Ready, set, get pregnant
10 things to do before you conceive  

Margaret Bream Paradoxically, good parenting begins well before you become a parent. “In fact, it starts before your pregnancy,” says Dr. Dan Farine, a University of Toronto professor of obstetrics and gynecology. To ensure your baby will be as healthy as possible, follow the doctor’s list of must-dos before you try for a child.

Photo: Mike Agliolo / SuperStoc

1. Have a general checkup, including a blood pressure test. High blood pressure may harm blood vessels in the placenta, reducing the flow of blood, oxygen and nutrients to the fetus and restricting growth. High blood pressure in early pregnancy triples the mother’s risk for developing pre-eclampsia, a condition that can lead to seizures (eclampsia), blood coagulation disorder, bleeding and liver or renal failure in the mother.
2. If you have diabetes, get your blood sugar levels under control before attempting to get pregnant. And if you have risk factors for diabetes—such as a parent or sibling with diabetes or a high body mass index (BMI)—get your blood glucose levels checked. Maternal high blood sugar early in pregnancy affects fetal development and places babies at a higher risk for structural and cardiac abnormalities.
3. Start taking a folic acid supplement three months before attempting to conceive. This is a B vitamin crucial for cell division and is known to reduce neural-tube birth defects of the spine (spina bifida: open spine) and the skull (open skull). Most women should take 0.4 milligrams (mg) of folic acid daily; women who have diabetes or epilepsy, or who have had a baby with spine or skull defects should take 5 mg daily. Eat more foods rich in folate (folic acid’s natural form): dark green vegetables such as spinach, broccoli and asparagus; legumes such as beans and lentils; whole grains and liver.
4. Adopt a healthy lifestyle that includes following Canada’s Food Guide to Healthy Eating. Reduce consumption of harmful trans fats (as found in hydrogenated margarine, commercial snack foods and french fries, baked goods and battered fish and chicken). These have been linked to low birth weight in infants. Establish or maintain a reasonable exercise regimen, but check with your doctor before beginning a new program. Getting in shape at least three months before conceiving will make it easier to maintain an active lifestyle during pregnancy. Good preconception activities include walking, jogging, swimming and aerobics. Try for at least 30 minutes of activity on most days of the week.
5. Visit your dentist for an oral health checkup and for cleaning and scaling. Get periodontal work done, if necessary. Maternal gum disease has been linked to an increased risk of premature delivery and low birth weight. Toxins released by bacteria may slow fetal growth and promote the production of inflammatory chemicals that cause the uterus to dilate and contract.
6. Stop drinking alcohol. Safe levels of alcohol in pregnancy have not been established. Alcohol is a toxin capable of causing serious defects in the baby. But don’t panic if you’ve been moderately consuming alcohol and unexpectedly learn you are pregnant. In men, heavy alcohol consumption can lower levels of the male hormone testosterone and reduce sperm production.
7. If you smoke, quit. And that goes for your partner, too. Smoke is full of toxic chemicals, and smoking is a known cause of low birth weight. It robs the fetus of oxygen and exposes it to cancer-causing compounds. Tobacco toxins can also affect the health and mobility of sperm.
8. Check out your prescription medicines. Ask your doctor if they are safe to take before you conceive and during your pregnancy. Many prescribed medications—the acne drug Accutane, for example—are harmful to the developing fetus.
9. Discuss non-prescription preparations. These include supplements, herbal remedies and recreational drugs. Some over-the-counter medications, such as ASA (especially in the third trimester), and many herbal products, such as black cohosh and dong quai, are not recommended for pregnant women.
10. Reduce exposure to workplace hazards.  Contact with radiation and with chemicals such as the commercial solvents used in dry-cleaning, for example, can increase the risk of miscarriage and fetal malformation.

For further information on preconception, visit www.canadian-health-network.ca and www.motherisk.org