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转几篇关于孕前保健(Pre-Conception Health)及孕前检查(Preconception checkup)的文章(上)
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发表时间:2012-04-08
更新时间:2012-04-08
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看到一些备孕与孕前检查的英文资料,分两次贴出来,仅供JMs了解与参考啊!

●7 Things You Should Know Before You Try To Get Pregnant
●Seventeen things you should do before you try to get pregnant
●Ten things HE should do before you try to get pregnant
●12 Steps to Follow Before Getting Pregnant
●Preconception checkup: Why you need one and what to expect
●Preconception checkup: Questions you'll be asked at your visit
●Preconception health care

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7 Things You Should Know Before You Try To Get Pregnant
By Maria T. Pepin

It’s an exciting time in your life! You and your significant other have decided to expand your family and take the plunge into parenthood. In order to give yourself the best chance for a healthy pregnancy and baby, there are a few things you should do before you try to get pregnant.

1.Know Your Family Health History

You and your partner should find out about your family health history. Call your parents and get the medical scoop on whether anyone in your family has a genetic or chromosomal disorder like Down syndrome. You may also want to find out if any relatives have mental retardation, other developmental delays or were born with a birth defect. Your doctor will ask you these types of questions when you schedule your preconception exam and your answers will help determine if specific prenatal tests are necessary.

2.Schedule a Preconception Exam

Once you decide you would like to try for a baby, set up an appointment with your doctor for a preconception checkup. You will get a routine pelvic exam, pap smear and be tested for sexually transmitted diseases to make sure everything is good to go. During this visit, your doctor will want to know about your personal and family medical history. This is a good time to bring a list of questions with you regarding diet, exercise, tossing your birth control, etc.

3.Fuel Up on Folic Acid

Ask your doctor to recommend a good prenatal vitamin. Even if you do eat a balanced diet, it’s difficult to get all the nutrients you need from food alone. Folic acid is important to take before you start trying for a baby and during your first trimester. Taking folic acid every day will dramatically decrease your chances of having a baby with neural-tube defects.

4.Stop Partying

If you are a smoker, use drugs or drink alcohol… now is the time to stop. Studies show that smoking or taking drugs can lead to miscarriage, premature birth or low birth weight. Tobacco can also affect your fertility and lower your partner’s sperm count. Alcohol can get in the way of getting pregnant as well. Drinking during pregnancy can cause fetal alcohol syndrome and lead to many birth defects, including mental problems.

5.Maintain a Healthy Lifestyle

Studies show that if you are a healthy weight, you will probably have an easier time getting pregnant. If you are not in a healthy range, losing or gaining weight now may increase your chances to conceive. Follow a regular exercise program. The more fit you are, the easier your pregnancy and delivery will be. It’s also important to start making nutritious food choices so your body has the nutrients it needs for a healthy pregnancy. You want to make sure you have plenty of calcium, folic acid, protein and iron. Talk to your doctor about the best way to achieve these goals.

6.Call Your Insurance Company

Think about the cost of having a baby and plan ahead. The best place to start is with a call to your health insurance company. Find out what kind of prenatal coverage they offer. You may want to switch if you are not satisfied. If you are considering a midwife or a doula to help during the pregnancy, find out how much that would cost so you can start putting money aside now.

7.Whoop It Up

Before you get pregnant, you and your partner should take that vacation to Mexico you keep talking about. Soak in the hot tub, ride horses on the beach, have a sushi dinner- embrace a little adventure while you can. Take advantage of whooping it up and being spontaneous. Once you conceive, there are A LOT of changes to be made, with a whole new adventure ahead of you!

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Seventeen things you should do before you try to get pregnant
Babycenter.com

Highlights
1. Schedule a preconception visit
2. Take folic acid (and watch out for vitamin A)
3. Give up drinking, smoking, and drugs – and get help if you need it
4. Stock your fridge with healthy foods
5. Give those cups of joe the heave-ho
6. Get your weight in check
7. Pay attention to the fish you eat
8. Create and follow an exercise program
9. See your dentist
10. Get in touch with your medical roots
11. Consider money matters
12. Consider your mental health
13. Avoid infections
14. Reduce environmental risks
15. Think your decision through
16. Figure out when you ovulate
17. Toss your birth control

You've decided to take the plunge into parenthood. But wait just a second — or a month or two, at least. To give yourself the best chance for a healthy pregnancy and a healthy baby, there are some important things you need to do before you head down the road to conception.

1. Schedule a preconception visit

You don't have to have a doctor or midwife lined up yet to deliver your baby, but call your ob-gyn, midwife, or family practice doctor now for a preconception checkup. Your practitioner will review your personal and family medical history, your present health, and any medications you're taking. Certain medications are dangerous during pregnancy, and some have to be switched before you even try to conceive because they're stored in your body's fat and can linger there.

Your practitioner should also discuss diet, weight, exercise, and any unhealthy habits (such as smoking, drinking, and taking drugs) with you; recommend a multivitamin; make sure you're up to date on your immunizations; test you for immunity to childhood diseases such as chicken pox and rubella; and answer any questions you have. If it's been a year since you had a checkup, you can also expect to have a pelvic exam and a pap smear, and to be tested for sexually transmitted diseases if you're at risk.

Many couples may also want to pursue genetic testing for specific conditions, such as sickle cell disease, Tay-Sachs, or cystic fibrosis, based on their ethnic background or family history.

2. Take folic acid (and watch out for vitamin A)

Taking a folic acid supplement is crucial. By taking 400 mcg of folic acid a day for at least one month before you conceive and during your first trimester, you can cut your chances of having a baby with neural-tube defects such as spina bifida by 50 to 70 percent, according to the Centers for Disease Control (CDC). Taking folic acid helps prevent some other birth defects as well.

You can buy folic acid supplements at the drugstore, or you can take a prenatal or regular multivitamin. Check the label on multivitamins to make sure they contain the 400 mcg of folic acid you need.

Also check to make sure that your multivitamin doesn't contain more than the recommended daily allowance of 770 mcg RAE (2,565 IU) of vitamin A, unless most of it's in a form called beta-carotene. Getting too much of a certain kind of vitamin A can cause birth defects.

If you're unsure about what to take, ask your healthcare provider to recommend a supplement.

3. Give up drinking, smoking, and drugs – and get help if you need it

If you smoke or take drugs, now's the time to stop. Numerous studies have shown that smoking or taking drugs can lead to miscarriage, premature birth, and low-birthweight babies. Keep in mind that some drugs can stay in your system even after their noticeable effects have worn off.

What's more, research suggests that tobacco use can affect your fertility and lower your partner's sperm count. In fact, studies have shown that even secondhand smoke may affect your chances of getting pregnant.

Alcohol can also get in the way of getting pregnant, so it's a good idea to cut back when you start trying. Abstain altogether during the last two weeks of your cycle in case you've conceived. Drinking alcohol during pregnancy can cause birth defects and a host of other problems for your developing baby.

