Mayo Clinic Guide to a Healthy Pregnancy

Myra J. Wick

• Publisher: Mayo Clinic Press
• Year: 2018
• ISBN:
  9780795351693
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

An essential resource for parents-to-be from the Mayo Clinic, ranked #1 on US News & World Report 's 2020-2021 Best Hospitals Honor Roll. This newly updated book includes information on everything from healthy lifestyle habits to the latest technologies in prenatal care and childbirth. Features include week-by-week updates on baby's growth, as well as month-by-month changes that mom can expect. In addition, you'll find a forty-week pregnancy calendar, an overview of common pregnancy symptoms, information on safe medicine use, tools to help parents with important pregnancy decisions, and general caregiving advice—information moms and dads can trust to help give their little ones a healthy start. The second edition of Mayo Clinic Guide to a Healthy Pregnancy is the collective effort of a team of health care experts who find nothing in medicine more exciting and satisfying than the birth of a healthy child by a healthy mother. Any parent-to-be looking for accurate and authoritative information from a reliable source will surely appreciate this illustrated, easy-to-understand book.

PART 1

Enjoying a healthy pregnancy

CHAPTER 1

Preparing to become pregnant

So you think you want to be a parent — at least sometime in the near future. How exciting! Having a child is a wonderful experience that will enrich your life forever. But the decision to have a child shouldn’t be taken lightly. Parenthood is a lot of work, and the best way to approach it is by preparing yourself so that you’re as ready as possible for this big change.

Thinking ahead can give you and your baby the best possible beginning. If you’re reading this book and are still in the planning stages before becoming pregnant, you’re giving yourself a head start on the exhilarating, sometimes bewildering path toward parenthood. Taking steps to be healthy and informed now can help set you up to enjoy a healthy pregnancy.

This introductory chapter includes some key concepts and actions to take that can help make your transition to pregnancy as smooth as possible. If you already know you’re pregnant, congratulations! You may want to page through this chapter and begin with Chapter 2.

Is the time right?

When your friends with children tell you to say goodbye to lazy weekends and impromptu nights out, and hello to nighttime feedings and loads of baby laundry, they’re not kidding. Having a baby is life-changing. In most ways it’s wonderful, but life will never be the same. Although there’s probably never a perfect time to have a baby, some phases of your life may be more conducive to pregnancy and new parenthood than others.

Questions to ask Here are some questions you might ask yourself in determining whether the time is right:

• Why do I want to have a baby?
• Does my partner feel the same way I do? Do we share the same ideas about how to raise a child? If not, have we discussed our differences?
• How will having a baby affect my current and future lifestyles or career? Am I ready and willing to make those changes?
• Is there a lot of stress in my life right now that could interfere with my ability to care for myself and enjoy my pregnancy? What about for my partner? Is stress an issue?
• Emotionally, are we ready to take on parenthood?
• Financially, can we afford to raise a child? If I’m single, do I have the necessary resources to care for a child by myself?
• Does my health insurance plan cover maternity and newborn care?
• If I decide to return to work, do I have access to good child care?

If you haven’t thought about any of these issues so far, it doesn’t mean you’ll have an unhealthy pregnancy or be unable to care for a child. But the sooner you set the stage for a successful outcome, the better your odds. That’s true whether you’re still in the planning stages, are trying to conceive or already have a baby on the way.

Is your body ready?

You don’t have to be exceptionally fit to have a child, but if you’re healthy to begin with, you have a better chance of enjoying a healthy pregnancy.

So how do you know if your body is ready for pregnancy? Have your care provider give you the green light. Make a preconception appointment with your obstetrician-gynecologist, family physician, nurse-midwife or other care provider who will be guiding you through your pregnancy.

A preconception visit gives you and your care provider a chance to identify any potential risks to your pregnancy and establish ways to minimize those risks, as well as discuss general health issues.

If possible, have your partner attend the preconception visit with you. Your partner’s health and lifestyle — including family medical history and risk factors for infections or birth defects — are important because they, too, can affect you and your baby.

At your appointment, your care provider will likely conduct a complete physical examination, including a blood pressure check and possibly updating your pap smear and pelvic exam. Some of the subjects you might talk about include:

Contraception If you’ve been using birth control pills, a vaginal ring, the patch, a contraceptive implant or an intrauterine device (IUD), you may be able to conceive shortly after discontinuing use. Some women become pregnant before their next period. (Not to worry — an expected due date can still be determined accurately without knowing the timing of ovulation.) If a waiting time is desired after stopping contraception, use condoms or another barrier method until you’re ready to become pregnant. For most women, a normal menstrual cycle will return within three months of stopping birth control.

If you’ve been using contraceptive injections (Depo-Provera), you can try to conceive as soon as you stop receiving regular injections — but it could take up to 10 months or more for fertility to return.

