are pregnant. MMR (measles, mumps, rubella) is a live vaccine, so it is recommended that you get it at least three months prior to becoming pregnant.

STD Screening: you will be offered screening for STDs such as gonorrhea, chlamydia, and HIV. It is important to know that you have these conditions and treat them accordingly (though there is not currently a cure for HIV).

Lifestyle Counseling:

  • The neural tube forms and closes around 6 weeks gestation, which is shortly after a pregnancy test becomes positive. Folic acid is essential for the formation of this tube, so the current recommendation is actually to start taking a prenatal vitamin for several months prior to conception to ensure adequate levels of folic acid and decrease the risk for neural tube defects and spina bifida.
  • Your doctor will advise you to eat a wide variety of healthy foods from all food groups and minimize food high in sugar and fat. He/she may also address your weight. If you are either overweight or underweight, he may refer you to a dietician that can aid you in either losing or gaining weight to make your body more suitable for carrying a baby and increase your chances for a healthy pregnancy.
  • Most doctors recommend moderate exercise for at least 30 minutes at least three times per week. Your doctor will discuss any specific concerns either of you may have.
  • If you smoke, your doctor will recommend that you quit and possibly offer you some form of smoking cessation aid. There are a wide variety of nicotine patches, gums, and lozenges on the market as well as a couple of prescription medications. Counseling services and support groups are often available as well.
  • If you drink alcohol, you will be advised to stop. There is no safe level of alcohol in pregnancy, and most pregnancy tests don’t become positive for two weeks after conception, so you could be drinking during pregnancy and not even realize it.

Contraception Counseling: if you are not quite ready to become pregnant, your doctor will discuss modes of contraception with you. If you are currently using contraception but wish to become pregnant, your doctor may offer recommendations about how long after stopping hormonal contraceptives (pill, patch, shot, IUD) you could conceive. Some doctors like you to have two normal periods prior to trying to conceive, though this is more to aid in accurate dating of the pregnancy when you do conceive than the safety of the baby. Some women’s bodies take a few months to begin ovulating again after being on contraception for awhile, so prepare to be patient.

Even if you maintain a healthy lifestyle, have no medical risk factors, and are physically ready for a baby, you are not necessarily ready emotionally and/or financially. It is a good idea to consider all aspects of your life before taking the plunge because a baby really does change everything. Your work-load at home will increase with baby chores. Your relationships with your significant other, friends, and family may change. Your sleep schedule will change. Your ability to do what you want when you want will change. Are you ready for those changes? Are you willing to accept the responsibility that a baby requires? Are you in a loving and stable relationship? Does your partner also want a child? Money is not the most important factor in deciding whether to have a baby, but it should be considered. Babies need diapers, clothes, and eventually food, and you are financially responsible for them until they are at least 18 years old. Do you have health insurance? Are you financially stable? Do you plan to stay home with the baby or go back to work? Will that be feasible? Will you be able to support your child(ren)?

Making the decision to try for a baby is a big one with many aspects to consider. Ideally the decision-making process should include discussions with both your significant other and your doctor. When you are physically, emotionally, and financially ready, let the fun of trying to conceive begin! You can increase your odds by understanding your menstrual cycle and knowing when you are approaching ovulation.

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