Pregnancy planning

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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What is a pregnancy calendar or calculator?

A pregnancy calendar or calculator is a tool that helps a woman determine precisely which changes are taking place in her body and in the fetus at a given week of pregnancy. Calculators are also available to predict a woman's due date. Many versions of pregnancy calendars and calculators can be found online.

How soon can a woman start trying to conceive after stopping birth control?

A woman is physiologically able to become pregnant as soon as she is no longer using birth control. For certain hormonal methods designed for longer-term contraception, the effects can take some time to wear off so pregnancy is possible when the hormonal effects wear off. There is no evidence to suggest that waiting a few cycles after stopping oral contraceptives will lead to better pregnancy outcomes.

What are dietary considerations for pregnancy planning?

A healthy diet that provides all the necessary nutrients for the developing fetus increases the chances of a healthy pregnancy. For this reason, it is best to avoid certain diets in pregnancy. In particular, high-fat diets, some vegetarian diets, and weight loss diets should generally be avoided by pregnant women. A healthy diet also means limiting sugar intake. Many women also choose to start eating a healthy diet in the stage prior to conception to maximize their chances of delivering a healthy baby. In general, a healthy diet is the same for both pregnant women and non-pregnant women, with a few special exceptions that will be discussed below.

Evidence about whether consumption of caffeine in pregnancy is detrimental has been inconclusive. However, it is known that the fetus metabolizes caffeine very slowly, so maternal consumption of caffeine results in a prolonged exposure for the fetus. Consumption of typical levels of caffeine has not been associated with any adverse pregnancy outcomes, yet individual studies have shown that caffeine can lead to changes in fetal arousal and heart rate. According to many experts, including the American Academy of Nutrition and Dietetics, caffeine intake in pregnant women should be limited to 200 mg per day (equivalent to one 12 oz. cup).

Women who are planning to become pregnant are advised to take folic acid supplements to reduce the likelihood of neural tube defects in the fetus. The neural tube closes early in pregnancy (18 to 26 days after conception) so supplementation with folic acid is most critical during the early days of pregnancy. Often, supplementation after the diagnosis of pregnancy is too late to reduce the risk of neural tube defects. Vitamins containing 400 to 800 mcg of folic acid, taken daily, are recommended.

Due to the presence of certain environmental toxins (such as mercury), the kinds and amount of fish (and shellfish) that are eaten during pregnancy should be regulated. The US FDA has issued guidance for pregnant women and those planning a pregnancy regarding the types and amount of fish that should be eaten.

  • In general, 2-3 servings of fish that are low in mercury are recommended per week.
  • Seafood that is lower in mercury includes salmon, shrimp, pollock, tuna (light canned), tilapia, catfish, and cod.
  • Tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel are typically high in mercury and should be avoided.
  • Pregnant women should not consume raw fish.

Megavitamins may not be safe for pregnant women, since excessive doses of vitamins can be harmful and their effects on the fetus have not been fully studied. Megadoses of vitamin A in early pregnancy have been linked to birth defects. Women planning pregnancy and who are pregnant also are advised not to consume nonessential dietary supplements or herbal preparations, since their effects on the developing fetus are unknown. The safest choice for women planning a pregnancy is to take a prenatal vitamin supplement that contains folic acid and iron.

Pregnant women also should try to avoid unpasteurized milk, soft cheeses, deli and luncheon meats, and undercooked or raw animal foods. This is due to the risk of exposure to Listeria monocytogenes, common bacteria that can cause miscarriages and other problems. Fruits and vegetables should be washed well before consumption.

Medically Reviewed by a Doctor on 2/12/2016
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