Optimizing Maternal Health to Avoid Pregnancy-Related Complications

As an Obstetrician and Gynecologist, I have had the privilege of caring for women through one of the most transformative experiences of their lives—pregnancy. While pregnancy is a joyous and life-changing event, it can also present challenges. As much as we hope for a smooth pregnancy, complications such as gestational diabetes, preeclampsia, preterm labor and more tragically fetal demise and even maternal mortality can arise. That’s why optimizing maternal health— before, during, and after pregnancy—are critical for reducing risks and ensuring the best outcomes for both mother and baby.

In this blog post, I’ll share my insights into how women can optimize their health to reduce the likelihood of pregnancy-related complications, ensuring a healthier, safer experience for everyone involved.

1. Preconception Care: Laying the Foundation Early

The best way to prepare for a healthy pregnancy is to start long before you get that positive test result. Preconception care is key in addressing health concerns that may impact pregnancy and working to reduce the risk of complications down the road. Here are several steps to take:

• Visit Your Ob/Gyn for a Preconception Check-up:  Visit your OB/GYN ideally 6-12 months before you plan to start trying to conceive or wish to be pregnant.  This is an excellent time to review your medical history, discuss any chronic conditions (such as diabetes, hypertension, or thyroid disorders), and evaluate any medications you may be taking. Getting these conditions under control before pregnancy can significantly reduce your risk of complications later on.
• Control Chronic Conditions: If you have chronic conditions such as high blood pressure, diabetes, migraines, or asthma, work with your healthcare provider to ensure they’re well managed before conception. For example, poorly controlled diabetes can increase the risk of birth defects and preterm labor, while uncontrolled hypertension can lead to preeclampsia, fetal growth restriction, and other serious complications.
• Reach a Healthy Weight: Being either underweight or overweight can affect fertility and pregnancy outcomes. If necessary, work with your healthcare provider to achieve a healthy weight before trying to conceive. A balanced weight helps reduce the risk of miscarriage, gestational diabetes, pre-eclampsia,  preterm birth, fetal growth issues and other complications. 
• Take Prenatal Vitamins: Start taking prenatal vitamins with at least 400-800 mcg of folic acid before conception. The idal time to start a prenatal vitamin is 2-3 months before you start trying to conceive.  Folic acid is crucial for preventing neural tube defects, which can occur very early in pregnancy, sometimes before a woman even knows she’s pregnant.
• Review Medications: Some medications may not be safe during pregnancy. Talk to your OB/GYN about any prescriptions or over-the-counter medications you’re taking. They may need to be adjusted, switched, or discontinued before you conceive.

2. Nutrition and Physical Activity: Fueling Your Body for Pregnancy

What you eat and how active you are can have a significant impact on both your pregnancy and long-term health. Here’s how to nourish your body for optimal pregnancy health:

• Focus on a Nutrient-Rich Diet: A balanced diet is essential for your health and your baby’s development. Aim to eat a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Meet with a nutritionist and speak to your OB/gYN based on your weight, risk factors, and medical history. You may need to adopt a special diet to reduce the risk of gestational diabetes and/or manage your weight gain during pregnancy to reduce risk of complications. Important nutrients for pregnancy include:
  • Folate: To help prevent neural tube defects.
  • Iron: To support increased blood volume and prevent anemia.
  • Calcium: For the development of your baby’s bones and teeth.
  • Omega-3 Fatty Acids: Essential for brain and eye development.
• Stay Active: Regular exercise, such as walking, swimming, or prenatal yoga, can help you maintain a healthy weight, improve circulation, reduce stress, and ease common pregnancy discomforts. Aim for 30 minutes of moderate activity most days of the week, unless advised otherwise by your Ob/Gyn.
• Hydrate: Drink plenty of water to stay hydrated. Pregnancy increases your blood volume, and staying hydrated supports better circulation, digestion, and the health of your amniotic fluid.

3. Managing Stress and Mental Health

Pregnancy can be both exciting and stressful. Managing stress is not only important for your emotional well-being, but it also plays a key role in your physical health. Chronic stress can increase the risk of complications like preeclampsia, preterm birth, and high blood pressure.

