By Richard L. Fischer, MD, FACOG
Head of the Division of Maternal/Fetal Medicine, Cooper University Hospital
Many pregnant women worry about the health of their unborn babies and often ask what they can do to improve the chances of delivering a healthy baby.
Avoiding tobacco and alcohol are well-known first steps, as well as attending regular prenatal visits so that doctors can monitor for any developing problems. Less known, however, are steps that can be taken prior to becoming pregnant.
Meeting with the obstetrician/gynecologist prior to planning a pregnancy is an important step. The physician can review the medical history, outcomes of previous pregnancies, as well as current medications.
Many women reflexively stop all their medications once they discover they are pregnant for fear that the medications will harm their babies. This is often ill-advised, as the medications may be needed to maintain their own health. Most medications can be safely continued during pregnancy, such as medications for asthma, high blood pressure, diabetes and depression.
While most medications cross the placenta and enter the baby’s circulation, few of them are known to increase the risk of birth defects.
The obstetrician/gynecologist may discuss those rare medications that should be stopped or switched prior to conception, or might recommend a consultation with a maternal-fetal medicine specialist if potentially risky medications need to be continued.
Folic acid is another important part of pre-conceptual care. Taking folic acid both before and during early pregnancy can reduce the risk of spina bifida in the baby.
Unfortunately, only one-third of reproductive-age women ingest an adequate amount of folic acid. The U.S. Preventive Services Task Force recommends that women planning to become pregnant should take a daily supplement of .4 to .8 mg of folic acid, which can be easily met by taking a daily prenatal vitamin before conceiving.
Finally, women who are planning to become pregnant should reduce their fish intake to avoid excessive mercury exposure. High mercury levels, which can remain for up to one year, can increase the risk of having a child with cerebral palsy or developmental delay.
Large fish, such as swordfish, shark, tilefish, and king mackerel, should be avoided entirely. Other fish, such as salmon, canned light tuna, fish sticks, and fast-food fish, should be limited to two servings per week. For those who prefer albacore tuna (white tuna), only one serving a week is recommended.
While no one can guarantee a normal pregnancy, taking these few steps prior to conceiving can help minimize the risk to your unborn child.
To visit the Cooper Obstetrics and Gynecology page click here.
To visit the Cooper Maternal/Fetal page click here.