HEALTHfocus
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Ideally, prenatal care should begin even before a woman becomes pregnant with pre-conception counseling. “This allows us to provide pre-education about their pregnancy, identify potential problems early on and make sure any existing health conditions are under control,” says Mark Carlson, MD, OB/GYN at Nebraska Methodist Health System. “One of the first things we like to recommend is that you start on prenatal vitamins with .4 milligrams of folic acid several months before you become pregnant. Folic acid helps prevent neural tube defects by helping the baby’s spine to close properly. Neural tube defects develop early on in the pregnancy. If a patient does not begin prenatal vitamins before their first visit, it could be too late.” Pre-conception counseling also allows your doctor to ensure pre-existing conditions like diabetes, thyroid disease and lung conditions are well contained before becoming pregnant. There also are many things women can modify on their own, like smoking, drinking, drug abuse and obesity, that will help decrease complications. “The risk of diabetes and primary c-section goes up greatly in obese women,” says Dr. Carlson. “These women may also require bed rest before delivery and more time for recovery after delivery. If they can bring their weight down before becoming pregnant, their pregnancy is likely to go much smoother.” Education is an important part of prenatal visits. This includes things like eating a healthy diet, exercising regularly and staying well hydrated. “Becoming pregnant doesn’t give you the green light to eat whatever you want, whenever you want,” says Dr. Ziegenbein. “Your baby only needs 300 to 400 extra calories a day. The recommended weight gain is 25 to 35 pounds. A large amount of weight gain can lead to a variety of problems such as preeclampsia, diabetes, still birth, infection and increased rate of c-section.” Women who were exercising before pregnancy can continue exercising as long as it is comfortable. If you have not been currently exercising, low impact exercise like walking, bicycling, swimming, water aerobics and using an elliptical are strongly encouraged, says Dr. Carlson. “Staying hydrated, especially in the summer, is very important as the body is very sensitive to dehydration during pregnancy,” he says. Foods, drinks and habits to avoid during pregnancy include alcohol and drugs, smoking, excessive caffeine, unpasteurized cheese, raw fish like sushi, and any fish that may carry high levels of mercury. This includes tuna, swordfish and mackerel. Getting vaccinated for the flu and the H1N1 virus should also be high on your priority list. Women are also counseled about some of the red flags that might indicate potential problems. For preeclampsia, this could include symptoms like swelling of the hands and face, headaches that don’t go away, abdominal pain in the right upper quadrant, and blurry vision. Gestational diabetes usually doesn’t cause any symptoms and rarely can cause excessive thirst and increased urination. Conditions that might signal pre-term labor include: cramping, more than four to six contractions in an hour, pelvic pain that doesn’t go away when you lay down, discolored discharge, lack of fetal kick movements after 28 weeks, and vaginal bleeding.
42 HER • AUGUST/SEPTEMBER 2010 • WWW.READONLINENOW.COM