What can you do to reduce the risk of birth defects?

This preconception visit can also encourage women to maintain a healthy weight and lifestyle. I counsel all of my patients that they will gain weight in pregnancy, and so they should start the pregnancy at a healthy weight. I encourage regular exercise even prior to becoming pregnant, and then continuing that level of activity during pregnancy. Being at a healthy weight prior to conceiving and maintaining a healthy weight throughout pregnancy can help decrease your risk of developing diabetes or elevated blood pressure during pregnancy. Having a body mass index (BMI) of 30 or above can also increase your risk of birth defects, which is why maintaining a healthy weight is also important.

All women who are trying to get pregnant should start a daily prenatal vitamin containing at least 400mcg of folic acid, at least one month prior to attempting to conceive. Folic acid helps to decrease the risk of certain birth defects, such as neural tube defects. Another risk factor for neural tube defects is increased core body temperature in a pregnant woman, particularly during the first trimester. I recommend that all of my patients avoid hot tubs, saunas, and hot yoga, and that they treat any fever promptly with acetaminophen (which is safe during pregnancy, unlike ibuprofen).

Similarly, it is important to avoid substances that increase the risk for birth defects, such as alcohol, tobacco, drugs, and retinoid medications. There is no safe limit of alcohol use during pregnancy, and while it is known that binge drinking during pregnancy increases the risk of fetal alcohol syndrome, there has been no clear definition of the amount of alcohol intake that is connected to fetal alcohol syndrome. I recommend that my patients abstain from alcohol during their pregnancies.

If you are smoking or using alcohol or other drugs, an ideal time to quit is prior to pregnancy. Planning for a pregnancy can be a powerful motivator to quit unhealthy habits, not just during pregnancy but beyond. There are many resources that can help you quit smoking, including medication and nicotine replacement. There may be clinics that specialize in recovery from drug use for pregnant women in your area; starting the conversation with your doctor will help you better understand how to ensure a safe pregnancy for you and your baby.