20 Things Doctors Want Future Moms To Know Before They Get Pregnant

Whether it’s a plan for the honeymoon, something a couple is thinking about in the future, a decision to do away with birth control or something that could be inevitable, if a pregnancy might happen, chances are some medical advice beforehand might not hurt.

Before getting pregnant there are a lot of things to look at, such finding out what kinds of medication are incompatible for those nine months, or whether a healthy pregnancy is possible despite having a chronic illness. Moms have so many questions and usually doctors don't have time to answer all of them. But that doesn't mean that the medical community doesn't have feedback or hard-earned advice for any potential moms out there. Even if a lot of pregnancy and motherhood is up to instinct and nature, there is a lot that doctors want women to know when they're thinking about starting a family.

Whether it’s just swapping out the ibuprofen for the Tylenol or really cutting back on the junk food and getting into a regular exercise routine, there are a lot of little life changes a good doctor may want to suggest to those looking to bear fruit prior to getting pregnant. Here is a look at some of the most popular!

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20 To be useful, Folic Acid has to be there before pregnancy

It’s the vitamin that doctors say all women of child-bearing age should be taking “just in case” because lots of pregnancies are unplanned, and according to some series on A&E, go unnoticed? Folate is a member of the B family of vitamins and it is found in most dark green vegetables. It is not limited to green leaves, though. It is also found in all kinds of things like fruits, nuts, beans, peas, grains, dairy, meat and eggs. Why is it so necessary for a woman who may conceive? Because, according SOGC or the Society of Obstetricians and Gynaecologists of Canada, “It is required for the production of new cells and for proper synthesis of DNA. This vitamin is particularly important to a baby’s health and development. To be effective, folic acid must be taken before conception. It is not helpful to start after the pregnancy is established.”

19 As always, a balanced menu is important

Eating a healthy, balanced diet can very subjective as lots of people may believe what they are eating a robust diet but that concept of “healthy," may not be based in science. Not surprisingly, this comes from living in a fast paced, consumer world where people now eat a lot of take out and  processed food that is merely marketed to them as “healthy.” While eating for two, the best premise to go with is whole foods, because whole foods are good foods! If you aren’t certain as to where to start or what you should be getting in terms of your maternal nutrition, Health Canada has a prenatal nutrition guide . Within it they suggest to “Eat according to Canada’s Food Guide. Take a daily multivitamin that has 0.4 mg of folic acid and 16 to 20 mg of iron. Include an extra 2 to 3 Food Guide Servings each day, for example a fruit and yogurt for a snack and be active every day as part of a healthy pregnancy.”

18 Pharmaceuticals and Homeopathy: What Is Safe And What Isn’t?

In some cases it is a simple matter of swapping out the Ibuprofen (Advil) for Acetaminophen (Tylenol). In other cases its far more complex, but women with all kinds of ailments get pregnant and have children under the supervision of their doctors every day. Sometimes it is a matter of altering a medication dose, stopping its usage or taking a different drug that is known not to disturb the development of the embryo or the fetus (Teratogenic drugs). Whatever the case, this is a discussion that is necessary to be had between a physician and a patient. Already having a plan ready before a woman is even pregnant is the best way to go! The same thing goes for any variety of herbal or natural medicine, unless it is known not to have caused birth defects or side effects in conjunction with the prescription medication you are already taking, stop taking it. Any medicine (natural or pharmaceutical) a woman takes while pregnant or even prior to conception needs to have been proven safe scientifically. It’s safety first for everyone.

17 The occasional drink or Recreational substance: nope to all of them

At the same time, it should also be noted that when it comes to substances outside of pharmaceuticals and natural remedies, there is no amount of recreational drugs or alcohol that are safe. According to the American College of Obstetricians and Gynaecologists or ACOG, while alcohol can cause birth defects like Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorder, other illicit drugs could have all kinds of impacts on an unborn baby. These impacts include other damaging birth defects, preterm deliveries and miscarriages. While it was previously thought that one glass of wine or beer in the second or third trimester was ok, the latest studies show that there is actually no evidence to suggest that there is a safe amount of alcohol to consume while pregnant. While it may seem more innocuous, green herb, even though it may have been previously prescribed to a patient for other medical ailments, should be ceased of usage during pregnancy.

