Care Before and During Pregnancy - Prenatal Care
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 milligrams 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.
Vitamins and immunizations aren't the only things that can help promote a healthy pregnancy. Things like diet, physical activity, medications, smoking, alcohol or drug use, and environmental factors can all affect pregnancy. A healthy diet, weight level, and regular physical activity level can help to reduce problems for both mother and fetus during pregnancy. For this reason, many health care providers suggest that women who are thinking about getting pregnant take steps to improve or maintain their own level of health before they get pregnant. A healthy diet helps to ensure that the fetus has all the nutrients it needs to grow and develop normally. Maintaining a healthy weight, both before and during pregnancy, can help to reduce stress on the mother's body and lower the risk of certain disorders of pregnancy. Being active before and during pregnancy, if approved by a health care provider, can help women maintain their healthy weight and can improve the function of the circulatory, cardiovascular, and skeletal systems. Just as important is keeping things that can be dangerous out of the mother's body. For instance, medications used to treat various diseases and conditions can affect the growth and development of the fetus. Certain herbal supplements and high amounts of vitamins can also make it harder for a woman to get pregnant, and can impact the fetus' health during pregnancy. Even being around certain materials, such as paint and pesticides can put the health of the fetus at risk. Women who are thinking about getting pregnant should discuss all of these factors with their health care providers. Some changes in medication or supplement use, or changes in environment may be recommended to prevent problems during pregnancy. Research shows that smoking, drinking alcohol, or using drugs, even now and again or in small amounts during pregnancy can cause health problems for the fetus, some of them severe. Many of these problems can have life-long effects. Alcohol and drug use may also make it harder for some women to get pregnant. To reduce the risk of problems during pregnancy, health care providers recommend that women stop smoking, stop drinking alcohol, and stop using drugs, completely, as early as possible before they start trying to get pregnant. They should maintain this tobacco-free, alcohol-free, and drug-free lifestyle throughout their pregnancies and after birth, as many of these substances can get into the baby's system through breast milk. If you are thinking about getting pregnant, talk to your health care provider about how best to promote a healthy pregnancy, in a way that takes your medical history and lifestyle into consideration.
National Institute of Child Health and Human Development
National Institutes of Health
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