The Importance of Preconception Planning
Intro: MemorialCare Health System, excellence in healthcare, presents Weekly Dose of Wellness. Here's your host, Deborah Howell.
Deborah Howell (Host): Hello, and welcome to the show. I'm Deborah Howell. And did you know that what you do before pregnancy is just as important as what you do during pregnancy? Well, today we'll be talking to Dr. Rachael Lopez, an obstetrician and gynecologist at MemorialCare Saddleback Medical Center, about preconception planning. And we hope you'll find it both interesting and informative. Welcome, Dr. Lopez.
Rachael Lopez, MD: Good morning.
Deborah Howell (Host): Great to be with you today. What is preconception planning?
Rachael Lopez, MD: It is preparing your body, preparing your mindset, and doing appropriate screenings before planning to have a baby.
Deborah Howell (Host): Sounds simple enough. How far in advance should couples plan to start or grow their families?
Rachael Lopez, MD: I think in order to get the, you know, available testing and to kind of have a little lifestyle change, easily three months or so before planning to conceive is a good time to connect with your provider and get some leg work done.
Deborah Howell (Host): Yeah, kind of get the ball rolling. And what considerations do you recommend for women who are high risk due to pre-existing medical conditions?
Rachael Lopez, MD: Without a doubt, it would be very important to see your provider before planning pregnancy. There are some pre-existing medical conditions that will require some real advanced planning. For example, a woman who has diabetes may need to make sure that her blood sugars are under extremely tight control and work with her primary provider and her obstetrician to make sure that the range and values are safe for conceiving a baby.
Deborah Howell (Host): And any other conditions you might want to mention?
Rachael Lopez, MD: Some other common conditions that are a good idea to speak with your doctor about before conceiving would be high blood pressure, certain autoimmune conditions because of the medicines that people may be taking and the effects they may be having on pregnancy, even certain mental health issues because some of the medicines that people take to make themselves stable can also affect a growing baby, and sometimes those things can be changed or modified to be safer before a woman tries to conceive.
Deborah Howell (Host): Got it. And of course, my mom always said, as yours probably did, 'You are what you eat.' So what health and diet considerations should mom-to-be take into account? And maybe what foods should she avoid?
Rachael Lopez, MD: Before trying to conceive, you want to be a healthy weight, if possible. We use this metric called a body mass index, which is height versus weight. And it would be a great idea to get in a reasonable height versus weight range before trying to conceive. Higher weights can be associated with certain extra risks for pregnancy. So for women who are having more impressive weight issues, they may have to actually plan on addressing that six to 12 months before trying to conceive instead of for just three months. I would say starting to adapt a healthy lifestyle, such as avoidance of alcohol and avoidance of tobacco even in the months before you conceive is a good idea. But no specific foods that you cannot eat immediately prior to trying to conceive.
Deborah Howell (Host): Got it. So she can have everything she wants before pregnancy, right?
Rachael Lopez, MD: Yes, but once you begin trying to conceive and you've stopped the contraception, you have to assume that there would be a risk for pregnancy and you have to be careful about over-the-counter remedies. You also have to be careful about alcohol and tobacco, and you have to be careful about medications, which, as I mentioned, is a good idea to discuss any medication you're taking with your provider before planning to conceive.
Deborah Howell (Host): And maybe sushi and grapefruit should be avoided, correct?
Rachael Lopez, MD: During pregnancy itself, yes. Grapefruit, no, you can have grapefruit. But sushi, prior to conceiving is absolutely fine.
Deborah Howell (Host): Well, that's really good news. I know there's a lot of sacrifices during pregnancy, but boy, it's so worth it for a healthy baby. Now, which exams and lab tests should mom-to-be complete before conception, and which immunizations?
Rachael Lopez, MD: Generally, I like to run a panel of labs to check for immunities to common infections in the community, such as measles and rubella and even chickenpox. That way we can offer vaccinations so that we know that going into pregnancy, our moms are immune to these illnesses. Some of the other tests that we offer are going to be specific according to your ethnic background or to your family history. Sometimes we're looking for genetic-type things and testing mom to make sure that she's clear of being a carrier for any illnesses that may be in her family or in her ethnic background. And also always a good idea to be current on your routine pap smear. Those are all of the most important things for planning to conceive.
