Recently, actress Angelababy's views on childbirth have attracted much attention: At a recent event, when a female fan asked her about childbirth, Baby replied, "I think having a child doesn't require too much preparation..."
"No... much... preparation needed..." After reading this, I felt like I'd been hit with a thousand points of damage. As an ordinary, slightly middle-aged woman, I've always thought that people who say "it'll be fine once you give birth" mainly fall into two categories: one is those whose objective conditions are already there, so there's no need to prepare anything; the other is those who advise others to hurry up and have a baby...
As an obstetrician and gynecologist who doesn't have the professional skills of a life coach, let's set aside the complex sociological aspects of childbirth and just talk about the medical preparations for childbirth.
1
Pre-pregnancy check-up
If you ask me whether pre-pregnancy checkups are necessary, or if there are any special precautions to take during the preconception period, I will answer seriously and decisively: Yes!
If you ask me, "Is it necessary to have a hundred or so pre-pregnancy checkups and live like a scientist during the preconception period?" I would say seriously and bluntly: "Girl, why bother?"
So, let's talk about what pre-pregnancy checkups should include.
1. Before going for a pre-pregnancy checkup
Please research your own and your husband's relatives' medical history and any adverse pregnancy history. For example, A's aunt had a child who died at birth, and her other aunt also had a history of intrauterine fetal death in late pregnancy—we need to be aware of all family histories that may be linked to genetic diseases. Also, confirm your own childhood vaccination records with your parents.
Please bring your most recent one or two medical examination reports. — Medical examinations and pre-pregnancy checkups often overlap, so repeating them doesn't necessarily cost extra money; after all, your baby will be a money pit in the future.
Please come on an empty stomach 2-3 days after your period ends, as this is the best time to check the uterus and ovaries (the need to understand ovarian reserve function will be discussed in detail later).
II. What pre-pregnancy checkups are included?
The purpose of preconception check-ups is to identify potential risks to the mother, fetus, and pregnancy, and to provide education and intervention in advance.
Medical history taking
Many people think pre-pregnancy checkups are just about ten vials of blood drawn and a gynecological ultrasound. Actually, taking a medical history is a very important part of a pre-pregnancy checkup. This includes questions like: How old are you? What are your menstrual cycles like? Have you ever been pregnant? Do you have any other illnesses or chronic health problems (like being overweight)? Do you take any long-term medications? Have you had any infectious diseases? Have you received all the required vaccinations? (Here, a kind, caring neighborhood committee auntie smiles) How do you usually eat, exercise, and sleep? What do you do for work? How is your mood usually? How is your relationship with your spouse? Don't underestimate these questions; each one is useful!
Physical examination
A gynecological examination is not enough. Pregnancy and childbirth are a whole-body system process, so you need to have your weight, blood pressure, heart, lungs, abdomen, breasts, thyroid, and even your teeth checked (seeing a dentist before pregnancy is very important!).
Laboratory assessment
In addition to a full physical examination appropriate for their age group, individuals with high-risk factors should be screened for several sexually transmitted diseases, including hepatitis, gonorrhea, chlamydia, and syphilis. Furthermore, before pregnancy, it is recommended to assess one's immune status against rubella (have you been vaccinated as prescribed?) and chickenpox (have you had them?). Those with high-risk factors should also assess their infection and immune status against toxoplasmosis (it's not just cat ownership that can lead to infection; contact with raw meat can also cause infection) and cytomegalovirus (such as frequent contact with children, which is a high-risk factor).
Examination of special populations
For older women trying to conceive: In addition to the above examinations, it is advisable to consider evaluating ovarian reserve function (including basal hormone levels on day 2 of menstruation, ultrasound examination of the number of antral follicles, and blood tests for anti-Müllerian hormone at any time). These tests can be helpful in planning a pregnancy.
For women with pre-existing conditions: Expectant mothers who are aware of any comorbidities or have had complications during their first pregnancy often know to consult a doctor before pregnancy. However, some people tell me vague statements like: "My blood sugar seemed a little high during a checkup," "My blood pressure is occasionally a little high," or "I think I've had proteinuria." These vague statements mean they think they're probably fine. But during pregnancy, these conditions can escalate significantly. Therefore, women with similar vague conditions should seek a definitive diagnosis and clear any obstacles before pregnancy.
Expectant mothers with a history of adverse pregnancy outcomes, such as multiple miscarriages or missed miscarriages, or a family history of suspected genetic diseases, need to have a detailed consultation with their obstetrician and, if necessary, receive genetic counseling.
