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Why planning a pregnancy reduces birth defect risks

Sally Segel, MD

The goal of every pregnancy is a healthy baby and mom—and future moms can do a lot to create that happy outcome. With proper planning and lifestyle choices, moms-to-be can reduce their chances of having a child with a birth defect.

Birth defects are problems that occur while babies are developing in the womb. They impact 1 to 3 percent of births in the U.S. A congenital heart defect, cleft lip, and clubbed feet are all examples.

While some problems are small or easily fixed, many more present lifelong physical, cognitive, and health challenges. A few are lethal. All women should have the ability to bring the healthiest baby possible into the world—and it starts with planning.

Manage health conditions

Planning when to conceive allows women to work with their doctor to control their health conditions. This is important because diseases can impact a pregnancy. For example, women who don’t have their diabetes under control when they become pregnant increase their risk of having a child with a heart defect or spina bifida by 30 percent.

Women who have ulcerative colitis and who conceive when they have a flare have a 70 percent chance of the disease being poorly controlled throughout their pregnancy. In addition to miscarriages, flares can cause premature delivery and labor and delivery complications, which are linked to long-term complications. However, being in remission for six months prior to conception reduces the risk of having a flare to 30 percent.

Review medications

Planning ahead also gives doctors the opportunity to discuss which medications are safe during pregnancy. Blood thinners, medications used to manage high blood pressure, certain antidepressants, and some antibiotics can cause serious birth defects. For women taking these medications, having unprotected intercourse just once can lead to an affected child. Women who are on these prescriptions need an effective form of birth control. Women who wish to become pregnant need safe prescription alternatives.

Reduce exposure

Women who know they might become pregnant can also reduce their exposure to harmful substances. Cigarettes, alcohol, and street drugs are all things that can harm developing babies. Smoking during pregnancy can lead to preterm birth, a low birth weight, and birth defects of the mouth and lip. Regular exposure to secondhand smoke also increases the chance of birth defects. It’s important to avoid drinking alcohol during pregnancy because it can lead to Fetal Alcohol Spectrum Disorders. By planning ahead, women can avoid exposing a fetus to these substances.

Take folic acid

Doctors have been advising moms-to-be to take folic acid for nearly 30 years for good reason. Taking 400 mcg of folic acid for three months prior to conception can help reduce the risk of brain and spinal cord defects. A baby’s neural tube starts forming during the first weeks of pregnancy—before women even know they are pregnant—so it’s critical women have adequate levels of this B vitamin present in the body before conception. Because so many pregnancies are unplanned, the CDC now recommends that all women of reproductive age take folic acid.

Additional measures

While pregnancy planning and folic acid use are essential when it comes to preventing birth defects, women have a few other things they can do:

  • Avoid infections by staying up-to-date on vaccines, such as the yearly flu vaccine.
  • Avoid overheating by staying out of saunas and hot tubs. Each two-degree rise in body temperature increases the risk of defects, and the risk increases the more frequently a woman’s body temperature rises.
  • Consider screening for genetic diseases, as these conditions are often associated with birth defects.

OBGYNs and midwives are experts at helping women assess their risks and plan healthy pregnancies. While not all birth defects have a known cause or can be prevented, women’s choices make a key impact. If you have health conditions that make pregnancy prevention important, or if you wish to become pregnant in the near future, schedule with a provider today.

Sally Segel is a maternal fetal medicine doctor at Vancouver Clinic. She encourages patients to be actively involved in their pregnancies. sally-segel