Before Pregnancy and After Pregnancy

Important information about what to do before becoming pregnant. Before pregnancy, have a thorough physical exam and prenatal care. Physician developed information for new parents. What you need to know about breastfeeding and postpartum depression.

Before Pregnancy and After Pregnancy

Before You Become Pregnant

If you are planning to have a baby, you should see your doctor for a thorough physical examination before you attempt to become pregnant. One reason for this is that you may have a medical condition that can complicate your pregnancy, but that initially has no obvious symptoms (such as diabetes, high blood pressure, or genital herpes).

Your doctor can advise you about how to deal with any health problems before you try to become pregnant. You can also find out whether any medication you are taking could be harmful and if a safer substitute is available. If you are overweight, your doctor may advise you to slim down to prepare for the weight gain that will occur during pregnancy.

If you plan to become pregnant (or already are an expectant mother), a doctor or another health-care professional can also counsel you (and your partner) about prenatal care and help you evaluate your diet, physical activity, and lifestyle as it will affect your baby. During the time you are trying to become pregnant, you should avoid smoking and drinking alcohol, and either avoid caffeine or minimize it (no more than one cup of coffee a day), since these substances increase the risk of miscarriage and other complications. (Smoking also affects your chances of conceiving: according to a study from the School of Public Health at the University of California, Berkeley, a woman reduces her chances of becoming pregnant by 50 percent if she smokes even less than half a pack a day.)

Nutritional savvy: All women who may become pregnant are advised to consume 400 micrograms of folacin daily—from foods or supplements—in order to ward off birth defects such as spina bifida. Because spina bifida and similar birth defects occur in the first two weeks of pregnancy—long before most women know they have conceived—women must start building up folacin stores at least 28 days before becoming pregnant. Since half of all pregnancies are estimated to be unplanned, it’s recommended that intake should be kept high at all times.

Concerns After Pregnancy

Breastfeeding: Women should seriously consider breast-feeding their babies, as breast milk is an ideal source of nutrients and can supply the newborn with antibodies to various infections. Breastfeeding also helps a woman’s uterus return to normal size after delivery. And the contact between mother and child provides a nurturing psychological bond.

Nevertheless, some women dislike the idea of breastfeeding or have a job that would make it very inconvenient to breastfeed. Also, some women should not breastfeed, including those taking certain medications that pass into breast milk or women with certain infections, such as HIV, chicken pox, or active tuberculosis. A woman who cannot or chooses not to breastfeed should not feel guilty, since babies do fine on formula.

If you decide to breastfeed, talk to your doctor about the care and preparation of your breasts. Even though breast-feeding is a natural process, many women can benefit from learning how to do it properly. Your doctor can instruct you or may refer you to a “lactation coach.” Some women develop sore, swollen breasts and/or cracked nipples; if this happens, see your doctor.

Also, talk to your doctor about when you can resume having sexual intercourse (generally at least three weeks after giving birth) and about any steps you want to take to avoid another pregnancy right away. (Breastfeeding does not prevent pregnancy.) You should also have a pelvic exam four to six weeks after the birth.

Postpartum depression: After a child is born, it is normal for the mother to experience a range of feelings. Joy and a sense of relief are part of this emotional spectrum, but it’s also common for new mothers to feel inexplicably “blue” at times, which may stem from fatigue, hormonal changes, and shifting emotions. Such intermittent feelings often develop a few days after the baby is home and may persist for several weeks.

The support of family members in taking care of the baby usually helps diminish the blue feelings, and so does talking to other new mothers. It’s also important to avoid becoming too tired. If you feel overwhelmed, you should talk to your doctor, who may be able to help you work through your feelings or can recommend a counselor or support group to provide assistance.

Severe depression is rare, but a few women do become so depressed after childbirth that they cannot take care of themselves or their babies. Depression of this nature is usually evident within a month of the birth. If it develops, the mother and/or father or other family members should seek professional help right away.