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Your Pre-Pregnancy Checkup

We all know about the importance of prenatal medical care in assuring the health of a pregnant woman and her baby. But many experts now recommend that women start seeing an obstetrician before they become pregnant for something called pre-pregnancy or preconception care.

It may seem excessive -- after all, why start worrying before you're pregnant? But a doctor can help even at an early stage. He or she can run tests to make sure that you and your partner don't have any hidden illnesses that could affect your pregnancy or your chances of becoming pregnant. Your doctor can also give you advice about exercise, eating, and lifestyle. Some studies show that preconception care can increase your chances of becoming pregnant and reduce the risks of miscarriage or birth defects.

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What to Expect During a Pre-Pregnancy Checkup

Your doctor will want to start a pre-pregnancy checkup by getting a full medical history from both you and your partner. He or she will also want to run a number of tests -- such as blood tests and a Pap smear -- to make sure that neither of you have any medical conditions that could affect pregnancy or your chances of conceiving. Your doctor might test for illnesses such as:

  • Rubella, or German measles
  • Chickenpox
  • HIV
  • Hepatitis B
  • Herpes
  • Other STDs (such as chlamydia, syphilis, and gonorrhea)
  • Thyroid problems (with a TSH test)
  • Other conditions, such as toxoplasmosis, parvovirus B19 (also called fifth disease), and cytomegalovirus

Your doctor may want to run tests to evaluate your fertility, such as:

  • Postcoital test. A small sample of your cervical fluid is taken shortly after you have sex during ovulation; your doctor examines both the fluid and the condition of the sperm in it.
  • Semen (sperm) analysis. A sample of semen is taken from your partner to determine his sperm count and sperm motility (how active the sperm are).

Finally, depending on your ethnicity, your doctor may recommend genetic tests for:

  • Sickle cell anemia
  • Thalassemia (an inherited form of anemia)
  • Genetic diseases common in the Ashkenazi Jewish population, such as Tay-Sachs disease

If it's time for you to update your vaccines, it's important to do so before you are pregnant. A few specific vaccinations, such as the MMR (measles-mumps-rubella), varicella (the virus that causes chickenpox), or hepatitis A vaccines increase the risk of birth defects. Experts advise that you wait at least 28 days after receiving some of these vaccinations before trying to conceive.

Managing Diseases in Pre-Pregnancy

If you have an existing medical condition, such as epilepsy, high blood pressure, asthma, or diabetes, it's especially important to seek out medical care before getting pregnant. Not only is it crucial to keep these illnesses under control during your pregnancy for both your and your baby's sake, but some common medications used to treat these conditions -- such as certain high blood pressure drugs -- can have an adverse affect on your pregnancy. If this is true of a medication that you're currently using, your doctor may be able to suggest a substitute.

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