It’s always a joy to meet a newly pregnant mother (and of course her family) and to embark on the greatest of journeys as her doctor.
What I want to focus on is the pre-pregnancy time frame, during which many topics are important, but I’ll focus on a few that seem to come up frequently.
Zika has been in the headlines and for good reason. Due to the nature of the infection, it is important for women and for the father of the baby to not travel to an area where there is known transmission. If travel cannot be avoided, the use of DEET and other anti-mosquito strategies like using bed nets and covering the arms and legs with long sleeves and pants is helpful.
My advice – if travel is not necessary to those affected areas, don’t go to those locations for at least three months prior to your desired conception. Be sure to check the CDC website for the most up-to-date areas of transmission, before you purchase your trip to a tropical climate location.
Exposures to certain foods and drinks can be harmful. Avoiding mercury rich fish should start well before the pregnancy starts. There are great resources through the Department of Health for Washington State and they produce a handy, wallet sized card that outlines what fish are highest in mercury. Ideally, start thinking about this and avoiding these fish at least three months prior to pregnancy. It’s great to eat certain fish, and in fact, it’s recommended to eat fish twice a week during pregnancy, but it’s important to know which are safe.
Cheese & Raw Meat
The other food exposure that women typically know about is unpasteurized milk/cheese and raw meats. This restriction only applies once pregnancy has started. It is safe to indulge in that cheese and sushi until your pregnancy test shows positive.
Everyone is aware that alcohol is bad for the unborn fetus, however, many women do come in for their first pregnancy visit with concerns about inadvertently drinking alcohol before knowing they were pregnant. This worry is easily avoided if a woman is aware of her cycle and can avoid consuming alcohol once it is possible that she could be pregnant. This is known as the luteal phase and is the time frame after ovulation. There are many apps that can be downloaded to help each woman figure out when she should be more careful.
The influenza vaccine is safe and particularly important for women who are or may become pregnant during the flu season. The vaccine is totally safe. Pregnant women are some of the highest at risk for getting the flu and for becoming sick from the flu. Don’t worry about getting it because you are thinking of becoming pregnant. Getting the vaccine will improve your chances of remaining healthy through the whole pregnancy.
Knowing your immunization status is also helpful. When women come in for pre-pregnancy counseling, we often check for immunity to rubella and chicken pox. These are both diseases that have devastating effects on an unborn child, so it’s good to know if you are immune prior to getting pregnant. We do not vaccinate for either of these diseases during pregnancy and we advise waiting three months after a vaccination for rubella or chicken pox before conceiving. Plan ahead so it doesn’t delay your ideal timing for getting pregnant.
You do need to take vitamins during pregnancy! Ideally, all women of childbearing age would be taking folate or folic acid (800mcg) daily regardless of their intent to conceive. But, it is even more important when you are thinking about pregnancy. You can take a prenatal vitamin which will have about 800 mcg in it, or you can take folate alone which typically comes in doses of 400mcg. Taking vitamins helps to prevent open spina bifida and other neural tube disorders.
Many women do not visit Obstetrics until after they have conceived and usually have not taken prenatal vitamins and folate. This timing is not ideal because the neural tube is often already formed before the visit occurs. It is important to plan and start the necessary vitamins before pregnancy. You cannot overdose and it’s one more way to promote the best health for you and your unborn child.
DISCLAIMER: The contents and opinions expressed by Everett Clinic teammates and providers on “A Healthier You” blog and those providing comments are theirs alone and are not a substitute for medical advice. Consult your own provider for personal health recommendations.
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