Easy Pregnancy:
Can It Be Done?

by Carolle Jean-Murat, M.D.

Pregnancy is, first of all, a natural occurrence in the life of a woman. Women have been doing it for millions of years, and until recently, doing it naturally. While it's comforting to know that you have the benefits of modern medicine at your fingertips, please know that planning to get pregnant, getting pregnant, and giving birth (if there are no major complications) can still be a happy, natural occasion.

The outcome of a pregnancy depends greatly on your state of health and your lifestyle before you ever become pregnant. Proper preconceptual and prenatal care go hand in hand with having a healthy baby, regardless of your age.

The best way to start the process is to take proper care of yourself even before you try to become pregnant. The fertilized egg (the embryo) draws all its nutrients from the endometrium -- the thick, blood-filled lining of the uterus. The embryo implants itself upon the endometrium and begins to develop into a baby ready for birth approximately 40 weeks later. The nutrients supplied by the endometrium come directly from what you put into your own body.

Many birth defects occur during the first two weeks of pregnancy, often at a time when the woman does not know she is pregnant. Birth defects can be hereditary, but they can also be caused by toxic substances, viral infections, nutritional deficiencies, radiation from x-rays, some prescription medicines, drugs, and alcohol. While the mother's health and activities can help to prevent many birth defects, some defects are beyond the mother's, or anyone's, control. If there is a family history of birth defects or inherited disorders, check with your health-care provider about genetic testing before you try to conceive.

Before becoming pregnant, have your dentist take care of any cavities, since the body reroutes minerals used for tooth maintenance to the unborn child. Hopefully, you already have a good relationship with the health-care provider who will care for you while you're pregnant. Discuss your respective views on childbirth to see if they coincide. If you don't agree, it may be appropriate to find another health-care provider. If you have any medical problems, now is the time to get them resolved or under control. Don't wait until after you become pregnant.

It is a good idea to be in optimal physical health and within five pounds of your ideal weight before conceiving. You should stop taking all over-the-counter medications, except folic acid found in vitamin B-complex or multivitamin supplements. The U.S. Public Health Service recommends that all women of childbearing age consume at least 0.4 mg of folic acid each day. Taking multivitamin supplements with folic acid during the three months before becoming pregnant has been demonstrated to reduce the risk of neural-tube defects. If you must take prescribed medications, talk to your health-care provider to make sure they are not known to cause birth defects. If necessary, your physician may be able to provide safer alternatives.

Avoid all toxic substances such as alcohol and other drugs; drinking can reduce a woman's chance of getting pregnant. If you smoke, this is a good time to quit. Taking herbs or over-the-counter supplements, which many people consider harmless, can be risky. For example, high dosages of St. John's wort, ginkgo biloba, and echinacea have been shown to have an adverse effect on fertilization.

Make sure you are vaccinated against or are immune to Rubella (German measles). If a woman contracts Rubella during pregnancy, especially during the first three months, it could cause serious birth defects. Because of the potential risk to the developing fetus, vaccines should be administered as part of the pre-conception evaluation.

If you are taking the Pill, switch to a barrier method of birth control (such as condoms together with foam) for at least three cycles before trying to become pregnant. It may take up to six to eight weeks for some women who have been on the Pill to begin having a regular cycle. Once your cycle becomes regular, it will be much easier to determine when you become pregnant, and to calculate your due date.

And What About Dad?

The father shares an important role in the outcome of a healthy baby. Just like the female egg, sperm are vulnerable to genetic and environmental influences, and the seminal fluid may contain harmful materials. If the father abuses drugs or alcohol, if he smokes tobacco, or if he is exposed to toxic agents in the environment, he can negatively affect the health of his offspring. Many studies have demonstrated a direct correlation between industrial compounds and possible risks to the baby. Some studies have found that the pregnant wives of men who are occupationally exposed to materials such as latex, plastics, benzene, and toluene, nave an increased risk of spontaneous abortion (miscarriage).

A study in British Columbia recently revealed that children born of fathers employed as firemen had a higher risk of congenital heart defects, possibly due to the toxic chemicals the men were exposed to in the line of duty. Prospective fathers should follow the same advice given to women who are trying to become pregnant: Do not drink use drugs or smoke before, during, or after pregnancy; and do not become exposed to toxic substances in the environment.

