Healthy Lifestyles

Preconception Care: 12 Things To Do Before You Become Pregnant

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Before you become pregnant, you want to be in the best physical and mental health you can be. Here are some suggestions to help you achieve this goal.

1. Talk with your partner about having a baby to be sure you both are ready. Talk about the financial impact of pregnancy as well as the physical and emotional impact. Is your relationship strong enough to handle the stress of pregnancy and childrearing? If you are not married, talk about marriage. Statistically, children with married parents have more advantages. Babies are cute and sweet but they are not babies forever. Are you ready to be responsible for the many needs of a crying baby, a demanding small child, a volatile adolescent? Becoming a parent will change your life forever.
2. Do you have health insurance? If you do not have health insurance and cannot afford to pay a private health care provider for a preconception health care visit, make an appointment at your local health department. The nurse, nurse practitioner, or physician there can help you for a very reasonable fee based on your income. Ask for a family planning appointment when you call.
3. See your health care provider before you begin trying to become pregnant in order to be in good health at the time of conception. Part of good health before you become pregnant is having your partner and yourself checked for sexually transmitted infections and treated if necessary. Sexually transmitted infections can keep you from getting pregnant. They can be harmful to the baby if you do become pregnant. Tell your health care provider you are planning to become pregnant. Ask for their advice. Finally, ask about the menstrual cycle if you are uncertain about how it works and when fertile days occur.
4. Tell your health care provider about any medications you may be taking including over-the-counter medications or herbal supplements.
5. Take a multivitamin with 400 microgram of folic acid prior to becoming pregnant or take a prenatal vitamin daily. Folic acid, prior to and during early pregnancy, helps prevent birth defects of the spinal cord. Prenatal vitamins are available over-the-counter or your health care provider can prescribe them.
6. Stop using tobacco, alcohol, or Illegal drugs. Ask your health provider for advice on how to quit. Call the Tennessee Tobacco QuitLine at 1-800-QUIT-NOW to get help quitting tobacco. Many health care providers also recommend that you stop using or reduce significantly your intake of caffeine.
7. Try to be at or near your ideal weight at the time of conception. Choose a healthy, well-balanced diet with plenty of fruits and vegetables. Ask your health care provider about seeing a registered dietician. There are registered dieticians with the WIC program (see #12) at your local health department.
8. Walk for 30 minutes everyday. It will help you control your weight, lift your mood, and help you sleep better. If you do not feel like it is safe to walk in your neighborhood, consider walking laps in a local mall or shopping center. Invite a friend or ask your partner to walk with you.
9. When you are ready, stop using your method of birth control. If you were using a hormonal method of birth control (Pill, Patch, Ring, Shot), try to have at least one month without birth control and one period at the end of that month before conceiving. This will help your health provider establish your due date correctly. During this month you could use over-the-counter male or female condoms or you could use a spermicide or you could use both a condom and a spermicide. Some health care providers will ask you to do this for 3 months prior to conceiving. Find out what your health care provider prefers.
10. Keep track of your periods. Write down the first day the menstrual bleeding begins each month. Your due date is based on the date of the first day of your last normal menstrual period. Also take note of whether or not the menstrual period was “normal for you”.
11. Women do not miss their period until about two weeks after conception. Most pregnancy tests can pick up the hormones of pregnancy in urine as early as a week after conception. However, it is recommended that you do not have a urine test until your menstrual period is at least one week late. By waiting, the accuracy of the test improves.
12. Report to your health care provider for prenatal care as soon as you suspect you are pregnant. If you do not have health insurance or do not have health insurance that covers pregnancy, report to your local health department. There is a type of TennCare just for pregnant women. The staff at your health department will assess whether or not you qualify for this program. Most women who do not have private health insurance will qualify. Staff at the health department can also see if you will qualify for WIC, a federal food voucher program for pregnant women and children. Many health departments also offer support and prenatal education through a series of home visits. Just ask!

Reproductive Health

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"Sexual and reproductive health concerns everyone, everywhere, and at every stage of life." Paul Van Look, Director, World Health Organization/Reproductive Health and Research

What Is Reproductive Health?

There are many definitions, but generally, "reproductive health" covers all matters relating to the reproductive system, at all stages of life. Good reproductive health for women begins in childhood and the teen years. Things such as nutrition, environment, education, income level, and cultural practices influence your reproductive health.

Why Is It Important?

