If you’re like most women, you may not have heard the term “preconception care.” But it’s an excellent way to start toward a healthy pregnancy. Preconception care is care for women planning a pregnancy or that might get pregnant. Its goal is to prepare for the healthiest pregnancy possible. With more women than ever before experiencing insulin resistance or diabetes, preconception care is more important than ever.
In getting preconception care, you will work with your healthcare provider to learn what your particular health risks are regarding pregnancy, and how to prevent problems. You’ll plan the best time to have a baby and learn how to prepare for meal planning, medications and exercise during pregnancy.
Why preconception care?
For you, preconception care can help to make sure you are in the best possible health, for example, this may mean controlling blood pressure or losing weight before you conceive. You’ll also learn which medications, herbs or supplements that could cause problems with a pregnancy. You’ll also learn the importance of getting folic acid
in your diet every day to prevent birth defects.
For your baby, preconception care can help prevent miscarriage (pregnancy loss) or stillbirth (baby born dead). It helps prevent birth defects and it encourages healthy growth for you and your baby throughout your pregnancy so so that your baby is not too big or too small.
Even if you’re not planning on getting pregnant anytime soon, you should still take good care of yourself. And this includes getting a physical exam every year, keeping blood sugars under control, losing weight if you need to, talking to your healthcare provider about family palnning and taking folic acid during your childbearing years, typically ages 12 to 50.
During a preconception care visit, you’ll get a complete physical exam, and perhaps see specialists including a diabetes specialist and eye and kidney specialists. If you have high blod sugar or diabetes, you’ll be guided on keeping diabetes and blood sugar under control for at least 3 to 6 months before getting pregnant. You should continue your family planning method until your healthcare team feels you’re ready to get pregnant. And remember to get support from your family and friends along the way.
What if I am getting infertility care?
If you’re also undergoing care for infertility, follow all of the recommendations with regular preconception care. Controlling your blood sugar and diabetes can increase fertility and prevent problems.
Some insulin resistance syndromes, such as polycystic ovary syndrome (PCOS), may cause difficulty in getting pregnant. Talk to your health care provider about medications such as Metformin, which are considered safe. This medication increases ovulation and decreases miscarriage.
If you have diabetes or insulin resistant syndrome, you’ll be encouraged to receive preconception care, along with infertility treatments. Some infertility medications can affect blood sugars and may require medication adjustments.
What if I had gestational diabetes during my last pregnancy?
You’re encouraged to have an oral glucose tolerance test to see if you have developed diabetes since your last pregnancy. You probably had this test six weeks after you had your last baby. If that test was normal, you should still be retested every year.
If you have diabetes, get preconception care. If you don’t have diabetes, you will still want to reduce your chances of getting gestational diabetes again, so lose extra weight, as needed, and be physically active everyday.
About the Authors
: Leona J Dang-Kilduff, RN, MSN, CDE, is with the Mid-Coastal California Perinatal Outreach Program at Stanford University. Suzanne Sparks, RN, BSN, CDE, is with the California Diabetes and Pregnancy Program, Region 7, at Loma Linda University Children’s Hospital in Loma Linda, CA. This article is supported in part by funds received from the California Department of Public Health; Maternal, Child and Adolescent Health Division.