Q&A: I conceived while using spermicides and I'm concerned about the health of my baby.

I have some good news for you: There is no evidence that spermicide failure causes birth defects or other problems. Since spermicides are not that effective at pregnancy prevention, lots of babies are born after spermicide use—so we have lots of data of the safety for babies conceived "through" spermicides. For comparison: if using no birth control, a woman has about an 80 to 90 percent chance of becoming pregnant in one year. If using just spermicide, she has a 20 to 30 percent chance. In contrast, birth control pills get the rate down to about 1 to 8 percent, and the IUD (intrauterine device) to under 1 percent.

I am glad to hear you are thinking about how to keep your baby healthy. Here are the best things that a pregnant woman can do to prevent birth defects:

• Take folic acid. Four hundred micrograms (also labeled as 0.4 milligrams) of the B vitamin folic acid has been shown to decrease the risk of spina bifida and certain other birth defects by as much as 50 percent. Since embryonic organs are forming in the first trimester, folic acid works when taken before pregnancy and in the first trimester. Many experts recommend that all women in the childbearing years take folic acid regardless of contraceptive use, since as you know, contraceptives can fail. If folic acid wasn't taken before pregnancy, it should be started as soon as the woman is aware that she is pregnant.
• Don't smoke cigarettes, use illegal drugs, or drink alcohol.
• Check with your doctor or midwife before using any medications, even over-the-counters and herbals.
• If you have the flu or other illness during the first trimester, tell your healthcare provider. If you have a fever, try your best to lower it with acetaminophen (Tylenol). This is the one exception to the rule of not taking medications during pregnancy. A fever is more dangerous to the developing fetus than are the medicines to bring it down. If you can't keep your temperature under 100 degrees Fahrenheit (38 degrees Celsius), call your doctor or midwife.