Get Healthy Carson City: Reproductive life planning should take place long before pregnancy

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Editor's Note: The Get Healthy Carson City column appears in the Nevada Appeal Wednesday health pages. It addresses topics related to the health of our community.

Q: What is a reproductive life plan and why should I have one?

A: A reproductive life plan (RLP) is men and women setting goals about having or not having children. Using their personal values and resources, people target when and how many children they want, and the timing and spacing of them. Once established, an RLP includes addressing various medical, social and behavioral factors that impact the health of the babies.

What does an RLP look like? Here are some examples:

"I don't want children now so to be sure, I'll correctly use effective contraception."

"I'll have children once I'm out of college, my relationship seems secure and I've saved enough money. I won't get pregnant till then. When the time comes I'll go to the doctor and be sure I'm in good health."

"I'd like to be a father after I finish school and have a job to support a family. While I work toward those goals, I'll talk to my wife about her goals for starting a family. I'll make sure we correctly use an effective method of contraception every time we have sex until we're ready to have a baby."

"I'd like to have two children, and space my pregnancies by at least two years. I'll visit my certified nurse midwife to discuss preconception health now. I'll start trying to get pregnant as soon as I'm healthy. Once I have a baby, I'll get advice from a health professional on birth control. I don't want to have a second baby before I'm ready."

"I'll let pregnancy happen whenever it happens. All along, I will be sure I'm in optimal health at all times."

The reason all this planning is important is to have healthy babies. In the U.S., birth outcomes are worse than in other developed countries. Nearly 25 percent of American-born babies are either low birth weight, premature or have major birth defects. We know that healthier moms have healthier babies.

Further, there are a lot of risks associated with poor pregnancy outcomes. Consider that 11 percent of pregnant women smoke and 10 percent drink alcohol. Of women who could get pregnant, 31 percent are obese; 69 percent do not take folic acid supplements; and 3 percent take over-the-counter drugs that are dangerous to fetuses. All of these factors present risks to pregnancies, and can be mitigated with proper health interventions including having a reproductive life plan.

Consider that prenatal care, which usually begins at week 11 or 12 of pregnancy, comes too late to prevent a lot of serious maternal or baby health problems. Fetuses are most susceptible four to 10 weeks after conception, before many women begin their prenatal doctor visits. Hence it is of utmost importance for parents to begin their preconception care early on - before pregnancy occurs - with a reproductive life plan that they follow to the letter.

Future fathers can participate by learning about and promoting good preconception health in their partners. Additionally, if they work with chemicals they can take caution not to expose women to them by handling and washing contaminated clothing separately (e.g., agricultural jobs typically involve exposure to potentially dangerous fertilizers and pesticides). Understanding genetic risks from both mom and dad is important, as is screening for and treating sexually transmitted infections.

Be healthy before the pregnancy happens! The five most important things a woman can do for preconception health are:

1. Take 400 mcg of folic acid a day for at least three months before becoming pregnant to reduce the risk of birth defects.

2. Stop smoking and drinking alcohol.

3. If you currently have a medical condition, be sure these conditions are under control. Conditions include but are not limited to asthma, diabetes, oral health, obesity, or epilepsy. Be sure that your vaccinations are up to date.

4. Talk to your doctor and pharmacist about any over the counter and prescription medicines you are taking, including vitamins, and dietary or herbal supplements.

5. Avoid exposures to toxic substances or potentially infectious materials at work or at home, such as chemicals, or cat and rodent feces.

The Carson City Health Department Family Planning Clinic emphasizes the importance of an RLP. If you are of childbearing age, be prepared by starting your RLP now. It's never too late.

It's all about Public Health.

Carson City Health Department Clinic

Services include:

• Family Planning

• Birth Control

• Pregnancy Testing

• HIV/STD Testing

• Well Baby Checks

Clinic hours are 9 a.m.-4 p.m. Monday-Wednesday and Friday, by appointment

Call 775 887 2195

• Pam Graber is the public information officer for the Carson City Health and Human Services. She can be reached at pgraber@ci.carson-city.nv.us .

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