Preparing for a Healthy Pregnancy

Planning to have a baby? There are steps you can take before you ever become pregnant to help ensure a smooth pregnancy and a healthy outcome for you and your infant.

Sally L. Avenson, a nurse midwife who teaches in the University of Washington School of Nursing and maintains a private midwifery practice, offers a number of suggestions for women who are expecting babies -- or hoping to.

Practice good nutrition

"It's wonderful to go into pregnancy healthy," says Ms. Avenson. Good eating habits are important to help minimize the likelihood of problems. "And the peace of mind is wonderful, knowing you're doing everything you can to give your baby a good start."

Ms. Avenson says it's probably a good idea to take a vitamin supplement, with special emphasis on the B vitamins. Lack of one of the B vitamins, folic acid, in the mother has been linked with spine bifida (open spine) in the newborn. (The usual recommended amount of folic acid supplement is 400 micrograms a day.)  However, excessive amounts of some vitamins can be harmful, so check with your healthcare provider before you start taking vitamins.

Practice healthy living

Plan on regular exercise, get enough rest and sleep, and try to keep stresses to a minimum. "It's an opportune time to make changes," says Ms. Avenson. "If you're motivated, you can do wonderful things." Strive to exercise regularly, raising your pulse rate, but not to the point that you can no longer converse.

Don't smoke

Smoking retards the growth -- including the brain -- of the fetus, and can affect the child's learning potential. "The connection has been made over and over," says Ms. Avenson. Mothers who smoke also have an increased rate of obstetrical complications, including pre-term labor, and premature separation of the placenta, which provides nourishment to the unborn baby. There is a higher rate of miscarriage among smokers, says Avenson, and the rate is related to the number of cigarettes smoked on a daily basis. "So it's worthwhile even to cut down on smoking, although it's much better to quit," she says.

Abstain from alcohol

"The best strategy is abstinence," stresses Ms. Avenson. While heavy drinking may cause fetal alcohol syndrome (which causes facial deformities, and severe behavioral and learning difficulties), any alcohol may result in a milder condition called fetal alcohol effect (FAE). Because there are no abnormalities in the child's appearance, FAE is more difficult to diagnose, but may cause behavior problems. Like cigarettes, alcohol's challenges to the fetus are dose-related. Binge drinking causes more problems than moderate drinking.

Refrain from substance abuse

Seek help if you have a drug problem, and remember that the child you're carrying has an even stronger response to drugs than you do.

Seek help in abusive situations

Statistics show that domestic violence often begins or increases when a woman is pregnant, because she is more vulnerable and dependent and makes an easier target. "There's such secrecy and stigma attached to the victims," Ms. Avenson says. "Call the domestic abuse hotline and get a referral to someone who can help."

Visit your provider early

See your health care provider as soon as you suspect you're pregnant. "It's wonderful to have early visits," says Ms. Avenson. "Be assertive about health care planning, and educate yourself to make good choices. If the health care provider you go to doesn't suit your needs, don't be afraid to make a change. Be proactive when it comes to your pregnancy."