Good reproductive health benefits the health and well-being of you and your family. It can improve the social and economic situation of you and your family. And most importantly, it can help make sure that every infant is wanted, loved and has a chance to grow up healthy. Some of the things that make up good reproductive health include:

• Being able to protect yourself against sexually transmitted diseases (STDs), including HIV/AIDS.
• Having healthy pregnancies and healthy babies.
• Having access to safe, effective, and affordable methods of birth control.
• Being able to space your pregnancies and avoid unintended pregnancies.

What are Unintended Pregnancies?

An unintended pregnancy is one that happens at the wrong time in your life or is unwanted at the time you got pregnant.

The usual reasons most people have an unintended pregnancy are:

• Not using any method of contraception.
• Not using your method the way you were told, like taking a pill every day.
• Not using your planned method, such as condoms or a diaphragm, every time you have sex.
• The method itself failed.

Why are Unintended Pregnancies a Problem?

In general, planned babies are healthier babies. Mothers, too, are less likely to suffer health and other problems if their pregnancies are planned. For many women, if a pregnancy is unexpected, they are more likely not to see a doctor early in pregnancy or not get prenatal care at all.

Starting prenatal care after you are three months along, or not seeing a doctor at all, is related to the baby being born too soon, or too small. Being born before nine months or weighing less than 5 ½ pounds can lead to problems for the baby.

If your pregnancy is unplanned, you may be more likely to have a poor diet, including not getting enough folic acid, a vitamin that helps prevent certain birth defects. You may also have a lifestyle with health risks to you and your baby. Smoking cigarettes, drinking alcohol, using other drugs, or having unsafe sex can put your baby at risk for being born too early or too small, dying at birth or soon after, dying of Sudden Infant Death Syndrome (SIDS), and developing asthma and/or learning problems later in childhood.

Unplanned pregnancies can put you at more risk of becoming a victim of domestic violence. The child of an unplanned pregnancy is also at risk of abuse and neglect.

If you have an unplanned pregnancy, you are less likely to finish your education.

Birth Spacing

Children born too close together are more likely to be born early, or small and underweight. Premature or too-small babies have a greater chance of becoming sick; some even die as a result. Researchers believe babies born close together are less healthy because the mother's body has not fully 'bounced back' from the previous pregnancy. Being pregnant and having a baby takes a toll on a woman's body. How long should you wait before having your next child? The healthiest babies are born to women who waited 18 to 23 months after giving birth before getting pregnant again. Using a family planning method helps you plan your pregnancies and control the amount of time between births.

• Baby Spacing Brochure: English | Spanish

Family Planning

The Choice Is Yours...Benefits of Family Planning

Family planning benefits the health and well-being of women and families throughout the world. Effective use of birth control methods can help young women avoid unplanned pregnancy and postpone childbirth. Contraceptive use between pregnancies can help ensure proper spacing between babies. And, for women who have reached their desired family size, birth control can help prevent unplanned pregnancy in later years. Family planning may also help you:

• Be able to prepare financially for your children.
• Have children when you want them.
• Have children further apart.
• Be healthier during pregnancy.
• Have a healthier baby.
• Have sex without worrying about an unplanned pregnancy.

The Tennessee Department of Health offers family planning services in every county health department clinic. Birth control services are provided on a sliding fee scale based on family size and income. Persons below the federal poverty level will not be charged for services. No one will be denied services due to inability to pay. Family planning services are available to anyone, male or female, who wants a method of birth control. All information is kept private. The clinics are staffed by doctors, nurse practitioners, and nurses. The staff are specially trained to provide education, counseling, physical assessments, medical histories, and contraceptives.

Services you will receive at your local family planning clinic

• Medical Services
• Education and Counseling Services
• Physical Exams
• Reproductive and Preventive Health
• Cervical Cancer Screening
• Self Breast/Testicular Examination
• breast cancer screening
• Contraceptive Methods
• STD Testing and Treatment
• STD/HIV
• Blood Pressure Screening
• Anemia Screening
• Referrals and Linkages with Community
• Pregnancy Testing Resources
• Dispensing of Birth Control Methods
• Emergency Contraception
• Sterilization Referrals

The Choice Is Yours...Birth Control Methods

The choice of birth control depends on factors such as your health, how often you have sex, how many partners you have, and when you want to have children in the future. For more information talk to your doctor or call the local health department in your county.

