A preconception doctor visit is the first step
Are you thinking about getting pregnant? Before picking out names or decorating a nursery, ensure you’re as healthy as possible to carry and deliver a thriving baby.
The first step is scheduling a preconception visit with your obstetrician-gynecologist, says Dr. Stephanie Berlet-Dach, an OB-GYN with Bon Secours’ Upstate OB-GYN Group. It will allow you to discuss your medical history and health concerns and receive personalized advice on healthy lifestyle choices. “During that visit, we can talk about potential risks and risk interventions and actually initiate interventions,” she adds.
That could include addressing any existing chronic conditions, such as diabetes, hypertension, and thyroid disease. If diabetes is a concern, your doctor may order blood sugar and A1C tests or check your thyroid levels if you are on thyroid medication.
“You should optimize any chronic condition,” Berlet-Dach says, adding that the medications for some conditions “could have a teratogenic effect on the fetus, meaning some potential for bad outcomes, whether it be the formation of the fetus or increased risk of miscarriage or growth restriction.”
Reviewing your medications and any over-the-counter herbal supplements you take during a preconception visit is vital. Some medicines can make conceiving difficult, and some supplements also “could have a teratogenic effect on the fetus,” she adds.
During the visit, ask if you need any vaccinations “that you cannot get during pregnancy, like rubella and varicella. Those must be completed at least two months before conceiving,” Berlet-Dach says, adding that you should also discuss your family’s medical history. “If there’s any concern that there’s a carrier risk for a genetic disease, then we would want to address that. And maybe do some testing for the genetic risk,” she says.
Finally, talk with your doctor about optimizing your mental health, including taking pregnancy-safe antidepressants if necessary. “We want to make sure there are no red flags as far as depression and anxiety that we need to address,” Berlet-Dach says. “New studies show maternal antenatal anxiety and depression increase risks for neurodevelopmental disorders and increase risk for mental illness.”
Berlet-Dach suggests scheduling a preconception visit “at least three months if not six months” before trying to get pregnant. “That’s because we can optimize therapy, and if obesity is an issue, you can try to optimize weight,” she says.
Many of Bon Secours’ OB-GYNs are accepting new patients. To see a list, visit Bon Secours’ Find a Doctor website: bonsecours.com/find-a-doctor. You can narrow your search by zip code, accepted insurance plans, and more.
Proactive Steps
In addition to a preconception visit, making smart lifestyle choices will help improve your pre-pregnancy health, Berlet-Dach says. Among the proactive steps you can take are:
- Prioritizing sleep. “If you’re not getting enough sleep, your cortisol levels are up. That can impact your ability to ovulate,” she says.
- Taking a prenatal vitamin that includes 400 to 800 micrograms of folic acid. “I like for patients to be on one three months before they conceive,” she says.
- Eating a well-balanced diet rich in essential nutrients like iron, calcium, and omega-3 fatty acids.
- Getting at least 150 minutes of physical activity per week. “If you’re not getting enough physical activity, that also can impact your cortisol levels,” she says, adding that you should optimize your cardiovascular health because “if you’re planning on carrying a baby, that’s very physically tasking.”
- Giving up smoking. “It can put the pregnancy at risk if you continue,” Dach says, adding that you should also limit alcohol consumption.
- Optimizing your body mass index. “For people who are obese, there’s a much higher rate of stillborn births, miscarriages, birth defects.”
- Managing stress through meditation, yoga or stretching, therapy, aromatherapy, or drinking lavender or chamomile tea. Outdoor exercise is a huge stress reduction technique, Berlet-Dach says. “Some studies show that your serotonin levels are higher when you exercise outside in the sunshine than when you take a serotonin pill.”