Immunizations Infections such as chickenpox (varicella), German measles (rubella) and hepatitis B can be dangerous in pregnancy. If your immunizations aren’t complete or you’re not sure if you’re immune to certain infections, your preconception care may include testing for immunity and receiving one or more vaccines, preferably at least a month before you try to conceive.

Chronic medical conditions If you have a chronic medical condition — such as diabetes, asthma or high blood pressure — you’ll want to make sure the condition is under control before you conceive. In some cases, your care provider may recommend adjusting your medication or other treatments before pregnancy. He or she may also discuss any special care you may need during your pregnancy.

• • • • •

Prenatal vitamins

One thing you’ll be advised to do right away as you prepare for pregnancy is to start taking prenatal vitamins. If you’re wondering whether this daily routine really matters, rest assured that it does!

It’s best to start taking prenatal vitamins one to three months before conception. Prenatal vitamins help ensure you’re getting enough folic acid, calcium and iron — essential nutrients during pregnancy.

• Folic acid helps prevent neural tube defects. These defects are serious abnormalities of the brain and spinal cord. The critical development of the baby’s neural tube, which becomes the brain and spinal cord, occurs during the first month of pregnancy, when you may not even know you’re pregnant.
• Calcium promotes strong bones and teeth for both mother and baby. Calcium also helps your circulatory, muscular and nervous systems operate normally.
• Iron supports the development of blood and muscle cells for both mother and baby. Iron helps prevent anemia, a condition in which blood lacks adequate healthy red blood cells. Many chewable gummy prenatal vitamins don’t contain iron, so check labels.
• Some research suggests that prenatal vitamins may reduce the risk of low birth weight.

Prenatal vitamins are available over-the-counter in most pharmacies. Typically, a prescription for prenatal vitamins isn’t necessary.

Taking prenatal vitamins prior to conception may help reduce nausea and vomiting in pregnancy. However, if your prenatal vitamins make you feel queasy, try taking them at night or with a snack. Chewing gum or sucking on hard candy right after may help, too. If they seem to make you constipated, drink plenty of water, and include more fiber in your diet and physical activity in your daily routine. Also, ask your care provider about using a stool softener.

If these tips don’t help you tolerate prenatal vitamins, ask about other options. Another type of prenatal vitamin, or taking separate folic acid, calcium and iron supplements, may cause fewer side effects.

• • • • •

Medications and supplements Tell your care provider about any medications, herbs or supplements you’re taking. He or she may recommend changing doses or stopping them altogether before you conceive.

This is also the time to start taking prenatal vitamins. Why so early? A baby’s neural tube, which becomes the brain and spinal cord, develops during the first month of pregnancy, possibly before you even know that you’re pregnant. Taking prenatal vitamins before conception is the best way to help prevent neural tube defects, which can result in spina bifida and other spinal or brain disorders.

• • • • •

Additional nutrients

While prenatal vitamins can help you meet most of your nutrient needs, there are a couple of nutrients you may want more of. Talk with your care provider about these:

• Vitamin D. This vitamin is especially important during the third trimester, when calcium demands increase. Most prenatal vitamins don’t contain optimal amounts of vitamin D. In addition to your prenatal vitamin, drink vitamin D-fortified milk or look for other calcium-rich foods containing vitamin D. If you don’t drink milk daily or eat calcium-rich foods such as yogurt, salmon or kale, it may be wise to take calcium and vitamin D supplements.
• Omega-3 fatty acids. Standard prenatal vitamins don’t include omega-3 fatty acids. The benefits of omega-3 fatty acids on fetal development are uncertain, but there’s some evidence they may promote fetal brain development. If you’re unable to or choose not to eat fish or other foods high in omega-3 fatty acids, talk to your care provider to see if supplementation with omega-3 fatty acids might be appropriate.

• • • • •

Sexually transmitted infections Sexually transmitted infections can increase the risk of infertility, ectopic pregnancy — when the fertilized egg implants itself outside the uterus, such as in a fallopian tube — and other pregnancy complications. If you’re at risk of a sexually transmitted infection, your care provider may recommend preconception screening, followed by treatment if needed.

Family history Certain medical conditions or birth defects run in families and ethnic populations. If you or your partner has a family history of a genetic disorder or may be at risk, your care provider may refer you to a medical geneticist or a genetic counselor for a preconception assessment (see Chapter 20).

Previous pregnancies If this isn’t your first pregnancy, your care provider may ask about previous pregnancies. Be sure to mention any complications you may have had, such as high blood pressure, gestational diabetes, preterm labor or birth defects. If you had a previous pregnancy that involved a neural tube defect, your care provider may recommend a higher daily dose of folic acid than what’s found in most prenatal vitamins.

If you have any concerns or fears about another pregnancy,...