If you’re trying to get pregnant, [that] might be a good window [in which] to really turn around and get healthy, so that you’re preparing the body for the baby and you, and also setting a pattern for lifelong health.— Vandana Sheth, registered dietitian, spokeswoman for the American Dietetic Association
Heather Stott of Charlotte, North Carolina, holds a master's degree in public heath, but she cares about her own health, too. So, “when it came time to try to get pregnant, I did take some extra precautions,” she said.
She lowered her caffeine intake and limited her alcohol intake to one glass of wine per week. She stuck with her regular workout routine, running or cycling five or six days each week, to maintain a healthy weight. She added fresh vegetables and prenatal vitamins to her diet, along with calcium and fish oil supplements. She safely stopped taking her anxiety medication, Lexapro, and sought natural ways to relieve anxiety, because she found no studies on the drug's effects on pregnant women.
"I did not want to chance anything," Stott said.
“One of the biggest concerns that we in OB/GYN worry about is that people start to think about pregnancy only when they’re already pregnant,” said Dr. Robert Atlas, chair of the Department of Obstetrics and Gynecology at Mercy Medical Center in Baltimore, Maryland. “There are things that we wish people did prior to pregnancy that would help them reduce the risk of complications.”
You don't have to have a health degree to prepare for pregnancy. You can change your nutrition, fitness and lifestyle habits to benefit your body and your future baby's wellness.
Eating for Optimal Nutrition
Registered dietitian Vandana Sheth, spokeswoman for the American Dietetic Association, said healthy eating is the foundation for a healthy pregnancy.
This means getting whole grains from products such as cereal, bread or crackers; eating seasonal fruits for optimal nutritional benefits; getting three servings of low-fat, calcium-rich foods daily; eating plenty of green, leafy vegetables; getting protein from lean meats or tofu; and consuming dried lentils, beans and legumes.
“In fact, if you’re trying to get pregnant, [that] might be a good window [in which] to really turn around and get healthy, so that you’re preparing the body for the baby and you, and also setting a pattern for lifelong health,” Sheth said.
Before pregnancy you should also add certain vitamins and minerals to your diet. Get 400 micrograms of folic acid and 425 milligrams of choline daily, both of which are important for a baby’s neural development. Increase your calcium and iron intake, because pregnant women have increased needs of both. Get 1,000 milligrams of calcium per day and increase iron absorption by eating a food rich in iron, such as dark, leafy greens, with a food that has vitamin C, such as citrus.
A multivitamin can also help you get all these essential nutrients if you are expecting to become expecting.
“The biggest thing that someone can do is, in fact, take a vitamin -- a daily vitamin,” Atlas said.
Watching the Way We Consume
While it’s important to consume healthy food and nutrients, it’s just as important to know what to avoid. For women considering pregnancy, the list is long.
For example, meats cooked raw to medium raw and seafood that may be high in mercury could be risky for a fetus. However, for women not yet pregnant, “If you have one serving a week, that should not increase the risk of complications in pregnancy,” Atlas said. “Moderation is the key.”
Then there are caffeine, nicotine and alcohol.
“Caffeine has been shown in an eloquent study to ... increase the risk of miscarriage,” Atlas said. He recommends limiting caffeine consumption to 200 milligrams per day -- about one 12-ounce cup of coffee.
“Alcohol is the No. 1 preventable cause of mental retardation,” Atlas explained. Pre-pregnancy, alcohol consumption is acceptable, but once pregnant, “there is no known safe amount of alcohol consumption," he said, so it's best to habitually limit alcohol intake if you're trying to conceive. Seek help for binge drinking or other alcoholism symptoms before becoming pregnant. The same goes for smoking, Atlas said; smoking while pregnant can cause serious damage to your child, including heart disease, cancer and blindness.
Women also should consult a doctor about any vitamins or herbal supplements they're taking, Sheth said. Consuming more than the recommended daily dose of vitamin A, for example, can harm a fetus. Herbal supplements are not always dangerous, but they're unregulated by the U.S. Food and Drug Administration.
Finally, a host of medications are known teratogens, or agents that can cause harm to a fetus, Atlas said. Examples include Depakote, a drug used to treat bipolar disorder and seizures; Paxil, used to treat anxiety or depression; ACE inhibitors, used to treat hypertension; and Accutane, used to treat acne. If you're on medication, consult with your doctor before trying to conceive.
Practicing Healthy Habits for a Healthy Pregnancy
"Motherhood is a sport. ... It’s the longest marathon you’re ever going to run," said Ilene Bergelson, a fitness trainer and founder of Lifemoves Health in New York City. Bergelson trains women before and during pregnancy.
It’s important to be in a healthy weight range when planning to conceive, she said.
Atlas agreed. “Patients who are in the obese category ... are increasing their risk of pregnancy complications. The heavier you are, the higher the risk,” he said.
A normal body mass index for a woman is between 18.5 and 24.9; a woman is in the obese category when her BMI is 30 or above.
Exercise also relieves stress, which may play a role in fertility. In a May 2000 study, the National Institute for Occupational Safety and Health could not prove a link between workplace stress and fertility, but "studies among couples going through infertility treatments have found that those who have the highest success rate maintained lower levels of stress," wrote registered dietitian Amy Ogle and Dr. Lisa Mazzullo, an OB/GYN, in their book, "Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception."
Ogle and Mazzullo recommended spending time outdoors, sleeping for seven or eight hours each night, developing an optimistic attitude, and practicing restorative habits, such as taking an hour before bed to relax with your spouse each night, as ways to reduce stress.
By learning healthy habits, women can approach pregnancy with confidence knowing they’ve done everything they can to prepare.
Stott said her frustrations rose each month as she and her husband tried to conceive. "We went through a great deal of heartache [and] ups and downs to create this special girl," she said. "Education prepared me ... in managing my health pre-, during and after pregnancy."
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