Dr. Matthew Bogard, Iowa Doctor - Preconception Planning

Preconception Planning - The pre-flight for an important journey

I am an avid pilot.  The freedom to hop in our small plane, see the countryside from above, and travel provides immeasurable satisfaction, but many decisions about the safety of the flight must be made prior to firing up the engine.  Pilots conduct a thorough pre-flight checklist of the airplane's condition as well as our own preparedness, because there is no way to "pull over on the shoulder" once airborne.  In much the same way, it is important to plan and prepare for pregnancy ahead of time to give your baby the best chance for a healthy start.  About half of pregnancies in the United States are unintended, and most turn out just fine, but having everything ready to go lowers stress for the parents-to-be.

Optimizing your health prior to becoming pregnant is very important because nearly half of women don't see the doctor about their pregnancy until they are already into their second trimester (greater than 13 weeks along), and by then many of the baby's organs have already formed.  In fact, by the time even the most diligent mothers realize they are pregnant (around 6 weeks), the central nervous system, eyes, heart, arms, and legs are already developed.

One of the most important things to do prior to pregnancy is eliminate things in your life potentially harmful to your baby.  Stopping smoking and moderating alcohol intake are two of the most common interventions mothers-to-be must consider.  In 2002 in the United States, about 7 percent of preterm-related deaths, nearly 20 percent of babies with growth restrictions, and about 30 percent of sudden infant death syndrome (SIDS) deaths were attributable to mothers smoking. In addition, smoking and secondhand smoke exposure increase the risk of infertility, stillbirth, congenital malformations and placental problems complicating pregnancy. 

Current recommendations are to also completely abstain from alcohol intake during pregnancy.  A British study in 2011 found that one small alcoholic beverage daily did not increase pregnancy risks, but the complications increased dramatically when drinking any more than that.  We have never definitively found a "safe" level of alcohol intake during pregnancy and still recommend avoiding it altogether.

Folic acid is instrumental in preventing congenital abnormalities like spina bifida.  In 1998, the FDA required breads, cereals, flours, pastas, rice, and other grains be fortified with folic acid to help prevent birth defects, and follow-up studies show it has decreased neural tube defects by 25%.  Since nearly half of pregnancies are unplanned, this fortification increases the chance that every mother-to-be gets enough folic acid.  However, if you are trying to conceive, I recommend taking daily prenatal vitamins containing folic acid before becoming pregnant.

There are other important things to discuss with your doctor prior to conceiving.  We should review any medications you take regularly to ensure they are safe during the pregnancy, and make substitutions if necessary.  Certain important immunizations like rubella cannot be administered during pregnancy and should be updated before you conceive.  Women with diabetes are at particular risk of problems due to both the fluctuations in your body's glucose levels and some of the medications prescribed to manage diabetes.  Chronic conditions like being underweight or overweight, high blood pressure, asthma, and thyroid abnormalities must also be closely monitored before and during pregnancy.

Dr. Matt Bogard, M.D. is a medical doctor.  He is board-certified in Family Medicine and Board-Eligible in Emergency Medicine.  He sees patients of all ages, genders, and complaints.

References:
Blog: https://matthewbogardmd.blogspot.com/
News: https://medicogazette.com/dr-matthew-bogard%2C-iowa

News: https://hippocratesguild.com/dr-matthew-bogard

News: https://hype.news/dr-matthew-bogard/
News: https://attorneygazette.com/matthew-bogard%2C-md#7244cab0-d3fa-44b9-8632-6f83b0524da4

LinkedIn Profile: https://www.linkedin.com/in/matthewbogard/

Dr. Matthew Bogard, Iowa doctor, is an emergency medicine doctor primarily at the Lucas County Health Center in Chariton, Iowa. Presently, he is Board Certified in Family Medicine by the National Board of Physicians and Surgeons and the American Academy of Family Physicians.