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Becoming pregnant
How much attention did you pay in high school biology class?
If you're thinking about becoming pregnant, here's a brief primer on how the reproduction process works, including tips on how you can monitor ovulation and help conception occur.
The birds and the bees
On each side of the uterus there's an ovary, and each comes stocked with a lifetime supply of somewhere around half a million eggs. Every 28 days near the middle of the menstrual cycle (about two weeks after your period begins), a mature egg is released, making its way through the Fallopian tube toward the uterus. This process is ovulation.
When you have intercourse, millions of microscopic sperm swim frantically toward that egg after ejaculation, combating everything from gravity to cervical mucous. If a sperm is hardy enough to make the trip and manages to penetrate the egg, the genetic material from both the egg and sperm combine to form new cells. These new cells attach themselves to the uterine wall and pregnancy begins.
If the sperm aren't successful, the egg disintegrates and is washed away during your period.
Helping mother nature
Women who want to conceive can help nature by keeping track of their ovulation and planning intercourse around it. In general, a woman's most fertile time is three to four days before ovulation through two days after ovulation.
You can determine ovulation by
- Charting your body temperature each morning. During ovulation, your basal body temperature (your base temperature before any movement) rises about one-half of a degree.
- Monitoring changes in your cervical mucous. Right around ovulation, a woman's cervical mucous is at its thinnest, clearest and most plentiful, resembling egg whites.
- Using an ovulation predictor kit that tests for luteinizing (LH) hormone. A woman's LH level surges prior to ovulation.
In addition to charting your ovulation cycles, there are other things you can do that may encourage conception.
- Many experts suggest using a sexual position (such as man on top) that encourages the natural tilt of the vagina toward the cervix.
- After intercourse, a woman should remain prone, ideally with her hips and legs elevated, for 15 to 20 minutes.
- If possible, have intercourse during the morning when sperm count is high.
Remember, be patient. Depending on your age, your odds in a given month are between 10 and 25 percent. On average, most fertile couples take three to six months to conceive.
Source of Material: National Women's Health Resource Center, Women.com, Pregnancy Today, BabyCenter, Estronaut, FertilityPlus, About.com.
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Diet and weight
Most women understand how important it is to take care of their bodies once they become pregnant. But it's also important to be healthy before conception in order to help ensure a healthy baby.
One of the best ways to make sure your body's in prime condition for pregnancy is to make sure your diet and your weight are as ideal as possible.
Weighing in
If you're planning to have a baby, it's important that you are not excessively underweight or overweight before pregnancy. It is not a good idea to be on a weight-loss diet while you are pregnant or trying to become pregnant because this could deny you and your baby the nutrients you both need.
The best way to plan for your pregnancy is to try to reach an ideal weight before you become pregnant. You will be more comfortable during pregnancy, and the extra weight you gain during pregnancy will be easier to lose later. If you have questions about what weight is ideal for you, consult your family doctor or gynecologist.
Diet and nutrition
A balanced diet is a basic part of good health at all times in your life. When you're pregnant, it's especially important because the foods you eat are the main source of nutrients for your baby. A good pre-pregnancy diet is the best way to ensure that you and your baby start out with the nutrients you both need. Be sure to eat a healthy diet that is rich in protein, calcium, iron and zinc.
The following factors can affect how your body uses nutrients. If any of these factors apply to you, consult your doctor because you may need to change your diet.
- Do you take medication (prescription or over-the-counter) regularly?
- Do you follow a strict vegetarian diet?
- Do you run long distances or perform strenuous exercise on a regular basis?
- Do you fast?
- Do you follow a reducing diet?
- Do you have a history of anemia?
- Do you have diabetes or phenylketonuria?
For a personalized nutrition consultation with a registered dietitian, call Grant Nutrition Services at (614) 566-1111, or Riverside Family Practice Center at (614) 566-5414. At Doctors Hospital call (614) 544-5620.
