Most women have heard about the importance of having folic acid in their diets, especially when they are of child-bearing age. Among other benefits, folic acid can lower the risk for certain neurological birth defects. It’s important to remember, however, that women should be getting this essential nutrient before they conceive.
"It's been estimated that as much as 50 percent of pregnancies in the United States are unplanned. That's why it’s so important to always be at the ready," says Xavier Pombar, DO, a high-risk obstetrician at Rush University Medical Center.
"All women of child-bearing age should receive preconception counseling at every visit to their health care provider. Ideally, this type of counseling should begin with the first visit after a woman begins to menstruate."
Besides folic acid, there are other things that women should consider when thinking about becoming pregnant:
Another thing that people sometimes forget to consider is their family history. A review of your family history with your physician can help show if you may be predisposed to certain disorders or complications. You may have a family history of heart and vascular disease, diabetes, miscarriages or fetal death.
"If you are a woman with a family history of diabetes, for instance, I would recommend that your blood sugar levels be tested before conception," says Pombar.
The newborn of a mother with diabetes is seven times higher risk for birth defects. "That's why it's so important to have control of the blood sugar before conception and throughout the pregnancy," says Pombar.
"Many of these issues must be addressed and managed before conception," he says. "It may be too late if we wait, especially since the organs develop around six to eight weeks into the pregnancy, and the first visit to the gynecologist or obstetrician is usually at the eight to 10 week mark. The fetus may have already developed problems before the mother comes in for her first prenatal visit."
You should be aware of possible toxins in your environment that can affect the health of a developing fetus. Some things seem more obvious than others for instance, if you work somewhere where you are exposed to toxic chemicals or radiation. Other things are not as obvious.
One example is toxoplasmosis from your cat. Toxoplasmosis can lead to fetal infections. You should also be careful about exposure to mercury and other heavy metals in fish and other seafood, as well as foodborne illnesses, including from unpasteurized cheeses and juices.
Talk to your doctor for more details and to discuss those things that may be of particular risk to you.
Women of child-bearing age should also consider the effects of any medications they are taking. A clear relationship has been established with birth defects and some anti-seizure medications and antidepressants, says Pombar. You can talk to your physician about the possibility of changing medications or dosage.
If you are of child-bearing age you should always be prepared for the possibility of having a child.
"In my opinion, they are very few women who would not benefit from preconception counseling," Pombar says. "If nothing else they can have the confidence that they did everything possible to optimize the first stages of the pregnancy."
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