What is a prepregnancy care checkup?
The goal of this checkup is to find things that could affect your pregnancy. Identifying these factors before pregnancy allows you to take steps that can increase the chances of having a healthy pregnancy and a healthy baby. During this visit, your health care professional will ask about your diet and lifestyle, your medical and family history, medications you take, and any past pregnancies.
If you are planning to become pregnant, it is a good idea to have a prepregnancy care checkup. The first 8 weeks of pregnancy are key for your fetus growing inside you. Most of the fetus’s major organs and body systems have begun to form. Your health and nutrition can affect your fetus’s growth and development in these early weeks.
Your body needs a regular supply of nutrients to grow, replace worn-out tissue, and provide energy. How much of each nutrient you need each day is called the dietary reference intake. You can get your daily dietary reference intake of nutrients from food as well as from supplements. However, most of your nutrients should come from the foods you eat.
To be sure that your diet gives you enough nutrients, you need to know which ones are in the foods you eat. The U.S. Department of Agriculture’s food-planning guide called MyPlate (www.choosemyplate.gov) can help you make healthy food choices. MyPlate takes into account your age, sex, and how much you exercise every day.
Excess weight during pregnancy is associated with several pregnancy and childbirth complications, including high blood pressure, preeclampsia, preterm birth, and gestational diabetes. Obesity during pregnancy also is associated with macrosomia, defined as a larger-than-normal baby, as well as an increased risk of birth injury and cesarean birth. It also increases the risk of birth defects, especially neural tube defects. Having too much body fat may make it more difficult for your health care professional to monitor your fetus with ultrasound exam and to hear the fetus’s heartbeat.
To lose weight, you need to use up more calories than you take in. The best way to lose weight is by making a few changes in your diet and by being more physically active. Cutting back on the number of calories you consume is a good first step. Exercise burns calories and helps you lose weight. In certain situations, medications or weight-loss surgery can be considered.
Being underweight also poses risks during pregnancy. It increases the risk of having a low-birth-weight baby. These babies are at risk of problems during labor and may have health and behavioral problems that last into childhood and adulthood. Being underweight during pregnancy also increases the risk of preterm birth.
Although most of your nutrients should come from the foods you eat, it is a good idea to start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements contain all the recommended daily vitamins and minerals you will need before and during your pregnancy.
Folic acid helps prevent neural tube defects when taken before pregnancy and during pregnancy. It is recommended that all women (even if they are not trying to get pregnant) consume 400 micrograms of folic acid a day by taking a vitamin supplement containing folic acid.
Iron also is important during pregnancy. It is used to make the extra blood needed to supply oxygen to the fetus. Not getting enough iron can be a problem for some women.
Smoking, drinking alcohol, and using drugs during pregnancy can have harmful effects on a fetus. The time when the fetus is most vulnerable to the harmful effects of these substances is during the first trimester of pregnancy. Stopping harmful behavior before pregnancy may reduce or even eliminate the risks of some birth defects that occur early in pregnancy.
Some substances found in the home or the workplace may make it harder for a woman to become pregnant or could harm her fetus. If you are planning to get pregnant, look closely at your home and workplace. Think about the chemicals you use in your home or garden. Find out from your employer whether you might be exposed at work to toxic substances such as lead or mercury, chemicals such as pesticides or solvents, or radiation.
Some medical conditions—such as diabetes mellitus, high blood pressure, depression, and seizure disorders—can cause problems during pregnancy. If you have a medical condition, your health care professional will discuss with you the changes that you need to make in order to bring your condition under control before you try to get pregnant.
Some medications, including vitamin supplements, over-the-counter medications, and herbal remedies, can be harmful to the fetus and should not be taken while you are pregnant. It is important to tell your health care professional about all of the medications you are taking during your prepregnancy care checkup. Do not stop taking prescription medication until you have talked with your health care professional.
Infections can harm both the mother and the fetus. Some infections during pregnancy can cause birth defects or illnesses in the fetus.
Infections passed through sexual contact—sexually transmitted infections (STIs)—also are harmful during pregnancy. Many types of STIs may affect your ability to become pregnant. They also may infect and harm your fetus. If you think you or your partner may have an STI, get tested and treated right away.
Vaccination (also called immunization) can prevent some infections. Some vaccines are not safe to use during pregnancy. It is important to know which vaccines you may need and to get them before becoming pregnant.
Some pregnancy problems may increase the risk of having the same problem in a later pregnancy. These problems include preterm birth, high blood pressure, preeclampsia, and gestational diabetes. However, just because you had a problem in a past pregnancy does not mean it will happen again—especially if you receive proper care before and during your pregnancy.
Why is it important for my partner and me to share our family health histories with my health care professional?
Some health conditions occur more often in certain families or ethnic groups. These conditions are called genetic or inherited disorders. If a close relative has a certain condition, you or your baby could be at greater risk of having it.
Link to ACOG article