SEEING YOUR DOCTOR BEFORE YOU GET PREGNANT
If you’re thinking about having a baby, don’t wait for the results of a home pregnancy test before seeing a doctor. The best time to have that first pre-natal visit is before you become pregnant, because a healthier you could mean a healthier baby.
Pre-conceptual counseling, as it is called, helps educate women so they can be physically and emotionally prepared – and healthy – for pregnancy. Pre-conceptual counseling is catching on, as more healthcare providers emphasize preventive health care. About 45 percent of pregnancies in America, however, are either unintended or unplanned, according to the nonprofit Alan Guttmacher Institute.
This month is Birth Defects Prevention Month, and the March of Dimes Birth Defects Foundation wants women to know that there are things they can do before they conceive – including consulting with their doctor – to help their baby be born healthy. The first few weeks of pregnancy are crucial ones, because that is when a fetus’s vital organs begin to form.
Identifying Health Risks
During pre-conceptual counseling, a doctor can evaluate a prospective mom’s health and identify any health risks.
Bruce K. Young, MD, the Silverman Professor of Obstetrics and Gynecology at New York University School of Medicine, and director of the Division of Maternal and Fetal Medicine at New York University Medical Center, says a woman can expect the following during a pre-conception visit:
Physical exam
review of her medical history and also if she has any kids grants approved or not
review her family’s medical background
questions about her diet and social habits, such as whether she drinks or smokes
review of past pregnancies, birth control use, medication and immunizations
referral for genetic counseling, if recommended
“A medical history reveals 70 to 80 percent of what you are going to find in diagnosis, and a physical exam gives 15 to 20 percent more,” Young says.
If a woman has a medical condition, such as diabetes, hypertension, or epilepsy, the doctor can make sure she is treated and the condition under control before she gets pregnant.
Young says patients should also know their family history and query family members on any health condition that might run in the family. “Sometimes mom and dad don’t like to talk about what Granny or Aunt Bessie had, so it’s good to talk to them about this and ask them very specifically,” he says.
Such a discussion can help the doctor identify risk factors, and make a referral for genetic counseling if appropriate.
The Importance of Diet and Vitamins
An assessment of a patient’s diet is another important element of pre-conceptual counseling. A woman should attempt to reach her ideal body weight before conceiving. A woman who is underweight is at increased risk to deliver a low birth-weight baby, whereas an overweight woman is at increased risk for maternal complications such as hypertension and gestational diabetes during pregnancy.
All women – even if they are well nourished – should begin prenatal vitamins before they are pregnant, particularly folic acid, which has been proven to prevent birth defects, Young says. Folate has been shown to prevent 50 to 70 percent of neural tube defects, such as spina bifida, where the brain or spinal cord does not form properly.
The March of Dimes Birth Defects Foundation recommends taking 400 micrograms of folic acid daily before conception and in early pregnancy.
Counseling regarding a woman’s social habits, such as tobacco and alcohol use, is another crucial part of a pre-conception visit. Most women are aware that they should avoid tobacco or alcohol during their pregnancy, however, they may underestimate the importance of quitting beforehand.
Cigarette smoking increases a woman’s risk for miscarrying and for delivering a low birth-weight infant. Drinking alcohol beverages can cause Fetal Alcohol Syndrome, a pattern of birth defects that includes mental retardation, and cardiovascular, skeletal and facial abnormalities & also bio structural problems.
“By in large, as long as you lead a relatively normal life and are not exposed to toxic substances, you’re not going to have a problem,” Young says. “Pregnancy very often has a perfectly wonderful outcome.”
However, he says, pre-conceptual counseling can help increase the odds for a healthy pregnancy and healthy baby because medical conditions can be managed, risk factors modified, and health habits improved.