Stopping unhealthy habits can be very difficult. Don't hesitate to talk with your healthcare provider. She can talk with you about aids for quitting smoking or refer you to a program to help you stop taking drugs, for example. Your local health department may also be able to help by putting you in touch with counselors, group programs, and other assistance.

4. Stock your fridge with healthy foods

You're not eating for two yet, but you should start making nutritious food choices now so that your body will be stocked up with the nutrients you need for a healthy pregnancy.

Try to get at least 2 cups of fruit and 2 1/2 cups of vegetables every day, as well as plenty of whole grains and foods that are high in calcium -- like milk, calcium-fortified orange juice, and yogurt. Eat a variety of protein sources, such as beans, nuts, seeds, soy products, poultry, and meats.

5. Give those cups of joe the heave-ho

While there's no consensus on exactly how much caffeine is safe during pregnancy, experts agree that pregnant women and those trying to conceive should avoid consuming large amounts.

Some studies have found an association between high caffeine consumption and decreased fertility. And too much caffeine has also been linked to a risk of miscarriage in some (but not all) studies.

The March of Dimes advises pregnant women to limit their caffeine consumption to 200 milligrams per day, about the amount in one cup of coffee, depending on the brew. That would be a good goal to aim for now.

See a chart showing the amount of caffeine in various coffee brews, other drinks, and select foods, in our article on caffeine during pregnancy.

6. Get your weight in check

You may have an easier time conceiving if you're at a healthy weight. Having a low or high body mass index (BMI) makes it harder for some women to become pregnant. (In one study, having a BMI below 20 or over 24 negatively affected fertility.) Calculate your BMI.

If you're not in a healthy range, losing or gaining weight may give you the boost you need to conceive. Getting to a healthier weight can also help you get your pregnancy off on the right foot. Talk to your healthcare provider about the best way to achieve your weight goals.

7. Pay attention to the fish you eat

If you're a big fan of fish, start watching your intake. While fish is an excellent source of omega-3 fatty acids (which are very important for your baby's brain and eye development), as well as protein, vitamin D, and other nutrients, it also contains mercury, which can be harmful.

Most experts agree that pregnant women should eat some fish, and that the best approach is to avoid those fish that are highest in mercury and limit your consumption of all fish. The FDA recommends that women of childbearing age not eat shark, swordfish, king mackerel, or tilefish, and eat no more than 6 ounces (1 serving) of solid white canned tuna per week. Other experts suggest a longer list of fish to avoid. It's also a good idea to avoid fish you've caught in local waters unless you're certain there are no contaminants.

The FDA and EPA recommend that pregnant women eat up to 12 ounces (2 servings) a week of fish that are not high in mercury. (Good choices include herring, farm-raised rainbow trout, salmon, and sardines.)

8. Create and follow an exercise program

Start and stick to a fitness plan now, and you'll be rewarded with a healthy body that's fit for pregnancy. Plus, working up a little sweat is a great way to relieve the stress that can get in the way of getting pregnant.

A healthy exercise program includes 30 minutes or more of moderate exercise, such as walking or cycling and weight training, on most days of the week.

To increase flexibility, try stretching or yoga, and you'll have a really well-rounded fitness program. Once you're pregnant, it's okay — even recommended — to continue exercising. (That's unless if you have pregnancy complications and have been told not to, of course.)

If exercising hasn't been a priority for you lately, you'll need to ease into an exercise routine. Start with something tame, like walking ten to 20 minutes a day. Add more activity into your daily routine by taking the stairs instead of the elevator or parking your car a few blocks away from work.

9. See your dentist

When you're preparing for pregnancy, don't forget about your oral health. Hormonal shifts during pregnancy can make you more susceptible to gum disease. Increased progesterone and estrogen levels can cause the gums to react differently to the bacteria in plaque, resulting in swollen, red, tender gums that bleed when you floss or brush.

The good news is that women who take care of their periodontal health before they get pregnant cut down on their chances of experiencing gum complications in pregnancy. See your dentist for a checkup and a cleaning now if you haven't done so in the last six months.

10. Get in touch with your medical roots

Find out what you can about your and your partner's family medical history, including any genetic or chromosomal disorder like Down syndrome, sickle cell anemia, cystic fibrosis, Tay-Sachs disease, or bleeding disorders. You'll also want to know if any relatives have mental retardation or other developmental delays or were born with an anatomical birth defect, like a cardiac or neural tube defect.

Your practitioner will ask you a series of questions at your preconception visit, and your answers will help determine whether specific prenatal tests should be recommended, or if you or your partner should consider genetic counselingbefore you even start trying.

11. Consider money matters

According to a 2009 report from the U.S. Department of Agriculture, families in the middle-income group will spend $286,050 to raise a child from birth through age 17. Find out how much you're likely to spend with our Cost of Raising a Child Calculator.

For the more immediate future, you'll want to consider the cost of pregnancy and delivery. Without insurance, a typical vaginal delivery can cost about $9,000 and a cesarean section about $15,000. Neonatal intensive care can cost $2,000 to $3,000 a day.

If you have health insurance, give the company a call and find out what kind of prenatal coverage they offer. If you're lucky enough to have a choice of plans, compare coverage and providers. If you have a particular doctor or midwife in mind, find out if she's in your plan or how much it would cost to go out of network for her care.

Find out what your deductibles are for prenatal visits and delivery, and ask what tests and procedures your insurance covers. If you have a high deductible, try to put a little aside now so you won't be slammed with exorbitant bills when the baby arrives.

If you're one of the millions of women without health insurance, contact your local health department to see what programs and resources are available in your area to help pregnant women and babies get the medical care and other services they need. Call 1-800-311-BABY (1-800-311-2229) to be connected to your local Health Department. (For Spanish, call 1-800-504-7081.)

12. Consider your mental health

Women who suffer from depression are twice as likely to have problems with fertility as women who don't, according to Alice Domar, director of the Domar Center for Mind/Body Health at Boston IVF. As she points out, "If someone is clinically depressed, she can barely take care of herself, much less a baby. From an evolutionary point of view, it makes sense that it's hard to get pregnant when you're depressed."

Domar suggests that all women, but especially those with a personal or family history of depression, do a mental health check before they get pregnant. If you notice signs of depression, such as a loss of interest and pleasure in things that you used to enjoy, a change in appetite, a change in sleep pattern, a loss of energy, or feelings of hopelessness and worthlessness, ask your practitioner for a referral to a therapist or psychiatrist for a consultation.

The two most effective treatments for depression are cognitive-behavioral therapy (CBT) and medication, and many patients do best with a combination of both. If medication becomes necessary, a psychiatrist can help you find an antidepressant that's safe to take while you're trying to conceive and during your pregnancy. You also may want to try stress management techniques, such as yoga and meditation, which research suggests can help depressed women conceive.

