Before Your Next Pregnancy

What to do before and during your next pregnancy to lessen the chance for birth defects?

If you are planning to become pregnant, taking certain steps can help reduce risks to both you and your baby. Proper health before deciding to become pregnant is almost as important as maintaining a healthy body during pregnancy.

The first few weeks are crucial in a child's development. Many women do not realize they are pregnant until several weeks after conception, planning ahead and taking care of yourself before becoming pregnant is the best thing you can do for you and your baby.

One of the most important steps to help you prepare for a healthy pregnancy is a prepregnancy examination, often called preconception care, performed by your physician before you become pregnant.

A preconception visit includes assessments of your overall health and identification of potential risk factors that may complicate pregnancy. Women can receive advice and treatment for medical conditions, such as diabetes or heart disease that may be changed by pregnancy.

By preparing in advance, you can be your healthiest before becoming pregnant. A preconception examination may include the following:

  • Family medical history, an assessment of the maternal and paternal medical history, determines if any family member has had any medical conditions such as high blood pressure, diabetes and/or mental retardation.
  • Genetic testing, an assessment of any possible genetic disorders, test for genetic disorders that may be inherited, such as sickle cell disease (a serious blood disorder which primarily occurs in African-Americans) or Tay-Sachs disease (a nervous disorder marked by progressive mental and physical retardation primarily occuring in individuals of Eastern European Jewish origin). Some genetic disorders can be detected by blood tests before pregnancy.
A personal medical history is an assessment that may help determine the following:
  • Medical conditions requiring special care during pregnancy, such as epilepsy, diabetes, high blood pressure, anemia and/or allergies
  • Previous surgeries
  • Past pregnancies including the number, length of pregnancy, previous pregnancy complications and/or pregnancy losses
  • Vaccination status an assessment of current vaccinations/inoculations to assess immunity to rubella (German measles), because contracting this disease during pregnancy can cause miscarriage or birth defects. If a woman is not immune, a vaccine may be given at least three months before conception to provide immunity
  • Infection screening to determine if a woman has a sexually transmitted infection or urinary tract infection (or other infection) that could be harmful to the fetus and to the mother

Reducing the risk of complications

Other steps that can help reduce the risk of complications and help prepare for a healthy pregnancy and delivery include the following:

  • Smoking cessation--If you are a smoker, stop smoking now. Studies have shown that babies born to mothers who smoke tend to have a lower birthweight. In addition, exposure to secondhand smoke may adversely affect the fetus.
  • Proper diet--Eating a balanced diet before and during pregnancy is not only good for the mother's overall health, but a proper diet essential for nourishing the fetus.
  • Proper weight and exercise--It is important to exercise regularly and maintain a proper weight before and during pregnancy. Women who are overweight may experience medical problems, such as high blood pressure and diabetes. Women who are underweight may have babies with low birthweight.
  • Medical management (of pre-existing conditions)--Take control of any current or pre-existing medical problems, such as diabetes or high blood pressure.
  • Preventing birth defects--Take 400 micrograms (0.4 mg) of folic acid each day, a nutrient found in some green leafy vegetables, nuts, beans, citrus fruits, fortified breakfast cereals and some vitamin supplements.

Folic acid can help reduce the risk of birth defects of the brain and spinal cord (also called neural tube defects). If you have a family history of spina bifida, congenital heart defects (heart defects present in a newborn) or cleft lip/palate, your physician may prescribe extra folic acid.

  • Avoid exposure to alcohol and drugs during pregnancy--Be sure to inform your physician of any medications (prescription and over-the-counter) and/or herbal supplements you are currently taking, they all may have adverse effects for the developing fetus.
  • Avoid exposure to harmful substances--Pregnant women should avoid exposure to toxic and chemical substances (e.g., lead and pesticides) and radiation (e.g., X-rays). Exposure to high levels of some types of radiation and some chemical and toxic substances may adversely affect the fetus.
  • Infection control--Pregnant women should avoid the ingestion of undercooked meat and raw eggs. In addition, pregnant women should avoid all contact and exposure to cat feces and cat litter, which may contain a parasite called toxoplasma gondii.

Other sources of infection include insects (e.g., flies) that have had contact with cat feces should also be avoided during pregnancy. Toxoplasmosis, from cat feces, can cause a serious illness to, or death of, the fetus.

A pregnant woman can reduce her risk of infection by avoiding all potential sources of the infection. A blood test before or during pregnancy can determine if a woman has been exposed to the toxoplasma gondii parasite.

  • Daily vitamins
    Begin taking a prenatal vitamin daily, prescribed by your physician, to make certain that your body gets all the necessary nutrients and vitamins needed to nourish a healthy baby.
  • Identifying domestic violence
    Women who are abused before pregnancy may be at risk for increased abuse during pregnancy. Your physician can help you find community, social, and legal resources to help you deal with domestic violence.