16 Get Any Major Dental Work Done Before

Because sometimes dental work can be messy, require multiple visits, pain medication and even antibiotics that could fall outside of the types of antibiotics a pregnant woman can take, get it out of the way. With a baby on the way, worrying about a root canal should be the last thing on a mommy-to-be’s mind, let alone how she is going to look in all of those “bumpie” shots! Whether it's reconstructive or purely cosmetic, getting those whites as pearly as pearly can be takes top priority before the “trying to conceive” part. In this day and age, with Facebook and Instagram and all of the shots everyone is taking, you will want your smile to be nothing short of glamorous!

15 Get A PAP Test Done First

While a PAP test may seem so routine and one of those things that can fall to the wayside if a gal doesn’t have a regular OBGYN, which is the case for many women in rural areas, it is really important! Getting a PAP test done prior to baby makin’ time is so necessary. While it may not be talked about as much as it should be, according to the SOGC website, “Cervical cancer is the second most common cancer in Canadian women between the ages of 20 and 44. Starting at age 21, all women should be screened for cervical cancer by a Pap test.” All the test consists of is a swabbing of cervical cells that get sent off to a lab to be examined for potentially cancerous cells. What can happen if a woman gets pregnant only to discover later on down the line that she does have pre-cancerous cells on her cervix, is that she will end up delaying her own treatment for those pre-cancerous cells until after the baby is born.

14 Vaccinations Are Another Box to Get Checked Off That List!

Though vaccinations are the kind of thing that people associate with childhood or travel to exotic lands, there are actually plenty of vaccinations to get in adulthood that are just follo- up boosters from childhood. At that, are also all sorts of new vaccines out now that are worth looking into. While you can get the Hepatitis B vaccination while pregnant and you absolutely should always get the flu shots while pregnant and while nursing, you should also get the “Tdap” vaccine (Tetanus Toxoid, Reduced Diphtheria Toxoid and Reduced Acellular Pertussis) between 21 and 32 weeks of gestation. According to the SOGC, this is new as pertussis (a contagious respiratory infection that can severely affect an infant less than four months old) has been added to the tetanus-diphtheria vaccine as there have been outbreaks in Canada in recent years. This is a vaccine that is safe for both mom and baby.

13 It's easiest before 35, but possible after (with technology's help)

Just because Janet Jackson had a baby at 50, that doesn’t mean the rest of us can hold off maternity that long. There are lots of celebrities out there that have had their babies late in life and that is often because they froze their eggs early on and did in-vitro fertilization later on. Genetically, women fare best and get pregnant easier when they have their children between the ages of 20-35 because they will have the most fertile eggs during this period of their lives. As the number of eggs a woman has is determined while she herself is in utero, on average approximately 250,000, by the time a woman hits 40, the amount of fertile eggs she has remaining is on the decline and so it can be much harder to conceive. What is interesting, however, is that women have really changed the way families develop, getting an education and establishing careers first in their 20s and then having children in their 30s. Sometimes even in their 40s due to the way relationships are changing and reproductive technology is advancing.

12 Being A healthy size is vital

Much like anything else in life, being both under and overweight has an impact on fertility because it has an impact on just about everything else going on in your body, from your hormones to your sleep cycle. While being obese may not affect ovulation, if could impact ovulation and menstrual cycles. Being both underweight and overweight can make it difficult to be pregnant, which is why doctors put such an emphasis on getting healthy prior to getting pregnant.

According to the ACOG, women who are defined as having a body mass index (BMI) of 30 or over when they get pregnant have a greater likelihood of having babies with a particular range of birth defects. “Among the most common obesity-related birth defects are neural tube defects, heart defects, and cleft palate. If you are planning a pregnancy, the best way to prevent problems caused by obesity is to be at a normal weight before you get pregnant.”

