Prior To Conception

Recently Answered

• QWhy should I see a counselor before getting pregnant if I have diabetes?

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  A American Diabetes Association answered

  Because you have diabetes, you need special care and advice from your diabetes doctor, nurse, and health care team before you get pregnant. This "preconception counseling" is individualized for the needs of each woman. Ideally, preconception counseling should be a part of every routine diabetes clinic visit for all women of child-bearing age, starting at puberty, before a woman becomes sexually active.
  
  Preconception counseling will help you:
  
  

  • prevent an unplanned pregnancy.
  • take care of your diabetes before and during your pregnancy to give you the best chance of having a healthy baby and preventing complications.
• QWhat can I do before I am pregnant to have a healthy pregnancy?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  

  Remember that 50 percent of pregnancies are not planned, so it is important to take a healthy approach to pre-pregnancy planning. So if you're a woman of childbearing age and not using birth control, you should follow these steps to better your chances of a healthy pregnancy.
  

  1. Stop smoking
  2. Stop drinking alcohol
  3. Stop using recreational drugs
  4. Avoid second-hand smoke
  5. Begin to floss every day if you do not already

  

  Find out more about this book:

  YOU: Having a Baby: The Owner's Manual to a Happy and Healthy Pregnancy
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• QWhat are some comfortable sexual positions during pregnancy?

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  A Dr. Hilda Y. Hutcherson, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Good In Bed

  

  While you can usually enjoy intercourse all the way up until your due date, some positions are more comfort¬able than others. You may have to give up your favorite position, or modify it a bit to make it comfortable. Be creative! It’s part of what makes sex fun during pregnancy and beyond. In general, any position that puts pressure on the woman’s back or stomach can be tough: Not only can her baby bump get in the way, but after the fourth month, lying on her back can cause her growing uterus to put pressure on major blood vessels in her body. Instead try these positions and experiment to see what feels right for both of you:
  
  • Woman on top In this position, the man lies on his back while the woman straddles him. It takes the pressure off her back and belly, allows her to control the depth and speed of thrusting -- and gives him a great view! This position is great in the first and second trimesters. Increased weight and size of ab¬domen may make it difficult to maneuver in the last trimester.
  • Sitting A variation on woman on top, this position involves the man sitting in an armless chair, with the woman facing and straddling him. It is extremely intimate and allows you to gaze in each other’s eyes. This position is best during the first and second trimester.
  • Side by side You both lie on your side, facing each other. This position also keeps the weight off her belly, supports the uterus, and may also make you feel particularly intimate. Enjoy it during the first trimester and early second trimester.
  • Spooning The same position that allows for such good post-sex cuddle is also great for intercourse during pregnancy. The man lies on his side behind the woman, facing her back. This takes the pressure off her belly and prevents deep penetration, which may be uncomfortable later in pregnancy. This posi¬tion is perfect during the last trimester.
  • Hand and knees Also known as rear entry or “doggy style,” this position places the woman on her hands andin knees with her partner entering her from behind. Place a few pillows under her belly and breasts to help support them. Try it during the first, second, and early third trimesters. Because this position can result in deeper penetration, you may want to avoid it later in the third trimester.
  • Modified missionary position She lies on her back, pulls her knees up to her chest, and rests her feet on his chest or, if she’s really flexible, on his shoulders. He kneels and enters without placing his weight on her body.

  

  Find out more about this book:

  The Good in Bed Guide to Sex and the Baby Years
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• QWhat medical tests can help determine if I will be able to get pregnant?

