Getting Ready for Pregnancy - Things to think about before you're pregnant

The information contained in this brochure may be out of date and is currently being reviewed. It is not intended to answer specific medical questions, but is provided for general information only. Please talk to your family physician directly about your health concerns.

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Developed by the College of Family Physicians of Canada

Conception occurs about two weeks before your period is due. That means you may not even know you're pregnant until you're more than three weeks along. Yet your baby is most sensitive to harm two to eight weeks after conception. This is when your baby's facial features and organs, such as the heart and kidneys, begin to form. Anything you eat, drink, smoke or are exposed to can affect your baby. That's why it's best to start acting as if you're pregnant before you are.

Any time - even before you're thinking about getting pregnant. You can talk about your diet, habits, lifestyle and any concerns you have. Plan on visiting your doctor within a year before you want to get pregnant. At that time, you may be given a physical check-up. You and the father-to-be will probably be asked about your medical history. You'll both also have the chance to ask your doctor questions. You may want to be screened for rubella and HIV or need other blood tests too.

What you eat will also feed your baby. Junk food like potato chips, soda and cookies won't have the right nutrients for your baby. You might also need to make some changes if you follow a vegetarian or weight-loss diet. Talk to your doctor before taking extra vitamins and minerals. Some of them may be harmful, like high doses of vitamin A and D. Limit your daily Vitamin A intake to 3000 IU and Vitamin D to 400 IU or less. A daily prenatal vitamin containing 30 mg of elemental iron is sufficient when combined with a diet that includes meats and other foods high in iron. Before conception, women need 1,200 mg of calcium per day, or the equivalent of a quart of milk or fortified orange juice. Alternatively, this can be obtained from six servings of fortified bread or cereals. Limit your daily caffeine intake to 2 cups of coffee or 6 glasses of soda.

Women who get enough folic acid (a B vitamin) during pregnancy are much less likely to have a baby with serious problems of the brain or spinal cord. Folic acid should be taken for 3 months before getting pregnant because these problems develop very early in pregnancy-only three to four weeks after conception.

Women need to take about 0.4 mg of folic acid a day. That amount is usually in a multivitamin. You may also want to eat more foods rich in folic acid, such as:

However, it may be difficult to obtain this amount of folic acid in your diet. Therefore, it is recommended you take a multivitamin.

If you're overweight, your risk during pregnancy is higher for things such as high blood pressure and diabetes. You can use the time before getting pregnant to lose weight if you need to.

Yes. The more fit you are, the easier your pregnancy and delivery may be. But if you exercise too much, it can make getting pregnant harder. And overdoing it once you're pregnant can be dangerous. If you haven't been exercising, start before you get pregnant. While you are pregnant, you can probably keep up a light exercise program. Walking every day is one of the best exercises. Talk to your doctor about a good exercise plan for you.

Using tobacco, alcohol or drugs can cause serious harm to your baby and sometimes even cause miscarriage. If you use tobacco, alcohol or drugs, get help from your doctor to quit. Try not to be embarrassed or scared to talk to your doctor. He or she will want to help you find a way to stop.

Smoking. Smoking can cause miscarriage, bleeding, premature birth and low birth weight. It's also linked to sudden infant death syndrome (SIDS), in which infants suddenly die of no obvious cause. Children of smokers may do less well on IQ tests, and their physical growth may be slower.

Alcohol. Drinking by a pregnant woman can cause fetal alcohol syndrome (FAS). FAS can lead to many problems, including mental slowness, poor growth, defects of the face and a head that is too small. Drink no alcohol or as little as possible before and during pregnancy.

Illegal drugs. Using marijuana, cocaine and other illegal drugs raises the chances of miscarriage, premature birth and birth defects. With some drugs, the child will be born addicted to the drug that the mother used and will go through withdrawal.

You may have heard that pregnant women shouldn't clean a cat's litter box. That's because a parasite that causes a disease called toxoplasmosis can be spread through the feces of cats. Toxoplasmosis isn't usually harmful to children and adults, but it can cause birth defects, including blindness and brain damage. You can also get toxoplasmosis by eating raw or undercooked red meat or touching dirt, such as when gardening, that has been contaminated by cat feces.

Maybe. Some dangers include radiation, heavy metals like lead, copper and mercury, carbon disulfide, acids, and anesthetic gases. The radiation from computer screens doesn't seem to be harmful.

Those who work in healthcare or childcare may be at risk of cytomegalovirus (CMV) and Parvovirus B19 (fifth disease) from infected kids.

Talk with your doctor about your workplace and home to find out if there are any dangers. If anything could harm your baby at work, you may be able to use special clothing or equipment to protect your baby, or you may be able to get a short-term transfer before and during pregnancy.

Soaking in a hot tub might sound relaxing, but it could hurt your baby if you're in the first trimester of pregnancy. Some research has shown that high heat-from a fever, hot bath or hot tub-during the first three months may cause birth defects.

Both prescription and over-the counter medicines can affect your baby. Ask your doctor before taking anything.

If you need to take medicine often because of health problems, such as asthma, epilepsy, thyroid problems or migraine headaches, talk with your doctor about your treatment. Many of these drugs can be taken safely in pregnancy but it is always best to ask.

You may need some tests to find out if you have problems that could harm you or your baby during pregnancy. Many things can be handled before pregnancy to help prevent problems for your baby and for you.

Rubella. If you don't know whether you've ever had rubella (German measles) or been vaccinated against it, a blood test can give the answer. Catching the German measles while you're pregnant can be very bad for your baby. You can get a vaccination at least a month before you try to get pregnant to prevent this.

Chicken Pox (varicella). If you don�t know whether you�ve ever had varicella (chicken pox) or been vaccinated against it, a blood test can give the answer. Catching chicken pox while you�re pregnant can be very bad for your baby. You can get vaccination at least a month before you try to get pregnant to prevent this.

Sexually transmitted diseases (STDs). STDs such as gonorrhea, syphilis and chlamydia can make it hard for you to get pregnant and can also harm your baby. These and other infections can be treated before pregnancy.

HIV (human immunodeficiency virus). HIV, which is the virus that causes AIDS (acquired immunodeficiency syndrome), can be passed onto your baby.

Other problems. Your doctor may also want to do some other tests depending on if you're at risk for other problems, such as anemia or hepatitis.

Diabetes, high blood pressure or problems with your circulation may need extra care during pregnancy. It's often easier to treat problems or get them under control before you're pregnant.

Were you born with phenylketonuria (PKU)? If so, you had to follow a special diet low in phenylalanine (an amino acid in many high-protein foods) when you were a child. Consult your doctor or dietician in order to start the same diet again before getting pregnant. If you don't, your baby may suffer from mental slowness, low birth weight and
other problems.

Your baby may be at risk for certain problems that run in your family. These are genetic diseases. Cystic fibrosis, sickle cell anemia and thalassemia (a type of anemia) are examples. These problems aren't caused by anything you do. Your baby is also at higher risk of genetic problems if you're over age 35. Talk with your doctor about assessing your risk factors and doing screening tests if needed.

Tracking my baby�s development

You may follow your baby�s development by using the Maternity Care Calendar approved by the CFPC. It is available for purchase at http://www.maternitycarecalendar.com/about_maternity.cfm

Domestic Violence

Domestic violence escalates during pregnancy. If you feel unsafe or threatened physically or emotionally in your current relationship, talk to your family doctor who will be willing to help you deal with the situation.