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A healthy baby starts at pre-conception

March 8, 2012
By STACEY KUKKONEN - DMG writer ( , The Daily Mining Gazette

Editor's note: This is the first in a series of three articles regarding pregnancy.

LAURIUM - About 50 percent of pregnancies in the United States are thought to be unintended.

"It would be nice if we lived in a perfect world where women intentionally got pregnant, but we don't," said James Feeley, M.D., OB/GYN with Aspirus Keweenaw in Laurium.

But because half are not, many couples are missing out on a prime opportunity to meet with their health care providers before conceiving. During this time, they learn about how to begin a healthy pregnancy and become informed about complications along the way.

Feeley, who meets with many couples a year at Aspirus, said he sometimes doesn't even see some pregnant women until they are already at the end of their first trimester; therefore, he cannot inform the couple of risk factors that go along with early pregnancy.

An important point, Feeley said, is that anyone taking a prescription medication should see a doctor before conceiving, as there are a series of healthy steps to consider.

These days, doctors are seeing patients who take medications well into the early stages of their pregnancy without knowing which prescriptions are safe to take, he said. A pre-conception consultation is important for parents-to-be to learn about vitamins and dangers.

"Something we are seeing more and more of now is people who are being medicated for psychiatric issues," he said. "That's where a pre-conception appointment would be very useful."

Drugs like antidepressants can have a negative effect on a developing fetus, Feeley said. As soon as a woman becomes pregnant, she should see her physician right away and nix the antidepressants.

"This is where a pre-conception visit is important because you're not expected to know all of the medical information," Feeley said. "There are a lot of medications over the counter that your doctor may say they really don't want you to take. And some women may stop taking medications even though they really need to keep treating issues, such as a thyroid or asthma."

Steven Woodworth, M.D., endocrinologist at Aspirus Keweenaw, said the thyroid should be checked to make sure it is healthy. Not only can an untreated thyroid cause fertility issues when initially trying to conceive, but the growing baby feeds off maternal thyroid for the first three months of development.

"It's important for women to have their thyroids checked and treated," Woodworth said. "An untreated thyroid could result in the child having a lower IQ."

Bonnie Hafeman, M.D., family medicine specialist with Aspirus Keweenaw, said when preparing to see the doctor for the first visit, many women have already taken a home pregnancy test and should write down dates of their menstrual period and even when they think they conceived.

"It gives the doctor a better idea of how far along the pregnancy is," she said.

Upon seeing the doctor, a series of tests will be administered, such as an ultrasound, and laboratory work will be conducted to find out whether the mother is anemic, if she has chlamydia she is unaware of or if she has a urinary infection, while looking for anything else that can be treatable.

"If you're already pregnant, the woman should come in before she's 12 weeks pregnant," said Sharon Stoll, M.D., family medicine/OB?at Aspirus Keweenaw. "That's the best time to figure out when the baby is due."

Immediately, the woman should begin taking a folate supplement, such as a prenatal vitamin. Smokers should kick the habit for a healthy pregnancy and it wouldn't hurt to cut back on caffeine and drink more water.

"One thing people don't realize is that there are contraceptives that deplete folate levels," Stoll said. "Some people may begin taking birth control pills for cases like endometriosis as teens and stay on birth control through college and sometimes into their late 20s and early 30s."

Stoll said women should quit taking birth control about one year before conceiving and women who are at high risk for low folate, which could be attributed to taking birth control pills, would benefit from taking folate.

Prenatal vitamins have a specific amount of iron important for a developing fetus, and have 400 mcg of folate. Smokers have lower levels of vitamin C, Hafeman said. And vitamin D is always a concern in the winter, as a certain amount of local residents have seasonal affective disorder, which could be related to a vitamin D deficiency.

"Fertility is affected by weight, but body weight aside, it's vital to get mild to moderate exercise," Stoll said.

Even if a woman gets pregnant before participating in a pre-conception consultation, or a woman is considering getting pregnant, Feeley advises couples to think about what's best for the baby, even if it means giving up certain kinds of fish, that morning cup of coffee or cigarettes.

"If you want to get pregnant, act like you're already pregnant," he said.



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