Pregnancy is an event, an adventure, an excitement and a commitment.

It is the commitment part that seems to not be so clearly anticipated or understood.

Studies tell us that most pregnancies are unplanned and a “surprise”! This is not a column on birth control or judgment or prudence or morality. Those are other issues of significance.

This column is for those of you who are planning your pregnancy and want to have the healthiest experience for you and your baby!

This column is designed to give you assistance and direction. I hope you find the information useful. Know that planning and prudence will pay dividends.

Consider these steps:

Take a prenatal vitamin. While prenatal-strength vitamins will provide you with nutrients, the main benefit is for the fetus. Studies reveal that folate supplementation, such as that in prenatal vitamin, can lower the risk of open birth defects involving the spine and head. The occurrence of birth defects such as spina bifida with paralysis and anencephaly, where part of the brain is not present, can be reduced by simply taking that vitamin. Vitamins are easy; do it!

 Exercise. Studies tell us that it is not a good idea to begin an exercise program after pregnancy has begun. In most women, however, it is safe to continue an established exercise routine. Aerobic training is an important thing for all of us, even young women! The habit needs to be initiated before you enter the pregnancy so that the heart and circulatory system will be up to the challenge. Being fit and having a regular exercise regimen will help control weight gain, resolve aches, and improve mood and self-confidence. If you haven’t already, begin now!

 Consider yourself pregnant at all times. A woman is usually not aware of when she ovulates, even when she thinks she is! Pregnancy may have begun without her awareness. That beginning embryo is most fragile in the first days and weeks after conception. Sometimes a pregnancy that might have survived can be lost early, even before the pregnancy is recognized, due to toxic exposures. What is toxic? That is a good question. We know certain toxins such as excessive radiation from too many X-rays and certain medications that are known to cause birth defects. We know that alcohol can create birth defects. The problem is that we don’t really know about the safety of most anything else. What about that over-the-counter medicine for the cold you have? Well, it probably has about three to four drugs in it. Are these all safe for early pregnancy? We may not know. What about that “natural nutritional supplement”? It may have more like 30 to 40 ingredients. Are they all safe? We don’t know. Intense exposure to fumes may also be harmful. If you are not using a contraceptive and if you are having intercourse, you should consider yourself pregnant and not be surprised when it happens. Plan for it and when in doubt, avoid exposures!

 Ideal body weight. Obesity is not a cosmetic choice, it is a medical challenge. More women are entering pregnancy with excess weight. Why is that important? Well, excess weight increases the risk of high blood pressure, pre-eclampsia or toxemia, pregnancy associated diabetes, excess baby size, and risk of Cesarean section. Once that pregnancy test turns positive, it is too late to start a diet. Get yourself in shape first.

 Do you have any medical problems? The time to make sure they are under control is before pregnancy begins. Asthma, hypertension, seizure disorders, lupus and especially diabetes should be well managed before pregnancy. Evidence is convincing that when blood sugars are out of control, the risk of a birth defect goes up in proportion with the sugar level. If you have Sickle Cell or Sickle Trait, pregnancy may present special hazards. Make sure you discuss your pregnancy plans with your medical doctor and be prepared.

 Discuss your medicines with your doctor. There are medicines that are known to be dangerous during pregnancy. Some affect the embryo early on and some affect the growth of the fetus later. You may want your medical doctor and your obstetrician to compare notes and plan for the safest pregnancy possible with the most “pregnancy friendly” medicines in use. If you do find yourself pregnant before you planned, call your doctor before you just stop anything you are on.

 Are your immunizations up to date? Have you had your tetanus shot within the last 10 years? Do you get your annual flu shot? We know that the flu can be much more dangerous to pregnant women; that is why we immunize, even during pregnancy. What about Varicella, or Chicken Pox. If you are not sure you have had it, you can get tested or you can get immunized against it. That would be prudent. If you are not sure that you were immunized against Rubella, you may want to get that titer checked as well.

 Family history. Have you shaken your family tree to see what falls out? It is true that the apple doesn’t fall far from the tree. If your mother, sister or other relatives have had pregnancy problems, you may be more at risk for these yourself. These are items that you will want to bring to the attention of your doctor for discussion.

 Smoking. It raises the carbon monoxide levels in your blood while interfering with oxygen transport. What else can I say? You know it is unsafe for you and the baby!

A commitment to pregnancy is really a commitment to a new life, the most precious of gifts. It is also a commitment to supporting that new life through all kinds of challenges for the next score of years. Why wouldn’t you want to start out that new life with both of you as healthy as possible?

A little time, thought, and preparation won’t be the same as a guarantee, but it will give you the best chance possible. Go for it!