Deborah Howell (Host): Now we're living in a time of coronavirus, and of course there's no vaccine as yet. Is there anything a mom-to-be can do to strengthen herself in this time?
Rachael Lopez, MD: Eating well, sleeping well, taking a multivitamin, and just following the CDC guidelines: wearing a mask, washing hands, and social distancing. That way we won't have the risk of having coronavirus when you're trying to conceive or having coronavirus once you are in early pregnancy. It is considered a high-risk state because we think that our pregnant women themselves may be a little more likely to have some severe complications from coronavirus versus our non-pregnant women. So just following the CDC guidelines and staying safe is the best.
Deborah Howell (Host): And probably no singing in the church choir.
Rachael Lopez, MD: Exactly. That would not be within the CDC guidelines.
Deborah Howell (Host): All right. Now, most of these conversations are always about mom-to-be, but what tips and considerations can dad or mom's partner do to help give the baby the best start possible?
Rachael Lopez, MD: Well, I think adopting the same healthy lifestyle as mom is a good idea. Of course, parents are going to model behaviors for children, and partners are going to make it easier for mom to comply with getting lots of rest, getting lots of exercise, eating right, and certainly avoidance of smoking and alcohol. Those things can be done as a family to help benefit the growing baby and benefit the baby once it's born. Other than that, you know, there is some data to suggest that things like drugs, alcohol, and smoking might actually affect sperm. So it would be a good idea to abstain from those things before trying to conceive and hopefully even once conception has occurred. And that's really about it for dad. Those are all the big things.
Deborah Howell (Host): Prenatal vitamins are taken during the course of pregnancy. Many women take them outside of the pregnancy situation. What's your opinion on that?
Rachael Lopez, MD: Women who are trying to conceive should start them even if they haven't stopped their contraception yet. You're going to build up folic acid, and folic acid is going to reduce the risk of certain birth defects. So getting that on board and building it up before you've removed your contraception is a good idea because the benefits of that particular vitamin are going to be most important before you even have a positive pregnancy test. So you can begin that anytime. Lots of women feel that taking the prenatal vitamins makes their hair and their nails healthier, which is just fine, but they are just multivitamins. There's not a whole lot that's specific just for pregnancy other than that folic acid. And they're perfectly safe to take whether you're pregnant or not.
Deborah Howell (Host): Okay, good to know. I've always wondered that because I do know quite a few friends who are on them. They just, like you said, they say it makes their hair shiny and their nails harder. And I didn't know if that extra component would be harmful to a non-pregnant woman. And thank you for answering that. Is there anything else our beautiful women should know?
Rachael Lopez, MD: Well, the prenatal vitamins are only beneficial. They're not negative in any way. They won't actually make you pregnant. So if someone had a fear that taking them would make them pregnant sooner than they would like, that isn't the case at all. They just prepare your body in the event that you stop using your birth control. But very, very good idea to begin those in advance.
Deborah Howell (Host): Okay. And who should be on the woman's team during preconception?
Rachael Lopez, MD: Well, certainly their partner, because as I mentioned, that healthy lifestyle and support of good habits is first and foremost. Their primary care provider, you know, is going to be screening them annually even before planning pregnancy, looking for things like high blood pressure and diabetes and other health conditions. And most importantly, their obstetrician-gynecologist, screening them for family issues, screening them for hereditary issues, looking at the big picture about when is the safest time to become pregnant and what special things for each woman they might need to do to prepare for the pregnancy itself.
Deborah Howell (Host): That is perfect. And I would add any other siblings or family members who are going to be important to that baby's life should also be on a team.
Rachael Lopez, MD: Absolutely. You know, as they say, it takes a village. And even preparing for pregnancy, if you have a big extended family involved in your lifestyle, it's not a bad idea to include them in this.
Deborah Howell (Host): Well, thank you so much, Dr. Lopez, for being on our show today. It's been great talking to you.
Rachael Lopez, MD: Thank you very much.
Deborah Howell (Host): For more information and to learn more, couples can go to startingmyfamily.com. And it's also recommended to set up a preconception planning visit with your OBGYN. That's startingmyfamily.com. To listen to the podcast, visit memorialcare.org. That's memorialcare.org. Thanks for listening and have yourself a fantastic day.
