Although you rarely hear about rubella, sometimes called "German measles," the virus still exists, and if a woman were to contract it while pregnant her baby could develop serious birth defects. The CDC reports that seven percent of all women are not immune to rubella. Varicella, or chicken pox, is another disease that raises concern, says Dr. Chames. A blood test can confirm whether you are immune and if vaccination will be recommended. Recently, mothers-to-be have been offered the Tdap vaccine to boost their immunity to whooping cough, a major source of infant illness.
It is possible to be sick and not know it? Diabetes can go undiagnosed, as can syphilis, hepatitis, and HIV. Your doctor will likely recommend you be tested for all these diseases. "Most of the blood work at the first prenatal visit—a CBC, the rubella status, hepatitis status, blood type, and antibody screen—should be done prior to conception so if there are issues they can be dealt with," says Dr. Chames. "The other thing I recommend is HIV testing. I would recommend all pregnant women have that test because there is a subset of women who don't know they are HIV-positive."
Your doctor should inform you of the risks of drinking alcohol, doing drugs, and smoking during pregnancy. If you smoke, don't wait until you are pregnant to give up the habit. Babies born to women who smoke are more likely to be born too early and have low birth weight, reports the March of Dimes. They are also at greater risk for sudden infant death syndrome (SIDS) and attention deficit disorder (ADD), adds Dr. Chames. For the mothers, there is a greater risk of placental abruption, placenta previa (where the placenta implants itself in the wrong place, blocking the cervix), and miscarriage.
Drinking and drug use also need to stop before conception. By the time you register a positive pregnancy test, your baby's central nervous system is already forming. Alcohol use during pregnancy can lead to fetal alcohol system, a leading preventable cause of mental retardation, says the March of Dimes. Use of street drugs such as heroin and cocaine can result in low birth weight and congenital abnormalities. Any risky behavior increases your chance of miscarriage.
If you are overweight, you might have trouble conceiving; the same is true if you are underweight. Achieving a healthy weight will benefit your baby once you conceive. If you're too thin, you risk having a low birth weight baby. If you are too heavy, you run the risk of diabetes, blood clots, and labor complications that could lead to a C-section. Your baby is also at higher risk of a neural tube defect such as spina bifida.