A healthy lifestyle during pregnancy is important, and, as local obstetricians point out, the steps women take before conceiving can have a big impact on the pregnancy, and the health of mom and baby.
“Pregnancy is an incredible stress on your body,” said Dr. Joy Pretcher, obstetrician and gynecologist at Kaiser Permanente Salmon Creek Medical Office. “If you’re already not handling your physiology well, pregnancy is going to put a further strain on that.”
A planned pregnancy and a healthy mother-to-be can help women to enjoy their pregnancy more and reduce the risk of serious complications and birth defects.
“You really, really want to optimize their health before conceiving,” Pretcher said. “Pregnancy is a marathon for your body.”
Folic acid
One of the most important things a woman can do before getting pregnant is to begin taking prenatal vitamins, which contain folic acid.
“That folic acid is really essential to helping the spinal cord form,” Pretcher said.
The folic acid helps to prevent two serious birth defects of the brain and spine — spina bifida and anencephaly — that typically occur early in pregnancy (three to four weeks after conception) and before most women even know they’re pregnant.
“That’s a missed opportunity for a lot of women to be optimizing their baby’s normal development,” Pretcher said.
Women who do not have existing medical conditions and who are at a healthy weight should begin taking 400 micrograms of folic acid three months prior to getting pregnant, said Dr. Sally Segel, a perinatologist at The Vancouver Clinic. Women with certain conditions, such as diabetes or epilepsy, should take 1 milligram of folic acid for three months, she said.
Prenatal vitamins can be started earlier and can continue to be taken throughout pregnancy, Pretcher said.
“Really, it’s a great vitamin for anyone of reproductive age,” she said.
Lifestyle changes
For any woman considering pregnancy, Segel recommends some basic lifestyle changes.
• Don’t smoke cigarettes or marijuana.
• Don’t use illicit substances.
• And don’t binge drink.
• Exercise regularly.
• Eat a healthy diet.
• Limit caffeine intake.
“Those will all hold you in good stead,” she said.
Getting pregnant at a healthy weight is also important, Segel said.
“One thing in our community that people have a big problem with is weight,” Segel said.
“Even losing 10 pounds can make a difference,” she added.
Obesity adds significantly to pregnancy risks, beginning with the ability to conceive, Pretcher said. In addition, women who are obese are at increased risk for stillbirths and pre-eclampsia, she said.
Ideally, women should have a body-mass index (a formula based on height and weight) of less than 25 before conceiving or, at the minimum, less than 30, Pretcher said.
Medical conditions
Women with chronic medical conditions should engage their provider in a discussion about pregnancy before trying to conceive, Segel said. Some medical conditions can increase the risk for certain birth defects and complications during pregnancy.
Uncontrolled diabetes can lead to birth defects of the heart or spine, preterm birth and miscarriage. Hypertension increases the risk for pre-eclampsia and other conditions, Pretcher said.
Women with relapsing diseases, such as inflammatory bowel disease or lupus, should be flare-free for six months before getting pregnant, Segel said. Doing so greatly reduces the risk for a flare during pregnancy, she said.
Before conceiving, Pretcher also recommends women review their immunization history with their physician. Some vaccines are not safe to give during pregnancy but, if vaccinated prior to conception, could prevent illness in women and prevent the illness from being passed along to baby, she said.
Women should also consult their physician about the medications they’re taking before getting pregnant. Some high blood pressure and epilepsy medications and blood thinners can increase the risk of birth defects, Segel said.
“If you have a medical condition and get pregnant, do not cold turkey stop your medication,” Segel said.
Instead, make an appointment with your provider, who can help you weigh the risks and benefits of discontinuing medications or prescribe different medications that are less harmful, she said.
Physicians can also help women to sort out which over-the-counter medications, such as cold and allergy medicines, are and are not safe to take during pregnancy, Pretcher said.
Family history
Women should also know the medical history of their family and their partner’s family, Pretcher said.
Women with a family history of complications during pregnancy, such as a heart attack, stroke or blood clots, could be at risk for those complications. Identifying those risks early is important, Pretcher said.
Women may also want to consider genetic testing if they’re at risk for certain recessive genes that could cause significant disorders in their children or if they have a family history of inherited disorders, such as cystic fibrosis and sickle cell disease.
“You may want to consider testing before finding out your baby has some horrible disease,” Segel said.
Consulting with a physician about preconception care is beneficial for all women, even those who consider themselves healthy, Pretcher said. Doing so gives women an opportunity to ask questions and make sure their bodies are healthy and ready for the stress of pregnancy, she said.
And that means healthier babies.
“The healthier we make the utero environment, the healthier adults we’re going to grow,” Segel said.
