Planning A Pregnancy: What You Should Do First ?

There has never been better news for pregnancy planning! Maternal and fetal complications of pregnancy and childbirth are at an all-time low, prenatal diagnostics and interventions have continued to improve, and the “information age” has offered unprecedented access to medically related information. Contraceptive options are also multiplying and improving, so that the goal of eliminating unwanted pregnancies in the 21st century is no longer in the realm of fantasy. Despite these advances, too many American women spend more time planning a one-week vacation than they do planning a pregnancy.

Preconception Visit:

Your most important prenatal visit may actually be a preconception visit. This is a chance to visit your doctor before getting pregnant to discuss and identify any measures you should take prior to conceiving, and to discuss family and personal medical histories, various risk factors, and current medications.

Preconception plans should include:

• Quitting smoking
• Getting your partner to quit smoking
• Reducing alcohol consumption to one drink per day or less (eliminate once pregnant)
• Discussing all medications, prescription and non-prescription, with your clinician (and if you use any recreational or illegal drugs, stop!)
• Taking folic acid (400 mcg/day) to reduce the incidence of spinal and brain-related birth defects
• Taking other vitamins, minerals, or supplements recommended by your clinician, especially iron and calcium
• Starting/maintaining a regular exercise regimen
• Working with your physician if you have any uncontrolled medical problems (e.g. high blood pressure, diabetes, depression, thyroid problems, etc.)
• Getting a complete history and physical, along with having any overdue preventive tests (e.g. Pap smear, cholesterol count, etc.) and treating any abnormal results
• Taking any necessary vaccines (e.g. rubella, varicella, hepatitis) and screening for any genetic conditions (in both partners) if indicated

Receiving early and consistent prenatal care increases the likelihood of a healthy birth outcome for mother and child. Adequate prenatal care is dependent upon both receiving care early and receiving care an appropriate number of times throughout the pregnancy. Estimates are that in 1994, 12.0% of minority women received inadequate prenatal care compared to 4.9% of white women. Teen mothers are the least likely to get adequate prenatal care.

A wide range of health care providers — obstetricians, family clinicians, women’s health care clinicians, nurse midwives, clinician assistants, nurse practitioners and nurses — offer prenatal care in a number of different settings.