You’ve got your crib picked out, and you’ve narrowed down your favorite baby names to your top three. You’re even thinking about starting a college fund. Mentally, you’re ready to be a mother. But what about physically?

Finding out you’re pregnant isn’t the ideal time to start worrying about your health, said Andrea N. Smith, M.D., who practices at a new University of Utah Health Care obstetrics and gynecology clinic located on the campus of Salt Lake Regional Medical Center. It’s important to begin preparing your body months ahead of conception, including seeing your doctor for a preconception appointment.

“It’s a great way to address health concerns and lifestyle concerns before you conceive so you can make changes that might need to be made to lead to a healthier, safer pregnancy,” Smith said. “Many times, it’s a little bit late to address health issues once conception has occurred.”

At a preconception appointment, your doctor will take stock of your total health picture. Are you eating right? Are you overweight or underweight? Are you a smoker? A drinker? Do you have a chronic disease? Is it under control? What medications are you taking? Are you getting enough folic acid?

Why folic acid matters

“Folic acid is important because it helps avoid neural tube defects,” said Smith, noting that the neural tube is the hollow structure in an embryo from which the brain and spinal cord form. “If you’re deficient, you’re likely to have poor brain development or even spina bifida.”

The brain and spinal cord are among the earliest and most important body parts to develop so you don’t want to be playing catch-up when it comes to folic acid, a B vitamin found in leafy green vegetables like spinach as well as in oranges, beans, rice, cereals and pastas.

Multivitamins and DHA

“Another thing that I recommend to women considering pregnancy is to start a multivitamin that contains DHA (docosahexaenoic acid) before conceiving,” Smith said.

DHA is an omego-3 fatty acid, a form of fish oil, and is a primary component in the brain, retina, skin and other parts. Many prenatal vitamins contain DHA or it can be taken as a separate supplement.

Keeping chronic illness in check

Smith is careful to keep an eye out for type 1 diabetes patients and women with poorly controlled type 2 diabetes who want to conceive.

“There are some birth defects that can occur with elevated blood sugars during conception and early development, so if you have diabetes, it’s a good idea to be in tight control of your diabetes before pregnancy and throughout pregnancy,” Smith said. “Your insulin needs could vary dramatically once you become pregnant.”

Other chronic diseases that should be well managed prior to pregnancy include thyroid disease — both hypothyroidism and hypothyroidism can cause problems — along with hypertension or high blood pressure.

“There are many antihypertensive medications that are used in the non-pregnant population that we don’t consider safe in pregnancy, so many times we’ll take those women and switch them to a pregnancy-safe antihypertensive before conceiving to make sure we have it under control in time.”

Eat right … and no, you shouldn’t smoke pot

Smith hears it more often than ever: women who say marijuana relieves their nausea. They want to know “Can I keep using marijuana while pregnant?” No, Smith tells them, you really shouldn’t. Anything a mom smokes, eats or vaporizes passes through her system into her baby. While we don’t know a lot about how marijuana specifically impacts children prenatally, the modern version of the drug is not the natural substance some perceive it to be. It’s full of unknown additives, and it’s just not worth the risk.

Smith recommends using the months leading up to conception to cut out other habits as well.

“If you’re prone to sweets or lots of soda or high doses of caffeine, you might try to cut back on those before pregnancy,” she said. “You won’t have to totally cut out caffeine or sugar once you become pregnant, but we try to cut back on those before conception.”

Practice eating a well-balanced diet before conceiving — it’ll be easier to keep it up once you become pregnant, Smith said.

Relax, you’re probably normal

Everyone seems to have a friend who got pregnant on the first try, and women wonder why it’s not happening that way for them. Unnecessary fear, anxiety and stress follow.

“Many women feel they need to know exactly the day they ovulate, and they plan their conception down to the right day and time to make it happen, and it really doesn’t have to be that micromanaged,” Smith said. “I reassure women by letting them know that it can take up to 12 months of unprotected intercourse with regular monthly menstrual cycles to conceive, and that’s still considered normal fertility,” Smith said. “Just relax and try not to overanalyze the situation.”

Don’t stop meds cold-turkey once you’re pregnant

Some assumptions about pregnancy are incorrect, and a doctor can help you navigate through those at your preconception visit. For example, Smith meets a lot of women who thought they needed to stop taking their medications for depression and other mental illnesses when they found out they were pregnant.

“That’s a horrible idea,” said Smith, noting that most antidepressants are safe during pregnancy. “Don’t make a blanket decision to stop your medications. That can really cause some difficulties. The standard recommendation is if you’re on an antidepressant and it’s considered one of the safer ones, it’s better to just stay on that treatment and stay stable during your pregnancy than to try to mess with or change your medications just because of pregnancy.”

Abruptly quitting medicines can trigger a downward spiral that can be worsened by pregnancy hormones, Smith said.

Practical matters

“From a practical standpoint, one thing we run into often is women should really check with their insurance and find out which providers are on their plan,” Smith said. “Call the doctor’s office and verify. Insurance companies can sometimes get it wrong, but offices will usually know.”

It can be frustrating to have a great preconception appointment and feel like you really hit it off with your doctor only to find out that she’s not on your plan or doesn’t deliver at the hospital where you want to deliver.

“It’s also important to find a provider who is a personality match,” said Smith, noting that the two-way relationship between doctor and patient is important because together you’ll be making big decisions. “Find someone you feel comfortable with. You’ll be together for nine months.”

Want to learn more or schedule a preconception checkup? Call 801-213-4000.

*Though it’s not a location you might expect to find a University of Utah Health Care OB-GYN clinic, one has opened on the campus of Salt Lake Regional. This new location and partnership will provide convenient access for women in the downtown area. Salt Lake Regional has also just opened a new labor and delivery suite.

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