Upping the Odds of Pregnancy

Planning to conceive a baby means different things to different women. Marlene Vickers* quit smoking cold turkey. Gail Myers gave up alcohol and caffeine. Angela Peterson started drinking more water and avoided being near cigarette smoke. They all saw their OB-GYNs or family doctors and began taking prenatal vitamins—essential steps in preparing to conceive.

Preconception Counseling

"Preconception counseling is an essential element in attaining the goal of a healthy pregnancy and birth," says OB-GYN Dr. David Barrere. "Unfortunately, less than 5 percent of women receive any [preconception-related] healthcare prior to conception."

Dr. Barrere's primary goal in meeting with a patient for preconception counseling is simple: He wants to identify factors in a woman's (or her partner's) medical or family history that could lead to problems with the pregnancy or baby. Preparation is key to good maternal and fetal health.

During her first pregnancy, Carrie Hooper* had several health conditions that needed to be controlled in order for her pregnancy to be a safe and uneventful one, culminating in a healthy baby. She suffered from both diabetes and high blood pressure, but with excellent medical care, she and the baby were just fine.

Hooper's last postpartum visit to her doctor also served as a preconception visit for planning her next pregnancy. "I asked how long I should wait until trying again, when I should stop breastfeeding to facilitate pregnancy, if my present medications would be OK for the next pregnancy and for a continuing prescription for my prenatal vitamins," she says.

Hooper's preparation made a difference in her first pregnancy and is likely to make a difference the second time around, too.

While not every situation is diagnosable, Dr. Barrere relies on information obtained during the preconception visit to decide whether or not to recommend genetic counseling. He says that in families with a history of cystic fibrosis, sickle cell disease, or other blood disorders (hemoglominopathies) or Tay-Sachs disease, genetic testing to determine the risk of having an affected child may be advisable.