Planning before Pregnancy Dr. S. K. Mangat, F.R.C.O.G Pre – conception counseling is yet not much known in our country. As science is progressing, pregnancy care has also improved. Antenatal care is well accepted in India but counseling before pregnancy is not known a whole lot due to some of the following reasons.   Ignorance Old traditions Financial issues    Family members tell the pregnant ladies to go to the hospital when pregnancy is in the 4th or 5th month only if there is some complaint. They think that it is a natural phenomenon. Some want only minimum check up such as taking weight measurement or blood pressure reading, which was the same when they had in their times. The family members feel that the doctor is causing inconvenience or may order costly blood tests and even perform an ultrasound. Some even have a belief that ultrasound causes radiation damage which is not true. There is no radiation effect with ultrasound. It is the doctor’s duty to talk to such patients when they mention these orthodox or false beliefs. At the present time, the woman should see an Obstetrician as soon as she gets married or sometimes even before they get married to clear any false belief, doubt or orthodox reason about pregnancy. This will help in the wellness of the baby and the mother herself. The doctor should get detailed history and perform a physical examination. If every thing is normal on examination, the doctor should talk to the pregnant women about the following important issues.   Importance of a healthy diet: Even if the woman is eating well balanced healthy diet, some nutrients are specially prescribed as their deficiency can be harmful to the baby. Folic acid: It is a type of Vitamin B. Its deficiency in a woman may cause a malformation of the brain and spinal cord of the baby. Folic acid tablets are given to the woman 3 months before one plan for pregnancy which reduces the chances of the tragedy of having an abnormality in the baby. Even though enough folic acid is found in dark green leafy vegetables, lentils, peas, dried beans, citrus fruits and berries, a tablet of Folic acid is a must before you become pregnant and during early pregnancy.     Vitamin B12: The deficiency if Vitamin B12 is very common in vegetarians    and causes anaemia [low Haemoglobin]. Sprouts should be added to a good   helping of salad. Vitamin B12 is found in milk and milk products, chicken, meat and fish. Iron: In pregnancy, the consumption of Iron doubles. Once the nausea and vomiting of early pregnancy settles, doctor will prescribe tablets of Iron with Folic acid. In Iron deficiency, the foetus [baby] will take iron from mother and she will become anaemic [deficient in blood] and may become weak, pale or tired. Iron is found in dark green leafy vegetables. Protein: This is needed to make the body mass and women should take at least 60 grams of protein each day. Take low fat milk 4 glasses a day or milk products, lentils, peas, dried beans, egg whites, chicken, lean meat, fish and cheese. Calcium: This is needed by the foetus [baby] to build bones, teeth, heart, muscles and nerves. Four glasses of skimmed milk is a must in pregnancy. It is found in milk, curd, cheese, fish [especially sardines], lamb meat, eggs, onions, methi, dark green vegetables, Soya beans, Bengal grains, Pista and almonds. Following precautions must be undertaken in general but especially when you are planning for pregnancy as well as during pregnancy:   Wash fruits and vegetables well so that any pesticides present are washed off. Try to go for organically grown or home grown vegetables.  Unpasturiezed soft cheese should be used with precaution as it can also get easily contaminated which can be a cause of infection for the mother and the baby.  Meat should be always be well cooked to avoid Toxoplasmosis infection for the woman. This can lead to a congenital disease of the baby if the woman becomes pregnant while harbouring the infection.  Raw fish or dirty water river fish are often full of germs and pollutants so fish should be well washed and well cooked.  Eat whole grain wheat chapattis and cereals. Avoid noodles, white bread, pizza, rice, potatoes, as such starches lead to significant weight gain.  Cut down on sugars like candy, sweets, ice cream, fruit juices with sugars.  Cut down on caffeinated drinks. Tea and soft rinks have half the amount of caffeine in comparison to a serving of coffee.  Smoking should be quit before deciding to get pregnant as it will deprive the foetus of oxygen which it needs for its growth and healthy outcome.  Alcohol should not be consumed when pregnant as it causes brain damage and other birth defects. As more and more women are starting to socially drink, it is a precaution that should be kept in mind when trying to get pregnant.  Illicit drugs is a serious issue and one must consult a doctor for advice if one is planning to get pregnant or is already pregnant.  Regular light exercise like brisk walking for 3o minutes 3 to 4 times a week during your pregnancy is a good habit unless there is a medical condition stopping you from exercising.  Prescription medicines or over the counter medication are important issue because a lot of times this issue is overlooked so one must consult a doctor if you are planning to be conceive or already pregnant.   Some well known facts about medical science should be also known: Conception takes place after ovulation takes place which id during the middle of the monthly cycle. If a woman has 28 days cycle, then ovulation usually takes place on the 14th day and if pregnancy takes place, a living foetus is formed 4 to 5th day after ovulation. Therefore if any medicine is taken during this period that is after mid cycle can be dangerous to the foetus [baby]. This may lead to an abortion or an abnormality of any organ. Please be careful with any medicine that get suggested by friends, chemists or any alternative medicines. Family history of inherited disease[chromosomal and genetic disease] is an important issue as sometimes there are inherited diseases or birth defects that are not discussed in our society but later the consequences are faced by the child, mother and everyone around them. Nowadays, there are Genetic counselors who can tell you about the risks involved which would a good idea before pregnancy. Other risk factors like environmental factors, X ray radiation, infectious diseases, marriage with close relatives, are also important issues to be discussed before pregnancy. Certain medical conditions make the pregnant women a high risk patient such as, history of diabetes, essential hypertension [high BP], thyroid problems, Rh negative blood, Toxoplasmosis, Rubella infection, TORCH infection, age 35 years plus and Gross obesity As a preventive measure against Rubella virus infection, vaccination of girls is carried out in schools and colleges and should be advised if not practiced. Diabetes must be controlled well before becoming pregnan as it can cause an abnormalities.Such precautions, preventive measures, good diet and nutrition will help the family with a healthy pregnant woman and a delivery of a healthy child. So it is better to see the doctor before you plan for your pregnancy. You can contact Dr.S.K.Mangat at +91-181-2455177 or email her at info@mangathospital.com for any questions or inquiries.   Services Offered Doctor's Message Medical Tourism       Surgery Videos   Articles