by Tara Gellasch, MD

Dear Doc:
I am interested in becoming pregnant within the next year. I heard I should be taking a prenatal vitamin. What else should I know?

Dear Reader:
Taking a prenatal vitamin is a very important first step in preparing your body for a pregnancy. Prenatal vitamins contain at least 400 micrograms of folic acid. Folic acid has proven to reduce the risk of certain kinds of birth defects, most commonly spinal bifida which can cause paralysis. This is most effective if a woman stars the vitamins BEFORE she gets pregnant because most of the major organ systems including the central nervous system are forming even before a woman may be aware she is pregnant. Prenatal vitamins can be purchased over the counter at a pharmacy or may be prescribed by your doctor.
When considering pregnancy it is also important to evaluate your overall physical and mental health. Women who have diabetes, high blood pressure, lupus, thyroid disease and or other physical or mental health conditions should see their doctor before getting pregnant. Physical and mental health conditions should be under optimal control before getting pregnancy. Any medications being used should be reviewed with an obstetrical provider to ensure they are safe during pregnancy.
Additionally overweight and obese women should consider weight loss prior to pregnancy. Obesity increases the risk of pregnancy complications such as gestational diabetes, preeclampsia, preterm birth, and the need for a cesarean section. Weight loss through healthy diet and increasing exercise can reduce these risks significantly.
Lifestyle choices can pose risks to pregnancy as well. Smoking can decrease fertility, increase the risk of miscarriage, increase the risk of low birth weight babies and increase the risk of preterm delivery. Quitting smoking is the best thing you can do for your health and the health of your family. Your medical provider can discuss with you some of the options available to help you quit while you are trying to conceive. Alcohol intake can also affect babies. It is a good idea to avoid alcohol consumption if you could be pregnant as this is associated with fetal alcohol syndrome. Marijuana along with illicit drugs should be avoided due to increasing risks to baby and mom.
Lastly, There are severe genetic medical conditions that can passed along to your to children. It is possible to test for several of these conditions before you get pregnant. This is call preconception carrier testing. Based on your personal family history you and your doctor can determine which tests are most appropriate for you.
Starting a family is an exciting and sometimes stressful time. While you begin to focus on having a healthy baby it is critical that you take care of your own health. Wishing you all the best and you start this journey!