Thursday 25 April 2013

The Importance of Preconception Care



“Healthy Minds and Bodies = Healthy Moms and Babies”





It is known that women who have higher levels of health prior to becoming pregnant have healthier reproductive outcomes. Prenatal care begins once the fetus is already developing, and this can cause challenges in the missed early weeks of growth.  Preconception care starts before a woman becomes pregnant. Its focus is on addressing the conditions and risk factors that could affect fertility, minimizing pregnancy complications of both the mother and the baby, as well as promoting healthy behaviors to strengthen the mother’s body and mind, enabling an easy pregnancy and delivery. By taking control of your health BEFORE pregnancy, future problems for both mom and baby can be prevented.  

                Preconception care is tailored to the individual woman and family, but there are a number of factors that all moms-to-be need to cover in the preconception period. Here are the TOP SEVEN things you need to know to guarantee that you are baby ready:


    1.    Ensure your body is well balanced
Speak to your chiropractor about your pregnancy plans. In my office, all women of child bearing age are encouraged to take proper care of their bodies. In Canada, 40% of pregnancies are unplanned and ensuring that even the youngest of women have the information they need to maintain healthy bodies is of the utmost importance (http://www.med.uottawa.ca/sim/data/Abortion_e.htm).

Chiropractic care is a natural, drug-free way to help women improve pelvic and spinal balance and alignment. Your spine is a highway of nerves that connect your brain to every cell, organ and tissue in your body. Just like an electrical cord has to be plugged in fully for an appliance to run, your reproductive system will not function properly if the nerves that lead to it are blocked in some way. This most commonly happens within the spine, and your chiropractor is the expert at detecting and removing any interference so that your entire body can work optimally and harmoniously.

       2.     400-800mcg of Folic Acid per day 
50-70% of neural tube deformities can be prevented if a woman has adequate levels of folic acid during the earliest weeks of pregnancy (http://www.folicacid.ca/pdf/2011%2002%2028%20Research%20-%20Weekly%20Administration%20of%20FA%20-%20SENT%202011%2003%2009.pdf).

3.       Cease smoking, alcohol  and caffeine use
Several studies have noted an association between smoking during pregnancy and an increased rate of miscarriage and infant death. Nicotine from cigarette smoke is absorbed by the mother and quickly crosses the placenta to enter the baby's bloodstream. The same mechanisms that increase the risk for miscarriage and infant death can also affect fetal growth. Infants exposed prenatally to smoke and even nicotine alone (through chewing tobacco, for example) have an increased rate of low birth weight, tend to be smaller for their gestational age, and can have a small head circumference. Low birth weight is associated with a later increased risk of several neurodevelopmental problems, including decreased academic ability, lower IQ scores, behavioral problems, substance abuse and psychiatric disorders (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656811/).

For the unborn child, alcohol interferes with the fetus’ ability to get enough oxygen and nourishment for normal cell development in the brain and other body organs. Research has shown that a developing fetus has very little tolerance for alcohol. Infants born to mothers who drink alcohol can have very serious problems, including Fetal Alcohol Spectrum Disorder, which can range from mild to debilitating (http://pubs.niaaa.nih.gov/publications/arh26-1/58-65.htm).

Caffeine has been shown to cross the placenta, cause birth defects, pre-term delivery, reduce fertility or delay conception and increase the risk of low birth weight. Two studies in 2008 showed women who consumed 200mg or more per day are twice as likely to miscarry than those who consumed less than 200mg of caffeine (www.americanpregnancy.org/pregnancyhealth/caffeine.html ).

4.       If you have a medical condition, ensure it is under control
Asthma, diabetes, oral health, obesity, epilepsy, high blood pressure, depression and anxiety most commonly affect pregnancy. As one example, birth defects related to high blood sugar of the mother can be reduced through glycemic control of the mother BEFORE pregnancy (http://care.diabetesjournals.org/content/21/4/535.full.pdf).

5.       Avoid toxic substances/materials that could cause infection at work and home.
Prescription medications, as well as a number of over-the-counter medications that are commonly used can be harmful. Speak with your health care professional to ensure that your medications are right for you in the preconception and pregnancy period.

Decrease your exposure to toxins, such as Bisphenol A, or BPA, (commonly found in plastics and Styrofoam) and Methylmercury and Polychlorinated Biphenyl, or PCB’s (found in some popular fish species).

6.       Decrease stress
It has been determined that those who are anxious are 12% less likely to conceive. In a study at Oxford University, blood levels of a marker for stress hormone called alpha-amylase were consistently higher in women who had trouble conceiving (http://www.nih.gov/news/health/aug2010/nichd-11.htm).

The US National Institute of Health discovered a link between increased cortisol (stress hormone) levels and miscarriages in the 1st trimester. 90% of women between the ages of 18-34 with elevated cortisol levels miscarried, compared to 30% of those with normal levels (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1533790/).

7.       Learn your family history (especially for chromosomal or genetic disorders)
Family history of diseases and behaviors should be discussed with your health care professionals before becoming pregnant.  Identifying a family history of a condition before pregnancy gives your doctors a chance to talk with you about possible increased risks and can assist in motivating appropriate behavioral change and decision-making that can reduce risk and improve pregnancy and pediatric outcomes.

If you are in the Toronto area and would like to learn more about preparing your body for pregnancy, feel free to attend Dr. Shaila’s complimentary workshop on preconception care. Call (416) 962-2000 to reserve your seat for her next health talk.