If you have decided to get pregnant, consult your health care clinician about your overall health status. Make certain you tell her/him you are considering pregnancy. A preconceptional evaluation should include a complete physical examination, complete history (including your family history) and the following tests. If your evaluation doesn’t include these aspects, go see a health care clinician who specializes in women’s health care.
The History
Your health history is an amalgamation of your genetic code, your environment, and your personal growth on all levels (physical, spiritual, emotional, social). Your personal and family history should include assessment on several aspects of health:
- Your race and ancestral background (are you at risk for sickle disease, thalassemia or Tay-Sachs?)
- Your age (the chance of having chromosomal abnormalities increase with age)
- Chronic diseases (such as diabetes, lupus, thyroid problems, heart/lung disease or kidney problems)
- Congenital abnormalities (that is, birth defects, in either yourself or family members)
- Hereditary illness (such as muscular dystrophy, Huntington’s chorea, hemophilia)
- Your obstetrical and gynecologic history
- Sexual history and risk for sexually transmitted disease
- Medications you are taking
- Your nutrition and nutritional habits
- Environmental hazard exposure (on the job, in your home, and in your recreation)
- Your alcohol and street drug usage
- Abuse history (sexual, physical and emotional)
- The history of your baby’s father
Preconceptional Laboratory Tests
If s/he doesn’t suggest it, ask your clinician to screen you for anemia, diabetes, immunity to German measles (see Rubella), and sexually-transmittable disease (if you are at risk).
If you are anemic, find out why……if you are iron-deficient, ask your clinician to assess that problem thoroughly. Ask your clinician to order a blood count that shows the “red blood cell index” , not just a hematocrit. If you are vegetarian or vegan, ask about B12 deficiency. You may want to see a nutritionist.
If you have high blood sugar, do NOT get pregnant until you have consulted a physician and your blood sugars are under control. That statement deserves repeating……if you have any sign of diabetes, do not get pregnant until you have consulted a M.D. physician and received his/her blessing to get pregnant. Go rent the movie, “Steel Magnolias”…..it may be a Hollywood “chic flick”, but there’s a sub-plot there about diabetes and pregnancy that contains a bit of truth. Women with pre-existing, insulin-dependent, diabetes who get pregnant have alarmingly high rates of birth defects, toxemia and stillbirth.
The Rubella virus which causes German measles can cause birth defects. If you are not immune to German measles, get the vaccination before you get pregnant.
If you are at risk for sexually transmitted disease, you should be screened and treated (if necessary) before becoming pregnant. The germs which cause gonorrhea, chlamydia, syphilis, AIDs, Hepatitis B and herpes can all be transmitted to a developing fetus or newborn. If you are HIV-positive, you should carefully consider your future with regards to childbearing. The risk of transmission of the viurs to your unborn baby is about 25% (much less if you are treated with certain medications during your pregnancy!). Herpes is a special situation which is explained HERE. If you carry the Hepatitis B virus, precautions must be taken to keep your newborn baby from being infected…….if your partner carries the Hepatitis B virus (or if you have sex with more than one partner [or your partner does!]) you should be vaccinated before you get pregnant.
Don’t forget about the Glossary.