Have you and your spouse or partner decided you’re ready to have a baby? It’s exciting to think about, that’s for certain. Before getting caught up in the excitement of trying to conceive, however, you should think about planning a trip to your doctor. Seeing your doctor before you get pregnant provides an opportunity to make sure that you’re as healthy as possible—and it allows you to test for certain conditions that might affect your pregnancy (even before it happens).
So, what happens at this pre-conception visit? Basically your doctor will review your medical history, as well as your family history to try to determine factors that could adversely affect the health of you or your baby. For example, if you haven’t quit smoking yet, now is the time! Your doctor will also review your immunizations to see if you’re at risk for things like Rubella (German measles) or Varicella (Chicken pox), and if you are at risk, your doctor may recommend that you be immunized before attempting conception.
This is also the perfect time to ask questions about your diet and making sure that you’re getting enough nutrients and protein. For example, all women trying to conceive should be taking folic acid supplementation. Folic acid has been shown to significantly reduce a specific type of birth defect, but needs to be present at the earliest stages of pregnancy (even before you might know you’re pregnant). Pregnant women should not drink alcohol and should limit their intake of fish with high methyl mercury content (check with your physician about the specific fish in your area that have a high mercury content). If you’re vegan or vegetarian, speak with your doctor about additional nutritional demands in pregnancy to ensure that you’re getting all of the nutritional elements that you need.
Although all women should talk with their doctor before planning a pregnancy, this is most important for women with chronic diseases, such as diabetes, thyroid disease, epilepsy, kidney problems, high blood pressure or anyone taking prescription medications. Some diseases, or the medications that are used to control them, can adversely affect pregnancy. You and your doctor can make sure that your condition is under the best control possible when you start trying. With all prescription medications, you should ask your doctor if the medications that you are currently taking are compatible with pregnancy or if you will need to change medications. In some cases, your doctor may want you to meet with a specialist in Maternal Fetal Medicine (doctors that specialize in high risk pregnancies) to provide the best care during your pregnancy.
In addition to making sure that you’re as healthy as possible, your doctor may also ask questions about your family history to see if there are other tests that you should check to ensure that your baby is healthy as well. Tell your doctor if there is a family history of birth defects and what your ethnic background is. Depending on your ethnic background and family history, your doctor may want to screen you to see if you’re a carrier for certain genetic disorders. If you test positive as being a carrier, your doctor may recommend that your partner be tested as well, to better predict your chances of having an affected child. If you’re at risk for passing on an inherited disease to your baby, your doctor can recommend prenatal (or sometimes even pre-conception) options to test for these diseases.
Although this may seem overwhelming to think about, even before you’ve started trying, making sure that you’re as healthy as possible and preparing in advance will help to make your pregnancy go smoothly.
Dr. Christine Skiadas is a board-certified obstetrician and gynecologist at Harvard Vanguard Medical Associates and a subspecialist in reproductive endocrinology and infertility. A native of Boston’s South Shore, she received her medical degree from The University of Pennsylvania. She completed her Obstetrics and Gynecology residency at the combined residency program of Brigham and Women’s Hospital and Massachusetts General Hospital and her fellowship in reproductive endocrinology and infertility at Brigham and Women’s Hospital. She has presented at multiple international conferences and is a published author on numerous topics including embryo selection and single embryo transfer. Dr. Skiadas prioritizes the patient experience, delivering focused medical care with a personalized, caring approach to treatment. In addition, she is skilled in robotic surgical techniques and can provide her patients with the highest level of modern, operative care.