I think the point about folic acid is especially important as many woman do not start to take it or prenatal vitamins until after they find out they are pregnant, which might be too late. I even read once that all woman who are sexually active should be taking folic acid, even if they are on birth control and not TTC, just in case they do still accidently become pregnant, just as a precaution to protect the baby
Nutrition Before Pregnancy
All of an unborn baby’s nutrients come from you, the mother. How well nourished you are at the time of conception seems to play a role in the health of your developing fetus. Studies have shown that if you are well nourished and have a balanced diet when you conceive, you are more likely to give birth to a healthy baby.
Eating wisely means choosing your meals from four basic food groups. In general you will be well nourished if you eat plenty of fresh fruit, vegetables, and whole grain products, as well as two servings a day of meat, fish, poultry, or other protein food. Calcium, found mostly in milk, cheese, and other dairy products, is also important during pregnancy.
Women who are underweight and subsequently gain little weight during pregnancy are at high risk for fetal and neonatal morbidity and mortality. One recent study found that more than half the infants born to women with a prepregnancy weight of 80 percent or less than standard weight and who gained less than 23 pounds during pregnancy were of low birth weight. At the other extreme, marked obesity is associated with gestational diabetes, hypertension, large infant size, and resultant prolonged and difficult labour. A study done in 2002 demonstrated that women who were obese prior to pregnancy were more likely to gain excessive weight during pregnancy and were, on average, 18 pounds heavier than their prepregnancy weight 6 months after delivery. The optimal weight gain for very obese women during pregnancy is not definitely known. For both significantly underweight and very obese women, preconception nutritional intervention is highly desirable.
A proper medical assessment of your nutritional status should include an individual and a family history, height and weight measurement, and a discussion of your optimal weight. The history will elicit special diets, food allergies you may have, your habits and attitudes, and your knowledge of proper nutrition. Lactose intolerance may be identified and the adequacy of your dietary calcium intake assess; lactose enzyme or calcium supplementation may be prescribed if indicated. Women on vegetarian or other special diets should receive nutrition counseling to assure the adequacy of their diet prior to and during pregnancy.
Neural tube defects (NTDs) such as spina bifida may be prevented by early vitamin supplementation, especially with preparations containing folic acid.
Note that the neural tube is formed soon after conception, so it is very important to begin taking folic acid while you are trying to conceive. By the time you discover that you’re pregnant, the neural tube has mostly formed and it is too late. To date, many studies have proven that folic acid can reduce the risk of this birth defect. The average prenatal vitamin has 0.4 mg of folic acid. According to a large study, 0.4 mg of folate will reduce NTDs by 36 percent, whereas 5 mg will reduce the risk by 85 percent. Therefore, either through diet or supplementation a woman should try to get a least this amount.
As soon as you start to think about getting pregnant, you should plan to first get your body in shape. If you are not sure what a healthy weight is, ask your doctor. Then you can work backward from your planned conception time, following the 2-pounds-a-week rule. Give yourself some leeway so the process can be as relaxed, gradual, and enjoyable as possible. By the time you are ready to get pregnant; you may just be in better shape than ever before.
*Understanding Pregnancy & Childbirth *
by Sheldon H. Cherry, M.D. and Douglas G. Moss, M.D.