| Basic Information |
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| Description |
The health of both partners before conception is vital to the development of
a healthy baby. The man's sperm and the woman's ovum are the foundation for
giving the baby the best start in life. As soon as you decide to have a child
you and your partner should assess your lifestyle to determine if any changes
are necessary and schedule a visit to the doctor for pre-pregnancy planning,
counseling and physical exams.
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| Medications |
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When possible, both partners should avoid medications while trying to conceive.
There are a few medications that are linked to birth defects and others that
carry unknown risks. If the medication is taken for a chronic condition, talk
to the doctor about its safety during pregnancy, and what are the treatment
options if there are any risks. Potentially harmful drugs should be discontinued
at least a month (in some cases, three to six months) before you try to conceive.
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| Contraception Method Concerns |
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Your present birth control methods should be evaluated before you are ready
to conceive. Oral contraceptives (birth control pills) should be discontinued
several months before conception so as to allow at least two regular menstrual
cycles to occur. An intrauterine device OUD) needs to be removed. To be extra
safe, the use of spermicides alone or with a condom or diaphragm should be discontinued
one to two months before you want to become pregnant (spermicide risk to a subsequent
pregnancy is unclear). As a temporary form of contraception, use condoms without
a spermicide.
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| Age |
- Most women over age 35 do experience successful pregnancies. Pregnancy-related
complications increase gradually with age, but they are still relatively low.
A woman may have more difficulty in conceiving because of decreased fertility.
She is also slightly more prone to problems during the pregnancy, such as
high blood pressure, gestational diabetes and miscarriage. Furthermore, the
risk of chromosome abnormalities, such as having a child with Down syndrome,
is increased. In addition to chromosomal abnormalities, advanced age has been
associated with several adverse pregnancy outcomes. Maternal age under 15
carries some additional risks also.
- Questions remain unanswered if advanced paternal age can be linked to any
birth defects. There may be some small connection, but medical studies have
not demonstrated any specific problems and it's not known at what age a problem
might begin. Following conception, if there is concern about the effects of
the father's age on the fetus, ask about prenatal tests to determine if they
are warranted.
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| Medical Conditions |
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If you have any chronic medical condition (e.g., asthma, diabetes mellitus,
high blood pressure, seizure disorder, thyroid disorder), talk to your doctor
about planning for a pregnancy. Find out how the condition will affect the pregnancy,
how the pregnancy will affect the condition, and if any medications you take
might affect the pregnancy. The medical condition needs to be under control
before you conceive and you must continue good selfcare throughout a pregnancy.
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| Immunizations |
For the mother-to-be, preconception is a good time to bring immunizations up
to date.
- Get a tetanus booster if you haven't had one in the past 10 years.
- A rubella infection (German measles) during a pregnancy can cause birth
defects. If you are unsure about your immunity, ask the doctor about a blood
test to verify it. If you require a vaccination, it's recommended to wait
three months after receiving one before trying to conceive. You should have
immunity against regular measles, either by prior immunization or by having
had measles. If unsure, discuss the options with your doctor.
- If you are at high risk for hepatitis B (usually because of a medical work
environment), immunization may be recommended.
- influenza vaccine may be recommended preconceptually in high-risk patients
who might become pregnant during flu season.
- Varicella vaccine (for chickenpox) is now available and should be considered
in women who have not had chickenpox (90% of women are immune to chickenpox,
even those who don't recall ever having the infection).
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| Reproductive Knowledge |
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Partners who want to conceive need to know the basics of the normal menstrual
cycle, the timing of ovulation and the timing of intercourse to accomplish fertilization.
If you are unsure, talk to the doctor.
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| Previous Medical History |
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At a prepregnancy doctor's visit, a medical history for both partners will be
discussed. It is useful for the doctor to know about previous disorders including
infectious diseases and sexually transmitted diseases in order to determine
any possible risks to a future pregnancy. The possibility of current or future
exposure to infectious disorders is important to know; also any behaviors in
either partner that are considered high risk, such as intravenous drug use.
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| Financial Considerations |
- Be sure you and your partner discuss the financial responsibilities involved
(not only the medical expenses for a pregnancy and delivery, but the costs
involved with rearing a child). Review any health insurance you have to verify
coverage for childbirth. Ideally, you should try to have the financial resources
available to pay the expected expenses for prenatal care and delivery if not
covered by insurance.
