Preparing for Pregnancy: An Overview

Happy couple smiling
If you are planning to become pregnant, your most important consideration is making sure your health is the best it can be. Most of your baby’s major organ systems and structures will develop in the first trimester of pregnancy, before you find out you are pregnant. Therefore, to ensure the best possible outcome for your baby, it is ideal if you can adopt a healthy lifestyle before you become pregnant.

Health care before pregnancy

Health care before pregnancy includes seeking medical attention before you become pregnant, starting a regular exercise routine that you can continue during pregnancy, adopting healthy eating practices, and increasing your folic acid intake.

The recommended folic acid intake for women with no health risks or with health risks such as epilepsy, diabetes, or obesity is 0.4 to 1.0 mg per day with a daily multivitamin. Folic acid should taken from two to three months before conception, throughout pregnancy, and for the first four to six weeks after birth or as long as breastfeeding continues. A woman who has previously conceived a baby with a birth defect such as anencephaly, myelomeningocele, cleft lip or palate, structural heart disease, limb defect, a defect of the urinary tract, or hydrocephalus should take 5.0 mg of folic acid daily from three months before conception until 10 to 12 weeks after conception. After that time, she needs to continue taking folic acid 0.4 to 1.0 mg per day throughout the rest of pregnancy and for the first four to six weeks after birth or as long as breastfeeding continues.

Daily multivitamins should also contain 200 to 400 IU of vitamin D per day, and some studies are starting to show that a higher dose of vitamin D is beneficial throughout pregnancy and breastfeeding.

You will also need to start avoiding certain substances called teratogens which are harmful during pregnancy. Teratogens include infections and certain chemicals, medications, smoking, alcohol abuse, and illicit drugs.

Before becoming pregnant, you should be screened for certain infections. Infections that can affect the baby during pregnancy include HIV, hepatitis B, syphilis, rubella, chicken pox, cytomegalovirus, parvovirus, and toxoplasmosis. If you have not already had rubella or chicken pox, you may want to consider taking the vaccines for both diseases before becoming pregnant. You may also need to undergo genetic screening if you are over age 35 or if you are a carrier of certain diseases such as sickle cell anemia or thalassemia.

If you have any chronic conditions, they may pose a threat to your baby during pregnancy. It is important to get these conditions under control before becoming pregnant. In some cases, a change in treatment may be needed, because some medications are harmful to the developing baby.

Getting pregnant

Once your health care is in order, you will then need to think about getting pregnant. You may assume that you will become pregnant as soon as you discontinue your contraception, but that is not usually the case. Depending on the type of birth control you have been using, it could take a considerable amount of time to become fertile. You may also want to know about your own unique fertility pattern. You can use certain changes in your body, such as cervical mucus and your body temperature at rest, to help predict when you are most fertile.

Learning about reproduction

You may also wish to learn more about your reproductive system and how reproduction works. Ovulation is the actual release of the woman’s egg cell from her ovary. Fertilization, or conception, is when a man’s sperm cell enters the egg cell, they unite and their chromosomes mingle together. Reproduction begins at fertilization, and involves the implantation of the fertilized egg cell into the uterus, and the growth and development of that fertilized egg cell into a baby.

 

Nicolette Caccia, MEd, MD, FRCSC

Rory Windrim, MB, MSc, FRCSC

9/10/2009


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