What lifestyle changes should women make? Smoking cessation programs that are preconception-based, not introduced when the woman is pregnant, are very important. We know that smoking has a high correlation with first trimester spontaneous loss, preterm birth, stillbirth and growth-restricted infants during pregnancy.
Of course, we encourage women who are considering pregnancy not to drink. We don't know how many drinks will affect the fetus or if one weekend of binging at a particular gestational age of the fetus is going to compromise it. If a woman doesn't have a planned pregnancy, but she's of childbearing age, we encourage her to either have effective birth control or not drink excessively.
Women who are using illegal drugs are certainly affecting their potential of having a healthy first trimester and a healthy baby. Women who are addicted need to be identified and assisted into social-service programs that help them either deal with their addictions prior to pregnancy or once they're pregnant.
How can women best improve their diets? There are so many recommendations out there about the healthiest way to eat. I would suggest that eating a healthy variety of foods from all the food groups is important.
If one is a self-identified vegetarian, and there are so many subcategories of vegetarianism, one should be aware of getting adequate protein, adequate folic acid, adequate calcium and adequate iron. If women can focus on those areas in whatever diet that they have adopted, they're going to be healthy when they go into pregnancy.
It's advisable for women who are overweight to try to lose weight prior to pregnancy. But if women are trying to lose weight in a period when they also want to conceive, I would suggest they seek medical advice and guidance. Fad dieting or extreme dieting in the preconception period is not a good idea.
Is exercise recommended? In terms of exercise and activity, if American women could be more mobile, that would be wonderful. We do discourage women who have never exercised in their life from all of a sudden deciding that they're going to be a long-distance runner or a downhill skier when they're planning to get pregnant or already pregnant. If they're not used to that kind of activity, it's not a good idea to introduce it at a point where they're much more vulnerable to potential risks, either to the fetus or to themselves, which is more likely.
We tell women athletes who have had a thorough health history and exam that they don't necessarily have to change an active lifestyle when they are pregnant because their body is used to it.
If women are unsure about their state of pregnancy, they should avoid excessive heat exposure. That's not going to happen in your home bathtub. It is going to happen in commercial hot tubs and saunas.
How can fathers prepare for their partner's pregnancy? On thing we often leave out is that men have babies, too. There's really a need for more importance on the male role in relationship to his occupational exposures, his use of alcohol or drugs, whether there's any genetic history in his family, in addition to risks such as HIV and sexually transmitted infections.