Q: When should I start thinking about my pre-pregnancy health?
A: Right Now! Even if you want to have a baby in the distant future! The care you give your body now can affect your future pregnancy health and the health of your future children. All single and married women, who have started their periods should be taking care of their pre-pregnancy health.
Q: When should I talk to my doctor about pre-pregnancy health?
A: At your yearly physical exam AND every time you visit your doctor.
Q: What are the most important things I can do to have a healthy pregnancy and healthy baby?
A: There are many things you can do, but the items listed below have the most evidence of improving your health, your future pregnancy and the health of your future baby.
What do I do if I am thinking of becoming pregnant? How soon should I confirm my pregnancy?
Confirm your pregnancy early. If you think you may be pregnant, a blood test can be accurate between 7-10 days after conception. A urine test is most accurate two weeks after conception. A fetus is most susceptible to environmental effects (such as medications, infections, etc.) during the first one to two months of pregnancy. A woman may not even know she is pregnant until she is two or three months along. If you are not using contraception, consider yourself potentially pregnant; avoid all medications, if possible. And, talk with your provider about any medications you might be on. Contact an OB/GYN doctor as soon as possible after you know you are pregnant. Most OB/GYN physicians schedule new patients according to the due date of the baby. It can occasionally be difficult to get an appointment unless you schedule with them early.
Nutrition and Folic Acid
What are the best things to eat, and do I need to take vitamins?
Eat nutritious foods. Make sure your diet includes plenty of fresh fruits and vegetables, especially green, leafy vegetables. Drink three glasses of milk daily (1500 mg of calcium). Avoid eating fish that may contain high levels of mercury, such as shark, swordfish, king mackerel, tile fish, and fish from noncommercial sources. Though you can get all the vitamins and minerals you need from nutritious foods, it is still a good idea to take a multivitamin supplement to fill in the gaps. One of the most important reasons for this is to ensure adequate intake of folate (folic acid), which can prevent birth defects. Take a supplement that contains 400 micro grams of folate. Other good sources of folate include fortified cereal and whole wheat bread.
Over-the-Counter Medications, Prescriptions, and Herbal Supplements
Is it ok to take herbs and medications?
Before taking any medication, discuss with your clinician how it may affect your pregnancy. This includes prescription and non-prescription drugs such as pain remedies (ibuprofen), as well as herbal or other remedies. Avoid mega doses of anything including vitamins.
How can I improve my current health while helping my future baby?
If you have high blood pressure, a seizure disorder, asthma, or any inherited diseases, talk with your provider before getting pregnant. Your provider may want to modify your treatment and may be able to prescribe medicine that is safer for a developing baby.
What kind of physical activity will help me and my future baby?
If you are not exercising, start now. Choose a form of exercise that you enjoy and that does not require a lot of balance or risk of abdominal injury. Do it every day, or most days of the week. If you are currently exercising, continue. You may want to consider an alternate form of exercise during pregnancy if your preferred regime requires balance or there is a potential for abdominal injury. Listen to your body. If you feel faint, dizzy, or have chest pain, stop what you are doing. If you feel any pain in any place on your body (not just the typical soreness or discomfort associated with exercise), then modify the exercise so that it is more conducive to your current condition or stop altogether.
Is there anything I should avoid?
Avoid toxic substances. Do not use illicit drugs. Avoid exposure to toxic chemicals. Stop drinking alcoholic beverages. This includes medications, such as Nyquil ®, that contain alcohol. Stop smoking. Avoid exposure to abdominal x-rays.
What shots should I have?
Rubella (german measles): Rubella infection while pregnant can cause your unborn baby to have serious birth defects. Be sure to confirm that you have had the vaccine before becoming pregnant, and avoid becoming pregnant until one month after receiving it.
Whooping Cough (Pertussis): Whooping cough is spread easily from person to person through personal contact, cough, and sneezing. It is very serious for babies because it can cause them to stop breathing. Pregnant women should receive the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks. It is also recommended that all family members and caregivers that will come into contact with mom or baby get vaccinated with Tdap. Hepatitis B: The Hepatitis B virus (a serious liver disease that can lead to an incurable chronic infection) is spread through exposure to blood or body fluids. A baby whose mother has hepatitis B is at very high risk for becoming infected with the virus. If you live with someone infected with hepatitis B, talk with your provider about getting tested and whether or not you should be vaccinated.
Pregnant women are advised to receive the inactivated flu vaccine. Pregnant women and their babies are at risk for complications associated with influenza. Pregnant women can receive the flu shot at any time during any trimester.
How should I care for my mouth, and when should I see a dentist?
Continue to see your dentist during pregnancy for oral exams and teeth cleanings. If you notice any changes in your oral health, let your dentist know. You should also let them know about any medications or supplements you are taking, as this may affect their choices for your treatment. For example, pregnant women should not be treated with tetracycline (for infection) because it can stain the fetus’ developing teeth. Your dentist also needs to know that you are pregnant so they can avoid exposing your abdomen to harmful radiation. Brush your teeth thoroughly twice a day with fluoride toothpaste to remove plaque. Use floss or another interdental cleaner daily. Daily oral care helps to prevent tooth decay and gum disease. Pregnant women are more likely to develop gingivitis, an infection of the gums that causes swelling and tenderness. Left untreated, gingivitis can affect the supporting tissues that hold your teeth in place. Tell your dentist if you notice extra bleeding or lumps that appear along the gum line and between teeth.
Family Health History
Is it important for me to know the health problems of my family members?
When you become pregnant, you may be given a questionnaire asking about your family history. This is to give your physician a better idea of potential risks or complications in pregnancy or delivery. It is important for you and your provider to be aware of your and your family’s history as it may affect your pregnancy and the future of your baby’s health.
Family Planning and Counseling
I’m planning on marriage, or I’m already married. How do I learn about family planning that is right for me and healthy spacing of my pregnancies?
To learn about the different kinds of birth control and methods of family planning, you can make an appointment to speak with your provider. There are different options that have advantages and disadvantages. Be sure to ask about all of the different options and choose which one is right for you with the help of your provider.
Bleeding in Early Pregnancy
My home pregnancy test told me I was pregnant, but now I am having some bleeding. What should I do?
If you have any bleeding at all during your pregnancy, you should notify your doctor, as they may want to administer blood tests. However, if you notice spotting in your early pregnancy (a few drops of blood that wouldn’t even cover a panty liner), don’t be alarmed. It is very normal to have spotting in the first few months of pregnancy. Bleeding (enough blood to require a liner or pad to keep from soaking through your clothes) is different than spotting, and may or may not be a problem. Some common causes of bleeding include sexual intercourse, hormone changes, and implantation of the egg. However, you should call or go to your provider right away if you have heavy bleeding, bleeding with pain or cramping, dizziness and bleeding, or pain in your belly or pelvis. If you cannot reach your provider, go to the emergency room.
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