Pregnancy Planning (Preparing for Pregnancy)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
- Pregnancy planning definition and facts
- What is pregnancy planning?
- What are the goals pre-pregnancy planning?
- What is a pregnancy calendar or calculator?
- How soon can a woman start trying to conceive after stopping birth control?
- What are dietary considerations for pregnancy planning?
- How much weight gain is recommended in pregnancy?
- What about alcohol consumption and pregnancy planning?
- Should I exercise when pregnant?
- Is it safe to have sexual intercourse during pregnancy?
- Is it safe to diet during pregnancy?
- Is air travel safe for pregnant women?
- Do medications need to be stopped when planning pregnancy or when a woman becomes pregnant?
- What infections should be avoided in pregnancy?
- Find a local Obstetrician-Gynecologist in your town
Pregnancy planning definition and facts
- Many women choose to start pregnancy planning prior to conception so that they may minimize possible toxic exposures to the fetus.
- Women or couples with an increased risk or family history of genetic (inherited) diseases may undergo genetic counseling as a step in pregnancy planning.
- For the best outcomes, chronic medical conditions should be treated and under good control prior to attempting pregnancy.
- Smoking cessation and avoiding alcohol or illicit drug use strongly improve a woman's changes of having a healthy pregnancy and baby.
- The amount of weight that a woman should gain during pregnancy depends partially on her pre-pregnancy weight.
- As soon as a woman stops using birth control, she is able to become pregnant. Some long-term hormonal contraceptives may require a period of time for the hormonal effects to wear off.
- Women who are planning to become pregnant should take folic acid supplements to reduce the likelihood of neural tube defects in the fetus.
- Some types of fish may be high in mercury or other toxins and are not recommended for pregnant women.
- Exercise is part of a healthy lifestyle and is recommended for most pregnant women with uncomplicated pregnancies.
- It is important to review all medications, whether prescription or over-the-counter (OTC), with your health-care professional if you are planning to become pregnant.
- Sexual activity is safe for most pregnant women.
- Certain infections, including Zika virus, rubella, toxoplasmosis, and parvovirus B19 can pose risks for the fetus.
- Women who do not have immunity to the rubella virus should be vaccinated before trying to conceive.
- Women who have been infected with the HIV or hepatitis B viruses can receive medications during pregnancy or at delivery to reduce the likelihood of transmitting these infections to their newborn.
What is pregnancy planning?
Pregnancy planning begins even before conception for many women. Others choose to start planning when they are aware of a pregnancy. While it is possible to have a healthy pregnancy and baby without a pregnancy plan, developing a pregnancy plan is one way to help ensure that your baby has the greatest chances of having good health and that you have a healthy pregnancy. Planning for pregnancy typically involves:
- Discussions with a woman's partner and her health-care team, and includes discussions about nutrition and vitamins, exercise, genetic counseling, weight gain, and the need to avoid certain medications and alcohol.
- Sometimes, planning for pregnancy includes fertility planning and scheduling sexual intercourse for the time of the month when the woman is most fertile. Couples who are having regular sexual intercourse and who still do not conceive typically consult a fertility specialist. Doctors generally recommend that healthy couples in which the woman is under 35 try to get pregnant for a year before consulting a fertility specialist. Women over 35 may want to consult a fertility specialist after 6 months of trying to conceive.
- Because some women experience light bleeding known as implantation bleeding around the time of the expected menstrual period, or because of irregular menstrual cycles, some women may not realize they are pregnant until specific symptoms of pregnancy start to develop. By this time, the woman may have unknowingly exposed herself to substances that may be harmful for the pregnancy. Women who choose to begin pregnancy planning before conception can take steps to ensure that potentially harmful exposures are avoided.
What are the goals pre-pregnancy planning?
Before a woman becomes pregnant she can discuss her medical history with a doctor, focusing on the following:
- Chronic medical conditions like diabetes, thyroid disease, kidney disease, or heart disease should be monitored and well controlled prior to conception for the greatest chances of a healthy pregnancy.
- Women may be tested to determine if they have been infected with the HIV or hepatitis B viruses, so that appropriate treatment during pregnancy or at delivery can help prevent transmission of the infections to the baby.
- Immunization history and immune response to varicella (chickenpox) and rubella (German measles): the status of a woman's immunity to these two infections, which can cause harm to the developing fetus can be determined by a blood test. If a woman is not immune to these infections, vaccinations can be given before trying to conceive. After receiving the varicella vaccine, women should wait 30 days before attempting conception. Precautions against developing certain other infections should also be taken.
- Couples who have a history of inherited diseases, have other children with genetic diseases, or who have family histories of certain conditions may choose to undergo genetic counseling prior to conception. Your doctor can help you determine whether genetic counseling is appropriate for you.
- Smoking cessation dramatically improves the chances of a healthy pregnancy, and women planning pregnancy should abstain from alcohol use. Those with substance abuse problems should ideally be identified and treated prior to planning a pregnancy.
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