Planning a Family
10 things to talk to your doctor about before you start your family

with Robert Stumpf, M.D., Obstetrician and Gynecologist, Columbia St. Mary's

Posted: Jan. 1, 2004

Before you choose a color for your nursery or buy that adorable sleeper, take some time to think about your body and the pregnancy itself. Pregnancy is a major event and good planning will increase your odds of staying fit and healthy for its duration. Going into your pregnancy with a healthy lifestyle will be the first gift you give your unborn child.

Robert Stumpf, M.D., Obstetrician and Gynecologist, Columbia St. Mary's "A point I stress with my patients is any woman of childbearing age who is not using contraception should be taking folic acid."

Many doctors encourage “preconceptual visits” in which a woman and her doctor can discuss her plans for starting a family. The following is a list of 10 subjects to discuss with your doctor before you conceive, as recommended by Robert Stumpf, M.D., an obstetrician and gynecologist with Columbia St. Mary’s.

1. Chronic or past medical conditions. Women who suffer from diabetes, high blood pressure or other chronic diseases will want to consult with their primary care physician as well as their obstetrician or gynecologist, Dr. Stumpf said. Some medications used to treat chronic conditions are acceptable to continue during pregnancy, while others are not. “There can be an interplay between the pregnancy and the effect it has on the disease or the effect the disease will have on the pregnancy,” he said.
2. Immunizations: Double check on what immunizations you received as a child or teenager, and if possible, ask your parents what childhood diseases you had. If you never had chicken pox, for example, you might consider becoming immunized for it, as chicken pox can be concerning during pregnancy. Contracting German measles (or rubella) also can put a baby at risk.
3. Genetic history: If cystic fibrosis, sickle cell anemia, fragile X syndrome or any other genetic disease runs in your family, you will want to discuss this with your doctor. Your physician may recommend genetic testing.
4. Personal history: If you have had two or more miscarriages, you should discuss this before trying to become pregnant again so that the doctor can try to determine the cause of the miscarriages. Women who have (or had) a sexually transmitted disease (STD) should also make their doctor aware of this fact. Some STD’s can make it difficult to conceive. Chlamydia, for example, can cause tubal scarring and can reduce the chances for conception. Outbreaks of genital herpes can occur more frequently during pregnancy and should be controlled at the time of delivery.
5. Diet and nutrition: While good nutrition is always important, it is especially key before and during pregnancy. Taking 0.4 mg of folic acid per day before becoming pregnant and early in the pregnancy can reduce the risk of neural tube defects. Dr. Stumpf added that being as close as possible to ideal body weight is important. “People who are significantly over their ideal body weight experience more problems during pregnancy and can run into more problems at delivery,” he said.
6. Exercise: Exercise is good for both the mother and the baby, but it’s better to begin a routine before becoming pregnant. Swimming, walking and recumbent biking are three excellent forms of exercise for pregnant women, Dr. Stumpf said. Talk to your doctor about your history of exercise and what you’d like to do during your pregnancy.
7. Stop smoking: Children of parents who smoke have more respiratory problems and colds than children who have non-smoking parents. Smoking during pregnancy increases the risk of premature birth. Be honest with your doctor about how much you smoke and talk about smoking cessation methods, Dr. Stumpf advised.
8. Environmental issues: If your work or home environment includes exposure to fumes or toxic substances, talk to your doctor about whether or not they are risky for your unborn baby.
9. Finances: While you might not want talk to your doctor about the ins and outs of your family’s financial situation, you should review your resources before you become pregnant so this is not a source of stress later in the pregnancy. “Babies are expensive,” Dr. Stumpf said. “From insurance costs to childcare, there are a lot of expenses and many people don’t think about them until the baby is born.” Getting a grasp on your family’s financial situation can help you determine if now is the optimal time to become pregnant or if waiting six months or a year (so you can work on saving or paying off debt) might be better.
10. Maternity leave: Discuss your company’s maternity leave policy with your doctor. How much time you’ll have off will affect some aspects of breastfeeding and recovery from the birth. Federal law requires companies with 50 or more employees to provide 12 weeks of unpaid family leave and job protection with the birth of a child.

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