There are many factors that play a role in achieving a successful pregnancy and decreasing your risk of complications during your pregnancy course. While sometimes you can do everything right and still have an adverse outcome, there are decisions and life choices you can make prior to attempting to become pregnant that can make for a less complicated pregnancy with decreased risk to you and your baby. First, it is our role as OB/GYNs to educate patients and provide preconception counseling before ever even trying to become pregnant. Then, it is your job as a patient to do these things so that we can work together to have a positive experience prior/during/after becoming pregnant.
These are a few things that should be addressed prior to becoming pregnant:
1. Start taking prenatal vitamins 3 months prior to trying to conceive (most women don't know they are even pregnant until there are well into the 1st trimester and after their baby's organs have started forming; therefore, you already want those vitamins in your system so start early by taking a prenatal vitamins early!
2. Review your medication list with your OB/GYN- while some medications are okay in pregnancy, there are some that aren't and definitely need to be discontinued or changed to a different alternative that is safe for your baby. Reviewing your medications (prescription or non-prescription) with your doctor prior to attempting to conceive can help eliminate preventable causes adverse development of your baby. So...take note of your medications and discuss with your doctor!
3. Optimize your health! Pregnancy can take toll on your body, so why not be in the best health prior to carrying a baby? Whether that is eating healthy and working out to obtain the ideal pre-pregnancy weight, getting medical conditions under control (like blood pressure, diabetes, depression/anxiety, thyroid disease, etc), or changing social habits (stop smoking, drinking, or doing drugs), addressing these issues can drastically influence your pregnancy course.
4. Get your immunizations! Some vaccinations are okay in pregnancy (for example, EVERY pregnant woman should get the flu vaccination and around 28 weeks get the Tdap [tetanus, diphtheria, pertussis] vaccine) but live vaccines are not (like varicella and measles/mumps/rubella). So before becoming pregnant, make sure you are vaccinated!
5. Limit travel to places that can have potential infectious diseases- for example, I'm sure you have heard of the Zika virus. You should restrict your travel to any places that could potentially expose you because it can be very dangerous to your fetus. The CDC provides a good summary of those places: https://wwwnc.cdc.gov/travel/page/zika-travel-informationLook
6. Get screened for any concerning genetic abnormalities/infectious diseases/etc--according to American College of Obstetrics and Gynecology, women who are in the preconception counseling period should be offered the same genetic screening provided to those women who are pregnant. For example, some diseases (like cystic fibrosis or sickle cell disease) can be genetic and it is important to know if you carry a trait that could be passed on to your baby. If you have that trait, it may be important to go the extra step and have your partner screened as well. Also, it is important to be screened against any sexually transmitted diseases and have those treated prior to conceiving.
7. Get yourself out of an abusive relationship or seek help if you are in a violent relationship. As doctors we should always screen for domestic violence. If you are in a relationship in which you are abused (mentally, physically, or sexually), it is vital that you remove yourself from that situation and seek help. It has been proven that domestic violence worsens in pregnancy and postpartum period in women that are already in violent relationships. So do not think because you are pregnant, it will all change. Thanks to ACOG website, here are some resources if you are struggling with intimate partner violence (open 24h and toll free): National Domestic Violence Hotline: 800–799–SAFE (7233) and 800–787–3224 (TDD). You also can find help online at www.thehotline.org.
I hope you find this information helpful. Pregnancy is such an exciting time in one's life and hopefully this advice can only help to provide you with the tools to makes sure you are READY so that is can be a positive experience for you and your baby!
Thanks y'all!
Dr. Riley
Reference: ACOG Committee Opinion #762
