Trying to Conceive Community

Planning for pregnancy is so important. When we see that positive pregnancy test, we want to know that baby is growing in the healthiest environment possible. We want to nurture and protect our child. It's really the first act of mothering. So what should you do to prepare? Let's start with the basics.

Folic Acid: The information is overwhelming; we can dramatically decrease the incidence of spinal cord defects by being sure that women have an adequate dose of folic acid. For those with no family or personal history of spinal cord defects, the recommended dose is 400 mcg of folic acid (0.4 mg) daily. Ideally you would be on an adequate dose of folic acid a full month before you start trying for pregnancy. Since many pregnancies are unplanned, ideally all women of reproductive ages would be getting this dose of folic acid on a daily basis. You will need a higher dose of folic acid if you have a history of a spinal cord defect or someone in your family has a history of a spinal cord defect. This should be discussed with your practitioner.

Weight Loss: Should you lose weight first? How much weight should you lose? My response: be very realistic. Our goal should be to be the healthiest we can reasonably be. If you attempt to lose weight in a healthy manner, you can probably continue your eating plan in pregnancy. Discuss your concerns with your health care provider. Working with a nutritionist might be beneficial. If you have chosen a surgical approach to manage your weight, then attempting pregnancy must be discussed with your surgeon and obstetrician before getting pregnant.

Medications: Tell your health care providers that you are trying for pregnancy. There are many medicines that can be used in pregnancy, but the possibility of pregnancy must be considered when prescriptions are being written. If you are on a medication that is not safely used in pregnancy, you need to consult with your caregiver about switching to a safer medication before you attempt pregnancy. It may take a while to stabilize on the new medication so you want to discuss this well ahead of time.

Excessive Heat: There is some information that exposure to excessive heat may increase the risk of spinal cord defects if the exposure occurs in early pregnancy. For a long time, our advice was to avoid saunas and Jacuzzis while trying for pregnancy. The American College of Obstetrics and Gynecology now recommends that you limit your exposure to no more than 15 minutes.

Dietary Restrictions: There are no dietary restrictions when you are trying for pregnancy, but this is a good time to begin improving your eating habits. Everything in moderation should be your mantra.

Truly Bad Habits/Behaviors: I include smoking, excessive alcohol, illicit drugs and similar activities in this category. Stop them. Do it for your baby.

Above are the general guidelines; however, there are many other special situations that should be factored in. Do you have medical issues? Are there medical issues in your family? Are there medicines you are taking? Have you had surgeries? Are there children in your family or your partner's family who were born with birth defects? You should consult your physician to discuss your plans for pregnancy well in advance so that these and other possible issues can be considered prior to conceiving.

So what's been the toughest thing about planning for pregnancy for you? Have you had to change any behaviors or habits that were particularly difficult for you? How did you do it? What pearls would you like to pass on?