Healthy Choices Before Pregnancy

Make Healthy Choices Together

Smoking

Alcohol and Other Drugs

Environmental Hazards

Some Sources of Environmental Hazards

       ● Workplace

       ● Home

       ● Hobbies

Are You Exposed To Environmental Hazards?

Health Hazard Resources

Prenatal Courses and Resources

References

Make Healthy Choices Together

Small changes can make big differences.  Ask yourself,

"Are there changes I would like to make?"

(Source: "Give and Take," AWARE, 1996, p. 31)

What better time to look at your lifestyle and make changes than before pregnancy?  Changing lifestyle habits, such as smoking or drinking, can be done together.  These changes won’t happen overnight.  Be patient.  Give yourselves time and support each other.

Smoking

You may be asking yourself, “Do I need to be concerned about my smoking behaviour now?  Why not wait until I become pregnant?”  Now is the time for change. 

• Smoking has been found to decrease fertility, making it harder for you to get pregnant.1-3 This
  applies to both men and women. 
   

• Smoking is not only a concern if you are planning a pregnancy, but also when you become pregnant. 
   

• If you smoke during pregnancy there is a greater chance of miscarriage, premature birth and having a
  low birth weight baby, under 5lbs. 8 oz. (2500gms).1-8 Exposure to second-hand smoke can have 
  similar effects. 2-5,8-⁹

“I  never thought I could quit smoking but I did  it and my family and  friends supported me all  the way. I feel better about myself because I did it!"

To quit smoking you must believe that you can quit.  Get support from your family and friends.  Tell them that you are trying to quit and it is important to you.  Prepare yourself and make a plan to help resist the urge to smoke.

Take a moment to write down the reasons why you smoke and what you could do instead.  Keep a copy handy, on your fridge, in your wallet, and at work.  Let others know so that they can support you with your alternatives.

Why do I smoke?                                             Instead of smoking I will...

___________________________________               __________________________________

___________________________________               __________________________________

___________________________________               __________________________________

"When I first looked at this diary stuff, I thought it was silly but I would give it a try. After keeping my diary for just one day,  I could see that one of the main reasons I smoked was to calm down when I was angry or upset. I'd always figured that I smoked out of habit.

                        Keeping a diary really helped me prepare to quit smoking."

Keeping a diary of when and how much you smoke is a helpful way to learn more about your smoking habits and what you want to change.  Rate your need to smoke below  (1 being low, 5 high).

Smoker's Diary Example:

(Source: “For Smokers Who Want To Quit One Step at A Time”, The Canadian Cancer Society, 1999, pp. 32,33)

Second-hand smoke and your newborn

While smoking is an important consideration in fertility and pregnancy, it is also necessary to focus on what will happen after your child is born.  Babies exposed to second-hand smoke have a higher likelihood of asthma, bronchitis and sudden infant death syndrome (SIDS).^4,5,7,8,10 Think about the environment around you and take steps to protect your child. 

“Support each other, don’t give up!  You can do it!”

Visit Smoking and Tobacco for more information on this issue.

Alcohol And Other Drugs

“When I found out I was pregnant my heart sank.

I was excited, but I worried about the drinks

I had before I knew I was pregnant.”

This is a concern often voiced by women when they find out they are pregnant.  In order to avoid this unnecessary stress it is important to take the time to plan your pregnancy. Let’s look at some other factors that you may want to change or explore as a couple.

To help you, here is a personal checklist for you and your partner. It may help you reflect on your present use of alcohol and other drugs.

To sum it up…

Please check whether the following statements are true or false. 

Use the information to help you plan your pregnancy.

 Alcohol Quiz Answers

For more information visit the Alcohol and Substance Abuse section.

                                                 www.alcoholfreepregnancy.ca

Wanting to do the best for your baby during pregnancy is not only your responsibility; your partner, family and friends can also provide a healthy environment for you before and during pregnancy.

Remember, the choices you make now will have lasting

effects for you and your family throughout the years to come!

