Get a Head Start on a Healthy Pregnancy

Planning on getting pregnant? This guide to preconception care will help you make healthier choices about avoiding toxins.

From the WebMD Archives

For women who want to rid their bodies and homes of toxins before pregnancy, there’s no shortage of dos and don’ts floating around. In fact, the list can seem overwhelming. So what are the best things you can do to stay healthy and make sure your children will be protected from environmental toxins when you do get pregnant? WebMD talked to some experts to find the latest tips pre-pregnancy health.

Preconception Care: What’s Most Important

Good nutrition, good general health, and exercise are the most important aspects of getting ready for pregnancy.

Plan a pre-pregnancy visit with your doctor. Talk to your doctor about your diet and lifestyle; medications, vitamins, and supplements that you’re taking; your medical history and that of your family; and any concerns you may have. Your doctor will advise you on preconception care and any vaccinations that you should have before getting pregnant.

"Get yourself into optimal health,” says Joel Evans, MD, author of The Whole Pregnancy Handbook and founder of the Center for Women’s Health in Stamford, Conn. Don't smoke or drink alcohol, and limit caffeine. Maintain a healthy weight; try to get health problems such as diabetes under control; exercise at least 30 minutes a day; and eat plenty of fruits, vegetables, and whole grains.

“Women who might be poorly nourished -- not necessarily underweight but not eating properly -- may be more susceptible to environmental exposures,” says Ted Schettler, MD, MPH, science director of the Science and Environmental Health Network and the author of In Harm’s Way: Toxic Threats to Child Development.

Make sure you get enough folic acid in your diet, by eating fortified cereal, beans and peas, citrus fruit, spinach, and asparagus. Folic acid helps protect a baby from birth defects of the brain and spinal cord, such as spina bifida, that can happen very early in a pregnancy (often before you even know you're pregnant).

It can be hard to get enough folic acid in diet alone. The American College of Obstetricians and Gynecologists recommends that all women of childbearing age take a daily supplement or multivitamin that contains 400 micrograms of folic acid before and during the first three months of pregnancy.

Here are some other precautions you may want to take:

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Pre-Pregnancy Health: Your Drinking Water

Generally, water from the tap is safe. Your local water utility is required to provide a Consumer Confidence Report that lists contaminants detected in your water. If you haven't received a report, you can call your water utility and request one.

If your home has lead pipes, lead solder on copper pipes, or brass faucets, significant amounts of lead can leach into your drinking water. Exposure to high levels of lead during pregnancy can contribute to miscarriage and preterm delivery, and to low birth weight and developmental delays in babies. Your local health department or water supplier can advise you how to get your water tested for lead and other contaminants.

If there are contaminants in your water, you may want to install a water filter that is certified by NSF International, and which removes lead as well as other pollutants.

Pre-Pregnancy Diet: What About Fish?

Many women worry about mercury in fish. Mercury can harm a baby’s nervous system and may lead to learning disabilities. But you don't want to miss out on the health benefits of fish, either: Fish and shellfish are high in protein, low in fat, and are a good source of omega-3 fatty acids. This benefits babies’ brain and vision development, and may reduce your risk of pre-term labor.

You can limit your risk by eating certain kinds of fish and avoiding others. The FDA and EPA advise women who may become pregnant to avoid eating shark, swordfish, king mackerel, or tilefish, which tend to have higher levels of mercury. They also recommend eating up to 12 ounces a week (about two meals) of fish that are lower in mercury, such as shrimp, clams, salmon, pollock, catfish, canned light tuna, or tilapia.

Freshwater fish caught in rivers and streams can have very high levels of mercury. For information on the safety of freshwater fish in your area, check with your state fish advisory. You can also use the Environmental Defense Fund’s Seafood Selector to help find the safest options.

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Preconception and Pesticides

“There is no question that there are causal associations between some -- not all -- pesticide exposures and infertility or pregnancy compromise, including miscarriages and birth defects,” Schettler says. Avoid exposure by using natural pest control methods in your home and yard. The EPA provides information on integrated pest management and beyondpesticides.org offers information on natural pest control methods. According to the American Pregnancy Association, this is especially important during the first trimester of pregnancy, when a baby’s nervous system is developing rapidly.

What about pesticides on your plate? Although there's no proof that eating organic will ensure a healthier pregnancy, it is a great way to lower your exposure to pesticide residues. If you can't go totally organic, Evans recommends consulting the “Dirty Dozen” list put out by the Environmental Working Group (EWG). It lists the 12 most pesticide-contaminated fruits and vegetables.

