As any future parent knows, caring for your baby begins long before you give birth. In fact, it should start from the moment you decide you would like to have a baby. Making sure your health is in the utmost shape may make it easier for you to get pregnant, may make your pregnancy easier, and it starts your baby off on the right track healthwise. These are some of the checks you should get before trying to conceive.
1. A general checkup
Even though you'll have tons of doctor's visits once you're expecting, it's best to schedule an appointment now. "Entering a pregnancy in the optimal health leads to a healthier pregnancy and a healthier parent," says Kenneth James, M.D., a board certified ob-gyn at Saddleback Memorial Medical Center, Laguna Hills, California. At the preconception visit, expect to answer a lot of questions. Your doctor will talk with you about weight, nutrition, exercise, medications you're taking, your medical history, menstrual periods, birth control you're using, previous pregnancies, and lifestyle habits. He or she will also get an overall view of your health, which may mean a blood pressure check, blood test, pelvic exam, Pap test, and other screenings. Your doctor will also address any chronic health issues, like diabetes, hypertension, thyroid disorder, asthma, and autoimmune disorders to make sure they're under control before you become pregnant, says Dr. James.
Your guy should see a doctor too. He can expect similar tests and discussions about any lifestyle factors he has that may affect fertility or pregnancy.
2. Vaccinations
This will likely also be part of your preconception visit. If you're planning to become pregnant, it's important to confirm your vaccinations are current so that you can avoid illnesses that may be harmful for your pregnancy or your baby, says Dr. James. Make sure you're vaccinated and up-to-date for Tdap (tetanus, diphtheria and pertussis), Hepatitis B, MMR (measles, mumps, and rubella), and chickenpox. You can get a flu shot before or during your pregnancy. Your partner should have a doc look at their shot record, too. "If the partner gets infected with chickenpox, for example, they can pass it to you if you're unvaccinated," says Dr. James. "And if they get a disease in the third trimester or near birth, you're bringing a newborn home to a partner that's sick, and the baby doesn't have any immunity," he adds. The ideal time to verify and get your vaccines is about 3-6 months before you plan to become pregnant.
3. Sexually transmitted infections (STIs)
Even if you're 100 percent sure you're in a monogamous relationship and your partner would never cheat, it's better to be safe than sorry. Your baby's health could depend on it. Untreated STIs can cause very serious problems for your pregnancy and baby. For example, chlamydia has been linked to preterm labor and low birth weight; gonorrhea can lead to miscarriages, premature birth and low birth weight; and syphilis has also been linked premature birth, as well as stillbirth, and problems with multiple organs, including the baby's brain, heart, skin, eyes, ears, teeth, and bones. "It's standard care for your doctor to check for chlamydia, gonorrhea, HIV, hepatitis, and syphilis during the first prenatal visit," says Dr. James. However, he recommends both partners be screened before conceiving. That way you can receive treatment and take any necessary precautions to protect your future baby.
4. Genetic testing
The actual test isn't a must-do for everyone, but all intended parents should be educated about genetic testing so they can make an informed decision about what is the correct option for them, says Shona Murray, M.D., an ob-gyn and Director of Advanced Reproductive Medicine Colorado Springs, at the University of Colorado Denver. Pre-pregnancy genetic testing, called carrier screening, is done using a blood sample or tissue from a swab inside the check. The test will help determine if you or your partner carries abnormal genes linked to certain diseases that might then passed on to your baby. Your doctor may recommend you not test at all or test for the most common inheritable disorders, such as cystic fibrosis (CF) and spinal muscular atrophy (SMA). If you or your partner are of certain ethnic backgrounds, you may be advised to screen for additional conditions because some ethnic groups are at increased risk for specific genetic disorders. "For example, a couple may want testing for sickle cell disease and thalassemia if of African heritage or Tay-Sacs disease if of Ashkenazi Jewish heritage," says Dr. Murray. Some couples choose to do what's known as an expanded carrier screening panel. "This will test for over 300 genetic diseases, including CF, SMA, sickle cell, and thalassemia," Dr. Murray says.
If you and your partner are positive for an abnormal gene, or one of you carries a gene that requires only one copy (from one parent instead of both) to produce a disease, this early testing allows you to decide whether you want to pursue pregnancy or not. In addition, screening before you become pregnant gives you the option to do in vitro fertilization (IVF) and preimplantation genetic testing, which identifies genetic defects in embryos before implantation. "Some embryos will be affected, some not," Dr. Murray says. "We would then only transfer an embryo that will not have the disease." Prenatal testing is still recommended. Genetic testing may or may not be covered by your insurance. Check with your provider.
5. Dental checkup
Yes, your teeth should be part of your pre-pregnancy game plan. "During pregnancy, your body goes through hormonal changes that may cause excessive gum inflammation, which is known as pregnancy gingivitis," says Mark K. Nguyen, D.D.S., a dentist at OC Healthy Smiles in Costa Mesa, California. "Pregnancy gingivitis increases your susceptibility to bacteria that cause gum disease," he adds. Research has shown that gum disease increases the risk for preterm delivery and low birth weight. "Another crucial reason to have a pre-pregnancy checkup is because you want to reduce the amount of radiation to the child, which means no dental x-rays while you're expecting unless you're having a toothache," says Dr. Nguyen. (According to the American Dental Association and the American Congress of Obstetricians and Gynecologists, having dental X-rays during pregnancy is considered safe with appropriate shielding.) So it's best to make sure your mouth is in good condition before you're pregnant. That way you'll have time to correct any issues.
6. Mental health check
Emotional well-being is just as important as physical health when you're planning to become pregnant. According to the Centers for Disease Control and Prevention, as many as 1 in 9 women experience depression before, during, or after pregnancy. So it's crucial to make sure your mental health—and your partner's—is in check before pregnancy. If one of you has or has had mental health problems in the past, it's a good idea to visit your care provider because pregnancy itself can bring on symptoms or worsen existing ones. "I encourage people to seek help, whether it's from a psychologist, psychiatrist, alternative health healer, or spiritual guide. A mentally healthy mom makes a mentally healthy baby," says Dr. James. A professional can help you and your partner with tools to cope with stress so that you're better equipped to handle emotional changes during and after pregnancy. And if medication is required, there are some options for expectant moms, so your should discuss them carefully with your doctor. If you or your partner do have any mental health issues, don't make this a one-time visit. You should receive care before, during, and after the pregnancy to make sure the whole family gets and stays mentally healthy.