• Practice Stress-Reduction Techniques: Activities like deep breathing, meditation, prenatal yoga, or even just taking a walk can help calm your mind and reduce stress. Even a few minutes a day can make a big difference in your overall well-being.
• Sleep Well: Try to get 7-9 hours of sleep each night. Quality rest is essential for both physical and mental health. As pregnancy progresses, consider using pillows to support your body and help you sleep more comfortably.
• Seek Emotional Support: Pregnancy can bring up many emotions, and it’s important to lean on supportive partners, family members, and friends. If you’re feeling particularly overwhelmed, don’t hesitate to reach out to a counselor or therapist specializing in maternal mental health. Addressing mental health concerns early can help prevent more serious conditions, such as postpartum depression.
• Establish care with a therapist or psychiatrist before pregnancy:  If you have a history of depression or anxiety or are currently taking medications to treat anxiety or depression – it is important to establish care with a therapist or psychiatrist before pregnancy.  This can insure that your current medications are safe for pregnancy and optimize your mental health before conception.  You may also need more regular check-ins with your mental health provider during pregnancy and in the postpartum period. Addressing mental health concerns early can help prevent more serious conditions, such as postpartum depression.

4. Avoid Harmful Habits: Protecting Your Health and Baby’s Future

Certain habits and exposures can negatively affect both you and your baby’s health. Eliminating these risks is essential to ensure a safe pregnancy:

• Quit Smoking: Smoking during pregnancy can increase the risk of preterm birth, low birth weight, and even stillbirth. If you smoke, seek help to quit before becoming pregnant. There are resources and support systems available to help you with this process.
• Avoid Alcohol: No amount of alcohol is considered safe during pregnancy. Drinking alcohol can lead to fetal alcohol spectrum disorders (FASDs), which can cause long-term developmental and physical issues in children.
• Steer Clear of Drug Use: Both illicit drugs and certain prescription medications can be harmful to pregnancy. If you’re on any medication, discuss with your Ob/Gyn whether it’s safe for you to continue taking it while trying to conceive or during pregnancy.
• Limit Exposure to Environmental Toxins: Certain chemicals in household cleaners, pesticides, and even beauty products can be harmful during pregnancy. Whenever possible, opt for natural, non-toxic alternatives.

5. Monitoring and Regular Prenatal Care

Once you’re pregnant, it’s crucial to stay in regular contact with your Ob/Gyn. Regular prenatal visits allow us to monitor both your health and your baby’s development. Early detection and management of complications can significantly improve outcomes.

• Attend Regular Prenatal Visits: These visits are essential for monitoring your health, checking for early signs of complications, and ensuring your baby is growing well. Your Ob/Gyn will monitor your blood pressure, weight, fetal development, and perform routine screenings such as  fetal genetic screening, gestational diabetes, preeclampsia, preterm labor, and much more. I encourage you to take a list of questions to each of your prenatal visits so that you can ensure your questions are answered and you can maximize the time you have with your provider.
• Know the Warning Signs: While most pregnancies progress without major issues, it’s important to be aware of warning signs that something might be wrong. Severe abdominal pain, heavy bleeding, headaches that won’t go away, sudden swelling, and visual disturbances are all red flags. If you experience any of these, contact your Ob/Gyn immediately.
• Get Vaccinated: Certain vaccines are recommended during pregnancy, such as the flu shot and the Tdap vaccine (for whooping cough). These vaccines help protect both you and your baby from serious illnesses that could cause complications.  I also encourage you and anyone that lives with you or will be interacting with you and your baby regularly to also get vaccinated. 

6. The Importance of Postpartum Care

It’s important to remember that pregnancy does not end with the delivery, the postpartum period lasts until a full year after delivery and is full of tremendous physical and emotional changes. In fact, the majority of preventable maternal deaths occur in the postpartum period.

• Support: It truly takes a village and having a new baby is no exception. Having a person that can be with your baby for at least 1 hour a day so that you can focus on yourself, take a shower, or just sit quietly is so important.  
• Self care: Ensure you are eating, drinking lots of water, and getting enough sleep.  Your physical and emotional health will allow you to take better care of your baby.  
• Doctor’s visits: Ensure you visit with your OB/gYN, midwife, therapist, and other providers regularly in the postpartum period.  Try to schedule virtual visits if they are available to reduce the stress of traveling with your baby.
• Headaches: If you have a headache in the first 6 weeks after delivery, be sure to check your blood pressure and notify your ob/gyn as it may be a sign of elevated blood pressure. 

Conclusion: Your Health, Your Baby’s Future

The health of both you and your baby is intertwined, and optimizing maternal health before and during pregnancy is essential to achieving the best possible outcome. By focusing on preconception care, proper nutrition, stress management, and avoiding harmful substances, you can significantly reduce the risk of pregnancy-related complications.

Every pregnancy is unique, so it’s important to work closely with your Ob/Gyn to create a personalized care plan that meets your individual needs. Together, we can help ensure that you have a healthy, happy pregnancy, a safe delivery, and supportive postpartum period. 

If you’re planning to conceive or are already pregnant and want to optimize your maternal health, don’t hesitate to reach out to your Ob/Gyn. We’re here to guide you every step of the way to ensure you and your baby are both as healthy as possible.