Pre-Pregnancy Health and Home Cleaning Products

You may also want to think about how you clean your house. Some cleaning products contain solvents that can be hazardous at high levels of exposure. There are a number of natural cleaning products on the market that don't contain harsh chemicals. Look for ones that don't contain harsh solvents, fragrances, chlorine, or ammonia. Or you can make your own. Baking soda can be used as a powdered cleanser to scrub greasy areas, pots and pans, sinks, tubs, and ovens. A solution of vinegar and water can be used to clean countertops, windows, and other surfaces.

Preconception Care: Are Plastics and Dry Cleaning Safe?

Some plastic wrap and containers contain phthalates, which can leach out when heated in a microwave. Although government and industry consider phthalates to be safe, one study found that pregnant women with higher levels of phthalates were more likely to have baby boys with slight changes to their genitals.

As an alternative, use glass containers to store food, and use a paper towel instead of plastic wrap when your microwave.

When it comes to dry cleaning, some doctors say that clothes laundered by conventional dry cleaning pose no risk to pregnant women; others say to avoid them altogether. The biggest concern is around perchloroethylene (“perc”).

"We know that perc exposures occur from clothes that are brought into the house, and we know that perc easily crosses the placenta and gets into the baby,” Schettler says. "It also gets into breast milk." Choose clothes that don't need dry cleaning, or look for a dry cleaner that uses a water-based process. If you have some clothes that have to be dry cleaned, hang them outside and let them air out before bringing them in.

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Avoiding Toxins Pre-Pregnancy: Solutions for the Nesting Instinct

Even if you’re just planning your pregnancy, you may be feeling the urge to get the house in order before a baby is born. But you should be careful about exposure to toxins from renovation work or new furniture and other items.

If your home was built before 1978, have it tested for lead paint. The EPA has a list of labs where you can send paint samples for testing. Removal of lead paint must be done by a professional lead abatement specialist. If you have lead paint removed, you should stay out of the house until it has been cleaned thoroughly.

You may also want to be choosy about new furniture and carpet, which can give off chemical fumes. “The rule of thumb is: Stay away from anything that smells,” says Evans.

Kimberly Rider, an interior designer in San Rafael, Calif., and author of Organic Baby and The Healthy Home Workbook, suggests buying solid wood vintage furniture and using No-VOC (volatile organic chemicals) paints.

Pre-Pregnancy and Toxins: What Men Should Know

It’s a good idea for your partner to get healthy before conception too.

According to the National Institute of Occupational Safety and Health, ongoing exposure to pesticides, chemical fertilizers, lead, nickel, mercury, chromium, ethylene glycol ethers, petrochemicals, benzene, perchloroethylene, radiation, and other toxins can lower sperm quality as well as quantity, and possibly lead to miscarriage in their partner’s pregnancy.

Prospective fathers may want to follow many of the same guidelines you do for avoiding toxins. Men should also see their doctor to discuss important preconception care on their part.

WebMD Feature provided in collaboration with Healthy Child Healthy World Reviewed by Michael W. Smith, MD on October 11, 2009

Sources

SOURCES:

American College of Obstetricians and Gynecologists Patient Pamphlets: “Good Health Before Pregnancy,” “Nutrition During Pregnancy”

Joel Evans, MD, author, The Whole Pregnancy Handbook: An Obstetrician's Guide to Integrating Conventional and Alternative Medicine Before, During, and After Pregnancy, Gotham, 2005; founder, Center for Women’s Health, Stamford, Connecticut.

Ted Schettler, MD, MPH, science director, Science and Environmental Health Network; author, In Harm’s Way: Toxic Threats to Child Development, Greater Boston Physicians for Social Responsibility, 1990.

Larson Duyff, R. American Dietetic Association Complete Food and Nutrition Guide,Third Edition; Wiley, 2006.

March of Dimes: “Environmental Risks and Pregnancy,” “Caffeine in Pregnancy,” Smoking During Pregnancy,” “Preconception Risk Reduction: Drinking Alcohol During Pregnancy”.

Kimberly Rider, author, The Healthy Home Workbook, Chronicle Books, 2006, and Organic Baby, Chronicle Books, 2007.

KidsHealth: “Health Experts Continue Weighing Possible Risks vs. Benefits of Eating Fish During Pregnancy”.

U.S. Environmental Protection Agency: “What You Need to Know About Mercury in Fish and Shellfish”.

American Pregnancy Association: “Pesticides Exposure During Pregnancy,” “Hair Treatment During Pregnancy,” “Preconception Health for Men”.

University of California Newsroom: “Study Warns of Cleaning Product Risk”

Johns Hopkins Bloomberg School of Public Health: “Q&A: Bisphenol A and Plastics.”

Sources

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