10 Ways to get ready for your pregnancy.
The Pregnancy Prequel is important to
ensuring the healthiest start for you and your baby to be. There are three general issues--fertility, early pregnancy development, and ongoing effects on your pregnancy.

The first step in getting ready for your baby is to be mindful of your intentions. Since 50% of US pregnancies are unintended, starting these steps before you're even planning to conceive is best. These tips are also important to preserving your general good health.
Most women start the preparation for a healthy pregnancy after conception. Some women want to give their baby the best chance but are unsure what to do.
We're here to help you!

The most important steps in your baby's development happen in the the week before your period is due, even before you have a positive pregnancy test. That's the time when the "neural tube", the part of the embryo that will eventually develop into your baby's brain and spine.
The window of opportunity to prevent birth defects has closed by the 12th week of pregnancy when the vast women know that they're pregnant.

Folic acid or folate is a B vitamin that has been shown over and over again to prevent brain and spine related birth defects like spina bifida and anencephaly. Folic acid 400 micrograms (or mcgs) in synthetic form is the minimum effective dose. Most women's multivitamins have that much folic acid while prenatal vitamins have at least 800 mcg in them. We recommend starting folate 2-3 months before conception to build up a store in your red blood cells.
Certain medical conditions and medications require even higher doses. So ask your physician what dose is best.
Other critical vitamins include Vitamin A, Vitamin C, Vitamin B12, Vitamin D,Vitamin E and Niacin (Vitamin B3). Whew that's a lot to remember but fortunately most prenatal vitamins have adequate levels of these vitamins.

The omega-3 fatty acids are critical building blocks for your baby's brain and eye development. These long-chain polyunsaturated fats also play a role in health and fertility for women and men. These "PUFAs" also play an important role in the anti-inflammatory and antithrombotic (blood clot prevention) pathways as well.
The omega-3 fatty acids include ALA (alpa-linoleic acid) DHA and EPA, these are the typically found in fish oils.
The omega-6 fatty acids include LA (linoleic acid) and AA (arachidonic acid). These are found in abundance in walnuts, safflower,sunflower,canola, soybean and corn oils. Linoleic acid is another important omega 6 fatty acid for health in pre-pregnancy--ideal dose 14 grams/day or the equivalent of 7-8 shelled walnuts.
Omega-6 fatty acids are more helpful than omega-3 fatty acids in conceiving.

Iron deficiency is common in non-pregnant women. This can lead to anemia (low blood count) that can worsen during pregnancy. Iron is critical in developing the baby's blood supply too. You need 16-20 mg of iron daily--sources include red meat,raisins,beans,leafy greens and hummus.
Zinc is important in enzyme pathways and fertility. A balance of intake between 11 mg and 40 mg is critical because a high zinc intake can lead to a copper deficiency. Too much or too little can also affect iron functioning and vice versa. Good zinc sources include animal meat, seafood,beans,seeds and whole grains.
Iodine is important in thyroid function and brain development. Iodine deficiency can lead to cretinism (brain malformation). Sources to get the 150 mcg you need daily include iodized salt, seafood, kelp,cranberries and yogurt.
Choline is needed for cell membranes, gene function, protein synthesis and neural brain development. Egg yolk,peanuts,spinach and beets are sources for the 450 mg/day that you need.
Protein is the building block for the structure and function of maternal and fetal tissues. Many women are protein deficient before pregnancy so be sure you're getting at least 46 grams of protein daily. You'll need more after you conceive.

Getting to a normal weight before pregnancy si the right idea. If you are overweight, losing just 10% of your total weight can give you a metabolic "reset" that decreases the risk of diabetes of pregnancy,pre-eclampsia and Cesarean section. Weight loss for you and your mate can also make conceiving much easier.
If you are underweight, the same general principles apply. Getting closer to a normal BMI (relationship between weight and height) can favorably impact fertility and risks of premature delivery. A normal BMI also ensures that you enter pregnancy in the best health possible.
Statistically women whose body mass index (BMI) is between 24 and 30 are the most fertile. A target BMI of less than 27 prior to pregnancy is considered ideal.
Exercise can help with weight loss but has other effects.
Aerobic exercise builds endurance, yoga and stretching can improve flexibility, resistance training builds strength through stronger muscles. Women who exercise in moderation also improve their fertility but over-exercising can stop ovulation. What is over-exercising can vary from person to person, so sometimes taking an exercise hiatus for a couple of months can help your system to regulate.
In summary, a small decrease in your waist-hip ration and gentle exercise have been shown to increase fertility.

If you have type one or type two diabetes or if you had gestational diabetes (diabetes of pregnancy) in a previous pregnancy, getting to a normal glucose and/or hemoglobin A1c level is critical. High blood sugars in early pregnancy can affect brain,spine,heart and limb formation in your baby. The optimal Hemoglobin A1c is less than 6.1%, representing an average blood sugar of 128mg/dL.
Weight gain between pregnancies sharply increases the risk of gestational diabetes in the subsequent pregnancy.

Certain medications for common medical problems are associated with poor medical outcomes.
Antibiotics, especially macrolides like azithromycin (Zithromax),quinolones (for example Cipro and Levaquin),tetracyclines, sulfa drugs and metronidazole (Flagyl) have all been associated with miscarriages.
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Although a positive pregnancy test prompts many women to decrease or stop using alcohol, the time lapse between that and conceptions includes critical periods of fetal risk during development of major organs. Alcohol consumption before and around the time of conception is linked to a higher risk of miscarriage and birth defects like GI malformation and brain and spine abnormalities.

Heavy preconception caffeine consumption,defined as 300 mg per day increases the risk of subsequent miscarriage by 31%. A typical 8 ounce cup of coffee contains on average 95 mg of caffeine.
We advise limiting your caffeine intake to 1-2 cups daily well in advance of conception.