Pregnancy and giving birth have been considered the most important events in a human life. They are the cornerstone to keep human society to be continued, so for many years pregnant women have often received special care from family and society. Safe birthing with healthy babies and mothers is always a wish for both family’s members and health care practitioners. Most delivery cases are safe; however, there are not a small number of mothers and babies who die during pregnancy or after birth. How to minimise the bad outcome? It is to have good preparation and appropriate management of the high risk events timely. Good preparation should be an initial important step, below are the recommendations from experts.
1. What is the best age for getting pregnant?
A recent study found that pregnant women between 23-32 years have the lowest risk for non-chromosomal abnormality of the baby (1). The fecundity of women starts going down significantly by age 32 years (2). So we strongly suggest you don’t miss this ideal period.
2. Practice a healthy lifestyle
- Quit smoking and drug use
It is because smoking is associated with many bad conditions such as: intrauterine growth restriction, placenta previa, and placental abruption ect. Children born to women who smoke during pregnancy are at an increased risk of asthma, infantile colic, and childhood obesity (3). Drugs like Marijuana have the similar harmful effect as smoking (3).
- Stop drinking alcohol.
It is because drink alcohol during pregnancy could lead to (3):
+ Physical defect: central nervous system abnormalities, growth defects, and facial dysmorphia ect.
+ Mental defect: the cognitive defects and behavioral problems.
- Maintain a good shape
Obtain a BMI in the normal range (18.5–24.9) before attempting pregnancy.
It is because abnormal high or low BMI is associated with complications to both mother and baby (3). Find your BMI here.
https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
- Stay away from harmful substances
Avoid exposure to environmental pollutants, workplace teratogens, and endocrine disruptors such as plastics with bisphenol-A, pesticides, lead paint, and asbestos etc (3). It is because they could cause birth defects.
- Do enough regular exercise
Perform moderately exercise at least 30 minutes a day, 5 days a week, for a minimum of 150 minutes per week.
Because not getting enough physical activity could increase the risk of heart disease, diabetes and cancer (4).
- Establish a good sleep habit
Sleep 7 or more hours per night on a regular basis for better health.
It is because experts said sleeping less than 7 hours per night on a regular basis is associated with bad health outcomes, including weight gain and obesity, diabetes, hypertension, and impaired immune function (5).
3. Pre Pregnancy consultation with your Obstetrician
Doctor will assess your general health, immunization status, and infectious disease ect. You may also be prescribed folic acid supplementation to reduce risk of neural tube defects for your baby. Tell your doctor if you have any health concerns.
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It is time for our story to begin.
It was about 5 years ago.
There was heavy rain today, the autumn rain made the weather become a bit cold and the road had little traffic. Everyone seems to want to stay indoors to enjoy the warm atmosphere in their house on the weekend. That day was Saturday, but Dr. Jack was still coming to his obstetric and gynecologic clinics to work in the morning. The heavy rain caused many patients to cancel their appointments. While Dr. Jack was interpreting the newly obtained lab test result, there was a door knocking. The knocking person was Ms Jane, she is Dr. Jack’s medical secretary.
Dr Jack: come in please!
Ms Jane opened the door and said: Doctor, there is one couple without an appointment in advance who wanted to see you. Do you want to see them?
Dr Jack: Of course, let them in.
The presenting couple is Lisa at 28 years old and Andrew at 30 years old. They had been married for about 5 years.
Dr Jack: sit down please! Fortunately, today I have a lot of time. What brought you here today, although there is heavy rain outside?
Lisa: Doctor, we have been married for a quite long time. I was pregnancy 2 times, but it end up with miscarage when it was still quite small. Our parents and us really expected a baby.
Andrew said with a moody voice: It is true. In the last 2 years we tried again, even with IUI (Intrauterine insemination) but no hope. We saw an infertility specialist already. That doctor recommended we should try IFV, but we are afraid of its side effects.
Lisa also said with moody eyes: Yes, I was scared when hearing about the invasive technique. Doctor, is there any hope for us?
The atmosphere of the consultation room on a rainy autumn day had become moodier with the story of the young couple. Dr Jack attentively listened to their story with empathy eyes.
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This couple is in the ideal age range to become pregnant, why can they not have a baby after trying for a long time? If and how will Dr. Jack help them? Please refer to the next chapter.
https://www.ganjingworld.com/s/paQ4b6vVl2
References
1. Pethő, B, Mátrai, Á, Agócs, G, et al. Maternal age is highly associated with non-chromosomal congenital anomalies: Analysis of a population-based case-control database. BJOG. 2023; 130(10): 1217–1225. https://doi.org/10.1111/1471-0528.17461
2. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014 Mar;101(3):633-4. doi: 10.1016/j.fertnstert.2013.12.032. PMID: 24559617.
3. ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstet Gynecol. 2019 Jan;133(1):e78-e89. doi: 10.1097/AOG.0000000000003013. PMID: 30575679.
5. Watson NF, Badr MS, Belenky G, et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015 Jun 1;38(6):843-4. doi: 10.5665/sleep.4716. PMID: 26039963; PMCID: PMC4434546.
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