Source of Material: OhioHealth, March of Dimes, UCLA Healthcare, Healthy Women, Your Baby Today.
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Exercise and pregnancy
Everyone knows exercise is good for you. Before getting pregnant, exercise is recommended to maintain a healthy weight, promote overall fitness and to provide a sense of physical and psychological well being while decreasing stress and anxiety. But what about when you're pregnant?
For decades people believed pregnant women shouldn't exercise because of their "delicate" condition. But studies eventually showed that not only does a mother's exercise make for a healthier baby, it also makes for a healthier pregnancy and delivery.
Exercise improves your mood and your stamina. It helps reduce backaches, bloating and constipation. It helps you sleep better and gives you energy.
Women who exercise during labor also have substantially shorter labors than those who don't. That's reason enough to lace up your sneakers!
But don't rush in headfirst. Take things slowly and sensibly. Here are some tips
- Consult with your doctor about your exercise plans, especially if you haven't been exercising on a regular basis or if you have a history of pre-term labor.
- Exercise regularly-ideally three times a week as long as you are healthy. Concentrate on activities such as walking, swimming and stationary biking instead of weight-bearing exercise such as running and jogging, especially during the last trimester.
- Drink plenty of water.
- Wear loose, comfortable clothing including a well-fitting bra and supportive shoes.
- After 20 weeks of pregnancy, avoid doing exercises that require you to lie on your back.
- As your pregnancy progresses, decrease the intensity. The added weight of your baby makes exercise more difficult. Avoid strenuous exercise the last few weeks of pregnancy.
- Avoid risky activities, such as skiing, horseback riding and racquetball.
- Avoid exercising in hot, humid weather or in extreme altitudes. Your rising body temperature is transmitted to your baby.
- Warm-up before exercising, but be careful not to overstretch. Pregnancy hormones make your body more supple, making it easy to strain muscles and ligaments.
- Monitor your heart rate. In general, it should not exceed 150 beats per minute.
- Listen to your body. If you feel like you're overwhelmed, take things more slowly.
- Stop exercising immediately if you experience pain, vaginal bleeding, dizziness, shortness of breath, uterine contractions or vaginal leakage. Consult your healthcare provider.
Source of Material: OhioHealth, Childbirth.org, American Academy of Family Physicians, ParentsPlace.com, American College of Obstetricians and Gynecologists.
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Genetics and pregnancy
Before you conceive a baby, you may want to consider the genetic counseling services available at Grant Medical Center and Riverside Methodist Hospital. You would meet with a board-certified, masters-trained prenatal genetic counselor to discuss any high-risk aspects of pregnancy, learn about inherited conditions, and discover any potential chance of having a child with a genetic problem.
Who should see a genetic counselor?
There are many reasons for seeking a genetic consultation. If you are concerned about an inherited disease or genetic disorder in your family, speak to your family doctor, gynecologist or obstetrician about seeing a genetic counselor in order to assess your risks. You may also contact Riverside Perinatal Services at (614) 566-4378 or call Grant Medical Center at (614) 566-9238. Your physician at Doctors Hospital may also refer you to Riverside perinatal services at the number listed above.
Other reasons to consider genetic counseling include
- Maternal age of 35 or more at time of delivery.
- Abnormal alpha-fetoprotein test results.
- Family history or previous child with a single-gene disorder, such as cystic fibrosis, hemophilia and certain muscular dystrophies.
- Family history or previous child with major birth defects, including spina bifida, congenital heart defect and clubfeet.
- Family history or previous child with a chromosome abnormality, such as Down syndrome.
- Family history of unexplained mental retardation.
- Previous recurrent, unexplained pregnancy loss.
- Use of potentially harmful drugs or medications during pregnancy.
- Pregnancy between biologically related individuals.
What happens at a genetic consultation?
During the genetic consultation, the counselor usually will:
- Construct a family history of all medical problems, then analyze that history for any genetic and/or birth defect risk.
