The following article was written by Holly Jo L. Hodges, MD.  It appeared in the July 2007 column, Health Matters published by The Central Oregonian.

Are you thinking about having a baby? Then it is important to also begin taking good care of yourself.

According to the Centers for Disease Control and Prevention (CDC), almost four million American women give birth every year.   Nearly one third of them will have some kind of pregnancy-related complication.  Those who miss getting adequate prenatal care run the risk that such complications will go undetected, or won’t be dealt with soon enough.  That, in turn, can lead to potentially serious consequences for both the mother and her baby.

 These statistics are not meant to alarm you, but rather to convey the importance of starting prenatal care as early as possible – ideally, before you even get pregnant.   If you are planning a pregnancy, see your doctor for a complete checkup.  He or she can do routine testing to make sure you’re in good health, and that you don’t have any illnesses or other conditions that could affect your pregnancy.

 If you are already being treated for a condition such as diabetes, asthma, high blood pressure, allergies, a heart problem, you should talk to you doctor about how it could affect your pregnancy.   In some cases, you may need to change or eliminate medications, especially during the first trimester (12 weeks).  Or you may need to be even more vigilant about managing your condition.  For example, women with diabetes must be especially careful about keeping their blood glucose levels under control.  Abnormal levels increase the risk of birth defects and other complications.

It is important for women who are planning to become pregnant to take vitamins with folic acid beforehand, because neural tube defects (problems with the normal development of the spine and nervous system) happen in the first 28 days of pregnancy, often before a woman even knows she’s pregnant.

If you or your partner has a family history of a significant genetic disorder and you suspect either of you may be a carrier, then genetic testing may be advisable.  Talk this over with your doctor.  This is also a good time to talk about other factors that can pose a risk to your baby, such as drinking alcohol or smoking.

If you find out you’re pregnant before you do any of this, don’t worry.  It is not too late to get the care that will help to ensure your health and that of your baby.

Routine visits and tests help monitor your progress.

 During your first visit, you can expect to have a full physical examination.   A blood sample will be taken and used for a series of screenings:  complete blood cell count, blood typing and screening for Rh antibodies, for sexually transmitted diseases, for evidence of exposure to measles.  You can also expect to provide a urine sample for testing and to have a Pap smear test for cervical abnormalities.

 Other screenings include ultrasound to make sure your pregnancy is progressing normally, and to verify the expected date of delivery.   Usually, an ultrasound is performed at 20 to 22 weeks to look at the baby’s anatomy, but can be done sooner or later, and sometimes more than once.

 Screening for diabetes usually takes place at 12 weeks for women who are at higher risk of having gestational diabetes, or at 28 weeks if you are not.   Roughly 2% to 3% of women develop this condition during pregnancy, usually after the first trimester.

Pregnant women also frequently worry about weight gain.   Pregnancy is not a good time to start a diet; however, it can be a great time to start eating healthy food if you didn’t before.  It is also a good time to get regular, low-impact exercise. I recommend walking.

If you are healthy and there are no complicating risk factors, you can expect to see your health care provider every four weeks until the 28^th week of pregnancy, then every two weeks until 36 weeks, then once a week until delivery.

Last year, 142 babies were delivered at Pioneer Memorial Hospital , and we are on track to deliver more in 2007.  You and your partner can attend Prepared Childbirth Classes which are free if you plan to deliver at PMH.

There is a new medication for post-partum birth control you may wish to talk with your doctor about:   Implanon.  This is a small, thin, implantable hormonal contraceptive that is effective for up to three years.   It was approved in July 2006 by the F.D.A.  It is a flexible plastic rod the size of a matchstick that is put under the skin of your arm, and is perfectly safe for breast feeding mothers.  The device can be placed as soon as two weeks post delivery.  At this time, Dr. Hodges is one of only a handful of specially-trained providers in Central Oregon .

Holly Jo L. Hodges, M.D ., is a family practitioner who includes obstetrical care in her practice.   She recently attended two advanced training seminars sponsored by the Oregon Academy of Family Physicians: Advanced Life Support in Obstetrics (ALSO®) an evidence-based program on the practical management of obstetric emergencies, as well as the 22^nd Annual Women’s Health Conference, which covered updates on a broad spectrum of topics specific to women’s health.

Dr. Hodges’ office is located in the Pioneer Health Care Center , 1103 NE Elm Street .  Her phone number for appointments is 447-3999; for further information, call 447-6263.