A printable discussion guide to bring to your OBGYN or midwife.
Choosing to have a baby and start this crazy journey we call motherhood can be one of the most terrifying and most rewarding decisions you will ever make in your life. If you are anything like me, I'm sure that you like to do everything in your power to be prepared for big life events— especially ones that include bringing a new little human into the world.
If you're wondering why you should have a preconception visit at all, here's why:
Most of your baby's organs start to form in the first 3-10 weeks of pregnancy, and about 30% of women don't have their first prenatal visit until after week 12—long after a lot of crucial development has already occurred. The goal of a preconception visit is to identify any risks to you, the baby, and your pregnancy, and then to minimize those risks and maximize your overall well-being. Take your partner with you, because at this visit, your doctor will ask you (and your partner) all sorts of past health and family history type questions.
With that in mind, I've put together 9 important questions you should ask your OB at your preconception visit.
1. Am I at a healthy weight?
If you are overweight or underweight, you may have irregular periods and find it harder to conceive (check out “6 Tips for Getting Pregnant Fast"), and both extremes are linked to pregnancy problems for mom and baby.
2. Am I at risk of any exposures?
Cats, for example, can carry a parasite called toxoplasmosis, so while only weakly associated with acute infection in humans, to be on the safe side, your partner should clean the litter box during your pregnancy. Also be sure to avoid lead, mercury, radioactive substances (no x-rays or CT scans unless necessary), and certain solvents. If you aren't sure if it's safe, ask your doctor.
3. Does my family history of “x" matter?
Ask around in your family to investigate if any of your relatives were born with a birth defect, had developmental delay, or any other genetic syndromes, and ask your partner to do some digging with his family too. These are things your provider will want to know as certain genetic conditions could be passed on to your kiddos. The preconception visit is the time that you and your partner can be screened (with a simple blood/saliva test) to see if you are carriers of certain conditions, allowing you to take steps to minimize your chances of passing them on.
4. Are the medications I'm taking safe for pregnancy?
Make sure you take a list of ALL the medications, supplements, and vitamins you are taking for your doctor to look over. Some medicines/supplements are known to cause birth defects and you may need to be switched to something else while you are pregnant.
5. Are my health conditions in good control?
Pregnancy, while generally a state of wellness, can wreak havoc on your body and pre-existing health conditions. High blood pressure, seizure disorders, diabetes, depression, clotting disorders, and hypo/hyperthyroidism are some examples of things that may require special attention or medication adjustments throughout your pregnancy. Also let your doctor know of any surgeries you've had or if you ever had problems with anesthesia.
6. What is a good exercise regimen?
If you already have a workout routine you like, your doctor will most likely tell you to continue. If you do not, they will encourage you to start. Some studies have shown that regular exercise during pregnancy may be associated with reduced risk for cesarean delivery.
7. Does anything in my obstetric or gynecologic history affect this pregnancy?
If you have a history of irregular periods, abnormal paps, surgery on your cervix, sexually transmitted infections, ectopic pregnancy, terminations, or any other gynecologic surgery, your doctor will need to know. Also be sure to mention any history of recurrent miscarriage, preterm birth, preeclampsia, or gestational diabetes.
8. Do you recommend a prenatal vitamin?
Most of the time any prenatal vitamin with 400mcg of folic acid will do. However, if you are on certain medications or have a history of a child with a neural tube defect, you may need more folic acid.
9. Are my vaccinations up to date?
This is important to ask at your preconception visit because some vaccines, like the MMR vaccine (Measles, Mumps, Rubella) and Varicella (Chicken pox), are not safe to receive during pregnancy. However, these infections can cause severe problems with your baby if you were to get them while pregnant, so being immune is best for your health and that of your baby.