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Pregnancy Planning

Becoming pregnant and having a baby is one of the most important events in a woman's life. Women considering pregnancy are encouraged to start planning for the pregnancy with their doctors early. This early planning process is called pregnancy planning. The goals of pregnancy planning are to create a healthy environment for the fetus and to prevent birth defects and other pregnancy related problems. The issues addressed during pregnancy planning include nutrition, vitamins, exercise, avoidance of certain medications and alcohol, weight, and genetic counseling. Even though many women will have normal pregnancies without any planning, pregnancy planning improves the chances of a smooth pregnancy and a healthy baby. Unfortunately, 40% of pregnancies in the United States are unplanned and many more women who are anticipating conceiving do not seek prior medical consultation. Public education is important to improve pregnancy planning.

Pregnancy planning can help prevent exposure of the mother to potentially harmful medications or substances during the early days of pregnancy. The baby's organs begin developing as early as 17 days after conception and the fertilized egg begins to grow even before the first day of the missed period. Some women continue to have menstrual periods during the first few months of pregnancy and may not even realize that they are pregnant. Others may not recognize that they are pregnant until they experience a weight gain or abdominal enlargement. By then, they may have already been exposed to medications or substances potentially harmful to the fetus.

In addition to avoiding medications and substances that are potentially harmful to the fetus, other important health issues are addressed during pre-pregnancy planning. Conditions such as diabetes, high blood pressure, kidney disease, and heart valve disease in the mother are controlled to optimize pregnancy outcome. Women lacking rubella antibodies are immunized before conceiving (see medical issues below). Women who are not immune to varicella (chickenpox) can be vaccinated, but should wait 30 days after vaccination before becoming pregnant. Women who are carriers of the hepatitis B virus can be identified by blood tests, and their infants can be protected from hepatitis B infection by immunizations at the time of delivery. Women with HIV (human immunodeficiency virus) infection should take certain medications during pregnancy to decrease not only their risks but those of the fetus as well.

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