When planning for pregnancy, there is an opportunity to optimize your health prior to becoming pregnant. This can be beneficial to both you and your baby. For this reason, we ask that you call to schedule a “Preconception Appointment.” Please contact your insurance company to see if this appointment is covered under your plan.
This appointment is an opportunity for you and your physician to discuss some of the following:
- Your current contraception and when to discontinue this.
- Your obstetric history including history of miscarriage, termination, prior vaginal or cesarean deliveries. If you have had a cesarean section, we will discuss the optimal plan for delivery of subsequent pregnancies. This conversation involves a close look at the reasons for your first cesarean, so having those records transferred to us prior to this appointment is very helpful. We can help discern if you are an appropriate candidate for a Trial of Labor after cesarian section (TOLAC ) or Vaginal Birth after Cesarian (VBAC).
- Your general medical health – especially issues like diabetes, high blood pressure, depression, and optimizing your weight prior to conception.
- Your current medications. This entails a discussion of the risks and benefits of each medication as well as healthier alternatives during pregnancy if they are available.
- Lifestyle changes to benefit both conception and pregnancy. It is important not to expose a fetus to smoking, alcohol, and other drugs. Moderate regular exercise during pregnancy is safe and recommended for most people during pregnancy and it is best to start this prior to becoming pregnant.
- Prenatal vitamins and nutrition. It is important to ensure that you are getting adequate amounts of some vitamins before becoming pregnant. At this time we can also prescribe a prenatal vitamin for you. It is ideal to start taking the vitamin 3 months prior to becoming pregnant.
- Folic Acid (folate): Ideally, you should start taking at least 800 micrograms (mcg) or 0.8 milligrams (mg) of folic acid before conceiving. All prenatal vitamins contain this amount of folic acid. This helps prevent Neural Tube Defects (NTD), a spine-development defect of the fetus. There is also new research suggesting that this decreases risks of abnormal development of the fetus’ heart as well.
- Eating healthy foods during pregnancy that include Vitamin D, Calcium Iron, and Omega-3 fatty acids are also important for both you and your baby.
- Vaccination history and immunity. We generally recommend laboratory testing to determine your blood type and whether or not you are immune to certain illness which can affect pregnancy like rubella (German measles) and varicella (Chicken pox).
Carrier screening for genetic disorders is available at your preconception appointment. Preconception is a great time to consider carrier screening. Please inform your health care provider if you or your partner have a personal or family history of birth defects or genetic disorders. Please call your insurance provider to see if genetic counseling appointments are covered under your plan.
When you begin planning for pregnancy, this can be a good time to discuss with your doctor your cycle timing to help you achieve a pregnancy. Infertility evaluations are generally not covered by your insurance and we request that you find out your fertility coverage before scheduling an appointment.