13. Avoid infections

It's important to steer clear of infections when you're trying to get pregnant, especially those that could harm your baby-to-be.

You'll want to stay away from certain foods such as unpasteurized soft cheeses and other dairy products, cold deli meats, and raw and undercooked fish and poultry. These foods can harbor dangerous bacteria that cause listeriosis, a food-borne illness that can lead to miscarriage or stillbirth. You should also avoid unpasteurized juices because they can contain bacteria such as salmonella or E. coli.

Be sure to wash your hands frequently when preparing meals, and make sure your fridge is set between 35 and 40 degrees Fahrenheit (2 and 4 degrees Celsius) and your freezer is at or below 0 degrees F (-18 degrees C) to keep cold foods from going bad.

It's a good idea to wear gloves when digging in the garden or sandbox, and to get someone else to change the litter box to avoid contracting toxoplasmosis, another infection that can be dangerous for a developing baby.

Finally, make sure you get a flu shot, to avoid coming down with flu when you're pregnant. Get vaccinated as soon as the vaccine for the coming season becomes available. Getting the flu while pregnant can lead to serious complications, such as pneumonia and preterm labor.

14. Reduce environmental risks

You may not be able to entirely eliminate all environmental dangers, but you can do your best to keep as many of them as possible out of your life now. Some jobs can be hazardous to you and your unborn children, for example. If you're routinely exposed to chemicals or radiation, you'll need to make some changes before you conceive.

Also, keep in mind that some cleaning products, pesticides, solvents, and lead in drinking water from old pipes can be dangerous for a developing baby. Talk to your doctor or midwife about your daily routine, and see if you can come up with ways to avoid or eliminate hazards in your home and workplace.

15. Think your decision through

Having a child is a lifetime commitment. Before you try to conceive, consider whether you're ready to take on this responsibility. Some key questions to think about:
●Have you thought through how you'll handle childcare responsibilities and balancing work and family?
●Are you prepared to parent a special-needs child if you have one?
●If you have a partner, are you both equally committed to becoming parents?
●If you and your partner have religious differences, have you discussed how they will affect your child?

16. Figure out when you ovulate

Some women simply stop using birth control when they're ready to get pregnant and let fate decide when they'll conceive. Others take a more calculated approach by charting their periods and tracking symptoms to try to pinpoint their fertile days each month.

Use our ovulation calculator to get a rough estimate. If you want to be more exact, start charting your basal body temperature (BBT) and the changes in your cervical mucus. Tracking these symptoms over several months can help you figure out when you're ovulating during each cycle.

Ovulation predictor kits can also help you figure out when you're ovulating by detecting hormones in your urine, or changes in chloride in the saliva or on the skin, that signal ovulation is about to occur. These kits cost $10 to $50 per cycle and are available at drugstores.

17. Toss your birth control

So you're ready to bid adieu to birth control. For some people, ditching contraception is as easy as moving the condoms or diaphragm to the back of the dresser drawer. But going off hormonal contraception can require a bit more planning.

If you've been using the Pill, for example, you may want to finish your current pack to avoid irregular bleeding. It may take a few months for your cycle to return to normal, but many women are fertile the first month after they stop taking the Pill. Some become fertile almost immediately. The same holds true for the contraceptive patch and ring.

Some practitioners recommend using a barrier method (such as a condom) until you have a normal period after stopping the Pill, the patch, or the ring. Waiting until you have a normal period can help you establish a more accurate due date and schedule any tests you plan to have in your first trimester. (It's a good idea to start keeping track of your cycles now, if you don't already. You can simply mark on a regular calendar any days you have bleeding.)

If you do get pregnant before your periods become regular again, don't be concerned. You can have an early ultrasound to date your pregnancy.

If you're using Depo-Provera, it can take up to a year after your last shot for you to start ovulating again, even if your period returns to normal sooner. Find out what you need to know about quitting other kinds of birth control, including IUDs.

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Ten things HE should do before you try to get pregnant
Babycenter.com

Highlights
●Check in with your doctor
●Get in touch with your medical roots
●Stock your fridge with healthy foods
●Just say no to partying
●Check your workplace for hazards
●Meet with a financial adviser
●Buy some boxers
●Steer clear of the hot tub
●Be bike-savvy
●Relax

You don't usually find men scouring pre-pregnancy books, stocking up on the right vitamins and minerals, and avoiding hidden dangers that could harm their baby-to-be. But this kind of male nesting behavior should be more commonplace, says F. Sessions Cole, a neonatal specialist and director of the newborn medicine division at St. Louis Children's Hospital in Missouri. When a couple is trying to get pregnant, "most of the attention is focused on the woman," he says, "but men make up half of the equation." If you're thinking about becoming a dad, here's a list of what you can do before heading down the conception road to ensure a healthy pregnancy.

Check in with your doctor

Make an appointment to see your doctor, especially if you have a chronic disease, take any medication, or experience problems with erections, ejaculation, or loss of libido. Certain drugs (including any steroid or hormone, one class of drugs for high blood pressure, a few antibiotics, and some medications used to treat diseases like fungal infections, ulcerative colitis, Crohn's disease, peptic ulcers, and seizures) can affect either the quality or quantity of sperm and cause male fertility problems. In most cases, the effect is reversible once you go off the drugs. Talk to your physician about your plans to become a dad, and find out if you can safely switch to a different medication.

One study found that St. John's wort and a few other herbal supplements adversely affect sperm, but the researchers mixed the supplements directly into the sperm. There is no evidence that taking these supplements by mouth affects fertility.

Anabolic steroids, which bodybuilders often use to bulk up, are well studied, and evidence shows they can reduce sperm count and shrink the testicles. Be sure to let your physician know about everything you're taking, whether it's prescribed or over-the-counter.

Also, let your doctor know if you think you may be at risk for a sexually transmitted infection — STDs can cause male infertility, so you'll need to be tested and treated if necessary. Your primary care physician may refer you to a urologist or a male fertility specialist if additional testing or treatments are required.

You'll also want to talk to your doctor about your family's medical history (see "Get in touch with your medical roots," below). If you have a family history of birth defects, including genetic or chromosomal disorders, mental retardation, or other developmental delays, you and your partner should have genetic counseling to find out what risks you face and which screening tests to consider.

Last, ask your doctor about any hazards you may be exposed to on the job (see "Check your workplace for hazards," below) or elsewhere. Exposure to pesticides, heavy metals, and organic solvents, for instance, can affect the quality and quantity of your sperm.

