Before You Even Get That Twinkle in Your Eye

Dear Mr. Dad: My husband and I are planning to get pregnant in about a year. We hear a lot about what to do, health wise, during the pregnancy itself. But what about before? Are there things I should be doing to get my body ready? And are there things my husband should be doing?

A: Yes on all counts. An unborn baby’s organs start developing 17 to 56 days after conception. But that’s so early that you might not even know you’re pregnant yet. And by the time you find out, you may have already done all sorts of things that could affect the baby—things you may end up regretting. So it’s good that you and your husband are preparing yourselves so far in advance. I’ll talk about what you should be doing now, and we’ll tackle your husband next week.

Make an appointment with your doctor for a preconception physical. Expect him to evaluate any medications you’re taking to see whether they’re safe during pregnancy. He’ll probably prescribe prenatal vitamins with folic acid (which lowers the risk of some birth defects of the brain and spinal cord as well as some childhood cancers), which you’ll ideally start taking 6-12 weeks before conceiving.

Your doctor will also discuss medical conditions such as diabetes, asthma, high blood pressure, depression, epilepsy, obesity, or any kind of problems with previous pregnancies. All of these reduce your ability to get pregnant, and if you do conceive, they can increase pregnancy complications and the risk of miscarriage, preterm delivery, and birth defects. Be sure your immunizations are up to date, and expect to be tested for sexually transmitted diseases.

Start getting healthy right now. That means:

  • Limit caffeine. Some studies show that caffeine can decrease a woman’s fertility and increase the risk of miscarriage or other problems. Other studies find no connection. Still, it’s probably best if you cut back to no more than one or two cups of caffeinated beverages per day or switch to decaf.
  • Exercise. It’s much better to continue an exercise routine you already have in place than to start a new one. If you haven’t been working out regularly, let your doctor know.
  • Watch your weight. If you’re overweight, now’s the time to start slimming down–you definitely don’t want to be dieting during the pregnancy. According to the Centers for Disease Control (CDC), “reaching a healthy weight before pregnancy reduces the risks of neural tube defects, preterm delivery, diabetes, cesarean section,” and other conditions associated with obesity.
  • Watch your diet. What you eat immediately before conception and in the first days and weeks of the pregnancy can have a big impact on fetal development and the baby’s long-term health.
  • Quit smoking and drinking. Both decrease fertility and increase the risk of a premature or low-birthweight birth, or pregnancy loss. In one study of couples trying to conceive for the first time, women who had fewer than five drinks per week were twice as likely to get pregnant as women who had more than five.
  • Stay out of hot tubs. A recent Kaiser Permanente study found that women who used a hot tub after conception were twice as likely to miscarry as women who didn’t. Other research hasn’t found much of a connection, But Kaiser’s lead researcher, De-Kun Li, recommends that, “…women in the early stages of pregnancy — and those who may have conceived but aren’t sure — might want to play it safe for the first few months and avoid hot tubs.”