Planning is key to healthy pregnancy

by Wendy L. Hellerstedt, M.P.H, Ph.D.

A planned pregnancy is usually a healthy pregnancy. But studies show more than half of all pregnancies in the United States are not planned, and that unplanned pregnancy is associated with poorer maternal and infant outcomes. Many unplanned pregnancies are related to either lack of, or ineffective, contraceptive use. In addition to identifying the right time for pregnancy, women should have a preconception visit with their health-care provider to assure that they are in the best possible health and have the resources, information, and support they need for a healthy pregnancy.

Why is preconception planning important? Because parenting is a complex and permanent life event, and individuals must prepare for it emotionally, financially, socially, and intellectually. Additionally, critical fetal development occurs early in pregnancy; the brain, spinal cord, heart, and other organs begin to form in the first weeks. Thus, the best chance for a healthy pregnancy is for a woman to begin pregnancy in optimal health: neither underweight nor overweight; eating healthy foods and exercising appropriately; and not exposed to environmental hazards, through work or home life. She should not be using cigarettes, alcohol, or recreational drugs because the fetus is directly exposed to these substances. Women are encouraged to quit using substances before they become pregnant, rather than struggle with the dual demands of pregnancy and smoking, alcohol, or drug cessation.

Women also want to make sure they are getting adequate vitamins and minerals. For example, women should have adequate folic acid intake before they become pregnant to help prevent major birth defects of the brain and spine that occur in the early weeks of pregnancy. Women with chronic conditions, like diabetes, can work with their health-care provider to assure that their conditions are under control before they get pregnant. Women also can ask their provider whether they should continue use of supplements or prescribed medication after they become pregnant.

The University of Minnesota has many research and outreach initiatives to promote healthy pregnancies. For example, the School of Public Health is participating in the National Children's Study that will follow women from conception through pregnancy to learn what environmental factors contribute to conception and healthy pregnancies. We will also study the offspring, from birth to age 21, to learn what exposures may have short- and long-term, as well as immediate and delayed, effects on health and development. And, to promote preconception care, the School of Public Health's Center for Leadership Education in Maternal and Child Public Health and the Medical School's Deborah E. Powell Center for Women's Health teamed up with the Minnesota Department of Health and the March of Dimes to present a conference about best preconception care practices for health care providers.

Researchers at the University of Minnesota understand that it is not enough to conduct innovative research projects and they are committed to translating data to action. To promote healthy pregnancies, researchers not only try to ask important questions, but they work to deliver the answers to health-care professionals, policy leaders, and, most importantly, the public.

Hellerstedt is an Associate Professor, the Director of the Center for Leadership Education in Maternal and Child Public Health (http://www.epi.umn.edu/mch), and Chair of the Maternal and Child Health Program at the University of Minnesota School of Public Health.

Health Talk & You is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to lafor016@umn.edu.