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Pregnancy 101: The Beginning And The End

There has never been better news for pregnancy planning: maternal and fetal complications of pregnancy and childbirth are at an all time low, prenatal diagnostics and interventions have continued to improve, and the "information age" has offered unprecedented access to medically related input. Contraceptive options are also increasing and improving, so that the goal of eliminating unwanted pregnancies in the 21st century is no longer in the realm of fantasy. Yet despite this, too many American women spend more time planning a one week vacation than they do planning a pregnancy.

Preconception Visit:

Your most important prenatal visit may actually be a preconception visit: a visit to your doctor before getting pregnant to discuss and identify any preventive measures you should take prior to conceiving, discuss family and personal medical histories, discuss various risk factors, and discuss current medications. Preconception prevention plans should include:

  • if you smoke, stop.
  • if your partner smokes, stop.
  • reduce alcohol consumption to one drink per day or less (eliminate once pregnant).
  • discuss all medications-prescription and non-prescription--with clinician if you use any recreational or illegal drugs, stop.
  • begin taking folic acid (400 mcg/day) to reduce incidence of spinal and brain-related birth defects.
  • begin taking other vitamins, minerals, or supplements recommended by clinician (especially iron and calcium).
  • start/maintain a regular exercise regimen.
  • if you have any uncontrolled medical problems (e.g. high blood pressure, diabetes, depression, thyroid problems, etc.), work with your physicians' advice to get them under control.
  • a complete history and physical, along with having any overdue preventive tests (e.g. Pap smear, cholesterol count, etc.) and treating any abnormal results.
  • take any necessary vaccines (e.g. rubella, varicella, hepatitis) screening for any genetic conditions (in both partners) if indicated.
  • Receiving early and consistent prenatal care increases the likelihood of a healthy birth outcome. . .for mother and child. Adequate prenatal care is dependent upon both receiving care early and an appropriate number of times throughout the pregnancy. Estimates are that in 1994, 12.0% of minority women received inadequate prenatal care compared to 4.9% of white women. By age, teen mothers are the least likely to get adequate prenatal care.

    A wide range of health care providers offer prenatal care in a number of different settings: obstetricians, family clinicians, women's health care clinicians, nurse midwives, clinician assistants, nurse practitioners and nurses. For the purposes of this article, they'll all be included under the term "clinicians".

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     Receiving early and consistent prenatal care increases the likelihood of a healthy birth outcome. . .for mother and child. 

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