Preparing for pregnancy

A balanced diet is important for everyone, particularly moms-to-be. It’s important to make the appropriate changes to your diet before you get pregnant.

Eat a balanced diet with foods high in protein, as well as fruits, green, leafy vegetables, grains and dairy products. Limit the amount of fish you eat, particularly ones with high levels of mercury like tuna, to no more than once a week. Avoid sushi.

Reduce your intake of empty calories, artificial sweeteners and caffeine, as too much caffeine can make it more difficult to get pregnant, and may increase the risk of miscarriage. As always, discuss your nutritional needs with your doctor before getting pregnant.

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Being overweight during pregnancy may increase your chances of having complications, such as high blood pressure or diabetes. If you are underweight or overweight, try to reach your ideal weight before you get pregnant.

Obesity affects your hormones, making it more difficult to conceive. It also increases the chance of problems during pregnancy, such as diabetes and high blood pressure. If your BMI (body mass index) is 30 or above, ask your doctor about diet and exercise programs that may help.

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Most doctors recommend that women begin taking a multivitamin supplement with 400-800 micrograms (mcg) of folic acid two months before getting pregnant. Taking folic acid is thought to reduce a baby's risk of developing birth defects of the spine, such as spina bifida.

Avoid vitamins with high doses of vitamin A, and avoid herbal supplements, as the safety of herbs in pregnancy is unknown. As always, discuss nutritional supplementation with your doctor before getting pregnant.

Exercising before you get pregnant may help your body deal with all of the changes that you will go through during pregnancy and labor. The amount of exercise you’re able to do during pregnancy will be determined by your overall health and how active you were before you got pregnant.

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While you’re trying to get pregnant, it is important to rest, relax and be as stress-free as possible. Practicing stress reduction techniques and getting plenty of rest and relaxation may make it easier for you to become pregnant.

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Now is the time to quit any unhealthy habits. Don’t wait to stop smoking once you become pregnant—quit smoking now. Smoking makes it more difficult to conceive and puts your child at greater risk of health problems later in life.

Smoking during pregnancy can affect your baby's development and birth weight, as well as the health of the placenta. It increases the chance of complications during pregnancy, and doubles the risk of having a low birth weight baby. Smoking also increases the risk of miscarriage, premature birth, stillbirths, cleft lip or palate, asthma, preterm labor, and sudden infant death syndrome (SIDS). Get help to quit smoking.

You should also avoid alcohol, which can decrease your ability to get pregnant and damage a developing fetus. Women who have two or more drinks a day are at greater risk for giving birth to a baby with severe long-term effects, such as mental retardation, behavioral problems, learning disabilities, and facial and heart defects.

Individuals at increased risk of passing genetic abnormalities on to their children include:

• People with family histories of inherited disorders, or those who have previously had children with genetic disorders
• Jews of Eastern European descent, who may have a high risk of having children with Tay-Sachs or Canavan’s (metabolic disorders that lead to death in early childhood)
• African-Americans, who may risk passing on sickle-cell anemia to their children
• Couples of Southeast Asian or Mediterranean origin, who are at increased risk of having children with thalassemia, a severe form of anemia
• Women who were exposed to toxins that could cause birth defects
• Women with prior medical conditions or diseases that may affect their fetus, such as diabetes
• Couples who share a common ancestor
• Women with a history of multiple miscarriages
• Couples who have family members with birth defects or severe developmental problems
• Women over the age of 35 and those who have received abnormal screening test results, such as alpha-fetoprotein (AFP)

For those who may be at risk, genetic counseling and prenatal diagnosis can answer some important questions, such as:

• Should we have a baby? Are the chances of having a baby with a genetic defect so high that choosing adoption or artificial insemination may be a better way to start a family?
• How can we treat the fetus' potential defects? Are there surgical techniques available or other medical interventions that may help alleviate problems?
• How do we prepare, physically and psychologically, for the possible outcome of a pregnancy? Are there special educational classes, training or information that we need in order to raise a child with defects?
• Should we continue the pregnancy? Are the fetus' abnormalities so severe that we might choose to have an abortion?

It is important to remember that preconception testing can only provide the odds of having a child with a certain birth defect. If you decide to conceive, prenatal testing can help reveal whether or not the baby has inherited a disorder. Certain tests, such as for spina bifida or Down syndrome, are done once you are pregnant.

If you decide to meet with a genetic counselor, we’ll ask you to complete an in-depth family history. You and your partner may also get blood tests and undergo an analysis of your chromosomes known as karyotyping.

If you get tested after conception, one of the following tests will be used to obtain fetal cells whose genetic and chemical makeup can be analyzed in a laboratory:

• Amniocentesis, in which fluid is withdrawn from the amniotic sac and analyzed.
• Chorionic villus sampling (CVS), which takes a sampling of the cells of the placenta.
• Percutaneous umbilical blood sampling (PUBS), which draws fetal blood from the umbilical cord.

Your genetic counselor will discuss with you the results and your options. If you are at risk of having a baby with a disorder, you may be able to use assisted reproductive technologies to reduce the chance that your baby will be affected.