The question
I'm in my mid 30s and finally ready to start trying to have a baby in the next year. Are there steps I should take - such as taking specific vitamins - now to prepare?
The answer
There are definitely steps you can take to prepare for a healthy pregnancy. Here are a few things you can think about and put into action before trying to conceive.
Visit your doctor for a check-up At this visit, have a breast exam, blood pressure check and weight check done and ensure that your Pap test is up to date. Let your doctor know that you are trying to conceive.
Review your personal medical history, current medications and family history with your doctor Certain medical conditions such as diabetes, high blood pressure and depression can change during pregnancy and may need to be closely monitored with medication adjustments or specialist consultation. Similarly, certain medications - including over-the-counter and herbal - can affect the health of your pregnancy and your baby. Let your doctor know what you are taking so that he or she can adjust doses or switch to safer options if necessary.
Your doctor will ask about a family history of certain disorders, such as high blood pressure, seizures, diabetes, a history of blood clots, and certain types of birth defects, to help you determine if you or your baby are at risk. Ask your relatives about their health history before your visit so you have the information you need.
Start taking folic acid Women who increase their intake of folic acid can reduce the rate of neural tube defects (NTDs) in their children by more than 50 per cent. NTDs are birth defects that can lead to abnormalities of the skull, brain and spinal cord.
Making sure you get enough folic acid every day from food can be a challenge, so it is recommended to take folic acid in a prenatal vitamin to ensure sufficient levels. For most people, the recommended dose of folic acid is 0.4-1.0mg daily starting three months prior to conception.
If you have a personal history of conditions such as epilepsy or diabetes, have a family history of NTD or are from a high risk ethnic group for NTD (i.e. Sikh, Celtic) - a higher dose of folic acid is recommended.
Check your immune status and get vaccinated Vaccine-preventable infections can harm both the mother and the fetus by causing birth defects or illness. Talk to your doctor about immunity testing for rubella and other infections, such as chicken pox, before becoming pregnant as these vaccines are not safe to use during pregnancy.
Achieve a healthy weight and exercise regularly Being overweight or underweight can affect your ability to conceive and your and your baby's health during pregnancy. Dieting during pregnancy can limit nutrients to your baby that are needed to grow and develop, so working toward a healthy weight prior to pregnancy by eating a balanced diet and exercising regularly is a safer option. Exercising at least 30 minutes a day most days of the week will help you create a routine that you can continue during your pregnancy.
Make healthy lifestyle changes Smoking, drinking and drug use before or during your pregnancy can make it difficult to conceive and can harm the baby. The best time to quit is before getting pregnant. Talk to your doctor about the support programs available in your community.
Have a dental check-up and floss regularly Dental and gum disease can worsen during pregnancy. It is unsafe to have dental X-rays done during pregnancy, so it is important to have your teeth cleaned and examined prior to conceiving and continue good dental hygiene throughout your pregnancy.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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