- Assess the risk that certain genetic conditions could occur and discuss the nature of those possible conditions.
- Explain the options available to reduce that risk, including the risks and benefits of each alternative.
- Assist in selecting the option that is appropriate for an individual or family.
- Provide supportive counseling and/or referral to community resources.
- Coordinate any tests.
Send a summary letter to the patient and/or her physician documenting the counseling session and outlining the care plan.
The genetic counselor does not make suggestions or recommendations as to which test you should pursue. The counselor's role is to help you understand the limitations and benefits of your testing options and to help you to arrive at an educated decision about these options.
Source of Material: OhioHealth.
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Healthy pregnancy over 35
If you are over age 35 and healthy, the chances of having a healthy baby are excellent. It's true that there are more risk factors for older women, especially for those having their first baby. But with good obstetrical care and attention to a healthy lifestyle, the odds are overwhelmingly in your favor.
About eleven percent of babies born in the U.S. each year have moms over the age of 35. Medical advances help keep risks to a minimum with genetic counseling, ultrasound, fetal monitoring and other procedures, which can help identify potential problems.
The risks
Probably the most well known problem is the risk of bearing a child with a chromosomal disorder, such as Down syndrome. At age 25, a woman has a 1-in-1250 chance of having a baby with Down syndrome; at age 35, a 1-in-378 chance; at age 45, a 1-in-30 chance.
Most often women who are 35 or older are offered prenatal testing with amniocentesis or chorionic villus sampling to diagnose any chromosomal abnormalities. About 95 percent of women who undergo prenatal testing receive the reassuring news that their baby does not have one of these disorders.
Older mothers are also more at risk for:
- Infertility and miscarriage
- Premature delivery and stillbirth
- Gestational diabetes and high blood pressure
- Cesarean section
- Growth retardation in babies
- Multiple births
- Placental problems, such as placenta previa, which can cause severe bleeding during delivery
It may take longer for a woman over 35 to actually become pregnant, simply because of her body's aging process. If you become pregnant after 35, your doctor will check you closely to help minimize problems.
Prenatal care
For mothers over 35, prenatal healthcare is critical.
- Get a pre-pregnancy checkup, getting any existing health problems under control before trying to conceive.
- Take prenatal vitamins before getting pregnant in order to help prevent neural tube birth defects, such as spina bifida.
- Get physically fit. Lose weight if you are overweight. Eat a balanced diet. Exercise regularly. Quit smoking. Reduce stress. Get plenty of sleep.
Mothers over 35 who pay careful attention to diet, exercise and good prenatal care can have very healthy pregnancies and babies. Many older mothers, in fact, are more educated, experienced, settled and patient, and are ready to parent a new child.
Testing
Most often women who are 35 or older are offered prenatal testing with amniocentesis or chronic villus sampling to diagnose any chromosomal abnormalities. About 95 percent of women who undergo prenatal testing receive the reassuring news that their baby does not have one of these disorders.
Both of these tests involve withdrawing a sample from within the uterus by using a needle. However, there is a new test to detect Down syndrome and trisomy 18 (a chromosomal abnormality that causes mental retardation and birth defects). Available only at Riverside Perinatal Services, this non-invasive procedure is a software screening program and is approximately 85 percent accurate. The test can be administered from the 11th week until the 14th week of pregnancy. The program analyzes three factors to determine a woman?s risk:
- The mother?s age
- Fetal nuchal translucency measurement (an ultrasound exam is used to measure the pocket of fluid located between the spine and neck)
- Two-part blood test on blood drawn from the mother
For more information, ask your doctor about the Ultra Screen Maternal Serum Screening or call Riverside Perinatal Services at (614) 566-4378. For testing offered at Grant Medical Center or Doctors Hospital contact your healthcare provider.
Source of Material: OhioHealth, March of Dimes, American Baby, The Baby Corner.
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