Which Method Is Right For You?

• Family Planning Methods Brochure: English | Spanish

Abstinence — Refraining from sexual intercourse.

Condoms (rubbers) — A thin sheath of latex rubber that fits over the penis and prevents sperm from getting inside the woman’s vagina. Helps protect both partners from sexually transmitted diseases. Condoms are more effective if used with a spermicide. Some people experience irritation from the latex.

Contraceptive Patch — An adhesive patch that contains the same hormones as birth control pills is worn on the body for one week at a time. Three patches are used per month.

Contraceptive Vaginal Ring — A small soft ring that contains hormones is placed in the vagina to prevent the release of an egg from the ovary. A ring is worn for three weeks at a time.

Diaphragm (with spermicide) — A small round rubber cup which is placed in the vagina over the cervix and keeps sperm from entering the uterus. It must be used with a spermicidal jelly or cream. Some people experience irritation from the latex.

Injectables — A contraceptive shot is given once every 3 months. May cause changes in menstrual flow.

IUD (intrauterine device) — A small, soft plastic device, covered with copper or a hormonal agent, which is inserted into the uterus. Effective for 5 or 10 years, depending on the type.

Natural Family Planning — Avoiding sexual intercourse during the fertile days in a woman’s cycle. Requires instruction from a health professional to determine the days of fertility.

Pills — Birth control pills contain hormones that work by preventing the release of an egg from the ovary each month. These must be taken daily.

Spermicidal Films, Foams, Creams, Suppositories, and Jellies — Chemicals which kill sperm and come in different forms. They are placed in the vagina just before intercourse. Some people may experience irritation from the spermicide.

Sterilization — Permanent method available to men and women who are absolutely sure they do not want children in the future. The male procedure is called a vasectomy and involves cutting and tying the tubes that carry sperm. The female procedure is called tubal ligation and involves cutting and tying the tubes which carry the egg.

Sexually Transmitted Infections (STIs)

These infections are the ones you can get by having sex (genital, oral, or anal) with someone who already has one of these infections. Many people do not know they have an STI because some common STIs cause no symptoms.

STIs can cause infertility (not being able to get pregnant when you want to). If you are already pregnant, STIs can cause miscarriage, tubal pregnancy, prematurity, stillbirth, birth defects, newborn illness, and death.

Some common STIs are chlamydia, gonorrhea, genital herpes, HIV, syphilis, and hepatitis B.

How to protect yourself against sexually transmitted infections

The surest way to avoid getting or giving any STI is to not have sexual contact, or to be in a long-term, faithful relationship with the same partner who has been tested and is known to not be infected with any STI. Latex condoms, when used every time and used correctly, are highly effective in preventing the spread of HIV, the virus that causes AIDS. Latex condoms, when used every time and used correctly, can also reduce the spread of gonorrhea and chlamydia. Condoms are not as reliable in preventing the spread of genital herpes.

For more information or to make an appointment to be tested for an STI, call your doctor or your county health department.

Smoking

Call the Tennessee Tobacco QuitLine at 1-800-QUIT-NOW (1-800-784-8669). IT’S FREE!!

It’s hard to quit smoking. But studies show that people who use a program really do better. Now you can sign up for the FREE Tennessee Tobacco Quit Line program to help you quit for good.

Click here for more information.

Folic Acid

The Who, What, When, Where and Why of Folic Acid!

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Who needs Folic Acid?

If you are capable of getting pregnant, you need folic acid!

What is it?

Folic Acid is a B vitamin. It is used in our bodies to make new cells.

Where can you get it?

The simplest way to get folic acid is to take a multivitamin. Multivitamins are loaded with nutrients that may help keep your bones strong, and protect against heart disease and some cancers. For women, a multivitamin that contains folic acid is especially important. A daily multivitamin containing 400 micrograms of folic acid helps reduce the risk of serious birth defects of the brain and spine called neural tube defects (NTDs).

When do women need it?

Now! Every day!

Why do you need it?

Neural tube defects (NTDs) like spina bifida and anencephaly happen during the first month of pregnancy. That’s before most women even know they are pregnant. Spina bifida, the leading cause of childhood paralysis, occurs when the spinal column fails to close properly. With anencephaly the brain fails to develop completely or is entirely absent. Anencephaly is always fatal. NTDs are serious defects. The good news is that 50 to 70 percent of NTDs may be prevented if women consume the recommended amount folic acid.

