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Plan ahead for a healthy, happy pregnancy

The first step to having a baby may not be what you think: A visit with your primary care doctor may be the most important step you can take to assure a healthy pregnancy for you and your baby. The purpose is to identify and modify any biomedical, behavioral and social risks to the woman’s health or pregnancy outcome.

“If you know you are ready to have a child but are not yet pregnant, this is the optimal time to assess, manage and treat many conditions,” said Melissa Stoffel, D.O., an obstetrician and gynecologist at Marshfield Clinic Wausau and Weston Centers. “We know that doing so beforehand improves pregnancy outcomes and reduces complications for both mother and baby.”

You can expect counseling before conception to include a complete personal and family medical history, a thorough physical exam and laboratory testing. If you’re a teen, we’ll pay close attention to your nutritional and emotional needs and will look for signs of sexually transmitted disease. If you’re older than 35, we’ll go over how pregnancy risk increases with age. We will want to know as much as possible about anything in your reproductive history that could contribute to infertility or pregnancy complications, and we’ll need to know your menstrual calendar.

“It’s very important for you to be as upfront with your physician as possible,” Dr. Stoffel emphasized. “This can be difficult when addressing psychosocial issues such as stress, financial problems or mental health conditions, substance use, or even your weight. But the last thing any of us wants is to be surprised by a revelation during your second trimester.”

If you haven’t been exercising regularly, start before becoming pregnant. Continuing with mild to moderate, low-impact exercise is normally not harmful to a pregnancy, but don’t start a strenuous program during pregnancy.

For nutrition, Dr. Stoffel does not recommend a vegetarian diet before or during pregnancy because it probably will lack adequate amounts of key nutrients. She recommends discontinuing megavitamins and other supplements that have not been studied to evaluate fetal risk. She does recommend a multivitamin or prenatal vitamin containing 400 mcg (0.4 mg) of folic acid.

Health conditions providers watch for include signs of diabetes, high blood pressure, asthma, thyroid disease, epilepsy, lupus, anemia and depression. For women who take medications, alternatives will be explored prior to conception that will be safer in pregnancy.

Think of preconceptual counseling as the classroom portion of your pregnancy. You will learn about subjects ranging from weight gain to activity, employment, nausea and vomiting, hemorrhoids, constipation, urinary frequency, sex during pregnancy, groin pains, backache and breastfeeding. You will be well prepared for the real test.