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Why the baby-making process needs a few months more
By Heather Warlick-Moore | The Oklahoman

Pregnancy lasts nine months? Some experts say it should be longer.


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Published: 5/18/2009 12:11 AM

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Nine months of pregnancy is a long time.

Too long, if you ask some women.

But more and more experts, from the U.S. Centers for Disease Control and Prevention to the American Academy of Pediatrics, are challenging the traditional nine-month timeline for having a baby by suggesting that it's time to add a few months to the whole baby-making process.

Don't panic. Nobody's planning to tinker with Mother Nature and extend your pregnancy.

"These extra months aren't meant to be spent being pregnant, they're meant to be spent getting ready to be pregnant," writes Heidi Murkoff in "What to Expect Before You're Expecting." Murkoff and Sharon Mazel, authors of arguably the most popular book on pregnancy in America, "What to Expect When You're Expecting," have teamed again to bring couples a comprehensive guide to preparing and planning for a pregnancy.

"A healthy pregnancy begins before you're expecting - which is why, if you're planning to get pregnant, you might want to start planning (and prepping) ahead," Murkoff writes.

Doctors agree that a healthy pregnancy begins before conception. Dr. Katie Smith, an obstetrician and gynecologist affiliated with the University of Oklahoma, said women have a lot to gain from visiting their doctor to plan for pregnancy. Before pregnancy, women often don't know how long it can take to get pregnant, what health tests and checkups they may need, which medicines can be harmful during pregnancy, and what additional risks they may face due to age or health concerns.

So, what do you need to know before you start making a baby? Here are the top pre-pregnancy topics Smith covers with her patients.

Don't smoke

Most women know that smoking during pregnancy is a no-no. But smoking before you try to conceive can mean you'll have trouble getting and staying pregnant.

"Smoking can age your eggs, meaning that a 30-year-old smoker's eggs may act more like 40-year-old eggs," Murkoff writes. This means conception can be more difficult and miscarriage more likely. Smoking also can lower the odds that a fertilized egg will implant and can lower your partner's sperm count.

Watch your weight

It may seem ironic that your pre-pregnancy weight is a factor in getting pregnant, considering all the weight you could gain being pregnant. But obesity is connected with infertility, higher risk of miscarriage, gestational diabetes, birth defects, increased risk of stillbirth and many other poor pregnancy outcomes.

Conversely, underweight women are at risk for preterm birth, low birth weight and placental abnormalities, Smith said.

More than 30 percent of the estrogen in a woman's body is produced by fat cells, Murkoff writes, and those fat cells are closely tied to fertility.

Too much or too little estrogen caused by being overweight or underweight can throw your fertility off kilter. Doctors suspect that more than 10 percent of fertility problems stem from weight issues, Murkoff writes.

Know your health status

It's important to have a complete physical before you try to conceive, Smith said, because many conditions can keep you from getting pregnant or staying pregnant.

Chronic conditions such as diabetes, high blood pressure, lupus, polycystic ovarian syndrome, endometriosis and other conditions should be identified and treated before pregnancy.

Preconception tests should include a blood test for hemoglobin, Rh factor, immunities to rubella, chickenpox, hepatitis B and sexually transmitted diseases.

You should have a gynecologic exam for any conditions that could interfere with pregnancy, including uterine fibroids, cysts or benign tumors, endometriosis, polycystic ovarian syndrome and pelvic inflammatory disease.

Also, you should discuss with your doctor any medicines you take, including those for mental health.

Consider age

Women are born with all the eggs they will produce for a lifetime. And while 40 may be the new 30, your biological clock may not fully cooperate with that trend.

As women age, it becomes harder to conceive. Women are their most fertile in their early 20s; by their early 30s, fertility starts to wane. Women 35 to 39 have about a 15 percent chance of conceiving per cycle, and at age 40, that chance goes down to about 5 percent.

It can take up to a year for any woman to conceive, but for women older than 35, Smith recommends visiting a fertility specialist after trying unsuccessfully for six months.

For women older than 40, she recommends visiting a fertility specialist before you try to conceive.

Take prenatal vitamins

Smith recommends that you start taking prenatal vitamins before you try to conceive. Look for a vitamin with at least 0.4 mg of folic acid.

Increase your calcium intake to help ensure the proper functioning of your reproductive system. Protein is important, but watch where you're getting it. Research shows that too much animal protein, the kind you get from meat, may hurt your chances of getting pregnant. Try to work in other sources of protein such as legumes, nuts and seeds.

Increase your iron intake to reduce your chances for anemia during pregnancy. And boost your omega-3 fatty acid intake to help regulate your hormones, including the ones that induce ovulation.

• Distributed by Scripps Howard News Service.