Women with a history of systemic allergies are advised to undergo evaluation by an allergist before pregnancy.
2
What do you need to do when preparing for pregnancy?
Actually, what Baby said isn't wrong. For most people, preparing for pregnancy isn't a complicated medical process. While the list of specific steps may seem long, once you start doing it, you'll find it's just like going through the motions of daily life. If that's how you feel, then kudos to you—it shows your lifestyle is very healthy! So, what exactly does preparing for pregnancy involve?
1. Supplement with 400-800ug of folic acid daily.
II. Vaccination:
Women who have never had chickenpox (especially mothers expecting their second child, as their firstborn may have been exposed to children with chickenpox) are advised to get vaccinated against chickenpox and wait at least one month after vaccination before becoming pregnant; flu vaccination is a must during flu season.
III. Consultation regarding the safety of taking this medication:
Women who require long-term medication for any condition (such as high blood pressure, diabetes, asthma, allergies, etc.) should consult about switching to medications that are safe during pregnancy.
IV. What do you need to do in your daily life?
Quit smoking and drinking, use iodized salt, and reduce caffeine intake (no more than 200mg/day; note that caffeinated beverages include not only coffee and tea, but also milk tea, which is a favorite among girls, and energy drinks, which are a favorite among those who work overtime).
Regarding nutritional supplements: Once your plans to conceive are revealed, many friends and family will send you vitamins, DHA, and other supplements from various countries. These bottles and jars are covered in fancy English labels, and you're too lazy to check them, so you just take them all without thinking. Here's a key point: It's not recommended to take high doses of vitamins, non-essential dietary supplements, or herbal preparations—the safety and risks of these products have generally not been evaluated. Avoid taking multivitamin preparations containing more than 5000 IU of vitamin A (more than 10,000 IU increases the risk of birth defects, so taking two or three vitamins at the same time can actually be risky!).
To achieve a healthy BMI (Body Mass Index), please calculate your weight (kg) / height squared (cm). The normal range for Chinese people is 18.5-23.9. Please maintain your weight within this range through healthy eating and moderate exercise. Note that I said "controlling weight," not "losing weight," specifically referring to those girls who aim for a slim figure and still feel overweight even though they are already quite heavy. You may need to gain weight. Both being overweight and underweight are associated with increased risks of infertility and pregnancy complications.
Avoiding teratogens: While many people are particularly careful to avoid radiation and potentially toxic chemicals during the preconception period, we want to reassure you that mobile phones, computers, and microwave ovens can still be used normally. Anti-radiation clothing is actually unnecessary. Hair dyeing and perming should be done in well-ventilated areas. Don't throw away those bottles and jars on your dressing table; you can still look beautiful, but please avoid retinoic acid and salicylic acid, and use high-quality products. You don't necessarily have to say goodbye to your cats and dogs, but you should pay attention to their hygiene, vaccinations, and deworming, and improve your own habits in caring for them.
V. Psychosocial Problems and Emotions:
Do you expect to conceive the very next month once you put pregnancy on your to-do list? Many people, from the moment they start planning a pregnancy, research everything from how to conceive a boy to which sexual positions have the highest success rate, trying all sorts of folk remedies. Once the ovulation test shows a positive result, the bedroom instantly transforms into a battlefield, tense and focused. In reality, anxiety and stress have a significant negative impact on pregnancy. If your pre-pregnancy checkups are normal, it's recommended that you follow your doctor's advice: everything's fine, relax, and go for it!
6. Always be aware that "I might get pregnant":
Once you start trying to conceive, please be aware that a fertilized egg may be developing inside you. First, try to avoid illness and medication. Second, if you need to see a doctor for any reason, please tell them: "I'm trying to conceive, and I may be pregnant but it's not detectable yet." The doctor will then choose the safest medication based on your situation.
After saying all this, it's actually not complicated to do. In terms of medical care, Baby is right. Having a baby doesn't require too much preparation. Just like the above, moderation is key.
Wishing you all a healthy pregnancy!
This article was first published on the Obstetrics and Gynecology Channel of Medical World.
This article was written by: Mu Tian, Obstetrician and Gynecologist at Zhuozheng Medical Center.
Layout by: Afeng
Editor: Zheng Huaju. The above content is exclusively authorized for use only and may not be reproduced without the copyright holder's authorization.
