Healthy Pregnancy Timetable
If you're serious about getting pregnant-or if you're already trying-you may be sorting through a whole lot of unsolicited advice and health tips. What's really important?
"Make your health a priority this year," says Tracy Gaudet, M.D., director of the Duke Center for Integrative Medicine and author of Body, Soul, and Baby. "You'll have time to really tune in to your body and change any bad habits before you conceive."
One year before, get a physical exam.
You might imagine that your ob-gyn should be the first to hear about your pregnancy plans, but talk with your regular doctor to find out how your health may affect your ability to conceive and carry a baby to term. Make sure that, in your physical exam, you address:
- Your blood pressure readings Ideally, your blood pressure readings should be lower than 120/80. Borderline hypertension (120-139/80-89) or high blood pressure (140/90) predisposes you to preeclampsia, a pregnancy high-blood-pressure disorder that can decrease blood flow to the fetus and increase the risk of premature birth; it can also raise your odds of stroke, heart attack, and kidney disease down the line. If your blood pressure is high, cut back on sodium, up your exercise level, or take medication (many are safe, even during pregnancy).
- Your blood sugar levels If you have diabetes, a family history of the disease, or certain risk factors such as extra weight or irregular periods, request a hemoglobin A1c test-it'll reveal your average glucose levels for the past three months. "High levels could mean your body is producing extra insulin, which can interfere with ovulation and lead to pregnancy complications," says Potter. High blood sugar levels also up your risk for gestational diabetes, which affects up to 7 percent of pregnant women.
Keep reading to discover what else you should have checked during your physical exam to help ensure a happy healthy pregnancy.[header = Healthy pregnancy: discuss medication information, vaccination records & more.]
When you get your physical exam, you'll also want to discuss your medication information, vaccination records and more.
- Your medication information Your life-and your pregnancy- depends on the effective treatment of certain conditions like asthma, thyroid problems, diabetes, and depression. But some drugs (including acne and seizure medications) could pose a grave risk to a developing fetus. During your physical exam, ask your doctor if your prescriptions may be linked to birth defects and whether there are safer alternatives for you to take.
- Your vaccination records If you get measles, rubella (German measles), or chicken pox while pregnant, you have an increased risk of miscarriage and birth defects. Most American women were inoculated at a young age (or may have chicken pox immunity because they had the disease as a kid), but some of these vaccinations require booster shots.
Assess your stress levels
When you're under pressure, your body pumps out adrenaline and cortisol to boost your strength, focus, and reflexes. But an overabundance of these stress hormones can lead to depression, irregular menstrual cycles (which can make getting pregnant difficult), and even pregnancy complications.
A University of Michigan study found that pregnant women with high cortisol levels were 2.7 times more likely to miscarry than women with normal levels. "There's not always a direct correlation- some people with high-pressure jobs conceive easily, and women in less demanding jobs can have all sorts of trouble," says Falcone. But if you notice stress manifesting itself in physical symptoms, make lifestyle changes to reduce stress levels now. Aim for eight hours of sleep per night, and seek out ways to relax. "Even small things, like deep breathing or picturing a calming image, can make a difference," says Gaudet.
Now that you know what to do twelve months in advance to help ensure a healthy pregnancy, read on to find out what to do six months in advance.[header = Healthy pregnancy: follow these health tips 6 months prior to your pregnancy.]
Now is the time to see your gynecologist to discuss any irregular bleeding, abnormal discharge, or pelvic pain that could interfere with your healthy pregnancy.
"These may be signs of hormonal problems that can lead to infertility," says Potter. In addition to your Pap smear and breast exam, ask for a full STD screening-even if you've been with the same guy for years. Finally, ask about a prescription for prenatal vitamins. They contain supplemental iron, calcium, and other nutrients that can ease you into your first trimester; many doctors suggest you start taking them three months before conception.
Also schedule a dental exam.
Here's why a dental exam is so important. More than 80 percent of Americans have some form of gum disease, according to the National Institutes of Health. "Among pregnant women, it's closer to 100 percent," says Karla Damus, Ph.D., a senior research associate with the March of Dimes. Hormonal changes make the mouth more hospitable to bacterial growth. Severe gum infections can release bacteria into the bloodstream that travel to the uterus and cause infections that could complicate pregnancy.
The American Academy of Periodontology estimates that women with periodontal disease are seven times more likely to deliver a preterm or low-birth-weight baby. "We don't know exactly how gum disease affects pregnancy outcomes," says Damus, "but we do know that good oral hygiene and regular checkups are important.
For your healthy pregnancy, discover what's important to do three months prior.[header = Final healthy pregnancy timetable: health tips for 3 months, pre-pregnancy.]
Three months before your pregnancy, make sure that you eat healthy foods.
"Eating for two should mean being twice as careful about food, not eating twice as many calories," says Robert Greene, M.D., author of Dr. Robert Greene's Perfect Hormone Balance for Pregnancy. Start making choices of healthy foods that boost your metabolism and optimize your hormone levels. Complex carbohydrates (fruits, vegetables, and whole grains) contain fiber that slows digestion and stabilizes your glucose levels. Protein builds a healthy placenta and produces red blood cells; one great source, fish, is also rich in omega-3 fatty acids, which will help your growing baby's brain and nervous system.
Here are more pregnancy health tips:
- Think before you drink
"Alcohol raises your future child's risk of physical and mental disabilities, so cut out drinking once you're actively trying to conceive," says Minkin. Before then, the occasional glass shouldn't harm an eventual pregnancy, though two-or more-a day is a different story. Heavy drinking may increase your estrogen levels, which can cause irregular menstrual cycles and deplete your body of folic acid (the vitamin that protects the fetus from neural-tube defects).
- Cut back on caffeine
A study in The American Journal of Epidemiology found that women who consumed 300 milligrams or more of caffeine a day (equal to three 8-ounce cups of coffee) had twice as much trouble conceiving as those who didn't drink any. Yet, most experts say a cup a day is safe. "Unless you've been diagnosed as infertile, have that latte," says Falcone. But if you're a triple-espresso gal, scale back now: Caffeine withdrawal can cause headaches and nausea, which only make morning sickness worse.
- Consider choosing organic food
Certain environmental toxins may stay in your system and endanger your developing baby, says Potter. "To avoid pesticides, buy organic food or make sure to wash fruits and vegetables with mild soap." Inhaling certain solvents, paints, and household cleaners has also been shown to cause birth defects and increase miscarriage risk, so make sure your home and workplace are well ventilated.
Four things he needs to do
- Quit smoking. Cigarettes hurt sperm motility and sperm count.
- Cut back on drinking. More than one daily drink may affect sperm production.
- Get down to a reasonable weight. A 20-pound increase raises his odds of infertility by 10 percent.
- Avoid hot tubs and saunas. Heat may hinder his ability to produce healthy, motile sperm.