What every woman needs to know pre-pregnancy

INDIANAPOLIS (WISH) - Having a healthy pregnancy starts well before conception. Women who focus on protecting their future baby’s health have a few critical steps to take now

For women, the do’s and don’ts during pregnancy are quite well known (don't eat raw fish, don't drink alcohol, make sure to exercise), but it seems women rarely know what critical steps to take before pregnancy that can affect the health of their child later in life.

“Women need to do several things prenatally,” says Dr. Mary Abernathy, IU Health Perinatologist at University Hospital. “I would say the most important things would be to start taking a prenatal vitamin, reach their ‘goal weight’ and stop smoking.”

Dr. Abernathy is ranked by US News as a “Top Doctor” in Indiana, achieving national recognition for outstanding work. Her area of expertise, perinatology (maternal-fetal medicine), is a subspecialty of obstetrics concerned with the care of the fetus and complicated, high-risk pregnancies.

“I’m the doctor women shouldn’t want to see,” Abernathy says. “I deal with women who have some of the higher-risk pregnancies.”

Pregnancies are deemed “high risk” when the mother is dealing with health issues like high blood pressure, diabetes or infectious disease. A suspected fetal anomaly or family history of heart disease might warrant the help of a perinatologist.

Karrie Theoharis, 35, is one such patient who required extra care during pregnancy.

"I gave birth to my first child in 2010, and at that point I was really overweight, considered to be obese,” says Theoharis. "I had high blood pressure, I was on two medications. So, before I got pregnant with my second child, I decided that I needed to get into better shape."

Theoharis used Weight Watchers to successfully lose 90 pounds. Because of the weight loss, she was able to stop using her medication and become more active before her second pregnancy.

“I knew after having my first baby that something needed to change. I just didn’t feel like I was being a good mom to my baby. I was actually worried about my baby’s health.”

Theoharis’ concerns were applauded by Dr. Abernathy, who says, arguably, the most important weight-scale reading is the one a woman logs before she becomes pregnant.

Lose the Weight
"If you want to have the perfect pregnancy, prepare yourself to be kind of like an Olympic athlete,” says Abernathy. “Be in good training mode to go through this rigorous 9-10 month pregnancy and put yourself in the best shape you can – put yourself as close to your ideal body weight as you can.”

An out-of-shape, overweight pregnant woman puts herself at risk for high blood pressure, diabetes and trauma at delivery. Her unborn baby is at risk of being too large at birth and possibly having ill health later in life.

"There are more and more studies that are showing that babies that have not-the-ideal inter-uterine environment, that may affect their lives further down the road,” Abernathy said.

Continuing to exercise during pregnancy is also important. According to research published in the official journal of the American College of Sports Medicine , low or moderate exercise and healthy eating habits markedly decrease the likelihood of excessive gestational weight gain.

Fill up on Folate
The Centers for Disease Control estimates half of all pregnancies in the U.S. are unplanned . For this reason, the agency suggests all women between the ages of 15 and 45 consume 400 micrograms of folate daily.

It is well known in the medical community that adequate amounts of folate before and during pregnancy prevents birth defects – the most noted of which is neural tube defects – which can occur in the first 4 weeks after conception, before many women even realize they’re pregnant.

The Centers for Disease Control estimates that most of these birth defects could be prevented if this recommendation were followed before and during early pregnancy.

So how much do you need? Dr. Abernathy recommends women planning on becoming pregnant should consume between 800 and 1200 mcg of folate per day for several months before the start of pregnancy.

To increase your folate intake before and during pregnancy, eat foods on the National Institutes of Health’s list of folate-full foods . Start by eating more vegetables like: romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets and lentils.

For many women, the answer to getting increased intake of folate is to supplement a good diet with an over-the-counter prenatal vitamin. The Mayo Clinic suggests this easy guide for what to look for in a prenatal vitamin:
Folic acid — 400 to 800 micrograms
Calcium — 250 milligrams
Iron — 30 milligrams
Vitamin C — 50 milligrams
Zinc — 15 milligrams
Copper — 2 milligrams
Vitamin B-6 — 2 milligrams
Vitamin D — 400 international units

As the Mayo Clinic suggests, prenatal vitamins are a complement to a healthy diet — not a substitute for good nutrition and “prenatal vitamins won't necessarily meet 100 percent of your vitamin and mineral needs.”

"[Pregnant women need] something that gives them some folate and makes sure they're getting a little iron in it, as well as some of the other vitamins and minerals,” says Abernathy.

Stop Smoking
Kicking the habit may seem like an obvious suggestion pre-pregnancy, but in 2010 – the most recent year for which data is available – 17.1 percent of pregnant women in Indiana admitted to smoking during pregnancy .

Babies born to women who smoke during pregnancy are more likely to be born :
- With birth defects such as cleft lip or palate
- Prematurely
- At low birthweight.

A study recently published in the Journal of the American Medical Association found that children born prematurely were at greater risk for lower cognitive test scores and behavioral problems when compared to full-term children.

How widespread is the problem? The Indiana State Department of Health  reports 8 percent of the 83,867 babies born in 2010 were born with a low birth-weight.

If you want to know how your Indiana county performs in maternal health, go to the state’s report HERE.

The March of Dimes has a full checklist of things you can do to get healthy before pregnancy. To read it, click on the link here .