Tip ❶: Be sure to take 400 micrograms (mcg) of folic acid every day.
Folic acid is very important because it can help prevent some major birth defects of the baby’s brain and spine. Our bodies use this B vitamin to make new cells.
Folate is found naturally in certain fruits, vegetables, and nuts. Folic acid is found in fortified foods (called “enriched foods”), such as breads, pastas, and cereals. In addition to eating foods with folate from a varied diet (including foods like spinach and avocado), you can:
- Take a vitamin that has folic acid in it every day.
o Vitamins can be found at most local pharmacies and grocery stores. Check the label on the bottle to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 mcg.
o Most vitamins sold in the United States have the recommended amount of folic acid women need each day.
- Eat fortified foods.
o You can find folic acid in some breads, pasta, breakfast cereals, and corn masa flour.
o Be sure to check the nutrition facts label and look for one that has “100%” next to folate.
Tip ❷: Book a visit with your healthcare provider before stopping or starting any medicine.
Many women need to take medicine to stay healthy, and there are often benefits to continuing your treatment throughout your pregnancy. If you are trying to have a baby or are just thinking about it, now is a great time to start getting ready for pregnancy by talking with your doctor about medications you may be taking.
Women who are already pregnant or think that they could be pregnant should also see their healthcare providers. Start prenatal care right away. It is important to see your healthcare provider regularly throughout pregnancy. So be sure to keep all prenatal care appointments.
It is not easy to study medicine use in pregnancy. This means there may not be easy answers about possible risks for some medicines when used in pregnancy. If you are planning to become pregnant, discuss your current medicines with your healthcare providers, such as your doctor or pharmacist. There are often benefits to continuing your treatment throughout your pregnancy. However, if you and your healthcare provider decide to change your medicines, discussing a treatment plan before a pregnancy can give you time to consider all options that can help keep you and your developing baby as healthy as possible.
Planning how to take care of your health conditions before you become pregnant can help keep you and your developing baby healthy. Don’t forget to talk about your family history when visiting your healthcare provider! Based on your family history, your doctor might alter your care or refer you for genetic or nutritional counseling.
Tip ❸: Become up-to-date with all vaccines, including the flu shot.
Vaccines help protect you and your baby. Some vaccinations, such as the flu (influenza) vaccine and the Tdap vaccine (adult tetanus, diphtheria, and acellular pertussis vaccine), are specifically recommended during each pregnancy.
Having the right vaccinations at the right time can help keep you and your baby healthy. Get a flu shot and Tdap vaccine during each pregnancy to help protect yourself and your baby.
Flu: You can get the flu shot before or during each pregnancy. Pregnant women with flu have an increased risk of serious problems for their pregnancy, including preterm birth. Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy has been shown to protect both mom and baby (for up to 6 months after delivery) from the flu.
Tdap: You should get the Tdap vaccine near the end of each pregnancy (weeks 27 – 36). After getting the shot, your body will make protective antibodies (proteins made by the body to fight off diseases) and will pass some of the antibodies to your baby before birth. These antibodies give your baby some short-term protection against whooping cough (also called pertussis). These antibodies can also protect your baby from some of the more serious complications of whooping cough. If you live in the home or will be helping to take care of a new baby, you should also receive the Tdap vaccine before the baby is born.
Tip ❹: Before you get pregnant, try to reach a healthy weight.
Obesity increases the risk for several serious birth defects and other pregnancy complications. If you are underweight, overweight, or obese, talk with your healthcare provider about ways to reach and maintain a healthy weight before you get pregnant. Eating healthy foods and being physically active are great ways to prepare for pregnancy.
One size does not fit all. During pregnancy, follow the guidelines for weight gain that match your weight before pregnancy. Talk to your provider about making physical activity a part of healthy pregnancy.
Tip ❺: Boost your health by avoiding harmful substances during pregnancy, such as alcohol, tobacco, and other drugs.
Alcohol: There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. A developing baby is exposed to the same concentration of alcohol as the mother during pregnancy. This can result in a range of lifelong physical, behavioral, and intellectual disabilities. In addition, alcohol may make it harder for a woman to become pregnant. Alcohol use in pregnancy can also increase the risk of miscarriage, stillbirth, prematurity, and sudden infant death syndrome (SIDS).
Alcohol can have negative effects on a baby’s development at any time during pregnancy, including before a woman even knows she is pregnant. That is why it is important to stop drinking alcohol when you start trying to get pregnant.
