Planning for a healthy pregnancy (Part 1)

Wednesday, March 26th, 2014 at 4:47 pm

By the time I see a pregnant woman, there’s only a very limited amount we can do.

We can manage nausea and try to have appropriate weight gain. We can make sure she doesn’t get listeriosis. We can treat her anemia. We can try to get her blood sugars back under control. But generally, we’re too far behind to make a significant difference.

If we really wanted as healthy a pregnancy as possible, we’d have needed to start before she got pregnant–not at 20 weeks along.

So, say you’re thinking about having a baby…what are the first steps you should take to plan for a healthy pregnancy?

1. Quit bad habits

If you smoke, you’re currently starving your body’s organs of oxygen. If you get pregnant while you’re smoking, you’ll be starving baby of oxygen. Womb-asphyxiated babies don’t grow as well–they are more likely to be born prematurely and more likely to be born small, both of which increase the risk for a whole slew of problems in infancy and beyond. Stop smoking before you start trying.

If you use illegal drugs, cut it out. Cocaine, meth, and narcotics all increase the risk of low birthweight and preterm birth. Think that’s not so bad? Low birthweight and preterm birth are the single leading cause of infant death. Furthermore, your baby can get addicted to those drugs in utero–and when they start going through withdrawal in the delivery room? You’re going to get your baby taken away.

Think marijuana’s okay? It’s legal in two states, so it’s fine, right? Think again. Marijuana use increases risk of at least two different types of congenital heart disease–and there’s plenty we don’t know about how marijuana affects pregnancy. It’s not worth the risk.

What about alcohol? If you’re drinking under the recommended amount for women (no more than once a day with no more than one drink on any given occasion), you don’t need to worry too much about this one in the preconception period. But if you’re dependent on alcohol or are used to consuming more than one drink at a time, now’s the time to rein this in to within the recommended amount for women. Since you’re going to be quitting drinking entirely once you start trying, it wouldn’t hurt if you were to cut back beyond the recommendations at this point.

I know that a lot of you are breathing a sigh of relief at this point. You’re good to start trying, you might be thinking.

But there’s more.

2. Attain a healthy weight

There are plenty of people who have their personal tiffs with BMI (myself included), but it does have some value. When we look at BMI as a predictor of pregnancy outcome, we do see an increased risk with both high and low BMIs. The risk of miscarriage is more than doubled in women with BMIs over 30, while women who have BMIs between 25 and 30 are at only slightly increased risk of having a miscarriage. Obesity (defined as a BMI above 30) also increases risk of having an infant born with a neural tube defect. Furthermore, obesity is frequently associated with a host of metabolic and cardiovascular abberations that can cause complications during pregnancy (predisposition to diabetes and hypertension among them). On the other hand, having too low a BMI has problems of its own. Women whose prepregnancy BMIs were below 20 have an increased risk of delivering a baby prematurely (which I’ve already mentioned leads to a whole host of other complications).

The good news is that you can do something about these risks. By attaining a healthy weight prior to pregnancy, you can improve your chances of having a healthy, uncomplicated pregnancy and delivery.

So, check out your BMI. If you’re under 20, start working on gaining weight. If you’re over 30, start working on losing weight.

I know, that last bit isn’t as easy as it sounds. If readers are interested, I’m willing to go into a bit more depth on the best approaches for losing or gaining weight prepregnancy–but this information isn’t dramatically different than normal healthy weight gain/weight loss strategies, so I was thinking to focus more specifically on the items that are more specific to pregnancy in this particular series.


And I’m now up to over 600 words with a bazilliondy things left to mention, so we’ve got ourselves a series :-)


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