Get in touch with your medical roots

It's a good idea to find out about your family health history, so call your parents, siblings, or other relatives to get the medical scoop. If they get suspicious and you're not ready to share your news, tell them you're trying out a new healthcare provider. The most important thing to ask about is whether anyone in your family has genetic or chromosomal disorders such as Down syndrome, sickle-cell anemia, cystic fibrosis, Tay-Sachs disease, or bleeding disorders. You'll also want to find out if any relatives have mental retardation or other developmental delays, or were born with an anatomical birth defect like a cardiac or neural-tube defect. Your partner will be asked for this information at her first preconception or prenatal visit, and your answers will help determine whether any specific prenatal tests are recommended or if either of you should consider getting tested before you even start trying.

Stock your fridge with healthy foods

If you thought you could continue chewing on chili dogs and cheese fries while your mate dines on grilled chicken and steamed vegetables, think again. Not only will it be easier for her if you join in on the healthy eating lifestyle, your sperm will be better off, too.

Studies have shown that poor nutrition can affect the quality and quantity of sperm. For example, men with low levels of folic acid — the same B vitamin women need to reduce the risk of neural-tube birth defects — were found to have low sperm counts. You may be able to get the amount you need (400 micrograms a day) from fortified breakfast cereals, leafy greens, legumes, and orange juice. Just to be sure, it can't hurt to take a folic acid supplement or a multivitamin, says Cole. Other fertility experts recommend vitamins that contain anti-oxidants or amino acids such as L-arginine for men with low sperm counts or poor sperm function.

Zinc is another nutrient to keep an eye on. Several studies show that even short-term zinc deficiencies can reduce semen volume and testosterone levels. Plus, research suggests that low levels of this mineral may interfere with the absorption and metabolism of folic acid. Eating meat, seafood, and eggs are great ways to get the 11 milligrams of zinc you need a day, and most multivitamins also contain the mineral.

And don't skimp on vitamin C, which has been shown to boost sperm motility. Fruits are an easy way to pick up this vitamin — load up on oranges, cantaloupe, kiwi, mandarins, and grapefruit. Broccoli, asparagus, and bell peppers are other good choices.

Just say no to partying

The party's over for your partner once you start trying for a baby, but what about you? Same goes for men, says Cole. Sperm is just as affected by tobacco, alcohol, and drugs as a woman's eggs. Research suggests that this troublesome trio may lower sperm counts and slow motility. That means you should completely cut out recreational drugs, such as marijuana and cocaine, cut down on alcohol, and quit smoking before you start trying. Plus, kicking the habit now can help your family later. Secondhand smoke is dangerous for your partner and your children, both in utero and after birth. Even the use of chewing tobacco has been linked to poor sperm function.

A lowered sperm count isn't the only reason you should lay off the bottle. Research shows that dads who drink the equivalent of two drinks a day during the month before conception have babies who weigh on average 6.5 ounces less than other babies. Low birth weight is a serious medical condition that can affect your child's health and behavior for the rest of his life.

Check your workplace for hazards

A hidden danger to sperm may be lurking where you work. Regular exposure to chemicals such as organic solvents, which are often found in dry cleaning and auto shops, and pesticides can make it more difficult to conceive. They also can alter sperm composition, leading to birth defects and premature delivery. Because it takes three months for sperm to develop and fully mature, cut your exposure to these chemicals at least three months before you and your partner start trying. Visit the Centers for Disease Control's Web site for more information on how to avoid workplace hazards that can harm your reproductive health.

Meet with a financial adviser

Shelling out $20 for cute designer baby booties is just the start of what you'll be spending on your little one in years to come. According to a 2005 report from the U.S. Department of Agriculture, families earning between $43,200 and $72,600 will spend about $190,980 to raise a child from birth through age 17. Find out how much you're likely to spend with our Cost of Raising a Child Calculator. But never fear: By investing just $50 or $100 a month, you can create a nice nest egg by the time your little one heads off to college. Talk to a financial adviser about how to start saving now.

Buy some boxers

The jury is still out on the boxers vs. briefs debate. Some say the testes can get overheated in briefs, inhibiting sperm production. Others say it's really not an issue unless sperm count is already a concern. Cole points out that if wearing boxers can potentially give you an edge over briefs, why not go with boxers for a few months? It's a fairly simple wardrobe adjustment that could speed things along.

Steer clear of the hot tub

Don't look to hot tubs, saunas, or hot baths as a way to unwind before all this baby business gets under way. Heat kills sperm. And because they take up to three months to regenerate, if you spend a long time in the hot tub in January, it could be April before you have a full set of swimmers again. Testicles function best when they keep their cool: "The boys" are happiest at 94 to 96 degrees, a couple of degrees cooler than normal body temperature. To protect your swimmers, avoid hot tubs and saunas for up to three months before trying to conceive.

Be bike-savvy

The casual cyclist shouldn't stress about recent studies that found long hours on a hard bike seat can lead to lower semen volume and reduced sperm count and motility. It's the hard-core cyclist who spends more than two hours a day, six days a week in the saddle who should take note. All that riding can injure the scrotum and testes and potentially lead to fertility problems. What's more, wearing bike shorts for hours on end can kill off your sperm as effectively as a spell in the hot tub. The scrotal area can also get hot and sweaty when it's sandwiched between the legs and bike seat, and that can lead to lower sperm counts in avid cyclists. Men's testes are outside the body for a reason — they need a cooler environment to function properly. If you're going to ride, limit your time on the bike, wear loose-fitting shorts, and choose the softest seat possible.

Relax

Although embarking on a pregnancy is wildly exciting, it can also be stressful, especially if it takes several months to conceive. Take time to relax and unwind — go for a swim, shoot some hoops, or take a stroll. While studies haven't concluded that such exercises will boost your conception odds, it will certainly make the process more pleasant, says Alice Domar, a psychologist and founder and director of the Domar Center for Complementary Healthcare, as well as assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.

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12 Steps to Follow Before Getting Pregnant
Parenthood.com

Thinking About Having a Baby?

It’s not something many couples think about, but preparing your body for pregnancy at least one month ahead of time can improve your odds of conceiving more easily, having a healthier pregnancy, delivering a healthy baby and recovering more easily.
Here are 12 tips from the March of Dimes and other pregnancy health sources to help you make the right choices for preconception nutrition, health and physical fitness:

1. Visit an Ob/Gyn, and request a “preconception” check-up. Your mission is to find out whether you’re in good health and physical condition for pregnancy. Your doctor will address any immunizations or medical tests you may need (such as a Pap smear for women), as well as personal and family medical history. Your doctor can also evaluate how much you weigh now and set a target weight gain for pregnancy. Future dads should go in for a general physical (preferably 90 to 120 days before trying to conceive) to be sure they’re also in good health. (See Choosing an Obstetrician)

2. See your dentist for a check-up. Because dental health affects overall health, it makes sense to have a dental exam before pregnancy. Furthermore, researchers have found that periodontal disease can lead to preterm delivery and a higher incidence of low birth-weight babies.

3. Get to a healthy body weight (in a healthy manner). This applies to women who are too thin or too overweight before pregnancy. Check in with your physician about your specific healthy weight.

