GENERAL PUBLIC
1. What is
preconception health?
2. What is preconception health care?
3. Why are there new recommendations on
preconception health and health care now?
4. Does preconception health apply to women who do
not plan to get pregnant?
5. How long before becoming pregnant should a woman
start preparing for pregnancy? What are the five most important
things she should do before pregnancy for her and her baby’s
health?
6. The new recommendations say that everyone should
have a reproductive life plan. What does this really mean?
7. What can men do to support the preconception
health of their female partners and their future babies?
8. What is the role of community groups in
promoting preconception health?
9. What should my health care provider be doing
about preconception care at my regular visits?
1. What is preconception health?
Preconception health is a
woman’s health before she becomes pregnant. It focuses on the
conditions and risk factors that could affect a woman if she
becomes pregnant. Preconception health applies to women who have
never been pregnant, and also to women who could become pregnant
again. Preconception health looks at factors that can affect a
fetus or infant. These include factors such as taking
prescription drugs or drinking alcohol. The key to promoting
preconception health is to combine the best medical care,
healthy behaviors, strong support, and safe environments at home
and at work.
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questions]
2. What is preconception health care?
Preconception health care is care
given to a woman before pregnancy to manage conditions and behaviors
which could be a risk to her or her baby. There are many topics
covered under preconception care.
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Folic acid supplements to
prevent neural tube defects.
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Rubella vaccinations to prevent
Congenital Rubella Syndrome.
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Detecting and treating existing
health conditions to prevent complications in the mother, and
reduce the risk of birth defects:
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Diabetes
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Hypothyroidism
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HIV/AIDS
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Hepatitis B
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PKU
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Hypertension
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Blood diseases
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Eating disorders
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Reviewing medications that can
affect the fetus or the mother, such as epilepsy medicine, blood
thinners, and some medicines used to treat acne, such as
Accutane.
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Reviewing a woman’s pregnancy
history – has she lost a baby before?
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Stopping smoking to reduce the
risk of low birth weight
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Eliminating alcohol consumption
to prevent Fetal Alcohol Syndrome, and other complications.
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Family planning counseling to
avoid unplanned pregnancies.
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Counseling to promote healthy
behaviors such as appropriate weight, nutrition, exercise, oral
health. Counseling can help a woman avoid substance abuse and
toxic substances. It can help women and couples understand
genetic risks, mental health issues (such as depression), and
intimate partner domestic violence.
Good preconception health care is
about managing current health conditions. By taking action on health
issues BEFORE pregnancy, future problems for the mother and baby can
be prevented. Preconception health care must be tailored to each
individual woman. It means helping women and their partners reduce
risks and get ongoing care. Men and other family members are also
very important in supporting the goals of preconception health.
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3. Why are there new
recommendations on preconception health and health care now?
There have been important advances in medicine and prenatal care in
recent years. Despite these advances, birth outcomes are worse in
the United States than in other developed countries. Many babies are
born prematurely or have low birthweight. In some groups of people,
the problems are actually getting worse.
Experts agree that women need to be
healthier before becoming pregnant. While this is not a new idea,
there has not been an organized effort to promote preconception
health and health care until now. The recommendations shown here
have been developed by local, state, and federal government
agencies, with help from national medical organizations and groups
such as the March of Dimes. They offer guidance to individuals and
their families, health care providers, planners, and policy makers.
The goal is to improve the health of women so that babies can be
born healthier in the future.
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4. Does preconception health apply to women
who do not plan to get pregnant?
Absolutely. Every woman should be thinking about her health, whether
or not she wants to get pregnant. Some of the basic recommendations
for preconception health include healthy weight and nutrition, and
identifying and managing existing conditions and infections. All
women should quit smoking and avoid other harmful substances. These
are important health goals for everyone, not just women planning to
get pregnant.
Since over half of all pregnancies
in the United States are unplanned, women who might be sexually
active with male partners should consider their health. As they
might not know they are pregnant, women need to avoid risks, such as
using medications that could harm a fetus, whenever possible.
CDC recommends that men and women
think about a reproductive life plan. This means deciding the ideal
time and conditions for having children and learning how to achieve
these goals. This can include effective contraception. (See Question
6 below) Women’s lives are rich and complex, and the possibility of
pregnancy is only one factor affecting women’s health choices. The
more that women know about the health care relevant to their own
circumstances, the more empowered they are to make the right choices
for their lives.
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5. How long before becoming
pregnant should a woman start preparing for pregnancy? What are the
five most important things she should do before pregnancy for her
and her baby’s health?
Every man and woman should prepare for pregnancy before becoming
sexually active, or at least three months before conception. Women
should begin some of the recommendations even sooner – such as
quitting smoking, reaching healthy weight, and adjusting
medications. Planning for pregnancy is also a good time to talk
about other concerns. Issues such as intimate partner domestic
violence, mental health, and previous pregnancy problems need to be
discussed. Although men and women can do much on their own, a health
care provider is necessary for finding and treating existing health
problems. They can also help a woman improve her health before
pregnancy.