- If both partners work now, will the mother return to work following delivery,
and if not what is the financial impact on the family income and lifestyle?
If both parents plan to work after the child is born, consider the cost of
day care (unless a family member will provide it).
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| Education for Pregnancy & Childbirth |
- To help prepare you and your partner for the parents-to-be experience, read
one or more reference books about pregnancy, childbirth and care of a newborn
before you plan to conceive. There are a variety of excellent books available
on these subjects. Check your local library, bookstores or borrow books from
a family member or friend who has gone through a pregnancy. The information
in the books will provide you with an overall perspective of the experience,
lessen your confusion, give you reassurance and answer many of your questions.
- Childbirth classes are available in many communities and are a valuable
source of information for expectant parents, particularly for learning ways
to cope with labor and birth. Classes also give you an opportunity to meet
other couples with whom you can discuss anxieties and concerns. Classes may
be conducted by the hospital, community organizations or by individual instructors.
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| Nutrition & Diet |
- Both partners should eat a well-balanced diet. Women should include adequate
folic acid intake (spinach, broccoli, kale). Folic acid supplements are often
recommended for all women of childbearing age to prevent certain birth defects.
For men, better nutrition helps assure healthy sperm.
- Women should try to get to their normal weight before conceiving. If underweight,
a diet to increase weight is appropriate, but keep it healthy. If overweight,
try to lose the excess pounds. Don't crash diet. Strenuous dieting can start
off a pregnancy with a nutritional deficit.
- To be safe, a woman who takes vitamins or supplements in high doses should
discontinue their use.
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| Smoking |
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Both partners need to stop smoking. In addition to a variety of health risks,
it can lead to decreased fertility in both men and women and is hazardous to
the pregnancy. A smoke-free home will provide a more healthy environment for
any child.
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| Alcohol Use |
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Men and women should discontinue alcohol use when trying to conceive. In women,
it can contribute to miscarriage, a low-birth-weight baby and fetal alcohol
syndrome. In men, heavy alcohol consumption may cause sexual problems that make
them infertile and possibly damage sperm, as well as reduce their number.
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| Drugs of Abuse |
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Men and women need to discontinue using any illicit drugs. Substance abuse drugs
can be dangerous in a pregnancy, including risk of miscarriage, prematurity,
and birth defects or death of the fetus. In addition, their use may inhibit
conception. For men, drugs of abuse may cause sexual problems.
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| Exercise |
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A regular exercise routine is important to both men and women. It leads to improved
health, less stress, helps take off excess weight and improves the quality of
life. It helps a woman prepare for the physical requirements of pregnancy and
delivery of a child.
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| Emotional Health |
- Couples need to assess their emotional health, both as individuals and as
a couple. Are both partners emotionally ready for a pregnancy? Are there unresolved
psychological problems for either partner such as stress, depression or anxiety?
These problems may create difficulties with conceiving and be heightened during
the pregnancy when both a woman and a man go through various mood swings.
- Couples should have an emotionally healthy partnership before trying to
conceive. Pregnancy, childbirth and childbearing bring on a whole new set
of stresses to both partners and if the relationship is already encountering
problems, having a child is not the solution. Any domestic violence situations
need to be resolved. Seek counseling for unresolved conflicts or if there
is an abusive relationship.
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| Genetic Counseling |
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If either partner has any genetic disorder or a family history of a genetic
disorder or related child with a birth defect, genetic counseling is recommended
to determine the risk of occurrence. Medical tests may be conducted for one
or both partners. Other reasons for genetic counseling including habitual abortion
(three or more miscarriages) or previous stillbirth, certain ethnic backgrounds,
maternal age over 35, or a previous child with a birth defect.
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| Exposure to Toxic Materials |
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If either partner works with toxic materials or if you live or work in a polluted
atmosphere, there may be possible hazards to a pregnancy. Some chemicals, usually
in large doses, may possibly be harmful to the ova, to the sperm, or to a developing
fetus. Discuss any of these concerns with the doctor.
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| Notify Your Healthcare Provider If |
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You or a family member has questions or concerns about preparing for pregnancy.
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