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Advice from the Momma Doc: Thinking about starting a family, or having another baby?

Photo credit: Pedro Ribeiro Simões
Photo credit: Pedro Ribeiro Simões

These days, more people are carefully planning when they start their families. In fact, according to the CDC’s National Vital Statistics Reportin 1980 the average age of first birth was 22.7, versus 26.3 in 2014. That’s a pretty significant shift over 26 years! I see most young couples spending more time together before they start a family. I can speak from personal experience that I was not ready to have my daughter until I was 30, and I wouldn’t change a thing! Yes, for many people, there is never a “perfect” time to start a family, but planning ahead is not a bad idea. 

So a question I get a lot is, “What can I do to prepare to start my family?”

One of the most important things for women to do before conceiving is to make sure they are taking a good prenatal vitamin with at least 400 mcg of folic acid beginning at a minimum the month before planning to conceive. This helps protect against conditions like spina bifida and other “neural tube defects.” It’s also not a bad idea to meet with your physician to talk about your general health status and any medications you may be taking that could be harmful to a developing baby, for a “preconception visit”. If you’re a smoker, use illicit drugs, or drink heavily, it’s important to work on quitting these habits for the healthiest possible pregnancy and baby as well.

For women over 35, talking with your provider as soon as possible is important to decide if early screening for birth defects is right for you. This is a very individual decision and the pros and cons should be discussed before making the choice to move forward with screening. 

Something that should be avoided, especially after conception is ibuprofen/naproxen etc, as these “NSAIDs” can affect the developing fetus’ kidneys, however, Tylenol is a safe choice. It’s always a good idea to check with your provider before taking any over the counter or prescription medications, as these can have varying effects on your baby’s development. It’s not worth the risk! 

Also, something to consider is avoiding unpasteurized cheeses/milk/juices, as they can harbor bacteria that can cross the placenta (the major organ feeding/protecting the baby) and harm the baby. Foods high in Mercury, such as certain fish, are also important to limit/avoid as these can harm your infants’ development. Raw or undercooked fish/sushi/meats/eggs also fall into this category to be avoided. 

Lunch meats can be contaminated with listeria, and should be re-heated to 165* to ensure safety before eaten (or until they “pop” in the microwave) 

Drinking plenty of water is important no matter what stage you are in as well, to avoid dehydration and urinary tract infections/stones, aiming for at least 2 liters per day for the average woman.

People also commonly ask “what about exercising?” It’s not a good idea to start marathon training after conception, but the generally accepted rule is you can continue to participate in exercise that you did before conception, with the exception of things that can put you at risk of trauma to your growing belly (i.e. soccer, skiing to name a few). It’s important for pregnant women to listen to their bodies and modify exercise as needed, as it will naturally become more challenging the further into the pregnancy they move. 

It’s important to keep in mind that you can theoretically become pregnant the day after you stop your birth control method (or while on birth control for some women!), and for some women, it can take months or even years to conceive – it’s difficult to predict. There is really no minimum time frame to conceive after stopping contraception, so it’s important for women to be prepared for this possibility. Lowering stress and being in a general state of good health increases the odds for successful conception/pregnancy. Making sure any chronic medical conditions you may have (i.e. diabetes or high blood pressure) are in good control are very important as well, and why the “preconception visit” is a good idea for many women. 

I think the most important thing to take from this is: don’t stress, be good to your body and your partner, and enjoy the journey! 


About Amanda Magrini

Amanda Magrini
Amanda Magrini, MD, is a board-certified family medicine physician at Northern Nevada Medical Group’s Los Altos location in Sparks. She completed her undergraduate degree at the University of Nevada, Reno and her medical training at the University of Nevada School of Medicine. Dr. Magrini has practiced family medicine for seven years, including residency, and enjoys her specialty, because she likes taking care of the whole family, from newborns to grandparents. She likes preventative medicine, helping people take care of themselves and the relationships she is able to form with her patients. Dr. Magrini grew up in Sparks, NV and likes that it is a safe place to live with great educational opportunities and beautiful scenery. She thinks Northern Nevada is a great place to raise a family and looks forward to raising her own children here. In her spare time, she enjoys outdoor activities such as hiking, biking, camping, boating, running and traveling the world. Dr. Magrini is also very close with her family; she is married to her high school sweetheart and values spending time with him and the rest of her family. Disclosure: "The author is a licensed physician practicing with Northern Nevada Medical Group, but all opinions expressed are solely the opinions of the author and do not necessarily reflect the views of Northern Nevada Medical Group or any other affiliates of Universal Health Services, Inc."

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