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    Planning for Pregnancy
    Joel Bernstien, MD posted:
    Being proactive and preparing for pregnancy can really work in your favor. Here are 10 important items to consider when you're thinking about having a baby.

    1. Start Prenatal Vitamins
    I recommend all women start taking prenatal vitamins well before they start trying to conceive, and certainly once they stop using contraception. You never know how long it will take to get pregnant. So start the prenatal vitamin of your choice today!

    Some very important nutrients, particularly folic acid, need to be up to par during the first few weeks of your pregnancy, and even before you get the positive pregnancy test. If you wait until you find out that you're pregnant, you may miss the window of time where the extra nutrients are the most beneficial.

    2. Stop Contraception
    In general, there is not a large delay to conception after you stop taking birth control. But the return to normal ovulatory function is not the same for all birth control methods. The exception may be a few months longer delay after stopping Depo-Provera injections (the birth control shot).

    3. Quit Smoking
    Smoking leads to an increased risk of miscarriage and a variety of pregnancy complications. Pregnancy, if nothing else, should be motivation enough to give up this noxious habit.

    4. Find an Obstetrical Provider
    Picking the practice that will take care of you before, during, and after you have your baby is an important decision. If you do not have an OB provider, I recommend interviewing one or more groups to get a feel for what it is like. You can make an appointment for what we call preconception counseling.

    5. Get Screening Tests and Vaccines
    Have your doctor check your blood work to see if you are immune to rubella. If you are not, get vaccinated. In addition, if you have not received a tetanus vaccine in the last 5 years, I recommend you get one. The new vaccine covers tetanus, diphtheria, and pertussis (whooping cough). By getting vaccinated for whopping cough before having a baby, you can decrease the chances of transmitting this awful disease to your baby when he or she is born.

    Also, there are a variety of genetic diseases that can be detected in potential parents prior to conception. Ask your provider what tests, if any, can be performed before you conceive.

    6. Manage Chronic Diseases
    If you have a chronic disease -- including hypertension, diabetes, lupus, asthma, thyroid disease, seizures, or any psychiatric disorders -- you should be diligent about achieving optimum control prior to getting pregnant. Be sure to see your primary care doctor or specialists and let them know you are planning to have a baby. They can work with you to ensure you optimal health.

    7. Get Pregnancy-Safe Medications
    If you take any medications on a daily basis, consult with your provider to ensure they are safe to take during pregnancy.
    Also be sure to check with your doctor before taking any over-the-counter medicines while trying or after conception.

    8. Limit Your Alcohol Intake
    Social alcohol intake is considered OK while trying to conceive. But once you find out you are pregnant, I recommend that you avoid all alcohol intake during the course of your pregnancy.

    9. Practice Weight Control
    If a mother is obese during pregnancy, she runs a higher risk of miscarriage, gestational diabetes, pregnancy-induced hypertension, the need for cesarean delivery, and other adverse outcomes for her baby. There is no better time than now -- before or while you're trying -- to start a healthy diet and exercise regimen. If you are markedly obese, I recommend delaying childbearing until you're able to reach a more healthy weight.

    10. Seek Financial Stability
    Pregnancy care and delivery are very expensive, even for insured patients. However, this is nothing compared to the cost of raising your child and paying for childcare if needed. You want to be comfortable in your ability to financially care for a child. And if you are not, I recommend taking the necessary steps to achieve that level of comfort before conceiving.

    What are your thoughts? Are there any other circumstances that you've monitored or changed in preparation for your own pregnancy?
    An_246533 responded:
    hi si ai argien en este sitio q me pueda alludar lla q quisiera q dar en barasada pero estoy in regular y esta ba cojiendo el depo digo me toca ponel mela este mes pero mi esposo quiere tener otro baby so cuanto tienpo secoje para q dar en barasada despues del depo help
    jessilove2010 responded:
    In number 5; you mention getting the mmr vaccine to ensure the mother has immunity for rubella. I know this is a live vaccine and should not be given while pregnant, but I am getting many different answers on how long to wait before trying after receiving the shot?
    I also never had the usual vaccines(hep a, hep b, etc) do I need EVERYTHING or just tdap and mmr ?
    Joel Bernstien, MD replied to jessilove2010's response:
    According to the American Congress of OBGYN, a woman should wait one month after an MMR before getting pregnant. And the same organization states that the Hep A and Hep B vaccines are safe in pregnancy and breastfeeding. The hepatitis series are usually given to those at higher risk of getting one of these infections. In the USA, the Hep B vaccine series is given more commonly. Some less developed countries have a much higher Hep A prevalence, and so if you travel abroad, you should get this too.
    Claudiett replied to An_246533's response:
    Lo major seria q buscaras ayuda profecional.....Nosotros vamos a tartar con la eseminacion el mes q viene surte contigo...
    jiyamitpatel responded:
    Hello ,
    I am 25 years old.we will trying for pregnancy but my prolactin is 34 mg.please help me.
    Wildtool responded:
    Is it ok to have a baby at 41 or 42?
    butterflys97 responded:
    Dr. Berstein,

    Hopefully you can give me your insight on my situation.

    brief history I am 34 soon to be 35.I have had 3 successful full term pregnancies. In 2003 I had a tubal ligation. To my despair in 2004 I lost my husband and one of my children in a horrific car accident. I know I will never replace my son but I met someone new( he has no children) and would like another baby in my son's honor. In 2009 I had a tubal reversal. In 2011 I had an etopic which resulted with my right tube being removed. My remaining tube is healthy and functioning (HSG) was done. I have been able to get pregnant but in the last year and half I have had 4 early miscarriages ending between 5-7 weeks gestation. My last pregnancy which ended in May, I was put on progesterone with no success .I recently did a work up (July & August) everything is normal with the exception that I tested positive for Lupus Anticougulant. I was told to take folic acid, baby aspirin and Lovenox I was also prescribed Clomid. Why is this happening to me. Did the tubal ligation & reversal change the chemistry in my body. What are my chances, I only have one tube I am on treatment now is my prognosis good since I have been able to bare children. I can not afford IVF. Please help me any advised welcomed. God Bless
    littlebluebell responded:

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