The healthy development of children, and the family as a whole, is enhanced by a man who is supportive of his partner and promotes healthful habits and a stable home environment.

Many women are used to being in charge of their lives, planning everything and working hard to succeed. Many women go to college, achieve postgraduate degrees, have successful careers, and postpone pregnancy for years. One day they decide to get pregnant and want it to happen NOW.

Sorry, it does nor work that way. Only about one in four women will conceive after the first try; it can take an average of eight months for 80 percent of women who are having regular, unprotected intercourse two or three times a week to get pregnant. So, please do not come running into my medical office wondering what is wrong with you! In a rare case, one of my patients had four children, all conceived exactly two years apart. Your body will let it happen when it is ready.

Have fun with your partner while trying to get pregnant, but do not make it a chore. If your next period comes, do not view this as the end of the world. Be patient. My personal opinion is that women who are stressed about conceiving may indeed delay conception. You've probably heard the occasional story of the couple told they were infertile who decided to adopt a child, only to become pregnant shortly after the adoption.

During your pregnancy, follow the advice of your health-care provider Keep your appointments as scheduled, and have the tests that are recommended. When it comes to getting the tests for birth defects -- alpha-feto-protein (AFP), chorionic villus sampling (CVS), and amniocentesis -- remember that whether or not you have them done is a personal choice. Some women want to know, at any cost, if their baby will be born healthy; they often choose to terminate any pregnancy upon learning that their baby has a birth defect: Yet many other women believe that a child is a gift from God and would welcome a baby whether or not there are abnormalities. These women decline any such testing.

Birthing used to be considered a natural event -- it took place in the home and was overseen by midwives, or "sage femmes". My first experience with a home birth was at the age of 11 when I accompanied my mother, a sage-femme, to a delivery in rural Haiti. Later on, during my year of community medicine in rural Mexico, more than 25 deliveries were done in the home, often with no running water or electricity available. In North America, this trend underwent a dramatic shift in the beginning of the 20th century, when births moved to hospitals and were attended by male doctors. Today, births rarely ever occur at home; in fact it is not recommended if there are any risk factors that may result in complications during labor or delivery. If you decide on a home birth, you should carefully investigate the reputation of your birth attendant and learn what arrangements have been made in case of an emergency.

Most deliveries occur without complications, but when problems arise, it can be life threatening for both mother and baby. Most complications can be taken care of at the hospital.

Wherever you choose to give birth, it is a good idea to have a "birth plan". Convey your wishes to the people who are taking care of you, and be willing to accept intervention when advised. Most hospitals allow a partner to be present even during a cesarean section (C-section).

During labor at a hospital facility, you will be cared for by the resident doctor on duty or a nurse midwife, the nursing staff, and, on occasion, a medical student. These people remain in constant contact with your health-care provider and notify him or her of any complications and when delivery is imminent.

During the labor process, you can sip water or juice. You do not want to have a full stomach. One of the causes of maternal death is aspiration during general anesthesia. Vomiting and retching is common during the late stages of labor.

With managed care, you may find that when you become pregnant you are no longer able to see the health-care provider with whom you have built a trusting relationship over the years. The idea of a solo practitioner who cares for you throughout your entire pregnancy and delivery is practically extinct. Most obstetricians are part of large practices who share calls for hospital deliveries. If you have been followed by a nurse practitioner at a clinic, you will probably be delivered by someone else at the hospital.

If you do not have a satisfactory relationship with your health-care provider, pay some consideration to finding a new provider, regardless of how far you are into the pregnancy. It is natural to trust yourself. It is true that your health lies in your hands, and you should enter into a relationship with your health-care provider where you are allowed to take part in the decision making. You must admit that you do not have the appropriate training and experience required to decide the best course to follow if an emergency arises, and you need to trust your health-care provider.

Remember, your pregnancy is an opportunity to learn about the effects of tension, stress, eating, and other habits on your health and state of mind -- lessons that will prove helpful for the rest of your life.

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Excerpted from the book "Natural Pregnancy A-Z" by Carolle Jean-Murat, M.D. ©2000. Reprinted with permission of Hay House Inc., Carlsbad, CA, USA. www.hayhouse.com
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