4. Eat a well-balanced diet that includes a wide variety of healthy foods from all the basic food groups. Be aware that there are some foods you should completely avoid (for example, liver). Keep well-hydrated primarily by drinking water.

5. Stop taking any and all supplements unless approved by your physician. This is particularly important if you’re already trying to conceive. Your doctor will likely prescribe a prenatal supplement to begin taking now.

6. Make sure your intake of folic acid, a B vitamin, is optimal to help prevent birth defects. Good sources of folic acid include a prenatal supplement, enriched breads, pastas, cereals, dried beans/lentils, asparagus, wheat germ, greens and orange juice. (See The Importance of Folic Acid).

7. If you’ve been told you have anemia (iron deficiency), it needs to be resolved prior to conception through dietary means and iron supplements prescribed by a doctor.

8. Begin reducing your intake of caffeine. You don’t have to eliminate it altogether, but the March of Dimes recommends limiting coffee to no more than one 12-ouce cup a day. Cut back on other sources of caffeine, too, including soft drinks, medications and foods containing caffeine.

9. Stop drinking alcohol, stop smoking, and stop taking any illegal drugs (dads, too). All of these can hamper attempts to get pregnant. During pregnancy, a woman who drinks, smokes or takes drugs puts her unborn baby at serious risk of low birth weight and dangerous health complications. (See Alcohol and Pregnancy a Dangerous Cocktail)

10. Use proper safety precautions around worksite agents, chemicals, lead and other potential hazards (dad, too). Avoid hazardous cleaning supplies, pesticides, chemicals and paint. If your water pipes are old, consider having them tested for lead.

11. Avoid potential infections. Wash your hands regularly with soap and water after using the bathroom, blowing your nose or handling soil. Avoid raw meat, raw fish and unpasteurized milk products. The future mom also should not handle cat litter; let someone else change the box from now on.

12. Establish a reasonable, regular exercise routine. Your level of fitness prior to pregnancy is what will determine how active you can be once pregnant. Just 30 minutes of exercise every day or most days of the week is enough to help maintain or lose weight, improve fitness and reduce stress. Good exercise choices during pregnancy, by the way, include walking, swimming and yoga, according to the March of Dimes.

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Preconception checkup: Why you need one and what to expect
babycenter.com

Highlights
●Taking your history and providing counseling
●Physical and gynecological exam
●Your questions

To give your baby the best start in life, it's a good idea to get your own health squared away before you get pregnant. Think about preconception care as preventive medicine for you and for the child you're planning to conceive.

A complete medical history and physical exam a few months to a year before you start trying to conceive will help you determine what steps you may still need to take to become physically and emotionally ready to have a baby. They'll also give your practitioner an important baseline to refer to during your pregnancy.

1.Taking your history and providing counseling

The first thing your healthcare practitioner will do is ask a long list of questions about your health and lifestyle. (If you already have a relationship with your practitioner, he may know much of this information and be looking for you to fill in the blanks.)

Your practitioner will look for any current or past conditions that might affect your ability to get pregnant or your health and your baby's health once you do get pregnant. (See our Preconception counseling checklist for a complete list of the questions you can expect.)

Your caregiver will then share any medical concerns he has, help you figure out how to address them, and answer any questions you have.

★Gynecological history

Your practitioner will want to know the following:

Menstruation
●Do you have regular periods?
●At what age did they start?
●How long do they last?
●When did your last period begin?

If you're not already keeping a menstrual calendar, now's a good time to start.

Birth control
●What kind of birth control have you used in the past?
●What are you using now?

With certain methods, such as Depo-Provera, it may take a relatively long time for your fertility to return. Ask about switching methods if you'd like to conceive soon.

Infections
●Have you ever had an abnormal Pap smear?
●Have you ever had a sexually transmitted infection (STI) such as chlamydia, gonorrhea, syphilis, human papillomavirus (HPV), or herpes?
●Has your partner ever had an episode of genital herpes?

Many STIs can be "silent" – meaning they don't cause any symptoms – but they can cause problems in pregnancy (or fertility problems in the case of pelvic inflammatory disease).

If you're not in a monogamous relationship, or if you or your partner has a history of multiple sexual partners, it's especially important to be screened now.

All women planning a pregnancy should be tested for HIV.

★Obstetric history

Your practitioner will want to know the following:
●Have you been pregnant before? (This includes ectopic pregnancies, or abortions.)

A previous ectopic pregnancy could make you less fertile. And if you get pregnant after an ectopic pregnancy, your caregiver may recommend a very early ultrasound to make sure this pregnancy isn't ectopic.

A history of recurrent miscarriage might mean that you should have chromosomal testing or be checked for certain health problems.

If you have given birth before:
●Did you have pregnancy complications (such as preeclampsia, preterm birth, or gestational diabetes)?
●How did you deliver (vaginally, with the help of forceps or a vacuum, or by cesarean section, and if so, why)?
●Were there postpartum complications, such as excessive bleeding?
●Did you have mental health issues (such as postpartum depression) during or after any of your pregnancies?
●Have you given birth to a baby who had problems?

If you've had a baby with a neural tube defect, such as spina bifida, taking a much higher daily dose of folic acid before and during your next pregnancy reduces the risk of this happening again.

★Medical history

Your practitioner will want to know the following:
●Do you have any medical conditions that could complicate your pregnancy, such as asthma, diabetes, high blood pressure blood clotting disorders, and thyroid disease?

If you have a chronic medical condition, your practitioner can help you manage it or refer you to a specialist who can.

The type or dose of medication you're taking to treat a chronic condition may need to be adjusted before and during pregnancy. (However, do not stop taking medication you've been prescribed unless advised to do so by your caregiver.)
●Have you ever had surgery or been hospitalized for any other reason?
●Have you ever had problems with anesthesia?

★Medications and allergies

Your practitioner will want to know the following:
●Do you have any allergies (to drugs, latex, foods, or anything else)?
●What drugs (prescription and over-the-counter), vitamins, herbs, or other supplements do you take and in what dosages?

It's a good idea to make a complete list of everything you take (including how much and how often). You might want to bring the bottles with you to your appointment.

This information helps your caregiver make sure that you're not taking anything that would be unsafe during pregnancy and that you're not taking too much of anything. (For example, megadoses of certain vitamins, such as vitamin A, can be dangerous for a developing baby.)

If you're not already taking folic acid, your practitioner will advise you to start taking 400 micrograms a day (alone or in a multivitamin), beginning at least one month before you start trying to get pregnant. Taking folic acid before conception can significantly reduce your baby's risk of neural tube birth defects, such as spina bifida.

Because half of pregnancies in the United States are unplanned, experts recommend that women of childbearing age take 400 micrograms of folic acid every day.