11 So many things could be holding pregnancy back

Fertility is a funny thing. Sometimes getting pregnant happens exactly when you don’t want it, or couples can go a whole year of trying and have it not happen at all. On average, it takes most Canadian couples approximately six to seven months to get pregnant. But there are a whole multitude of factors that can be at play here. According to the SOGC, on the more basic end there are factors like age, lifestyle, genetics, weight, stress, anatomical variations, and infections that can all play a role in a couple’s chances at getting pregnant. This is why they put so much stress on getting as healthy as possible before getting pregnant. One in every six couples in Canada experiences infertility.

There are very basic tools to use if a couple wants to plan, such as keeping a calendar or using an app that calculates it all for your because it all depends on how long a woman’s cycle is and where those days fall in between. Then there are other methods that can be employed such as cervical mucus testing, basal body temperature testing and also purchasing an ovulation prediction testing kit.

10 Sometimes it's On His End

Try as much as you would like, sometimes a couple can’t get pregnant because there is a physical problem on his end. When it comes to men and infertility, there is a whole myriad of reasons as to why he may not be able to provide on his end of things and some are much less obvious than others. If he has been treated for cancer and he didn’t freeze some genetic material prior, it’s not going to happen because the treatment for cancer will usually destroy a man or a woman’s fertility. According to the SOGC, some major factors included: a history of relevant infections, other chronic illnesses, weight, genetic causes, an injury, substance use or exposure to environmental toxins. The only way to know, outside of the obvious cancer treatment, if it is a case of poor count or quality, is through the initial phase of assisted fertility treatments where they do analysis as well as genetic testing when necessary.

9 Assisted Reproductive Technology is becoming more common

Montreal Gazette

Call it the wave of the future, but Assisted Reproductive Technology, or ART, is growing in popularity as couples push starting families later and later on in life, and different areas of the world declare infertility a medical illness that gets insured or partially insured coverage.

According to the SOGC, Assisted Reproductive Technology is any kind of handling of male material and/or egg outside of the body and this can happen on a number of different levels depending on where or how the problem lies. When a couple heads into a fertility clinic, a check up is done to assess the problem. If it is not the on the aforementioned male end, there are a number of conditions that women could have that could keep them from getting pregnant or a combination of both parties. There are a wide range of issues that could be at play when it comes to infertility and there are a number of different treatments depending on what is standing in the way of conception.

8  Artificial Insemination is the simplest method

Artificial Insemination, also known as IUI for Intrauterine Insemination, is about the most cost effective fertility treatment. According to the American Pregnancy Association , IUI is a fertility treatment that is very cost effective as it is the least invasive as it simply involves placing sperm inside a woman’s uterus to facilitate fertilization. “The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.”

While the sperm may have to reach the egg on its own and the recipient has been primed for the procedure through medication to aid the procedure, this procedure is usually carried out a few times before moving on to a more expensive and invasive procedure.

7  Sometimes she needs help to ovulate

Sometimes a couple may not be getting pregnant because, without realizing it, the female partner is simply not ovulating or not ovulating regularly. Ovarian stimulation is the way to go if this is the case! Through treatment, female patients can get primed for conception through the use of medication to stimulate her ovaries into producing multiple mature eggs simultaneously. This way her chances at conception are much, much higher. There is one potential drawback to this method, according to the SOGC, “there is an increased risk of multiple pregnancies – twins or more – are associated with ovarian stimulation.”

6 In-Vitro: Egg And Partner get together in a cup, not mom

The process of putting a man's material and an egg together to create an embryo that can be replanted into a woman’s uterus is what is defined as “in-vitro”. Put simply, this is baby-making in a laboratory because the natural way hasn’t been working and this is an option for the party at hand. This is a several step procedure that first involves getting the woman to produce a large batch of eggs by taking injections of hormones to help her do so and then having those eggs surgically removed for the procedure of having the embryo created in the laboratory. The hopeful mother is then primed medically for her egg transfer in the hopes that the egg begins to grow within her. As the majority of egg transfers do not work on the first try, the hope is that many embryos can be created in the same batch so that multiple transfers can happen until one takes. Even in the best scenario there is only a fifty percent chance that the procedure will work on each trial.