Tobacco: Today, tobacco can be consumed in multiple ways; this includes traditional forms like cigarettes, cigars, pipes, chew, snuff, and hookah as well as newer forms like e-cigarettes/vapes.
Smoking causes cancer, heart disease, and other major health problems. Smoking during pregnancy can harm the placenta and a developing baby and can cause certain birth defects. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord. Cigarette smoke has over 4,000 chemicals. When you smoke during pregnancy, chemicals like nicotine, carbon monoxide and tar damage the placenta and/or pass through the placenta and umbilical cord to reach your baby’s bloodstream. Quitting smoking will help you feel better and provide a healthier environment for your baby.
Because they are relatively new and are not well-regulated, there is less known about the effects of e-cigarettes on pregnancy. Until more and better information is available, it is recommended that pregnant women not use e-cigarettes.
Marijuana: During pregnancy, the chemicals in marijuana (in particular, tetrahydrocannabinol or THC) pass through mom to a developing baby, and can harm a baby’s development. More research is needed to better understand how marijuana may affect mom and baby during pregnancy. However, it is recommended that pregnant women not use marijuana.
Prescription Opioids: Painkillers such as codeine, morphine, and oxycodone may be prescribed following an injury, surgery, or dental work. Any type of opioid exposure during pregnancy can cause neonatal abstinence syndrome, or a condition the newborn experiences from withdraw from certain drugs after exposure during pregnancy. If you are pregnant and taking an opioid, talk to your doctor before making any changes. Ask about options for opioid treatment to decide what’s best for you and your pregnancy.
Other Drugs: Using certain drugs during pregnancy can cause health problems for a woman and her developing baby. If you are pregnant or trying to get pregnant and can’t stop using drugs―please ask for help! A healthcare provider can help you with counseling, treatment, and other support services.
Can thyroid disease cause problems getting pregnant?
Both hyperthyroidism and hypothyroidism can make it harder for you to get pregnant. This is because problems with the thyroid hormone can upset the balance of the hormones that cause ovulation. Hypothyroidism can also cause your body to make more prolactin, the hormone that tells your body to make breastmilk. Too much prolactin can prevent ovulation.
Thyroid problems can also affect the menstrual cycle. Your periods may be heavier or irregular, or you may not have any periods at all for several months or longer (called amenorrhea).
How does thyroid disease affect pregnancy?
Pregnancy-related hormones raise the level of thyroid hormones in the blood. Thyroid hormones are necessary for the baby’s brain development while in the womb.
It can be harder to diagnose thyroid problems during pregnancy because of the change in hormone levels that normally happen during pregnancy. But it is especially important to check for problems before getting pregnant and during pregnancy. Uncontrolled hyperthyroidism and hypothyroidism can cause problems for both mother and baby.
Hyperthyroidism that is not treated with medicine during pregnancy can cause:4
- Premature birth (birth of the baby before 39 to 40 weeks, or full-term)
- Preeclampsia, a serious condition starting after 20 weeks of pregnancy. Preeclampsia causes high blood pressure and problems with the kidneys and other organs. The only cure for preeclampsia is childbirth.
- Thyroid storm (sudden, severe worsening of symptoms)
- Fast heart rate in the newborn, which can lead to heart failure, poor weight gain, or an enlarged thyroid that can make it hard to breathe
- Low birth weight (smaller than 5 pounds)
Hypothyroidism that is not treated with medicine during pregnancy can cause:4
- Anemia (lower than normal number of healthy red blood cells)
- Low birth weight (smaller than 5 pounds)
- Problems with the baby’s growth and brain development
What to ask your Physician:
- Where is the thyroid located, and what does it do?
- What are the differences between hypothyroid and hyperthyroid patients and what are the symptoms of each?
- What is Thyroid Stimulating Hormone (TSH), how is it measured, and what should my target number be?
- What else besides TSH levels are important for making sure my thyroid condition is under control?
- Why are more people than ever being diagnosed with thyroid cancer and should I be checked for it?
What to ask your Pharmacist:
- What is the difference between a generic thyroid hormone pill and a brand name thyroid hormone pill?
- Will you notify me in advance if you switch my thyroid medicine from the brand name I normally use to a generic?
- What time of day is best to take my thyroid hormone pill?
- May I take my thyroid medication with food, other medications, vitamins or supplements?
- Can any of my other medications affect my thyroid?