★Vaccination history

Contracting certain diseases during pregnancy could put your baby at risk for serious birth defects or other complications. Bring your immunization record along (if you have one) so your practitioner will know whether your vaccines are up-to-date.

Here are the recommended immunizations:

●Rubella (German measles). If you don't have documented evidence of immunity to rubella, you'll be tested for immunity. You'll need to wait a month to get pregnant after you receive a rubella shot.

●Chicken pox. If you haven't had chicken pox or been vaccinated against it, you'll be tested for immunity. The chicken pox vaccine requires two doses, given four to eight weeks apart. You'll need to wait a month to get pregnant after you receive a chicken pox shot.
●The one-time Tdap vaccine, which includes a tetanus booster as well as a booster for pertussis (whooping cough) and diphtheria.
●The current flu vaccine (if it's flu season).
●If you're 26 or younger and haven't had the HPV shot, your practitioner may recommend that you get one now.
●Hepatitis B. If you haven't been immunized and are at risk for getting the disease.

Let your practitioner know if you plan to travel out of the country in the near future or during your pregnancy. Additional vaccines may be required if you travel to other parts of the world, and some are unsafe to get once you're pregnant.

★Emotional and social history

Your practitioner will want to know the following:

Mental health
●Do you have a history of mental health problems, such as depression or an eating disorder?
●Are you being treated with any psychiatric medications?

If you're being treated with any medications, you may need to switch to a different medication. Also, trying to get pregnant and pregnancy itself can cause emotional ups and downs, and your healthcare provider can be more helpful if he's aware of your feelings.

Abuse
●Have you ever been a victim of domestic violence?
●Are you currently in an abusive relationship?

Abuse can take many forms – it can be physical (hitting, slapping, kicking), verbal and psychological (involving threats or constant putdowns), sexual, or any combination of the above.

Abuse affects millions of women in the United States each year. While revealing such information may seem difficult, it's critically important to be honest, since abuse often escalates during pregnancy. (What's more, studies have shown that abusive partners often become abusive parents once they have children.)

Your practitioner will be able to direct you to any resources you need, which may include counseling, legal and social services, domestic violence hot lines, and safe havens. You can also contact the National Domestic Violence Hotline – where help is available 24/7 ­– by calling (800) 799-7233 (799-SAFE) or by visiting the group's website.

★Lifestyle questions

Your practitioner will cover the following:

Diet and exercise
●How's your diet?
●How often do you exercise?
●How much coffee and other caffeinated beverages do you drink?

Your practitioner will review your diet to make sure you're getting the nutrients you need. If you've been a couch potato, she'll recommend that you start an exercise program now. And if you're over- or underweight, she'll help you make a plan to attain a healthy weight before you get pregnant.

She'll also advise you on what to avoid eating, like certain fish that might contain too much mercury, and how to avoid infections like listeriosis and toxoplasmosis that can cause problems for your developing baby. Among other things, you'll want to steer clear of unpasteurized milk or cheese, as well as raw or undercooked fish, meat, or eggs, and some deli items.

If you have any pets or do any gardening you may be at risk for toxoplasmosis, which is relatively

Your practitioner may advise you to limit your coffee or tea consumption, as some studies suggest that too much caffeine can be bad for the health of your baby.

Unhealthy habits
●Do you smoke?
●Do you drink alcohol?
●Do you use drugs?

If you need help quitting smoking, drinking, or any other addiction, talk to your healthcare practitioner and ask for a referral to a program or counselor.

Staying safe, at home and at work
●Are you or your partner exposed to any environmental hazards at home or work?

Some toxic substances may put your pregnancy or your baby at risk. If you have any concerns about health hazards at your workplace, be sure to discuss them with your healthcare provider.

●Do you use hot tubs and saunas?

Raising your body temperature too high early in pregnancy can interfere with your baby's development. It can also make it harder to get pregnant.

Oral health
●When was your last visit to the dentist?

Your caregiver may suggest that you pay special attention to your oral hygiene. Your gums are more likely to become inflamed during pregnancy, so brushing and flossing are especially important now. And some studies suggest that women with severe gum disease are at higher risk for preterm delivery (and a low-birth-weight baby). If you're due for a checkup and cleaning, make an appointment to see your dentist now.

★Genetic screening

You may be referred to a genetic counselor if you or your partner has any risk factors, including:
●a family history of genetic disease
●if you've had recurrent miscarriages
●if you'll be 35 or older when you give birth

Depending on your ethnic background and family history, you may choose to be tested to see whether you're a carrier for certain genetic diseases (see below). Genetic screening and counseling before pregnancy can help reassure you that your child won't be at risk for these diseases. And if your baby will be at risk, it can give you the opportunity to discuss your options (such as prenatal testing).

2.Physical and gynecological exam

Your practitioner may do the following:
●A standard head-to-toe physical exam, including measuring your height, weight, and blood pressure – unless you've had a physical exam recently.
●Examine your genital area for any suspicious lesions that may indicate an infection or other problem.
●Swab your vagina to check for vaginal infections, such as trichomoniasis or yeast, if you've had any abnormal discharge, itching, or burning.
●Insert a speculum into your vagina and examine your cervix and vagina.
●Do a Pap smear (if it's been more than a year since your last one) to screen for cervical cancer or other abnormal cell changes, and possibly screen for gonorrhea and chlamydia.
●Do a pelvic exam by inserting her fingers into your vagina and checking your ovaries, uterus, and cervix for any masses, tenderness, or other problems.

★Urine tests

Your practitioner may ask for a urine sample. If you have sugar in your urine, you'll have a glucose tolerance test to check for diabetes. Uncontrolled blood sugar can have dire consequences for a developing baby, so if you have diabetes, it's recommended that you see a diabetes specialist well before you try to conceive.

If you have symptoms of a urinary tract infection (such as burning, frequent, or painful urination), your urine sample will be sent to a lab for a culture.

★Blood tests

Your healthcare provider might order:
●A complete blood count to see whether you need to take iron supplements. (Being pregnant can make iron-deficiency anemia worse.)
●A blood test if it's not clear whether you're immune to rubella or chicken pox
●A test for syphilis
●A test for HIV
●A test for herpes if your partner has a history of herpes but you've never had symptoms
●A test for hepatitis B if you're at risk for it. (If you don't have it, you can be vaccinated against it before you get pregnant.)

You'll also be offered carrier screening to see whether you're a genetic carrier for cystic fibrosis. Depending on your ethnic background and medical history, you may also want to be tested to see whether you're a genetic carrier for sickle-cell anemia, Tay-Sachs disease, thalassemia, and a number of other conditions.

Your provider should call you with the results from these tests within a few weeks.

3.Your questions

Your preconception visit is a good time to talk about any problems or concerns you may have.

Don't be bashful. No matter how embarrassing your question may seem, your healthcare provider deals with these issues all the time and should be able to give you good advice and refer you to any other specialists or counselors you need to see.