5 Women can have Endometriosis and babies at the same time

Endometriosis is a condition that affects the endometrium, which is the tissue that lines the uterus. It makes life more difficult for a woman and can wreak havoc on her fertility, but it does not mean that she is infertile.

For that matter, according to endometriosis.org, the majority of women who have endometriosis and try to have babies, eventually do. “It is generally believed that 60–70% of women with endometriosis are fertile. Furthermore, about half the women who have difficulties with getting pregnant do eventually conceive with or without treatment.”

According to the SOGC, endometriosis affects 5-10 percent of women during the course of their reproductive years. Unfortunately, during those years they have painful periods. The biggest problem however is “Scar tissue can block your fallopian tubes and prevent egg and sperm from meeting, in some cases it is necessary to have the tissue surgically removed laparoscopically (with fibre-optic instruments inserted through the abdominal wall).”

4 You don't have to get rid of the cat

General healthier living practices are a big part of family planning. According to the ACOG, it is really necessary to try and avoid infections like Rubella, also known as the German measles, while it sounds like something out of the dark ages there are occasional outbreaks, and 107 current cases in the US presently.

Toxoplasmosis, a virus that can seriously harm the unborn, is another word that gets tossed around a lot when someone gets pregnant as cat litter can be a source of the disease, and some people even believe that the myth that they have to get rid of their cat. Not true! While toxoplasmosis can be carried by a cat that goes outside, there is nothing to worry about if the cat is an indoor cat only. At that, if the daddy to be takes on the new responsibility of cleaning up the cat box, the problem is solved. At the same time, toxoplasmosis can also come from under cooked meat or fully cooked meat that was exposed to undercooked meat (like on a restaurant grill).

3 Pregnant women can still eat sushi

Just like it is recommended that pregnant women take fish oil capsules while pregnant, certain types of fish and seafood are ideal for consumption once a week when pregnant, but others go onto the “occasional” list until baby is born. This is because predatory fish such as shark, swordfish, walleye, mackerel and even tuna more than twice a week should be avoided because they all contain higher levels of mercury as a result of eating other little fishes. According to the American Pregnancy Association, “make sure to choose a variety of fish lower in mercury, such as salmon, tilapia, shrimp, tuna (canned-light), cod, and catfish.” For that matter, Health Canada puts fish on the menu for expecting moms by recommending at least 150 grams or five ounces each week of a low mercury fish as part of a healthy diet while pregnant.

2 Watch Out For Lead in the paint (and other things)

While it’s something that you may not think much about on a regular basis, in previous generations lead was in everything and it’s still in a lot of things that come from other countries. According for the Center for Disease Control or the CDC, “you might want to be really cautious if you are renovating an older home while pregnant because most lead comes from paint in older homes. When old paint cracks and peels, it makes dangerous dust. The dust is so small you cannot see it. You can breathe in lead dust and not even know it.”

Along with home renovations they also recommended that pregnant women avoid candy, make up, glazed pots, and folk medicine made in other countries. Also, certain jobs and hobbies should be avoided if they are looking to avoid lead such as home renovation and repair work in older homes as well as battery manufacturing and recycling.

1  Pregnancy And viruses

It’s kind of amazing that in 2018, for people living in the 1st world, HIV has been reduced to a chronic illness and people with it can reproduce and have children that are born without the virus. With that said, HIV pregnancy planning is something that really needs to be done under the strict supervision of a physician just to make sure that everybody is safe.

According to the SOGC, “together, antiretroviral therapy, Caesarean delivery, and not breastfeeding have reduced the chances of transmitting HIV to the baby to less than 1%. In the absence of such preventive measures, transmission rates can be as high as 42%.” And this is in cases where the mother has HIV.

In cases where the male partner has HIV, there are a number of ways that a child can be conceived without passing on HIV to his partner or to the baby they are trying to conceive. For those looking to go the extra precautionary route, artificial insemination is one route as is in-vitro, sperm washing and direct injection of sperm into an egg.

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