Caring for your health before you become pregnant -- called preconception care -- will help you identify any factors that may put you or your baby at risk during pregnancy and allow time to treat any medical problems that you may have before you become pregnant.
A pre-conception counseling appointment with your doctor is an important first step in preparing for pregnancy. Pre-conception counseling helps educate women so that they can be physically and emotionally prepared -- and healthy -- for pregnancy.
What Happens at a Preconception Doctor's Appointment?
During a preconception office visit, your doctor will discuss your:
- Reproductive history. He or she will ask you about previous pregnancies, your menstrual history, what type of contraceptive you use, previous sexually transmitted diseases and vaginal infections, as well as previous Pap test results.
- Medical history. You will be asked about pre-existing medical conditions or allergies. Any medical condition, such as diabetes or high blood pressure, should be well controlled before you become pregnant.
- Surgical history. Tell your doctor about any surgeries, transfusions, and hospitalizations you may have had.
- Current medications. Tell your doctor about any prescription or over-the-counter medications you are or have taken. This may be a good time to discuss the possible need for drug substitutions to decrease the risks of birth defects.
- Family health history. Your doctor will ask you questions about your family's health. Tell your doctor if anyone in your family has high blood pressure (hypertension), diabetes, twins, mental retardation, blindness, deafness, cystic fibrosis, congenital birth defects, ethnic-related conditions, such as Tay-Sachs disease, sickle trait/sickle cell, and thalassemia.
- Home and workplace environment. Your doctor will discuss possible hazards, such as exposure to cat feces (toxoplasmosis), X-rays, and lead or solvents that could influence your ability to become pregnant or maintain a healthy pregnancy.
- Your weight. Your doctor will recommend you try to reach your ideal body weight before becoming pregnant. This means losing weight if you are overweight to reduce your risk of high blood pressure complications during pregnancy; or gaining weight if you are underweight to reduce the risk of delivering a low birth-weight baby.
- Lifestyle factors. Your doctor will ask you questions about you and your partner's habits that could influence your pregnancy, such as smoking, drinking alcohol and using recreational drugs. If you or your partner participate in any of these activities, they will have to be stopped in order for you to have a healthy pregnancy.
- Exercise. Tell your doctor what type of exercise you do. Generally, you may continue your normal exercise routine throughout pregnancy unless you are instructed to decrease or modify your activities.
- Diet. Your doctor will ask you about your dietary habits, including how much caffeine you consume. To ensure a healthy pregnancy, you should follow a healthy, well-balanced diet and eat a variety of foods to get all the nutrients you need. Choose foods high in starch and fiber. Make sure you are getting enough vitamins and minerals in your daily diet: eat and drink at least 4 servings of dairy products and calcium-rich foods a day, choose at least one source of Vitamin C, Vitamin A and folic acid every day.
- Caffeine consumption: When planning a pregnancy, it is recommended that you do not have more than 300 mg. of caffeine per day. The caffeine content in various drinks depends on the beans or leaves used and how it is prepared. An 8 oz cup of coffee has about 150 mg on average while black tea has about 80 mg of caffeine. A 12-ounce glass of caffeinated soda contains anywhere from 30-60 mg of caffeine. Remember, chocolate and certain medications contain caffeine too -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
- Prenatal vitamins: Before considering a pregnancy, you should begin taking a daily vitamin that contains folic acid. Folic acid has been shown to decrease the risk of having a baby with a neural tube defect, such as spina bifida - a serious condition in which the brain and spinal cord do not form normally in the baby. The medical and public health community recommends taking 400 micrograms of folic acid daily before conception and in early pregnancy. Many pharmacies sell over-the-counter prenatal vitamins that do not require a prescription.
Your doctor may also:
- Perform a physical exam to evaluate your heart, lungs, breasts, thyroid and abdomen. A pelvic exam and Pap smear may also be performed.
- Order lab tests. Some of the conditions screened for include rubella, hepatitis, HIV, syphilis and others as indicated.
- Discuss how to chart menstrual cycles to detect ovulation and determine the time when you are most likely to get pregnant.
- Discuss genetic counseling. Counseling can help couples become aware of their chances of having a child with a birth defect. Genetic counseling is advised for women who will be 35 or older when the baby is due, for couples who have already had a child with a birth defect or for couples with a family history of genetic problems, birth defects or mental retardation.
- If you are not protected against rubella or chicken pox your doctor may recommend the appropriate vaccines and delaying attempts to conceive for at least one month.
This appointment is also the time for you to ask your doctor any questions that you may have. No question is dumb, so feel free to ask about anything that you may be concerned about.