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  A Dr. Jennifer A. Kalich, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Carolinas HealthCare System

  Several tests may help gauge a patient's fertility potential, also known as ovarian reserve:
  

  • Day 3 levels of FSH and estradiol: Follicle stimulating hormone (FSH) is a hormone released from the brain that triggers egg development by the ovary. Estradiol is the hormone produced by the ovary as the egg develops. Patients with an elevated estradiol and/or FSH level on the third day of a menstrual cycle have poor pregnancy rates with both ovulation induction and in vitro fertilization.
  • Clomiphene citrate challenge test (CCT): The day three FSH and estradiol levels may be normal in patients with decreased ovarian reserve. The CCT is another test to more thoroughly evaluate fertility potential. Clomiphene citrate is a medication given orally on menstrual days five through nine. Estradiol and FSH are measured on day three and day 10 of the cycle. Elevated blood levels of these hormones are associated with very low pregnancy rates with fertility treatment.
  • Response to fertility medications: The response to injectable high-dose fertility medications is another method for determining ovarian reserve. Patients with decreased ovarian reserve require larger amounts of medication to produce eggs and generally have lower pregnancy rates with ovulation induction and in vitro fertilization. Egg donation is an option for those patients who do not conceive with other therapies or have abnormal ovarian reserve testing. Egg donation involves using eggs donated by another woman. Patients may provide a donor (typically a sister or close friend) or an anonymous donor may be provided.
• QHow can I safely and effectively lose weight before getting pregnant?

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  A Brigham and Women's Hospital answered

  Pregnancy complications are increased in obese women, and individualized pre-conception assessment and counseling are strongly recommended. Before pregnancy, a specific weight reduction program tailored to the individual woman should/could include diet, exercise, and behavior modification. These should all precede a surgical remedy and be given an appropriate time to have an effect. Fortunately, for those who do choose the surgical remedy, recent studies have not shown (early studies did) an increase in adverse perinatal outcomes.

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• QIs it safe to get pregnant if I have multiple sclerosis (MS) or epilepsy?

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  A Multiple Sclerosis Foundation answered

  The largest study to date of pregnant women with multiple sclerosis (MS) or epilepsy shows that women with the disorders face only a slightly elevated risk of abnormal fetal growth rate and cesarean section delivery, and are not more likely to have blood pressure problems or deliver prematurely. The study appeared in a medical journal of the American Academy of Neurology.
  
  After factoring for maternal age, race and ethnicity, the researchers found that MS and epilepsy were associated with mildly increased rates of c-section delivery (42.4 percent for women with MS and 44.5 percent for those with epilepsy, compared with 32.8 percent for healthy women) and abnormal fetal growth rate (2.7 percent for those with MS and 3.8 percent for those with epilepsy, compared with 1.9 percent for healthy women).
• QWhat is birth spacing?

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  A March of Dimes answered

  Birth spacing is the period of time between giving birth and getting pregnant again. It's also called pregnancy spacing or interpregnancy interval (also called IPI). It's best to wait at least 18 months (1½ years) between giving birth and getting pregnant again. Too little time between pregnancies increases your risk of premature birth (before 37 weeks of pregnancy). The shorter the time between pregnancies, the higher your risk. Learn more at: marchofdimes.org/birthspacing
• QWhen should I plan my next pregnancy?

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  A Riverside Health System answered

  Having another baby might be the last thing on your mind right now. But getting pregnant too soon after giving birth can be risky. One recent large study found that becoming pregnant less than six months after giving birth increased the risk of preterm birth by 41 percent. And becoming pregnant 6 to 12 months after giving birth increased the risk of preterm birth by 14 percent. The study also found that getting pregnant between 12 and 18 months after giving birth posed no significant increase risk of preterm birth. A separate study had similar results, and also found that babies born to mothers who waited more than 59 months to become pregnant again had a 20 percent to 43 percent increased risk of health problems.

  The take-home message is that planning your next pregnancy if you want more children or preventing a pregnancy if you don't is important. Spacing pregnancies at least 12 months apart will give your body time to fully recover. In the meantime, using reliable birth control is the best way to prevent pregnancy until you decide if and when to have another baby. Talk to your doctor about your birth control options. Keep in mind that breastfeeding alone isn't a foolproof way to prevent pregnancy, and some birth control methods should not be used by breastfeeding mothers.

  This information is based on source information from the National Women's Health Information Center.

• QIf I'm Rh negative,should I have a RhoGAM shot before I get pregnant?

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  A Dr. Margaret L. McKenzie, MD , OBGYN (Obstetrics & Gynecology), answered

  

  You may need to have a RhoGam shot if you are Rh negative. Watch this video to learn why you may need to get the RhoGAM shot before you become pregnant.