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Mommy’s First Steps

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A healthy maternity starts early

This Mother’s Day month, we’re dedicating our health column to keeping mothers healthy, even before they become moms—or even mothers-to-be. To do so, we sought the sage advice of a woman who knows: Ochsner OB/GYN Dr. Elizabeth Lapeyre, who happens to be a mother of five. Here, she confirms that a healthy maternity starts long before your baby is conceived. Whether you’re hoping to be a mommy-to-be sometime soon, you have a little one on the way right now or you just think you might want to have children in the future, these simple steps can help guarantee the best possible health for you—and for your baby.

BEFORE YOU CONCEIVE
1 Take folic acid.

Says Dr. Lapeyre: “Folic acid supplementation (400 micrograms a day for most patients) reduces the incidence of neural tube defects like spina bifida and anencephaly.” Since your baby needs a good supply of folic acid from the moment you conceive, you should start taking supplements “at least one month prior to pregnancy.” You can get your daily dose of folic acid in a good prenatal vitamin, which also contains extra boosts of calcium for strong bones and teeth for you and your baby (and for your circulatory, nervous and muscular system) and iron, for healthy blood and muscle cells for baby and you

2 Avoid fish high in mercury.
Since mercury can remain in the body for long periods of time, women who are trying to conceive should follow the same guidelines for seafood consumption that pregnant women follow. Lapeyre cautions that “fish with high levels of mercury, including shark, swordfish, king mackerel and tilefish, should be avoided. This is not to say that pregnant women should not eat seafood. They should choose fish that are not known to be high in mercury content.”

3 Quit smoking.
Smoking has been found to lower fertility levels and make getting pregnant more difficult. The habit is also linked to 20% of low-birth-weight deaths, 8% of pre-term deliveries and 5% of all delivery deaths. “Women who are smokers should try to quit prior to conception and not smoke during pregnancy—or after,” says Lapeyre.

4 Maintain a healthy weight.
According to Lapeyre, “Obese women are at increased risk for several pregnancy complications. For this reason, obese patients should attempt a weight-reduction program prior to conception.” Reaching and maintaining a healthy weight can also help boost your energy levels, increase your longevity and decrease your risk of heart disease and other adverse health conditions—which will help ensure you’ll live a longer, healthier, happier life with your children (and theirs!).

5 Get preconceptional counseling.
A preconception exam is always recommended for women with any preexisting medical conditions—“women with underlying medical problems like diabetes and hypertension should seek preconceptional counseling,” Lapeyre notes—or for women who regularly take medication for any chronic concerns such as migraines, seizure disorders, stress, anxiety, depression or chronic pain. Preconceptional genetic testing and counseling is also becoming increasingly available for women who may be at risk for genetic disorders and want to know their risk factors before conceiving children.

IF YOU THINK YOU MIGHT EVER WANT TO GET PREGNANT
Increasingly, many women today are waiting later and later to start their families, for reasons both professional and personal. Unfortunately, fertility rates do decline once women reach their 30s, and complications during pregnancy are more common after 35. We asked Lapeyre if there are any health, dietary or lifestyle recommendations for preserving fertility for those who want to have families after age
35. “The question regarding ‘preserving fertility’ is a tough one,” says Lapeyre. “A woman is born with a certain number of eggs. These deplete over time. Maintaining your overall health is the best advice. Eating a balanced diet and exercising is important. A 38-year-old woman of average weight with no medical problems is in a better position for a pregnancy than a 38-year-old obese, hypertensive, diabetic.”
All the more reason to start taking “mommy steps” towards living your healthiest lifestyle now.