Being as healthy as possible at the time of conception is the first step towards a successful, normal pregnancy. One way to help accomplish this is a pre-pregnancy examination by your Primary Care Team or, even better, your obstetric team to be. (Ask you PCP for a referral.)

This examination should include a review of the following:

• Family medical history - do you have mental retardation or any possibility of genetic disease in your family?
• Personal medical history - are you on medications that might affect a pregnancy?
• Vaccination status - have you had DTaP- the special tetanus shot with a whooping cough booster?

A physical examination is usual unless you have had one recently; and you should be tested for appropriate infections and genetic diseases.

There are many health conscious activities that can help minimize the risk of pregnancy complications These include:

• Smoking cessation: If you are a smoker, stop smoking now. Studies have shown that babies born to mothers who smoke tend to be lower in birth weight and a higher incidence of several other adverse pregnancy events. In addition, exposure to secondhand smoke is not good for the fetus.
• Proper diet: Eating a balanced diet before and during pregnancy is not only good for the mother's overall health, but essential for nourishing the fetus.
• Proper weight and exercise: It is important to exercise regularly and maintain a proper weight before and during pregnancy. Women who are overweight may experience medical problems such as high blood pressure and diabetes. Women who are underweight may have small babies.
• Medical management of preexisting conditions: Take control of any current or preexisting medical problems, such as diabetes or high blood pressure.
• Preventing certain birth defects: Take 400 micrograms (0.4 mg) of folic acid each day, a nutrient found in some green, leafy vegetables, nuts, beans, citrus fruits, fortified breakfast cereals, and some vitamin supplements. Folic acid can help reduce the risk of birth defects of the brain and spinal cord (also called neural tube defects). Most multivitamins have the correct amount of folic acid.
• Avoid exposure to alcohol and drugs during pregnancy: In addition, be sure to inform your physician of any medications (prescription and over-the-counter) you are currently taking - all may have adverse effects on the developing fetus.
• Exposure to harmful substances: Pregnant women should avoid exposure to toxic and chemical substances (i.e., lead and pesticides), and radiation (i.e., x-rays). Exposure to high levels of some types of radiation and some chemical and toxic substances can be bad for the growing baby.
• Infection control: Hand washing is the most effective way to avoid contacting and passing on infections of many kinds. There is parasite carried in cats and raw meat called toxoplasmosis that pregnant women should avoid - so someone else can change the kitty litter.

Marcie Richardson, MD, assistant director of OBGYN for quality, notes, “Planning a pregnancy is ideal but all sexually active women in their reproductive years should be attentive to the above advice. Many pregnancies just happen!”

For more information go to the March of Dimes web site.