healthy spring

Before the Bump

By Kristen Carmichael, MD and Myesha Johnson, APRN, WHNP-BC

Deciding that you’re ready to start or grow your family is an exciting time, filled with emotions and uncertainties. The first step has been taken; you’ve decided it’s time for a baby! Now what? When and how do I stop using my birth control? How quickly will I become pregnant once I’ve stopped use? Is my age going to be a problem? You’re probably wondering about all of this and more! Scheduling a preconception counseling appointment with your OB/GYN provider to discuss all your concerns is the next step toward achieving pregnancy. Not only will you be able to get answers to your questions, but your provider will have particularly important information to share to get your pregnancy off to a great start, before the bump.

Why consider preconception counseling?

The first eight weeks of fetal development are crucial.  Major organs and body systems have started to take shape.  Often, the first prenatal care appointment (the 1st visit after you find out that you are pregnant) doesn’t take place until 8-10 weeks gestation.  Knowing how to be your healthiest before you conceive means that during the first eight weeks of pregnancy, your baby’s most important stages of development are taking shape in an optimal environment.

What can I expect during my preconception visit?

Your provider will want to review your full medical history.  This includes discussing medications you may take for conditions such as asthma/allergies, diabetes, high blood pressure and depression/anxiety.  Health conditions like these can affect pregnancy, and you will want to discuss how to improve those conditions with your provider. Most medications for such health conditions should be continued until your first prenatal care appointment where your provider will discuss adjustments, if needed.  It is also a good time to discuss the safety of common over the counter medications and supplements you may be in the habit of using.

A discussion regarding your current birth control method will be an important item on the checklist.  This is a good time to talk about expectations about how quickly you may be able to conceive once you discontinue use.  The majority of hormonal birth control methods do not impact your ability to conceive.

Reviewing your vaccination schedule is important, and your provider will address this at a preconception visit as well.  There are some vaccines that should not be given during pregnancy, and you should be careful to avoid pregnancy if a vaccine has been administered recently or needs to be given to get you up to date.

If you’ve been pregnant in the past, your provider will want to review the details of your past pregnancies and deliveries.  If a complication arose with a prior pregnancy, discussion with your provider may help reduce the risk of the same scenario occurring in future pregnancies.

While it can be a bit awkward, be prepared to discuss your sexual history.  If you’ve ever been diagnosed or treated for a sexually transmitted infection (STI), it is important to share this information.  You may be encouraged to be screened for STIs, so any potential infection that is harmful to pregnancy can be addressed prior to conception.  You and your partner will also be asked to discuss your family health history. Your provider will want to know if there are genetic risk factors to consider, and if pertinent, she will counsel you about disorders that could potentially affect your baby.

What changes should I make before trying to conceive?

During a preconception counseling visit, your provider will discuss some important lifestyle factors to consider as you begin trying to conceive.  A healthy diet is key to providing your soon to be baby with good nutrition for growth and development. Adding an over the counter prenatal vitamin or folic acid supplement to your daily routine will greatly reduce the risk of birth defects and add essential vitamins and minerals that you may not get from your diet.  Women of childbearing age should get at least 400 mcg of folic acid daily. Eat a colorful diet with fruits and vegetables of all colors for maximum nutrition and keep sugars and fats to a minimum.

Stay active!  The exercise habits you have prior to pregnancy are safe to continue during pregnancy and encouraged to help maintain a healthy weight.  Being overweight poses an increased risk for developing high blood pressure, diabetes and can lead to complications at the time of delivery.  If you’re not regularly active and are concerned about your weight, discuss ways to improve with your provider.

If you smoke, make every effort to quit before you become pregnant.  Smoking increases the risk of preterm birth and low birth weight infants.  Keep alcohol to a minimum as you begin trying to conceive and stop drinking alcohol as soon as you discover you’re pregnant.  There is no way to study the effects of alcohol on pregnancy or to know for sure how much alcohol causes harm. For that reason, your provider is likely to instruct you not to drink once you’ve conceived.

Good Luck!

If you and your partner need a preconception visit, don’t hesitate!  Dr. Kristen Carmichael is located on the campus of Medical City Las Colinas at 6750 N. MacArthur Blvd, Ste. 304, Irving, TX 75039 and can be reached by phone at 972-247-8757.  Dr. Carmichael supervises Myesha Johnson, MSN, RN, WHNP-BC, a nurse practitioner specializing in women’s health care. They are excited to help start you off on a healthy journey to parenthood!




About Dr. Carmichael

Dr. Kristen Carmichael is an OB/GYN with the Medical & Surgical Clinic of Irving.  After completing her undergraduate degree at Southern Methodist University in Dallas, TX, she went on to attend medical school at the University of Texas in Houston.  She has been in private practice since 2004.  She is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the Texas Medical Association, and many other organizations.  Dr. Carmichael has been awarded the Best OB/GYN in Las Colinas, Coppell, and Irving and has been recognized as a Mom-Approved Doctor by DFW Child.   She loves helping her patients achieve their best health and is most satisfied when they feel educated, engaged and empowered in their healthcare.


About Myesha

Myesha Johnson works with Dr. Carmichael and has dedicated her professional career to helping women achieve their best health by providing the best care she can offer and taking an interest in the needs of her patients. Myesha holds a Bachelor of Science in Nursing and Master of Science in Nursing from The Ohio State University in Columbus. She makes it her priority to provide her patients with quality care and attention. Women’s health issues can be stressful, but Myesha does her best to answer any questions and guide women to achieve their best health.