The Preconception Wellness Exam: What You Need to Know Before Conceiving
The time to start working toward a healthy pregnancy is before you conceive!
Schedule an appointment for all your regular health maintenance needs and any booster vaccines you may need. Talk with your provider about nutritional and lifestyle changes that will help you achieve a healthy pregnancy. Ask your provider about fertility awareness and strategies to help you get pregnant quickly when you are ready. Start a prenatal vitamin or folic acid supplement for at least 3 months prior to conception to help reduce your baby’s risk for birth defects. If you are approaching 40, it may be good idea to evaluate your ovarian reserve by testing certain hormones that can predict conception success in older moms.
Diabetes in Pregnancy
Gestational diabetes occurs in a pregnant woman who did not have diabetes before pregnancy. Gestational diabetes can usually be controlled just by eating a healthy diet and exercising regularly. When diet and exercise aren’t enough, some mom’s with gestational diabetes will need oral medications or insulin to help control their blood glucoses.
For most women with gestational diabetes, the diabetes goes away soon after delivery. When it doesn’t go away, the condition is called type 2 diabetes. Even if the diabetes does go away after the baby is born, women who had gestational diabetes are at an increased risk to develop type 2 diabetes later. It's important for a woman who has had gestational diabetes to continue to a regular exercise program, eat a healthy diet after pregnancy and maintain a healthy weight to prevent or delay developing type 2 diabetes. Women who have had gestational diabetes should also remind their healthcare provider to screen for type 2 diabetes every few years.
One strategy to reduce your risk for gestational diabetes during pregnancy is to achieve a healthier body weight prior to conception, perform 45 minutes of cardiovascular exercise at least 3 times per week and start a low fat, high protein, and low carbohydrate diet prior to becoming pregnant. Try to eliminate as many processed foods as possible and invest in a juicer to ensure that you will get high potency micronutrients before and during your pregnancy.
High Blood Pressure in Pregnancy
High blood pressure is a serious concern during pregnancy. If your blood pressure is not well controlled prior to conception, you should avoid becoming pregnant until you and your cardiologist feels it is safe to do so.
Things to try to reduce risk for hypertension would be 10% reduction in body weight, eating a heart healthy, low sodium diet and making sure to exercise regularly.
If you are already taking an antihypertensive medication, be sure to check with your healthcare provider about whether it is a medication safe to take while pregnant.
The onset of high blood pressure during pregnancy may be a sign of preeclampsia.
Preeclampsia is a serious pregnancy complication. High blood pressure caused by pregnancy induced hypertension can cause damage to other organ system, often the kidneys. This complication requires immediate medical attention.
Other Medical Conditions in Pregnancy
Infections during pregnancy can be a threat to the fetus. Even a simple urinary tract infection, which is common during pregnancy, should be treated immediately. An infection that goes untreated can lead to premature labor and rupture of the amniotic sac membranes surrounding the fetus.
Some serious infectious diseases include: Toxoplasmosis which is transmitted through cat feces, food poisoning such as listeria and sexual transmitted diseases like chlamydia, gonorrhea, hepatitis, human immunodeficiency virus (HIV) and herpes.
As soon as you discover you are pregnant or if you are trying to conceive, make sure to arrange for someone else to change your kitty litter, and avoid high risk foods at deli counters and raw dairy products known to sometimes carry listeria. Wash all your fruits and vegetables carefully. Make sure to see your medical provider for all the appropriate screening tests for infectious diseases.
Pregnancy After 40
The risks associated with pregnancy in healthy, fit women after 40 are probably less worrisome than our mother’s thought. Most healthy women do very well. After 45, experts say, it's almost impossible to get pregnant using your own eggs. However many women 40 and older do get pregnant! Some use fertility treatments and others don’t. It's harder to get pregnant the longer you wait. That's because a woman’s ovarian reserve starts to significantly decrease in her mid 30’s and this diminished reserve can really impair fertility the closer we are to 40. Pregnancy loss rates are also more frequent as we age and embryos are more likely to be affected by chromosomal problems, raising the risk of miscarriage and birth defects
Twins
A twin pregnancy is a blessing but it can also carry greater risks than a singleton pregnancy. Get prepared. Familiarize yourself with the differences and risks associated with a multiple pregnancy. Learn what you didn't know about your twin pregnancy from conception through delivery and things you can do to decrease your risk for preterm labor, pregnancy complications and just some of the more intensified normal discomforts of pregnancy.
Teen Pregnancy
Missing one or more menstrual periods is the classic sign of pregnancy. But this can be tricky for teenage girls, whose periods aren't yet regular. It can also be tricky for girls whose cycles are off as a result of excessive dieting or exercise, low body fat from sports, or anorexia. Pregnant teens and their unborn babies have unique medical risks and unique prenatal care needs.
Teenage girls who are pregnant (especially if they don't have support from their parents) are at risk of not getting adequate prenatal care, dropping out of school and experiencing other health problems such as nutritional deficiencies and depression. Prenatal care is critical, especially in the first months of pregnancy. Prenatal care screens for medical problems in both mother and baby, monitors the baby's growth, and deals quickly with any complication that comes up. It is very important to receive prenatal care and follow up as instructed to make sure to keep you and your baby healthy.
If you are a pregnant teen, you should continue to attend school every day. Talk with your guidance counselor about any adjustments you need to make as your pregnancy continues and also about school sponsored childcare programs to support your continued education after your baby is born.
Many girls feel afraid to tell their parents about an unplanned pregnancy. In California, young women can obtain reproductive services without parental consent. This includes contraception like birth control pills or even an IUD. You can also obtain pregnancy termination services if you find that continuing your pregnancy is not the right choice. And of course you can come for prenatal care on your own or with your family.
California offers a number of free programs such as Family Pact for pregnancy prevention and STD testing and treatment, as well as Medi-Cal insurance programs especially for pregnancy care. If you are a pregnant teen and have any questions about what you should do next, please call us and we will try to help guide you through your options.
