Diseases & Conditions : High-Risk Pregnancy
Planning a Pregnancy
If you're planning to become pregnant, taking certain steps can help reduce risks for both you and your baby. Proper health before deciding to become pregnant is almost as important as maintaining a healthy body during pregnancy.
The American Academy of Pediatrics offers these two recommendations to reduce the risk for SIDS:
Get prenatal care. Routine prenatal care is critical for reducing the risk for SIDS.
Avoid using illicit drugs and alcohol, and don't smoke during pregnancy or after birth.
The first few weeks of pregnancy are crucial in a child's development. However, many women don't realize they're pregnant until several weeks after conception. Planning ahead and taking care of yourself before becoming pregnant is the best thing you can do for you and your baby.
One of the most important steps in helping you prepare for a healthy pregnancy is a prepregnancy examination (often called preconception care) performed by your physician or a midwife before you become pregnant. This examination may include:
Family medical history. An assessment of the maternal and paternal medical history will help determine if any family member has had any medical conditions such as high blood pressure, diabetes, and/or mental retardation.
Genetic testing. An assessment of any possible genetic disorders—as several genetic disorders may be inherited, such as sickle cell anemia (a serious blood disorder which primarily occurs in African-Americans), or Tay-Sachs disease (a nerve breakdown disorder marked by progressive mental and physical retardation which primarily occurs in individuals of Eastern European Jewish origin). Some genetic disorders can be detected by blood tests before pregnancy.
Personal medical history. An assessment of the woman's personal medical history will determine if there are any of the following:
Medical conditions that may require special care during pregnancy—such as epilepsy, diabetes, high blood pressure, anemia, and/or allergies
Vaccination status. An assessment of current vaccinations/inoculations will assess a woman's immunity to rubella (German measles), in particular, since contracting this disease during pregnancy can cause miscarriage or birth defects. If a woman isn't immune, a vaccine may be given at least three months before conception to provide immunity.
Infection screening. An infection screening will determine if a woman has a sexually transmitted infection or urinary tract infection (or other infection) that could be harmful to the fetus and to the mother.
Other steps that can help reduce the risk of complications and help prepare for a healthy pregnancy and delivery include:
Smoking cessation. If you're a smoker, stop smoking now. Studies have shown that babies born to mothers who smoke tend to be born prematurely, be lower in birth weight, and are more likely to die of sudden infant death syndrome (SIDS). In addition, women with exposure to secondhand smoke are more likely to have low-birth-weight babies. There may also be dangers from thirdhand smoke, the chemicals, particles, and gases of tobacco that are left on hair, clothing, and furnishings.
Proper diet. Eating a balanced diet before and during pregnancy isn't only good for the mother's overall health, but essential for nourishing the fetus.
Proper weight and exercise. It's 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 babies with low birth weight.
Medical management (of preexisting conditions). Before getting pregnant, take control of any current or preexisting medical problems, such as diabetes or high blood pressure.
Preventing 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).
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're 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 (for instance, lead and pesticides), and radiation (for example, X-rays). Exposure to high levels of some types of radiation and some chemical and toxic substances may adversely affect the developing fetus.
Infection control. Pregnant women should avoid the ingestion of undercooked meat and raw eggs. In addition, pregnant women should avoid all contact and exposure to cat feces and cat litter, which may contain a parasite called Toxoplasma gondii that causes toxoplasmosis. Other sources of infection include insects (for instance, flies) that have been in contact with cat feces and should be avoided during pregnancy. Toxoplasmosis can cause a serious illness in, or death of, the fetus. A pregnant woman can reduce her risk for infection by avoiding all potential sources of the infection. A blood test before or during pregnancy can determine if a woman has been exposed to the Toxoplasma gondii parasite.
Daily vitamins. Begin taking a prenatal vitamin daily, prescribed by your physician or a midwife, to make certain that your body gets all the necessary nutrients and vitamins needed to nourish a healthy baby.
Identifying domestic violence. Women who are abused before pregnancy may be at risk for increased abuse during pregnancy. Your physician or a midwife can help you find community, social, and legal resources to help you deal with domestic violence.