Midwife Matters

Pregnancy preparations, women's health, and care options

The Preconception Visit

on January 31, 2013

Welcome to the grand opening of Midwife-Matters!  We worked hard to get this site started and are so excited to share our experiences with you.  Getting started seems like a good theme for me to blog about today.

Sometimes we plan our pregnancies and sometimes life has other plans for us.  When trying to conceive the timing of intercourse with ovulation is the key. We usually ovulate 14 days before our upcoming period.  So, if you have a 28 day cycle and call the 1st day of your period “day 1”, then you would ovulate around day 14.  If you have a 35 day cycle then you would ovulate around day 21 etc.  An easy way to predict what your due date would be is to take the date of your last menstrual period, subtract 3 months and add 7 days.  So if you wanted a “May” baby, you would try to conceive in August.

I frequently see women for preconception counseling.  At that visit I take an in depth look at your health history, medications, genetic risks, immunization history, lifestyle choices, occupational hazards and family history.  Some things in life are out of our control, like our family history.  Lifestyle choices can be altered to support a healthy pregnancy.

1)  Take a look at your prescription medications.  Consider discontinuing medication that is not necessary and look into the safety of your medications in pregnancy.  It is best to seek medical advice before stopping medications.

2)  Start taking folic acid. Folic acid is a B vitamin. Women who take 400 micrograms of folic acid starting before conception through the first 3 months of pregnancy can help prevent defects in the baby’s brain and spine development.

3)  Try to improve any unhealthy life style choices. Quit smoking!  Stop using street drugs!  Stop drinking alcohol!  All these substances pose risks for your baby.  Caffeine is more controversial.  Some studies tell you to discontinue due to an increased link to miscarriage.  Other studies say moderate (1-2 cups per day) is OK.  I chose to believe the latter studies when I was pregnant, I couldn’t give up my morning cup of coffee!

4)  Learn to eat a healthy diet if not already doing so. Eat plenty of protein, choose whole grains, eat 4 servings of calcium rich foods (milk, cheese, yogurt) For those who are lactose intolerant try kale, broccoli, arugula, turnip greens, dried figs, oranges, oatmeal, soy beans, soy milk, tofu, or almonds to get your calcium.  Eat 5 servings of fruits and veggies daily.

*Remember, once pregnant, not to “eat for 2”.  Pregnant women need about 200-300 calories more a day.  You want to avoid excessive weight gain in pregnancy (that’s another whole topic to blog about another day).

There are also special diet considerations once you are pregnant:

1)  Avoid soft, unpasteurized cheeses. They can carry bacteria called Listeria, which can be harmful to get in pregnancy. Deli meats can also contain listeria but become safe if heated thoroughly.

2)  Follow recommendations for fish consumption. Fish, although very healthy, can also be contaminated with mercury. There are guidelines that set limits, which differ depending on the variety of fish. Sushi is more controversial. There are still the mercury concerns but also concerns about the risk of parasitic infections, which would be more difficult to safely treat in pregnancy.

3)  Avoid raw meats. Uncooked meat can be contaminated with bacteria or carry a parasite called toxoplasmosis that can affect your baby.  Cats can be infected with toxoplasmosis so handling cat litter could also expose you.  Some people will have very little they need to change from their normal lifestyle, others may feel overwhelmed by the information I have provided.

Remember to take things one step at a time.  I welcome your feedback and would love to visit with you for more in-depth, personal recommendations and advice.


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