The five most important things a
woman can do for preconception health are:
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Take 400 mcg of folic acid a
day for at least 3 months before becoming pregnancy to reduce
the risk of birth defects.
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Stop smoking and drinking
alcohol.
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If you currently have a medical
condition, be sure these conditions are under control.
Conditions include but are not limited to asthma, diabetes, oral
health, obesity, or epilepsy. Be sure that your vaccinations are
up to date.
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Talk to your doctor and
pharmacist about any over the counter and prescription medicines
you are taking, including vitamins, and dietary or herbal
supplements, you are taking.
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Avoid exposures to toxic
substances or potentially infectious materials at work or at
home, such as chemicals, or cat and rodent feces.
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6. The new recommendations say that
everyone should have a reproductive life plan. What does this really
mean?
A reproductive life plan is a set of personal goals about having (or
not having) children. It also states how to achieve those goals.
Everyone needs to make a reproductive plan based on personal values
and resources. Here are some examples:
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“I’m not ready to have children
now. I’ll make sure I don’t get pregnant. Either I won’t have
heterosexual sex, or I’ll correctly use effective
contraception.”
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“I’ll want to have children
when my relationship feels secure and I’ve saved enough money. I
won’t become pregnant until then. After that, I’ll visit my
doctor to discuss preconception health. I’ll try to get pregnant
when I’m in good health.”
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“I’d like to be a father after
I finish school and have a job to support a family. While I work
toward those goals, I’ll talk to my wife about her goals for
starting a family. I’ll make sure we correctly use an effective
method of contraception every time we have sex until we’re ready
to have a baby.”
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“I’d like to have two children,
and space my pregnancies by at least two years. I’ll visit my
certified nurse midwife to discuss preconception health now.
I’ll start trying to get pregnant as soon as I’m healthy. Once I
have a baby, I’ll get advice from a health professional on birth
control. I don’t want to have a second baby before I’m ready.”
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“I will let pregnancy happen
whenever it happens. Because I don’t know when that will be,
I’ll make sure I’m in optimal health for pregnancy at all
times.”
There are many kinds of
reproductive life plans. What’s important is that you think about
when and under what conditions you want to become pregnant. Then
make sure your actions support these goals. Health care providers
and counselors can help you understand the clinical and lifestyle
options that are best for you.
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7. What can men do to
support the preconception health of their female partners and their
future babies?
Men can make a big difference in promoting good preconception
health. As boyfriends, husbands, fathers-to-be, partners, and family
members, they can learn how their loved ones can achieve optimal
preconception health. They can encourage and support women in every
aspect of preparing for pregnancy.
There are other ways men can help.
Men who work with chemicals or other toxins need to be careful that
they don’t expose women to them. For example, men who use
fertilizers or pesticides in agricultural jobs should change out of
dirty work clothes before coming near their female partners. They
should handle and wash soiled clothes separately.
The family health histories of men
are also important when planning a pregnancy. Understanding genetic
risks from both sides enables providers to give more accurate
advice. Screening for and treating STIs (sexually transmitted
infections) in men can help make sure that the infections are not
passed to female partners. Men can improve their own reproductive
health by reducing stress, eating right, avoiding excessive alcohol
use, not smoking, and talking to their health care providers about their
own medications. It is also important for men who smoke to stop
smoking around their partners, to avoid the harmful effects of
second-hand smoke.
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8. What is the role of community groups in
promoting preconception health?
Since preconception health affects so many women, community groups
can help ensure that no one gets left out. They can learn about
preconception health and make sure their members know. Also, because
community groups are often trusted sources of support, they can be
effective in encouraging healthy choices.
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9. What should my health
care provider be doing about preconception care at my regular
visits?
Health care providers have a lot to cover during an appointment, so
it’s always a good idea to make a list and bring up any issues on
your mind. Do this even if the health care provider doesn’t ask
about them. The first thing to discuss is your plan for pregnancy.
If you tell your provider that you might become pregnant in the near
future, there will be a number of things to discuss. You may need to
schedule another visit to make sure everything gets covered.
Your health care provider should:
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Review your family’s medical
history. This includes your previous experiences with pregnancy,
fertility, birth, and use of birth control methods.
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Ask about your lifestyle,
behaviors, and social support concerns that affect your health.
Do you smoke, drink alcohol, use drugs, or have psychological
problems, including depression? Do you have nutrition and diet
issues? Concerns about health conditions in your or your
partner’s family? Are there issues around intimate partner
domestic violence? What are the medications you are taking?
Are there
chemicals, solvents, radiation, or other potential risks at your
workplace or home that could harm you or your baby?
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Schedule health screening tests
– Pap smear, urinalysis, blood tests. Your provider needs to
know your blood type, Rh factor, and whether you have diabetes,
hypertension, sexually transmitted infections, or other
conditions.
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Review your immunization status
and update them if needed.
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Perform a physical exam,
including a pelvic exam and a blood pressure check.
Based on your individual health,
your health care provider will suggest a course of treatment or
follow up care as needed.
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Date: April 12, 2006
Content source: National Center on Birth Defects and Developmental
Disabilities
