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Taking Care of Your Body

Clean Up Your Act Before Conception

WebMD Feature

There's nothing like a fetus to keep you honest. No matter how much health sense you might choose to ignore when the consequences are only yours, it's a different ballgame with a baby on the way. So it's natural for women to shun unhealthful substances or behavior during pregnancy.

But prenatal sages have a new message these days: You'd better come clean first.

The standard pregnancy do's -- eat right, cut out cigarettes and alcohol, ease up on caffeine -- should all crank into gear three months before conception, not after the fact, experts warn. "Pregnancy is no longer nine months -- it's 12," says Dr. Robert Cefalo, a maternal-fetal medicine specialist at the University of North Carolina at Chapel Hill and coauthor of "Preconceptional Health Care: A Practical Guide."

Why all the fuss? Allowing extra prep time to deal with medical, social or environmental factors that could complicate your pregnancy is critical because it's during the very early weeks after conception -- when most couples still don't know they're pregnant -- that a baby's organs are developing. "The fetus is most sensitive to any little adverse event or drug between 17 and 56 days," Dr. Cefalo says.

If you are thinking about getting pregnant, consider these factors first.

Getting Physical

Make sure you're up-to-date on annual physical and dental exams, and schedule a preconception exam with your OB-Gyn to review any medical conditions, lifestyle habits or hereditary diseases that could complicate your pregnancy. Your doctor will want to know, for example, if you have diabetes, high blood pressure or another condition that needs to be closely monitored while you're pregnant.

"In reality, the vast majority of women are perfectly fine, but it's just a good idea to get all of this on the table beforehand to minimize anything unexpected," says Michael Zinaman, director of reproductive endocrinology at Loyola University Medical Center in Chicago.

Your doctor also will scrutinize medications you may be taking to make sure they aren't harmful because even some over-the-counter drugs, like some nasal sprays, can cause birth defects. And if you're taking birth control pills, you may be advised to use another method until you've had two normal periods before you attempt pregnancy; this will reduce the risk of miscarriage.

The few extra months can help because some conditions are more difficult -- or even impossible -- to resolve during pregnancy. Vaccination for rubella (German measles), for instance, must be administered at least three months before getting pregnant. Even minor surgeries or X-rays, which may take time to schedule, are safer to get out of the way before conception, says Dr. John Queenan, chairman of the department of obstetrics and gynecology at Georgetown University School of Medicine and author of "A New Life" and "Preconceptions: Preparation for Pregnancy." It also takes time to quit smoking and drinking, and to rid the body of harmful toxins.

Nutrition and Weight

A growing fetus needs plenty of protein, calcium and iron right from the start, so make sure your nutrient level is up to snuff before you get pregnant. "Preconceptionally speaking, eating for two means eating twice as well," says Diane Dimperio, a nutritionist and director of the Maternity and Infant Care Project at University of Florida at Gainesville.

That means eating all the recommended servings of fruits, vegetables and other food groups -- something most people don't typically do. "That's why the preconceptional period can be so important," she says. "If you can develop good eating habits and they become part of your lifestyle ahead of time, then pregnancy will be more fun because you won't have to be thinking so much about your diet."

One of the most critical nutritional requirements before pregnancy is folic acid, which can reduce by one-half or more your baby's risk of neural tube defects, such as spina bifida. Since the right amount of this essential B vitamin can't be assured through diet alone, women should begin taking 0.4 milligrams of folic acid daily, either as a supplement or by taking a prenatal vitamin three months before conception, Dr. Queenan says. Also, avoid megadoses of vitamins, especially the fat-soluble ones like vitamins A, D and K, he cautions.



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