Successful pregnancy depends on healthy choices, forethought

There has been much discussion recently about preventing pregnancy -- especially with the new contraceptive Norplant -- but what about women who want to get pregnant? Is it simply a matter of stopping birth control and leaving the rest to nature, or is there more we can do to increase the chances of a healthy and successful pregnancy?

To find out, I spoke with Donna Storbino, a professor of maternal and child health at the Johns Hopkins School of Public Health, and Lisa Summers, certified nurse-midwife in the Department of Obstetrics and Gynecology at the Johns Hopkins Hospital.


What should a woman do if she is thinking about getting pregnant?

Even before stopping birth control, a couple should consider the effect a new baby will have on their lives. Are they financially prepared? Are they ready for the demands a baby will make on their time? Once the decision has been made to have a baby, there are some steps a woman can take to ensure that she is physically ready for pregnancy.


Q: Can a woman influence the outcome of her pregnancy even before she gets pregnant?

Yes. Most experts agree that a woman can protect against having a low birth-weight baby (less than 5 pounds, 8 ounces) by actively planning her pregnancy, entering pregnancy in good health and being fully informed about her reproductive and general health.

Should a woman consult her doctor?

Yes. Her obstetrician/gynecologist, nurse-midwife or family practice doctor should be able to give her general advice about preparing for pregnancy and specific advice on genetic screening and other tests for preventable diseases or abnormalities that can occur during pregnancy.

What kind of tests?

There is one disease in particular that all women should be tested for -- Rubella (German measles). Although most women have either had Rubella or been immunized against it, epidemics still occur. If a woman gets Rubella while she's pregnant, it can cause severe abnormality in her baby. What about genetic testing?

The ideal time for genetic testing of couples and counseling about tests during pregnancy is before pregnancy occurs. In some cases, couples may defer pregnancy or decide against it altogether.

For further information, the Johns Hopkins Nurse Midwifery Service runs a three-hour preconception class, "Expecting the Best." (410) 955-4094.


Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.