Care Before and During Pregnancy--Prenatal Care
Getting early and regular prenatal care is one of the best ways to promote a
healthy pregnancy. Prenatal care is more than just health care; it often
includes education and counseling about how to handle different aspects of
pregnancy, such as nutrition and physical activity, what to expect from the
birth itself, and basic skills for caring for your infant.
Prenatal visits also give you and your family a chance to talk to your health
care provider about any questions or concerns you have related to your
pregnancy, birth, or parenthood.
Many health care providers recommend that a woman who is only thinking about
getting pregnant see a health care provider about preconception health. There
are steps she can take to reduce the risk of certain problems.
Folic Acid and Prenatal/Preconception Vitamins
The U.S. Public Health Service recommends that women of childbearing age get
at least 400 micrograms of folic acid each day, through food sources and/or
supplements. For women who are thinking about getting pregnant, health care
providers recommend supplementing the diet with folic acid for three months
before pregnancy, and then for at least the first three months of pregnancy.
Prenatal vitamins are a good way to get extra folic acid into the diet. Prenatal
supplements often contain high amounts of folic acid and other compounds, such
as iron and vitamin A. (But, women should take care in choosing a supplement, to
make sure that no more than 5,000 IU of vitamin A is included.) Findings from
research supported by the NICHD and other agencies indicate that the right
amount of folic acid can help prevent certain types of
birth defects and other problems during pregnancy.
Even though many foods available in the United States are fortified with
folic acid, women who are thinking about pregnancy benefit from an extra boost
of this important compound. It can be hard to get the full amount of folic acid
from food sources alone, so preconception supplements are important. For more
information about NICHD-supported research on this topic, read the news releases on folic acid research.
Proper Immunizations for the Mother
Women who are thinking about getting pregnant should make sure that they have
been properly vaccinated and are immune to certain diseases, such as rubella
(also called German measles). If a woman gets rubella while she is pregnant, the
fetus is at increased risk for a variety of problems, including deafness, heart
problems, cataracts of the eyes, and mental retardation, just to name a few.
These problems, which together are called congenital rubella (kon-JENN-it-ul roo-BELL-uh)
are much more severe than the effects of getting rubella as a child.
Health care providers often test a woman's blood for immunity to this
infection, or they try to find proof of childhood immunizations from a woman's
health history. If a woman is not immune to rubella, she should be vaccinated.
The American College of Obstetricians and Gynecologists (ACOG) recommends that
women wait at least one month
after getting vaccinated before trying to get
pregnant. ACOG also suggests that women take steps to prevent pregnancy during
this time. This time period can protect against any lingering traces of the
vaccine/illness that may affect the fetus.
A woman who is already pregnant should not get a rubella vaccination.
In addition, if a woman gets chickenpox while she is pregnant, the fetus is
at increased risk for a number of problems, which together are called congenital
varicella (vair-i-SELL-uh). The name varicella comes from the name of the virus
that causes chickenpox, called varicella zoster virus. Congenital varicella is
much more serious than the effects of getting chickenpox as a child. It can
result in scarring of the skin, weakening or withering of the arms and legs,
called atrophy (AT-row-fee), and eye abnormalities.
Just like they do for rubella, health care providers will likely test a
woman's blood for immunity to varicella, or they will try to find proof of
childhood immunizations from her health history. If a woman is not immune to
varicella, she should be vaccinated. The Advisory Committee on Immunization
Practices (ACIP), part of the Centers for Disease Control and Prevention,
recommends that all non-pregnant women of childbearing age be vaccinated against
varicella. ACIP and the American Academy of Pediatrics also recommend that women
wait at least one month after getting vaccinated before trying to get pregnant.
This time can protect against any lingering traces of the vaccine/illness that
may affect the fetus.
A woman who is already pregnant should not get a varicella vaccine.
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