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The plan

Preparing for pregnancy lets you create a healthy and hospitable environment for the foetus- to-be and helps prevent problems such as birth defects.

WE plan meticulously for many things in life. We plan to buy a new home by saving up money and doing research about property. We plan our weddings feverishly, poring over bridal magazines and choosing flowers with great excitement. We plan our career path by making strategic decisions in our workplace that will help us climb up the ladder of success.

If a woman were to put as much care and thought into planning her pregnancy, she can contribute a lot towards ensuring the health and well-being of her baby, as well as eliminating many of the uncertainties that are present during pregnancy. The state of your physical health before you conceive plays a huge role in determining whether you will conceive and carry through a healthy pregnancy.

Who needs a pregnancy planner?

Every woman of reproductive age is a potential mum and should be aware of her body and health even if she is not consciously planning to have a baby. It’s good to practise prenatal care during pregnancy, but it is often the period before, and in the early stage of, conception that women forget about – and that is the most important time!

A baby is conceived about two weeks before a woman’s period is due, which means that she most likely will not know that she is pregnant until she’s more than three weeks into the pregnancy. Yet the little one is most vulnerable in the two to eight weeks after conception, which is when the vital organs are beginning to develop. Any dangerous substances or injuries to your body at this point could cause irreversible damage.

That is why I tell my patients to start acting pregnant before they actually are. It may sound silly to go through life pretending to be pregnant, but in actual fact, you are creating a healthy and hospitable environment for the foetus-to-be and preventing problems such as birth defects.

If you are consciously planning to have a baby, you can start discussing with your doctor any time, even as early as a year ahead. Your doctor or obstetrician will be able to evaluate your health and identify health and lifestyle risks that may affect your future pregnancy.

Pregnancy planning covers a whole range of lifestyle elements, including diet and nutrition, body weight, exercise, intake of medications and other substances, immunisations, and genetic testing.

Healthy lifestyle habits

Your lifestyle covers a range of behaviours and practices in your daily life – many of which you may take for granted and not give a second thought to. It is important to pause and look at the areas of your life that need to be changed.

Eating healthily, maintaining the right body weight, and exercising regularly will help you keep in good health for conception, and reduce problems for you and your baby during pregnancy. What you should and should not eat is so important that I will explain it in an entirely separate article, which will form the second part of this series.

Linked to good nutrition is your body weight, which you need to monitor before and during pregnancy. If you’re underweight or overweight before you conceive, try to get to a healthier weight – which not only makes it easier for you to conceive, but also reduces stress on your body during pregnancy and lowers the risk of problems like high blood pressure or high glucose.

What other habits would you need to discard or change? Smoking, drinking alcohol and taking drugs can cause problems for the baby in the womb, and after it is born. Smoking can cause miscarriage, bleeding, premature birth, low birth weight, as well as slower physical and intellectual development.

Alcohol can cause foetal alcohol syndrome, which contributes to birth defects, including mental problems, slow growth and physical defects. Abuse of illegal drugs like marijuana and cocaine is not only risky for the mother, but also causes harm to the baby, such as miscarriage, premature birth, or even addiction to the child when he or she is born.

There are no shortcuts to this – you have to stop smoking, stop drinking alcohol, and be drug-free if you want to get pregnant. This will have to go on during pregnancy and during the breastfeeding period as well.

Getting the right shots

If you are planning to get pregnant, you should see your doctor and ask whether you may be at risk of any infectious diseases, such as rubella or chickenpox, that could cause serious harm to your unborn baby during pregnancy.

Rubella can cause your baby to be at increased risk for deafness, heart problems, cataracts of the eyes, and mental retardation. Chickenpox during pregnancy causes congenital varicella in the baby, including problems such as scarring of the skin, weakening or withering of the arms and legs, and eye abnormalities.

If you test negative for immunity against these diseases, it means that you have never developed them before and you require vaccinations before you conceive. You should wait at least one month after the vaccination before trying to get pregnant – and if you are already pregnant, you should not receive either of these vaccinations.

Other infectious diseases that you should be concerned with are hepatitis B and HIV. If you are a carrier of the hepatitis B virus, your baby can be protected with immunisation during delivery. If you have HIV, there are antiretroviral medications that will be given to you during pregnancy, labour, and delivery to reduce the risk of transmitting the virus to your baby.

Medications and illnesses

You may rely on medications for certain health problems, or on supplements, but be aware that many of these compounds can be dangerous to a foetus during pregnancy. Normal over-the-counter medicines like aspirin can cause defects in the baby, while prescription medications, such as for asthma, epilepsy, thyroid problems, migraines or acne, may also be harmful.

Even certain supplements containing herbs or vitamins and minerals can impact the foetus’ health during pregnancy. It is best to sit down with your doctor for a full review of the medications and supplements that you commonly take, when you are planning your pregnancy.

Needless to say, many women may be taking prescription medications to control chronic conditions, such as high blood pressure or diabetes. You should not stop the medications on your own, as these conditions can cause complications during pregnancy.

Hypertension can interfere with the growth of the unborn baby and increase the risk of foetal death, as well as preeclampsia. Uncontrolled diabetes can lead to miscarriage or birth defects. To keep these conditions well under control throughout pregnancy, your doctor should switch you over to safer medications before you conceive. For instance, oral diabetes medications should be replaced with insulin instead.

Genetic testing

As medical technology improves every day, we know now more about diseases that run in the family, as well as other diseases that are linked to chromosomal abnormalities. Genetic testing and counselling can help you detect if you are at risk of, or carry these genetic traits.

Cystic fibrosis, Tay-Sachs, sickle cell anaemia, and certain neurological diseases are among the conditions that can be tested for genetic traits prior to pregnancy. If you are above 35 when you get pregnant, you may be at higher risk of having babies with chromosomal abnormalities, such as Down’s Syndrome. These conditions can also be detected through genetic analysis. Part of the planning process is counselling to help prepare you and your spouse for the risks of these pregnancies.

Other hazards

There are many other aspects of your daily life which you may have taken for granted, and which you will now have to be extra careful about, due to an impending pregnancy.

For instance, are you exposed to hazardous chemicals in your home or workplace? Stay away from strong-smelling cleansers, chemicals, paint, heavy metals like lead, copper and mercury, or materials that produce radiation, cardon disulphide, acids, and anaesthetic gases. If you do have to come into contact with them, reduce your risk by wearing rubber gloves, special equipment or working in a well-ventilated area.

Even cats can be a hazard! Cats’ faeces can contain a parasite that causes toxoplasmosis, which is harmful to an unborn baby. This parasite is also present in raw or undercooked meat, or dirt that has been contaminated by cat faeces.

While all the precautionary measures described above may sound insurmountable, it is a small price to pay for the health of your baby. Sometimes, all it takes are some small changes in your lifestyle or environment – it’s not too much to ask of anyone.

The Star Newspaper, Sunday March 7, 2010

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