Importance of Good Health Before Pregnancy

QUESTION: My husband and I are considering starting a family. Is there anything I should do to help prepare myself for a healthy pregnancy?

ANSWER: by Jon S. Matsunaga, M.D.

Most women know the importance of prenatal care. But many don’t realize that even before you get pregnant, you can make wise choices that will benefit both your health and the future health of your baby.

If you are planning on becoming pregnant, it is a good idea to make an appointment with your Ob/Gyn or primary health care provider to arrange a physical exam and discuss preconceptual care, which includes medical, lifestyle and family history assessments.

When a woman is preparing for pregnancy, there may be special medical concerns to consider, including diabetes, high blood pressure or cardiovascular problems, all of which can increase pregnancy risks for the mother or the baby. Current treatments and possible adjustments to treatment need to be considered.

You should also tell your doctor about any medications you are taking, either prescribed or over the counter, as some may be harmful to a fetus.

Other medical topics that should be discussed are infections and vaccinations. Infections can harm both the mother and fetus. Vaccinations can prevent some infections such as measles, mumps and rubella. If you have not been vaccinated for these diseases, your doctor needs to know as he/she may recommend immunization. Because certain health conditions occur more often in families, a full family health history should also be taken during the exam.

In terms of lifestyle issues, your doctor should ask you about your family life, work and lifestyle to learn of any behaviors and exposures that could be a risk in a pregnancy.

Diet and nutrition should be reviewed, and changes may be suggested in areas such as:

• Your weight and whether it would be beneficial to gain or lose some before becoming pregnant;
• Your use of vitamins and other food supplements;
• Your eating habits, such as being a vegetarian;
• Any eating disorders you may have

Regarding diet and nutrition, it is advisable to take folic acid supplements prior to conception to reduce neural tube birth defects -- deformities in which the spinal cord is exposed in a developing fetus.

Certain fish contain high levels of mercury and should be avoided for health reasons: swordfish, shark, tilefish and mackerel.

Alcohol and illegal drug use can harm both you and your fetus; no amount of these substances has been proven safe to use during pregnancy.

Cigarette smoking can cause premature birth, low birth weight, premature rupture of membranes and problems with the placenta. The risk of the baby dying from sudden infant death syndrome (SIDS) is also increased. If you do smoke, your doctor can give you resources and provide options for quitting before pregnancy.

Environmental factors should also be considered. If you are a cat owner, have someone else change the litter box for you. Cats are the primary hosts for the parasite Toxoplasma, which can be transmitted to humans who come into close contact with the litter. If you become pregnant, you can transmit the infection, called Toxoplasmosis, to your unborn child. Toxoplasmosis outbreaks are also linked to undercooked meat, so avoid eating raw beef, pork or lamb, and always wash your hands after handling raw meat.

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Jon S. Matsunaga, M.D. is an Ob/Gyn specialist and chair of the Ob/Gyn department at Saint John’s Health Center in Santa Monica. For more information on Saint John’s, please contact the health center at (310) 829-5511 or visit the hospital’s website at http://www.stjohns.org