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Preconception checkup: Questions you'll be asked at your visit
babycenter.com

As soon as you start thinking about trying to get pregnant, you'll want to see your ob-gyn or midwife for a preconception visit. Your caregiver will start by asking you some questions. She'll use the information you give her to help you become physically and emotionally ready for pregnancy. (See what to expect at your preconception checkup for a description of what else will happen at this appointment.)

Here's a list of the questions your practitioner will ask. If you've seen her before, she may already have much of this information and will only need to fill in what's missing.

Age
●How old are you?
●How old is your partner?

Gynecological history
●When did you first menstruate, and when did your last menstrual period start?
●Are your periods regular?
●What kind of birth control are you using now, and what kinds have you used in the past?
●Have you ever had an abnormal Pap smear?
●Have you or your partner ever been diagnosed with a sexually transmitted infection?
●Have you ever been diagnosed with pelvic inflammatory disease?
●Have you ever been tested for HIV?
●Are you in a monogamous relationship?
●Have you ever been told you have uterine abnormalities?
●If you were born before 1972, or if your mother was living in another country when she was pregnant with you, do you know if your mother took DES (a drug that could cause birth defects) when she was pregnant with you?
●Have you ever had any kind of gynecological surgery?
●Have you ever been treated for infertility?
●Have you ever had – or do you have – any gynecological problems not listed above?

Obstetric history

Note: If you've had complications during a pregnancy, labor, or delivery that your practitioner is unaware of, try to get hold of the related medical records and bring them with you to your checkup. (But don't delay your preconception visit waiting for them, particularly if you're going to start trying to conceive soon.) Have you ever been pregnant before?

Have you ever had a miscarriage? If so, how many weeks pregnant were you? Did you have a D&C? Were there complications? Do you know the cause of the miscarriage?

●Have you ever had an abortion? If so, in which trimester? Were there any complications?
●Have you ever had an ectopic pregnancy? If so, how many weeks pregnant were you? Did you have surgery?
●For each child you've given birth to: What was the birth date? Place of birth? How many weeks gestation? Gender? Birth weight? Was it a normal vaginal delivery, an assisted vaginal delivery, or a cesarean section?
●Have you ever had pregnancy complications, such as gestational diabetes, preterm labor or delivery, preeclampsia, intrauterine growth restriction, or placental problems?
●Did you suffer from depression during pregnancy or postpartum depression?
●Did you have any complications during labor and delivery?
●Did you have any postpartum complications, such as a postpartum hemorrhage?

Medical history
●Have you ever had any serious medical problems?
●In particular, do you have diabetes, hypertension, epilepsy or another seizure disorder, kidney disease, hepatitis or other liver disease, heart disease, a blood clotting disorder, lung disease, including asthma, thyroid disease, cancer, or a connective tissue disease such as lupus or rheumatoid arthritis?
●Do you have any digestive problems?
●Have you ever been hospitalized?
●Have you ever had any operations? When and why? Have you ever had problems with anesthesia?
●Have you ever had a blood transfusion?
●Are you being treated for any conditions right now?
●Have you been exposed to any infectious diseases recently? Is there anyone in your household who has or has had hepatitis? Tuberculosis?
●Has anyone in your family ever had diabetes, hypertension, a stroke, epilepsy or another seizure disorder, kidney disease, hepatitis or other liver disease, heart disease, a clotting disorder, lung disease including asthma, thyroid disease, cancer, or a connective tissue disease such as lupus or rheumatoid arthritis?

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Preconception health care
marchofdimes.com

Preconception health care is care a woman of childbearing age receives before pregnancy or between pregnancies. This type of care looks at biomedical, behavioral and social risk factors that may affect a woman’s health. The goal is to provide information and treatment before pregnancy that can improve a woman’s health and help reduce risks to her future baby.

All women of childbearing age can take steps before they get pregnant to improve their chances of having a healthy, full-term baby. More and more babies are born prematurely (before 37 completed weeks of pregnancy), which increases the risk for serious health problems. By getting preconception health care, a woman can learn what steps she can take before pregnancy to protect her health and give her baby the best chance to be healthy.

Why is a preconception checkup important?

A preconception checkup can help assure that a woman is as healthy as possible before she conceives. Her provider can identify and often treat health conditions that can pose a risk in pregnancy, such as high blood pressure, diabetes or certain infections. The provider can give her information on things like nutrition, weight, smoking, drinking alcohol and occupational exposures that can pose pregnancy risks. The provider also can make sure a woman’s vaccinations are up to date and that any medications she takes are safe during pregnancy.

The provider can ask a woman about her health history, as well as that of her partner and her family. If the woman or her partner has a history of birth defects or prematurity, or if either has a high risk for a genetic disorder based on family history, ethnic background or age, the provider may suggest seeing a genetic counselor.

What does a genetic counselor do?

A genetic counselor discusses the risks for a genetic disease in a couple’s future children. The counselor can arrange blood tests (called carrier tests) that can identify carriers of many genetic diseases. If both parents are carriers of a disease, each child has a 25 percent chance of inheriting the disease. Carrier tests are given for a variety of conditions, including:
●Cystic fibrosis (CF), a disease of the lungs and digestive system that is most common in Caucasians, but can affect children from many backgrounds
●Tay-Sachs disease, which causes fatal brain damage and is more common in people of Eastern European Jewish ancestry and in some non-Jewish individuals of French-Canadian and Cajun ancestry
●Sickle cell disease, a blood disorder that mainly affects African-Americans
●Thalassemia, a blood disorder that mainly affects those of Mediterranean, African and South Asian descent

Genetic screening and counseling before pregnancy may reassure a couple that their children are not at increased risk for a specific inherited disease. Genetic counseling also allows carriers the opportunity to understand their risk and discuss options. Women who can benefit from genetic counseling include:
●Women over age 35
●Women who have certain genetic disorders, such as phenylketonuria (PKU)
●Women who have had a child with a neural tube defect (NTD), a birth defect of the brain and spinal cord

Why should women of childbearing age take folic acid?

Folic acid is a B vitamin that can help prevent birth defects, particularly NTDs. Studies show that if all women consumed the recommended amount of folic acid before and during early pregnancy, up to 70 percent of all NTDs could be prevented. Studies also suggest that folic acid may help prevent some other birth defects, including cleft lip and palate and some birth defects involving the heart. A recent study also suggests that women who take folic acid for a least 1 year before becoming pregnant may reduce their risk of having a premature baby.

To prevent NTDs, the March of Dimes recommends that all women who could become pregnant take a multivitamin containing 400 micrograms of folic acid every day starting before pregnancy, along with eating healthy foods. This advice, based on recommendations from the Institute of Medicine (IOM), assures that a woman gets all the folic acid and other vitamins she needs.

