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What to Expect: The Preconception Check-Up

The Importance of Seeing Your Doctor Before You Conceive
-- By Stepfanie Romine, Staff Writer

You already know that you should see your health care provider as soon as you see the stick turn blue. But did you also know it's a good idea to see your health care provider before you try to get pregnant?

Even if you don't foresee any complications in conceiving, it's important to get a full checkup before entering into such a major life event as pregnancy. (If you're already pregnant, remember that half of all pregnancies are unplanned. If yours was, too, don't worry. Just try to be the healthiest and happiest mom you can be.) Beautiful and exciting as it might be, pregnancy can also be taxing to your body. When you're ready to conceive, you should make sure your body - and mind - are ready. Here are some topics you might want to address with your health care provider:

Antidepressants
If you suffer from depression or another mental illness and you take antidepressants, your health care provider will want to discuss the effects of your medication on your pregnancy. Your health care provider could suggest alternative treatments or antidepressants that have been proven safe for women who are pregnant and breastfeeding. Some antidepressants are fine to take during the duration of your pregnancy; others are not. Ask your health care provider.

It's a bad idea for anyone to suddenly stop taking prescription antidepressants without her health care provider's guidance. Factor in the fluctuating hormone levels of pregnancy, and changing or stopping your medication without medical supervision could pose serious risks. You should never change or stop taking medication without consulting your health care provider. Learn more about dealing with depression during pregnancy.

Caffeine
Are you a java junkie? Your health care provider likely will tell you to reduce and possibly eliminate caffeine, especially during the last two weeks of your cycle. Too much caffeine can inhibit iron absorption and increase risk for stillbirth.

Contraceptives
If you are currently using prescription contraceptives, talk to your health care provider about how and when to stop taking them. Some birth control methods have unpleasant side effects when you stop using them, so ask your health care provider what to expect.

Stopping the pill midcycle can cause irregular bleeding, and it can take a few months for your cycle to regulate. Many women conceive the month after they stop taking the pill, patch or ring.

If you get shots of Depo-Provera, it can take up to a year for you to ovulate again, even if your period is normal before then.

If you have an implant or IUD, talk to your health care provider about having it removed.

Dental Care
Good oral health is important for more than just a nice smile. Schedule a cleaning and any necessary dental work (X-rays, etc.) before you conceive. If you have a cavity or need other dental work done, you might not be able to undergo certain procedures if you're pregnant.

According to the CDC, pregnant women with gum disease can be seven times more likely to have a premature baby. Another study linked gum disease and preeclampsia, a harmful pregnancy complication. Learn more about Dental Care During Pregnancy.

Family history
Your health care provider will ask about your health, your partner's health, and both of your family histories, including whether you may be carriers of certain birth defects or diseases. If you are a carrier of diseases such as cystic fibrosis, sickle-cell anemia, Tay-Sachs disease (a rare yet often fatal genetic disorder that affects the nervous system) or thalassemia (a group of genetic blood disorders), you might have to consult with a genetic counselor to ensure a safe pregnancy.

He or she might also ask about your family's pregnancy history to get an idea of what you might also expect for your own. For example, did you mom, sisters, or grandmothers have problems with their pregnancies?

Folic acid
Folic acid (folate) is such an important nutrient for preventing birth defects that all women of child-bearing age are advised to get 400 mg daily. Why all women? Health authorities made this recommendation so that even women who aren't trying to conceive will have their bases covered in the event that they do become pregnant. This means that meeting your daily folic acid quota is important even before you start trying to get pregnant. Your health care provider will advise you to start taking a daily multivitamin that contains at least 400 mg of folic acid. Even though you can also get this crucial B vitamin from foods such as fortified cereals, leafy greens, beans, and orange juice, it is hard to get an adequate amount from foods alone.

Lifestyle and vices
Do you smoke, drink regularly, or use illegal drugs? Your health care provider will strongly encourage you change your lifestyle before attempting to conceive.
Smoking (and secondhand smoke) can lead to low-birth weight babies, miscarriage, and premature birth, so work with your health care provider to devise a plan to quit before you conceive. Other studies have shown that smoking can affect your fertility and lower sperm count in men too. Your health care provider can give you resources to quit before you get pregnant.

Illegal drugs also can harm your baby, even if you stop taking them before you try to conceive. Tell your health care provider about any past drug use. Don't be embarrassed or ashamed. Being honest can help your unborn child.

Alcohol can inhibit your fertility. Be honest with your health care provider about your drinking habits, and abstain from heavy drinking for at least a couple of months before you try to conceive. Drinking during pregnancy can lead to fetal alcohol syndrome, which includes physical, mental and behavioral problems. Get more facts about how alcohol, drinking and drugs affect your pregnancy.

Medical conditions
Certain diseases and conditions, such as epilepsy, high blood pressure, and diabetes, can become complicated by pregnancy. Your health care provider will explain how pregnancy can affect your health and any special care you might need to take. In some cases, you might need to change your prescriptions during your pregnancy, but it's a good idea to have a plan in place before you conceive.

Medication
Obviously, if you're on oral contraceptives, your health care provider will talk to you about stopping them (see "Contraceptives" above). But he or she will also ask you about any over-the-counter medicines, supplements, herbs, and other medications you might be taking since even these seemingly "safe" drugs and supplements can affect your fertility and pregnancy.

Some medications, such as blood thinners, diabetes medicines, and seizure drugs, can affect a fetus too. For example, the acne medication Accutane can cause serious birth defects and miscarriage. If you take Accutane, you must talk to your health care provider about how long to wait before getting pregnant.

Sexual health
Sexually transmitted diseases don't just affect you and your partner; they can also harm your unborn child. STDs can permanently damage the brain, spinal cord, eyes, hearing, or immune system of a developing fetus.

If you haven't had a gynecological exam in more than a year, you can expect to have a pelvic and breast exam, pap smear, and STD testing during your preconception exam.

Vaccinations
Certain diseases, such as chicken pox and rubella, can seriously harm your baby if contracted during pregnancy. Your health care provider will check to make sure you've had the disease or a vaccination. If not, you'll be encouraged to get the vaccination before conceiving.

Weight
When it comes to weight, it's a good idea to avoid extremes-too low and too high. Women who have BMIs (Body Mass Indexes, which measure the relationship between your height and weight) below 20 or above 30 can have a harder time conceiving. (For a 5'3" woman, that's means weighing less than 113 pounds or more than 169 pounds.)

But even if your weight doesn't prevent you from getting pregnant, underweight women (who weigh less than 100 pounds before conception) are more likely to have small or underweight babies, while women who were obese before getting pregnant are more likely to have large babies. Obesity also raises a woman's risk of gestational diabetes and preeclampsia, two potentially serious complications. Learn more about pregnancy and delivery.

If you're able to plan your little bundle of joy, then by all means do. You want to make sure your body is as healthy and prepared as possible. Don't worry too much about being in "perfect" health. Your health care provider will help you ensure your little one is healthy and developing at the right rate.


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Member Comments About this Article
"i loved this before during and after my pregnancy and it was great that i had it done. this information is very useful to women
" -- LISSA2601
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About The Author
Stepfanie Romine
A former newspaper reporter, Stepfanie now writes about nutrition, health and fitness, with an emphasis on whole foods and from-scratch cooking. She is a certified Ashtanga yoga teacher who enjoys Spinning, international travel and vegetables of all kinds. See all of Stepfanie's articles.

 


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