THIS ARTICLE HAS BEEN EDITED SINCE ITS ORIGINAL POSTING DUE TO THE SPREAD OF ZIKA VIRUS. FOR CURRENT CDC RECOMMENDATIONS ABOUT ZIKA VIRUS AND FOREIGN TRAVEL–INCLUDING RECOMMENDATIONS FOR PREGNANT WOMEN–CLICK HERE.
First things first–why did I add the subtitle? Every woman can benefit from most of these recommendations even if her pregnancy plans are uncertain or a long way off. Preconception health care focuses on improving wellness, now and for life. Keep in mind as well that about half of pregnancies in the United States are not planned.
Your annual well-woman visit is a good time to begin this discussion with your doctor. Think carefully about your life goals and plans. If pregnancy is not your intention, we will help you consider your birth control options including long-acting reversible contraception.
So what does preconception health care involve?
- We will discuss how your overall health fits into your future plans. Medical conditions like STDs, diabetes, high blood pressure, thyroid disease, and others need to be well controlled. Your family health history is also important. Family history tells us whether you are at higher risk for certain health problems and whether your child may have higher risk for an inherited condition. If your family history is significant, genetic counseling can help you understand the risk.
- We will encourage you to make positive decisions about weight management and exercise, smoking cessation, and use of alcohol or other substances. We can refer you to specialists or support resources if any of these presents a significant risk to your long-term good health.
- We will consider whether your vaccinations are up-to-date. Some vaccination like flu and pertussis (whooping cough) are especially important for pregnant women. Others like HPV and chicken pox should not be taken by anyone who may be pregnant.
- We will talk about folic acid. Folic acid is a B vitamin that the body requires to make new cells. All women need folic acid each day. Hopefully, you get this from a well-balanced diet, but to be sure, we recommend that reproductive-age women take a multi-vitamin containing 400 mcg of folic acid each day. Getting enough folic acid becomes even more critical for women who may become pregnant. Folic acid helps to prevent certain birth defects of the brain and spine. Having enough folic acid is so important during pregnancy that we recommend you begin taking a daily pre-natal vitamin containing 800 to 1000 mcg of folic acid as soon as you begin trying to become pregnant. If you or a close family member has had a previous pregnancy with a neural-tube defect like spina bifida, the recommendation is 4000 mcg of folic acid daily beginning before conception. Read more from the Centers for Disease Control and Prevention in their “Folic Acid Fact Sheet.”
- We will consider the prescription medications you may be taking and advise you about their risk during pregnancy. Both prescription and over-the-counter medications, including some herbal and dietary supplements, can be harmful to a developing infant. We encourage you to take only medications that are necessary. You will also want to avoid toxic substances in the environment if you are planning to become pregnant. The CDC provides a brochure “Toxic Matters” that contains good information about environmental toxins.
- We will make you aware of other health problems, including food-borne illnesses,and communicable diseases like flu and Zika, that present special risks for pregnant women and their babies.
- We want to discuss any concerns you may have about anxiety, depression, family violence, or other risks to your health or your future pregnancy. We will offer you support and referral to mental health or social services professionals.
- Finally, we want to consider Dad in our conversation. His overall health is very important to the well-being of the woman and future child in his life. This includes his family medical history, exposure to sexually transmitted illnesses, use of medications, alcohol and other substances, immunization status, and exposure to environmental hazards. Dad’s health also has an impact on your fertility together.
Above all, we encourage you to plan ahead. For some women, preparing physically for pregnancy may take just a few months, for others it might take longer. Your best step toward a healthy pregnancy is to protect your own good health—a worthwhile goal for every woman regardless of her reproductive plans.