A woman also can get folic acid by eating a serving of folic acid-enriched cereal every day that contains 100 percent of the daily value (DV) of folic acid (400 micrograms). Healthy food choices include foods that are fortified with folic acid and foods that contain folate, the natural form of folic acid found in foods. Many grain products, including flour, rice, pasta, bread and cereals, are fortified with folic acid. Folate-rich foods include green leafy vegetables, dried beans, legumes, oranges and orange juice.

A woman who has had a pregnancy affected by an NTD should take a higher dose of folic acid. Taking a higher dose of folic acid daily (4,000 micrograms or 4 milligrams), beginning at least 1 month before pregnancy and in the first trimester of pregnancy, reduces by about 70 percent the risk of having another affected pregnancy. Women with diabetes or epilepsy and women who are obese are at increased risk of having a baby with an NTD (1). Women with these conditions should consult their providers before pregnancy about taking a larger dose of folic acid.

What vaccines might a woman need before pregnancy?

At a preconception visit, the health care provider may do a blood test to see if a woman is immune to rubella (German measles) and chickenpox. Both of these diseases can cause birth defects and other complications if a woman gets them during pregnancy.

If a woman is not immune, she should be vaccinated before pregnancy. She should then wait 1 month after vaccination before attempting to get pregnant.

Women who are at high risk for hepatitis B (such as health care workers) and have not been vaccinated for it should consider getting the hepatitis B vaccine before or during pregnancy. This disease can be passed on to the baby during delivery. A provider also may recommend other vaccines, such as the flu shot.

What maternal illnesses should be treated before pregnancy?

●Diabetes: Women with poorly controlled diabetes that started before pregnancy are about 3 times more likely than women without diabetes to have a baby with a serious birth defect (6). They also are at increased risk for miscarriage and stillbirth and for having a baby that is very large. Controlling blood sugar before pregnancy and during the first few months of pregnancy can help prevent birth defects.
●High blood pressure: Chronic high blood pressure can increase the risk of pregnancy complications, including placental problems, poor fetal growth and preeclampsia (a pregnancy-related disorder characterized by high blood pressure and protein in the urine).
●Systemic lupus erythematosus (SLE): This autoimmune disorder can cause arthritis-like symptoms, kidney disease, skin rashes and other problems. Affected pregnant women are at increased risk for miscarriage, poor fetal growth, preterm labor and stillbirth (7). However, if symptoms are well controlled before pregnancy, the risk of these complications is reduced.
●Seizures: Some seizure control medications increase the risk of birth defects. During a preconception visit, a provider may adjust a woman’s dose or switch her to a drug that is safer for the fetus. A woman should not stop taking seizure medication without asking her provider, as seizures themselves might harm a fetus.
●PKU: Women with this inherited condition cannot process certain proteins. They must eat a special diet and be carefully monitored before and during pregnancy to prevent mental retardation and birth defects in their offspring (6).
●Kidney disease: Some women with severe kidney disease may suffer additional kidney damage during pregnancy, and their babies may be at increased risk for death, premature delivery or poor growth (7).

How long should a woman wait between pregnancies?

For most women, it’s best to wait at least 18 months before getting pregnant again. This gives a woman’s body enough time to get ready physically for another pregnancy. It also gives her time to adjust to life as a mom. Shorter time intervals between pregnancies may increase the risk of premature birth (8). However, not all women can wait 18 months because of their age or other reasons. A woman should talk to her health care provider to determine the right amount of time for her.

How can preconception care help prevent problems that occurred in past pregnancies?

Even if a woman has not had problems in a previous pregnancy, preconception care can help prevent birth defects or pregnancy complications in a future pregnancy. For example, taking folic acid can help prevent NTDs, and treatment of certain health conditions, such as high blood pressure, can help prevent premature delivery. A 2006 report from the Centers for Disease Control and Prevention (CDC) recommends that all women who have had a previous pregnancy that ended in an adverse outcome receive evaluation and treatment between pregnancies to reduce the risk in future pregnancies (6).

Preconception care is important for women who have had a miscarriage, stillbirth or premature delivery. The health care provider can review a woman’s medical record and may recommend tests to help determine the cause of an adverse outcome. The tests may include blood tests and imaging tests, such as ultrasound. If tests show that a health problem in the woman may have contributed to the outcome, treatment between pregnancies often can reduce the risk of the problem recurring in another pregnancy. If a woman had a previous premature delivery, the provider may recommend lifestyle changes, such as quitting smoking, and discuss the possibility of treatment with the hormone progesterone during her next pregnancy to help reduce the risk of another premature delivery.

What can a woman do to help stay healthy before pregnancy?

A woman should:
●Avoid alcohol. Drinking alcohol during pregnancy can cause physical and mental birth defects called fetal alcohol syndrome (FAS). Because no amount of alcohol has been proven safe in pregnancy, pregnant women and women considering becoming pregnant should avoid it entirely.
●Quit smoking. Smoking during pregnancy nearly doubles the risk for having a low-birthweight baby. It also increases the risk for premature delivery, other pregnancy complications and sudden infant death syndrome (SIDS) (9). Smoking also may make it more difficult to conceive (9).
●Stay away from cocaine and other illicit drugs and prescription drugs not prescribed for her. These drugs pose many risks, including premature delivery, low birthweight, birth defects, learning or behavioral problems, and withdrawal symptoms.
●Fully cook all meat and don’t change a cat’s litter box. Undercooked meat and cat feces can contain a parasite that causes an infection called toxoplasmosis, which can cause birth defects. Another way to avoid cat feces is to wear gloves when working in the yard or garden.
●Avoid contact with all rodents, including pet hamsters, mice and guinea pigs. These animals can carry a virus that can harm your baby (10).
●Avoid sitting in hot tubs and saunas. These may elevate body temperature and, possibly, increase the risk for NTDs (1).
●Avoid hazardous chemicals, such as solvents (substances that dissolve other substances, like paint thinner). Working with solvents may increase a woman’s risk for miscarriage or having a baby with birth defects (11).
●Avoid eating fish that can be high in mercury. Mercury is a metal that can harm an unborn baby; it often is found in fish. Pregnant women and women considering pregnancy should not eat fish that are high in mercury, like shark, swordfish, king mackerel and tilefish (12). These women can eat up to 12 ounces per week of fish that are low in mercury, including shrimp, salmon, pollock, catfish and canned light tuna. They should eat no more than 6 ounces of albacore (white) tuna per week. Women should always check with their local health department before eating any fish they catch themselves (12).

Why should a woman try to achieve a healthy weight before pregnancy?

Women who begin pregnancy overweight or obese may be at increased risk of having high blood pressure and diabetes, having a baby with certain birth defects, having labor and delivery complications, and having a stillborn baby (6, 7). They also may have more difficulties becoming pregnant (13). Women who are underweight may be at increased risk of having a premature or low-birthweight baby (7). A woman can help reduce her risk for these complications by attaining a healthy weight before pregnancy.

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