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Pregnancy & Childbirth

Planning for a Healthy Baby


The road to having a healthy baby starts long before pregnancy. And, while pregnancy typically lasts 40 weeks, planning for pregnancy can take that long, too.

Up to One Year Before Pregnancy

Start out right by seeing your OB/GYN for a preconception consult to discuss your personal health and any issues you might have before getting pregnant. It’s also a good idea to have a general physical exam from your primary care physician and review your personal and family history.

“Some people may have genetic conditions, but no family history,” says Susanne Prather, MD, FACOG, OB/GYN.

“We have excellent non-invasive genetic testing available to determine if there is an increased risk for genetic syndromes on the mom or partner’s side.” If it’s possible, get your weight right before you embark on pregnancy. “Obesity is a risk factor for gestational diabetes and hypertension, and increases the risk of prolonged labor,” says Mary Crowther, MD, FACOG, OB/GYN. “At the other end of the spectrum, women who have low body weight and exercise a lot can have growth-restricted babies. The optimal body mass index is over 18 and less than 30.”

Get into the habit of regular exercise pre-pregnancy. That will make you more likely to continue exercising after you are pregnant. Virginia Hospital Center offers a wide variety of exercise classes.

Six Months Before Pregnancy

This is the time to start addressing any medications you are currently taking. For example, if you have high cholesterol or high blood pressure, you may have to discontinue or change your medications during pregnancy.

If you have Type I Diabetes, your insulin requirements will increase dramatically. Talk with your doctor about how to control your insulin during pregnancy. With Type II Diabetes, you may need to begin taking insulin. In either case, diabetes increases the risk of Cesarean section, due to having a larger baby and, therefore, a more difficult labor. “Women who are on medication for anxiety or depression may not necessarily have to stop taking their medication. We use an individualized approach to medication, depending on what is best for our patients,” says Dr. Prather.

Do not travel to areas where there is incidence of the Zika virus. The timeline for safety is six months for males and eight weeks for females to wait before getting pregnant after possible exposure to Zika.

Three Months Before Pregnancy

Make sure your vaccines for measles, mumps and rubella are up to date, as live vaccines cannot be administered during pregnancy. If you did not have chicken pox as a child, immunization is recommended. “We can test your immunity level and if you are not immune, we vaccinate you—but you should not conceive for at least four weeks afterwards,” says Kimberly Lenhardt, MD, OB/GYN, Kaiser Permanente.

Begin taking prenatal vitamins three months before becoming pregnant, as well as folic acid, which helps prevent neural tube defects such as spina bifida. And, try to eat a healthy diet and reduce your intake of caffeine.

Ready to Conceive

A meeting with your OB/GYN can help prepare you for the process of conception. “During that visit, we discuss your menstrual cycle, and if it’s regular, how to predict your most fertile time,” says Dr. Lenhardt.

“What patients are most concerned about is ‘Will I be able to get pregnant,’” says Dr. Prather. “Fertility rate starts to decrease after age 35 and plummets after age 40. We can do blood tests to look at egg quality and determine how many eggs you have left.”

When should you be concerned that you’re not pregnant after trying to conceive? “With young women, up to six to eight months. Women in their 40s should check with their OB/GYN after three months,” says Andrea Williams, MD, OB/GYN.

Fertility can be affected for women who consume moderate amounts of alcohol (up to one drink a day). For men, even moderate consumption of alcohol (up to two drinks a day) can decrease testosterone and sperm levels.

“Smoking can make it harder to get pregnant,” says Dr. Lenhardt. Half of smokers have a much higher chance of taking a year or more to conceive.

During Pregnancy

You should have the Tdap vaccine for tetanus, diphtheria and pertussis (whooping-cough) after 30 weeks, so you can develop an antibody response to the vaccine, and your baby will be passively immunized. Having a flu vaccine is recommended as pregnant women are more susceptible to severe illness from flu and can be at higher risk for premature labor if they have the flu. Virginia Hospital Center offers prenatal classes that cover the spectrum from labor and delivery, to anesthesia, to lactation and child care (see classes, this page). “You can start developing your birth plan,” says Dr. Crowther.

Knowing your options for anesthesia during labor and delivery is also important. “We work closely with OB/GYNs and schedule consults if a patient has any significant medical issues,” says Rand Kirshner, DO, Director of Obstetrical Anesthesia. “Even if they are just feeling anxious about the labor process and want to know more about anesthesia, patients are welcome to call us or schedule an appointment at any time prior to delivery.”

Get Started Now

It’s never too early to start planning for a healthy baby. “The earliest a pregnant mom typically sees her doctor is around six weeks,” says Dr. Williams. “By that time, the baby’s organs have already started developing. You need to take care of yourself way before you get pregnant.”

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