What to expect when you're expecting (7 page)

About The What to Expect Foundation

Every parent should know what to expect. That’s why we created The What to Expect Foundation, a nonprofit organization that provides vital prenatal health and literacy support to moms in need—so they, too, can expect healthier pregnancies, safer deliveries, and healthy, happy babies. For more information and to find out ways you can help, please visit our website at
whattoexpect.org
.

S
O YOU’VE MADE THE DECISION TO
start a family (or to grow that family you’ve already started). That’s a great—and exciting—first step. But before sperm meets egg to create the baby of your dreams, take this preconception opportunity to prepare for the healthiest pregnancy—and baby—possible. The next steps outlined in this chapter will help you (and dad-to-be) get into tip-top baby-making shape, give you a leg up on conception, and get you to the pregnancy starting gate with all systems go.

If you don’t get pregnant right away, relax and keep trying (and don’t forget to keep having fun while you’re trying!). If you’re already pregnant—and didn’t have a chance to follow these steps before you conceived—not to worry. Conception often sneaks up on a couple, cutting out that preconception period altogether and making those preconception pointers pointless. If your pregnancy test has already given you the good news, simply start this book at
Chapter 2
, and make the very best of every day of pregnancy you have ahead of you.

Ready to board that cute little passenger on the mother ship? Here are some preconception steps you can take to make sure that ship is in shape.

Get a preconception checkup.
You don’t have to choose a prenatal practitioner yet (though this is a great time to do so; see facing page), but it would be a good idea to see your regular gynecologist or internist for a thorough physical. An exam will pick up any medical problems that need to be corrected beforehand or that will need to be monitored during pregnancy. Plus, your doctor will be able to steer you away from medications that are pregnancy (or preconception) no-no’s, make sure your immunizations are up to date, and talk to you about your weight, your diet, your drinking and other lifestyle habits, and similar preconception issues.

Start looking for a prenatal practitioner.
It’s easier to start looking for an obstetrician or midwife now, when the pregnancy meter’s not already running, than when that first prenatal checkup is hanging over your head. If you’re going to stick with your regular ob-gyn, then you’ve got a head start. Otherwise, ask around, scout around, and take your time in picking the practitioner who’s right for you (see
page 21
for tips on choosing one). Then schedule an interview and a prepregnancy exam.

Smile for the dentist.
A visit to the dentist before you get pregnant is almost as important as a visit to the doctor. That’s because your future pregnancy can affect your mouth—and your mouth can possibly affect your future pregnancy. Pregnancy hormones can actually aggravate gum and tooth problems, making a mess of a mouth that’s not well taken care of to begin with. What’s more, research shows that gum disease may be associated with some pregnancy complications. So before you get busy making a baby, get busy getting your mouth into shape. Be sure, too, to have any necessary work, including X-rays, fillings, and dental surgery, completed now so that it won’t have to be done during pregnancy.

Check your family tree
. Get the scoop on the health history on both sides of the family tree (yours and your spouse’s). It’s especially important to find out if there’s a history of any medical issues and genetic or chromosomal disorders such as Down syndrome, Tay-Sachs disease, sickle cell anemia, thalassemia, hemophilia, cystic fibrosis, muscular dystrophy, or fragile X syndrome.

Take a look at your pregnancy history.
If you’ve had a previous pregnancy with any complications or one that ended with a premature delivery or late pregnancy loss, or if you’ve had multiple miscarriages, talk to your practitioner about any measures that can be taken to head off a repeat.

Putting It All Together

Does looking at this list of to-do’s make you realize there’s a lot to do even before sperm meets egg? Having a hard time knowing where to start? For a list of questions to ask when choosing a prenatal practitioner, a complete personal medical and obstetrical health history, a family health history chart, and plenty of other helpful information to help you get organized for your baby-making journey, see
The What to Expect Pregnancy Journal and Organizer
and
whattoexpect.com
.

Seek genetic screening, if necessary
. Also ask your practitioner about being tested for any genetic disease common to your ethnic background: cystic fibrosis if either of you is Caucasian; Tay-Sachs disease if either of you is of Jewish-European (Ashkenazi), French Canadian, or Louisiana Cajun descent; sickle cell trait if you are of African descent; one of the thalassemias if you are of Greek, Italian, Southeast Asian, or Filipino origin.

Previous obstetrical difficulties (such as two or more miscarriages, a stillbirth, a long period of infertility, or a child with a birth defect) or being married to a cousin or other blood relative are also reasons to seek genetic counseling.

Get tested.
While you’re seeing all your doctors and checking out all your histories, ask if you can get a head start on
some of the tests and health workups every pregnant woman receives. Most are as easy as getting a blood test to look for:

Hemoglobin or hematocrit, to test for anemia.

Rh factor, to see if you are positive or negative. If you are negative, your partner should be tested to see if he is positive. (If you’re both negative, there is no need to give Rh another thought.)

Rubella titer, to check for immunity to rubella.

Varicella titer, to check for immunity to varicella (chicken pox).

Tuberculosis (if you live in a high- incidence area).

Hepatitis B (if you’re in a high-risk category, such as health-care worker, and have not been immunized).

Cytomegalovirus (CMV) antibodies, to determine whether or not you are immune to CMV (see
page 503
). If you have been diagnosed with CMV, it’s generally recommended you wait six months before trying to conceive.

Toxoplasmosis titer, if you have an outdoor cat, regularly eat raw or rare meat, or garden without gloves. If you turn out to be immune, you don’t have to worry about toxoplasmosis now or ever. If you’re not, start taking the precautions on
page 80
now.