I've been getting a lot of questions about how to prepare for pregnancy lately. Seems like fall and winter is when most people plan to start!
  1. Get a preconception check-up with your OB/GYN or primary care doctor.
    Check blood pressure, screen for anything that could make you high risk (hypertension, diabetes, lupus, cardiac disease, renal disease, history of DVT/PE, prior pre-term babies or complications), review meds, review menstrual cycle, get a pelvic exam to see if there are large fibroids or ovarian cysts or infection, make sure vaccinations are up to date, discuss timing intercourse to ovulation. Ask all your questions!
  2. Eat a healthy diet and avoid things you shouldn't eat or drink in pregnancy.
    When you stop using contraception, start eating like you are pregnant. Some women don't realize they're pregnant until they're 6+ weeks along and in the middle of fetal organ formation (a very important time)! Foods and drinks to avoid: raw meats/seafood, fish with high mercury content, deli meats, soft cheeses, unpasteurized foods, heavy alcohol intake, and basically anything you're not sure about. BTW- it's ok to have a little caffeine (~small Starbucks coffee or tea) everyday.
  3. Achieve a healthy BMI.
    Obesity and excessive weight gain can lead to complications in pregnancy and at delivery-- gestational diabetes, hypertension/pre-eclampsia, really big macrosomic babies that are at risk of shoulder dystocia (and subsequent nerve injury) from the shoulder getting stuck behind the pubic bone during vaginal delivery, needing a C-section, and more. Being underweight can lead to low birth weight babies and pre-term deliveries.
  4. Check if the medications you take are safe in pregnancy.
    Go over your med list with your OB/GYN and prescribing doctor. If you're on an anti-depressant or bipolar medication, talk to your doctor about whether you can come off them or can try one that's safer in pregnancy. Each case is different depending on the patient and the specific risks of the medications. For the most part, taking care of mom takes care of baby, too!
  5. Talk to any medical specialist you're seeing (Psychiatry, Cardiology, Nephrology, Rheumatology, Neurology, Endocrinology, etc).
    Let them know your time frame so they can adjust your medications, treatments or frequency of follow up visits, if needed. Give them your OB's contact information in case they need to get in touch about your care.
  6. Ask your family about any inherited medical conditions/diseases, genetic anomalies, birth defects, blood disorders that increase risk of blood clots or hemorrhage.
    If any of the above are in your family history or you and your partner are from Ashkenazi Jewish backgrounds, your OB can refer you to a genetic counselor to talk about additional testing.
  7. Start taking daily prenatal vitamins with folic acid 1-2 months before you start trying to conceive.
    They're all pretty good and you can buy them over the counter. Try the gummy prenatals if you can't stomach the big pills. Standard folic acid dose is 400 micrograms to prevent fetal neural tube defects. If you had a baby with a neural tube defect or take certain medications, you will need to take 4,000 micrograms or 4 MILLIgrams.
  8. Stop drinking, smoking, doing recreational drugs.
    I know, I know, but I have to say it! Also, don't sit in hot tubs because the heat can affect the fetus. No more crazy hot tubs parties for you.
  9. Make sure you're not exposed to dangerous chemicals or radiation at work or at home.
  10. Encourage your partner to get a physical exam from his doctor, too!
    It takes two to make a baby!
  11. Figure out when you're ovulating.
    You'll need to be off the pill or hormonal contraception. Women generally return to their usual menstrual cycles within 1-2 months of stopping the pill or removing the IUD. It may take longer after Depo Provera injections. Ovulation occurs about 14 days before your period starts and can vary slightly cycle to cycle. Keep having sex when you want to! Just don't miss the week around ovulation. If you're not sure when you're ovulating, use a home ovulation predictor kit from the drug store.
  12. Good Luck!!