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DESCRIPTION
The health of both partners before conception is vital to the development of a healthy baby. The man's sperm and the woman's ovum are the foundation for giving the baby the best start in life. As soon as you decide to have a child you and your partner should assess your lifestyle to determine if any changes are necessary and schedule a visit to your midwife or health care provider for pre-pregnancy planning, counseling and a physical exam.
MoonDragon's Pregnancy Information: Birth Concerns Index
NUTRITION & DIET
Both partners should eat a well-balanced diet. Women should include adequate folic acid intake (spinach, broccoli, kale). Folic acid supplements are often recommended for all women of childbearing age to prevent certain birth defects. For men, better nutrition helps assure healthy sperm. For more information about pregnancy and nutrition see MoonDragon's Nutrition Index.
Women should try to get to their normal weight before conceiving. If underweight, a diet to increase weight is appropriate, but keep it healthy. If overweight, try to lose the excess pounds. Don't crash diet. Follow a healthy, reduced calorie diet. Strenuous dieting can start off a pregnancy with a nutritional deficit.
To be safe, a woman who takes vitamins or supplements in high doses should discontinue their use. Check with your midwife about obtaining natural supplements, if they are needed, to include in your diet. Do not use over-the-counter drugstore quality supplements, if at all possible. These are usually inferior to natural supplements and artificially manufactured using chemical substitutes for "real food". Research natural food resources and stores in your regional area, and buy from reputable sources only. It is not uncommon for your midwife to suggest that you may want to take a natural prenatal supplement along with some herbal suggestions to be used in the form of teas or such that are rich in many of the nutrients that you will need to make a strong healthy baby.
SMOKING
Both partners need to stop smoking. In addition to a variety of health risks, it can lead to decreased fertility in both men and women and is hazardous to the pregnancy. A smoke-free home will provide a more healthy environment for any child.
ALCOHOL USE
Men and women should discontinue alcohol use when trying to conceive. In women, it can contribute to miscarriage, a low-birth-weight baby and fetal alcohol syndrome. In men, heavy alcohol consumption may cause sexual problems that make them infertile and possibly damage sperm, as well as reduce their number.
DRUGS OF ABUSE
Men and women need to discontinue any illicit drugs (this includes prescription medication that may be non-essential and/or abused). Drugs of abuse can be dangerous in a pregnancy, including the risk of miscarriage, prematurity, and birth defects or death of a fetus. In addition, their use may inhibit conception. For men, drugs of abuse may cause sexual problems. Prescription and non-prescription drugs should be discontinued unless they are essential for your health and then only after consultation with your health care provider or midwife. Be sure to let your health care provider know that you are trying to conceive. This way he/she can help you find alternative medications or therapies for your health care issues. See medications below.
EXERCISE
A regular exercise routine is important to both men and women. It leads to improved health, less stress, helps take off excess weight and improves the quality of life. It helps a women prepare for the physical requirements of pregnancy and delivery of a child.
EMOTIONAL HEALTH
Couples need to assess their emotional health, both as individuals and as a couple. Are both partners emotionally ready for a pregnancy? Are there unresolved psychological problems for either partner such as stress, depression or anxiety. These problems may create difficulties with conceiving and be heightened during the pregnancy when both a woman and a man go through various mood swings.
Couples should have an emotionally healthy partnership before trying to conceive. Pregnancy, childbirth and childrearing bring on a whole new set of stresses to both partners and if the relationship is already encountering problems, having a child is not the solution. Any domestic violence situations need to be resolved. Seek counseling for unresolved conflicts or if there is an abusive relationship.
GENETIC COUNSELING
If either partner has any genetic disorder or a family history of a genetic disorder or related child with a birth defect, genetic counseling is recommended to determine the risk of occurrence. Medical tests may be conducted for one or both partners. Other reasons for genetic counseling including habitual abortion (3 or more miscarriages) or previous stillbirth, certain ethnic backgrounds, maternal age over 35, or a previous child with a birth defect.
EXPOSURE TO TOXIC MATERIALS
If either partner works with toxic materials or if you live or work in a polluted atmosphere, there may be possible hazards to a pregnancy. Some chemicals, usually in large doses, may possibly be harmful to the ova, to the sperm, or to a developing fetus. Discuss any of these concerns with your midwife or health care provider.
MEDICATIONS
When possible, both partners should avoid medications while trying to conceive. There are a few medications that are linked to birth defects and others that carry unknown risks. If the medication is taken for a chronic condition, talk to your midwife or health care provider about its safety during pregnancy, and what are the treatment options if there are any risks. Potentially harmful drugs should be discontinued at least a month (in some cases, 3 to 6 months) before you try to conceive. Remember... There is no drug that can be taken during pregnancy that is guaranteed to be safe. Alternative therapies may be suggested (such as homeopathy, reiki, herbal therapies, naturopathy, acupuncture, etc.) that may be much safer, but still effective.
CONTRACEPTION METHOD CONCERNS
Your present birth control methods should be evaluated before you are ready to conceive. Oral contraceptives (birth control pills) should be discontinued several months before conception so as to allow at least two regular menstrual cycles to occur. An intrauterine device (IUD) needs to be removed. To be extra safe, the use of spermicides alone or with a condom or diaphragm should be discontinued 1 to 2 months before you want to become pregnant (spermicide risk to a subsequent pregnancy is unclear). As a temporary form of conception, use condoms without a spermicide. See MoonDragon's Contraception Index for more information about your specific birth control method.