Increased consumption of folic acid is making a difference. Since 1998 when food manufacturers added folic acid to enriched grain products, the number of babies born with spina bifida and anencephaly declined 27 percent in the United States. According to the Centers for Disease Control and Prevention (CDC), publishers of this data, this means 1,000 fewer babies are affected by these birth defects each year. Even more babies could enjoy life without NTDs if all childbearing age women consumed 400 micrograms of folic acid every day.

There’s Still More You Need to Know!

Not ready for a baby yet?

About half of all pregnancies are unplanned. Women need adequate folic acid every day so their bodies will be ready whenever pregnancy occurs. To prevent NTDs the CDC recommends taking a multivitamin one month before and during the early weeks of pregnancy. Even if you aren’t planning a pregnancy, start the folic acid habit now. There are lots of good reasons to take a multivitamin. Preventing birth defects is just one of them.

Have problems taking a multivitamin?

If swallowing pills is hard for you, buy chewable multivitamins instead. Can’t remember to take your vitamins? Put the bottle where you are likely to see it – next to your toothbrush, on the kitchen counter, with your car keys. Take them the same time everyday. If cost is a factor, buy generic brands and watch for coupons and specials.

Are there other ways to get folic acid?

Absolutely! Many breakfast cereals and some other foods are super-fortified with 400 micrograms of folic acid in a serving. Look for 100 percent of the Daily Value for folic acid on the label (100 % DV). Enriched grain products have extra folic acid added to them. Breads, pasta, grits, cereals and rice are part of this group.

The following are good sources of folate, the form of folic acid found in food: Dried beans and peas; Juices – orange, pineapple, tomato; Fruits – oranges, cantaloupe, honeydew melon, avocado; and Vegetables – green leafy vegetables such as spinach, turnip greens, and collard greens; broccoli; lima beans; romaine lettuce; and asparagus

Although folic acid is found in many foods, it is difficult to get enough folic acid from diet alone. That’s why the Institute of Medicine recommends that women who can become pregnant consume 400 micrograms of folic acid every day in addition to eating a healthy diet. A multivitamin or food containing 100 percent of the Daily Value for folic acid provides the amount recommended by experts.

Are you taking medications that impact your need for folic acid?

Certain medications or health conditions put you at higher risk for having a baby with an NTD. Phenytoin, an oral and injected anti-seizure medication, and methotrexate, an oral and injected antimetabolite drug used for cancer treatment, psoriasis, and rheumatoid arthritis, are examples of two medications that increase your need for supplemental folic acid. Ask your doctor or pharmacist for more information.

Have you already had a pregnancy affected by an NTD?

If you have had a previous pregnancy affected by an NTD you are at high risk for another NTD affected pregnancy. It is very important to talk with your doctor about how to get the increased amount of folic acid right for you.

Disease Prevention

Women Create Their Own Paths to Health

The familiar proverb, “A journey of a thousand miles begins with a single step” is useful when thinking about women’s health in Tennessee.

According to Tennessee Department of Health data, the top three causes of death for women residents of Tennessee are heart disease, cancer and stroke. Death rates for heart disease and stroke are considerably higher in the Southeastern states than in the rest of the country. The good news is there are simple steps women can take to improve their health and lower the chance of dying from these and other diseases. The important thing is to begin with that critical first step.

In fact, there are many first steps that a woman can take to lower her individual risk of disease, from having a screening test to walking more or taking the stairs to including fruits and vegetables in her diet. This seems like a "common sense" approach to improving health, but women need to be reminded that developing healthy habits occurs one step at a time, one day at a time, and certainly, one woman at a time.

It can be overwhelming to hear messages calling for major changes like: ‘lose weight,’ ‘eat nutritional foods,’ or ‘avoid alcohol and illegal drugs'. It is more realistic to begin with steps like ‘walk, don’t ride,’ ‘plan an evening out that’s alcohol-free,’ ‘take the stairs,’ or ‘skip the soft drinks, drink water instead.’ These are just a few examples.

Women tend to be the caretakers in our society – of children, spouses, parents, grandparents, friends and neighbors – often caring for others before themselves. As a result, many women do not get the preventive health tests they need. Tests like mammograms for breast cancer, pap smears for cervical cancer, or blood pressure and cholesterol screening can save lives. Another simple step to improve health: make an appointment for a check-up.