AGE
Most women over the age of 35 do experience successful pregnancies. Pregnancy-related complications increase gradually with age, but they are still relatively low. A woman may have more difficulty in conceiving because of decreased fertility. She is also slightly more prone to problems during pregnancy, such as high blood pressure, gestational diabetes and miscarriage. In addition, the risk of chromosome abnormalities, such as having a child with Down syndrome, is increased. In addition to chromosomal abnormalities, advanced age has been associated with several adverse pregnancy outcomes. Maternal age under 15 carries some additional risks also.
Questions remain unanswered if advanced paternal age can be linked to any birth defects. There may be some small connection, but medical studies have not demonstrated any specific problems and it's not known at what age a problem might begin. Following conception, if there is concern about the effects of the father's age on the fetus, ask about prenatal tests to determine if they are warranted.
MEDICAL CONDITIONS
If you have any chronic medical condition (e.g., asthma, diabetes mellitus, high blood pressure, seizure disorder, thyroid disorder), talk to your midwife or health care provider about planning for a pregnancy. Find out how the condition will affect the pregnancy, how the pregnancy will affect the condition, and if any medications you take might affect the pregnancy. The medical condition needs to be under control before you conceive and you must continue good self-care throughout a pregnancy.
IMMUNIZATIONS
For the mother-to-be, preconception is a good time to consider checking your immune status and possibly bringing any immunizations up to date. Research your options before obtaining vaccinations. Be a informed consumer.
A tetanus booster is recommended if you haven't had one in the past 10 years.
A rubella infection (German measles) during a pregnancy can cause birth defects. If you are unsure about your immunity, ask your midwife or health care provider about a blood test to verify it. If you feel you need to obtain an vaccination, it is recommended to wait 3 months after receiving one before trying to conceive to prevent birth defects to the developing fetus.
You should have immunity against regular measles, either by prior immunization or by having had measles. If unsure, discuss the options with your midwife or health care provider.
If you are at high risk for hepatitis B (usually of a medical work environment where contaminated blood specimens are a potential hazard), immunization may be suggested.
Influenza vaccine may be recommended prior to conception in high-risk women who might become pregnant during flu season.
Varicella vaccine (for chickenpox) is now available and may be considered in women who have not had chickenpox (90 percent of women are immune to chickenpox, even those who don't recall ever having the disorder).
REPRODUCTIVE KNOWLEDGE
Partners who want to conceive need to know the basics of the normal menstrual cycle, the timing of ovulation and the timing of intercourse to accomplish fertilization. If you are unsure, talk to your midwife or health care provider.
The Conception Kit™ - Contents & Use
PREVIOUS MEDICAL HISTORY
At a pre-pregnancy midwife visit, a medical history for both partners will be discussed. It is useful for the midwife to know about previous disorders including infectious diseases and sexually transmitted diseases in order to determine any possible risks to future pregnancies. The possibility of current or future exposure to infectious disorders is important to know; also any behaviors in either partner that are considered high risk, such as intravenous drug use. Nutrition and dietary habits are usually reviewed and discussed. A nutritional analysis may be done to see where you and your partner need to make changes.
FINANCIAL CONSIDERATIONS
Be sure you and your partner discuss the financial responsibilities involved (not only the expenses for a pregnancy and birth, but the costs involved with rearing a child). Review any health insurance you have to verify coverage for childbirth, especially important if planning a homebirth with a midwife. Many insurances do not cover out-of-hospital births, which includes birth center and homebirths. Ideally, you should try to have the financial resources available to pay the expected expenses for prenatal care and delivery if not covered by insurance.
If both partners work now, will the mother return to work following the birth, and if not what is the financial impact on the family income and lifestyle? If both parents plan to work after the child is born, consider the cost of daycare (unless a family member will provide it). Both partners need to check with their workplace about maternity leave and whether or not they qualify for this program.
EDUCATION FOR PREGNANCY & CHILDBIRTH
To help prepare you and your partner for the parents-to-be experience, read one or more reference books about pregnancy, childbirth, childbirth options, and care of a newborn before you plan to conceive. There are a variety of excellent books available on these subjects. Check with your midwife about loan-out books she may recommend and have available to her birthing clients or check with your local library, bookstores or borrow books from family or friends who have gone through a pregnancy. The information in the books will provide you with an overall perspective of the experience, lessen your confusion, give you reassurance and answer many of your questions.
Childbirth preparation classes are available in many communities or may be taught by your midwife in addition to her midwifery care. These are a valuable source of information for expectant parents, particularly for learning ways to cope with labor and birth. Classes also give you an opportunity to meet other couples with whom you may discuss anxieties and concerns. Classes may be conducted by the hospital, community organizations or by individual instructors. Not all classes are alike. Research them before attending. If you are planning a homebirth, you may be very dissatisfied with a hospital class which teaches about drug medications, cesareans and normal hospital interventions. It is better to attend classes geared toward your chosen method of birthing.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or your family member has questions or concerns about preparing for pregnancy.
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