Environmental Hazards

Avoiding Environmental Hazards at Work, Home and Play

Have you ever thought about the biological, physical and chemical hazards that surround you everyday?  Environmental hazards can be present in the workplace, at home or even when you are doing your favourite hobby.  If you are planning a pregnancy, it is a good idea for you and your partner to explore the hazards around you and take steps to avoid potentially harmful substances before you conceive.  By reducing unnecessary exposures, you can improve your chances of a healthy outcome.^1,2,4,6,9-11

●  If you are concerned about the potential exposures in your workplace, make it your job to find out

    more information.  Talk to your health care provider or the Health and Safety representative at your 

    work; he or she may be able to help you uncover any potential hazardous exposures.¹

●  If there are environmental hazards that concern you, quitting your job is not usually the answer.  In 

    some instances, work modifications (e.g. transferring to another department) or taking extra 

    precautions (e.g. using gloves and a mask) may be advisable. ^{1,2,6,9,10,12,13,16}  

● During pregnancy, it is important to avoid strenuous work or avoid standing for long periods at a 

   time.  Studies have linked this to a slight rise in problems such as low birthweight, premature labour 

   and miscarriage. ^1,10,14

What Are Some Possible Sources of Environmental Hazards?

Workplace 

“My husband Dave has a job where he works with very

high temperatures.  We are thinking about getting

pregnant.  Should we be concerned about the extreme

temperatures with his job?”

● In the workplace, toxic substances such as lead, pesticides, organic solvents and  

   mercury can be  harmful to your reproductive health. ^1-6,10

● Exposure to heat can cause lowered sperm production in men and birth defects

   from maternal hyperthermia (body temperature >38°C) in pregnant women.^7,10 

● Radiation exposure can cause fertility problems in both men and women. ^1,2,9,11,15 Computers or   

   video display terminals (VDTs as they are sometimes called) are considered safe for use during 

   pregnancy.^2,8,13  The external structure and the material of the screen absorb the weak x-ray 

   emissions. 

Chemical hazards can be detected using Material Safety Data Sheets (MSDS).⁹  Find out where they are located in your workplace.  It is important to follow the recommended guidelines by understanding your rights under WHMIS (Workplace Hazardous Materials Information System).  Do not forget to use protective equipment when suggested.

Home

“I was thinking about painting the living room in my new house.  Should I take any special precautions?”

Home is where the heart is…but it is also full of possible hazards.  Have you ever taken the time to read what is in your household cleaner?  Do you follow the directions for use? 

● Cleaning substances, paints, lawn chemicals and pesticides are all possible hazards in the home.

● Most products are safe for use as directed.  However, it is important to remember to work in a well-

   ventilated area, wear gloves whenever possible and wash your hands after handling any potentially  

   hazardous substance!^6,9,13 

● Whenever possible, avoid using industrial strength cleaners.¹³  

● If you suspect that you are pregnant and plan to do some painting, make sure you use a latex (water-

   based) paint in a well-ventilated area. ¹³  Never use oil-based paints.  If you feel sick while painting, s   

   stop and check with your health care provider. ^2,13

Hobbies

“I love to garden, it’s one of my favourite things to do.

I never thought that the weed killer that

I use might be toxic.  Looking back, I probably

should have worn gloves and maybe even a mask.”

Who ever thought that gardening could be potentially bad for your health?  Well, in terms of reproductive health, it just might be.  Insecticides, fertilizers, and weed killers may contain toxic chemicals, but if handled properly, the risk of exposure can be minimized.

Substances such as lacquer, paint thinners, paint and varnish removers should be handled with care.  Reduce your risk by wearing rubber gloves and working in a well-ventilated area.^{6, 9, 13}

Are You Exposed To Any Environmental Hazards?

Use this worksheet to help identify any potential hazards.  You may wish to bring it to your health care provider to discuss questions or concerns about environmental exposures prior to pregnancy. 

Chart any potential hazards that you are concerned about, whether it is at work, home or at play.  Write down how you were exposed to it, (e.g. inhalation for 7 hours per day while at work).  After you have filled out the first two columns, try to figure out ways to reduce the risk.  This is something that you can do with your health and safety representative at work.

Environmental Exposure:

(Source: “Think Ahead!  Is There a Baby in the Future?”  March of Dimes, 1995)

Health Hazard Resources:

If you have questions about possible hazards before and during pregnancy, including the use of medication, alcohol, tobacco, and other drugs during pregnancy and breastfeeding, contact:

Centre for Addiction and Mental Health:   1-800-463-6273    or at www.camh.net

Motherisk:                                             1-416- 813-6780   or at http://www.motherisk.org/

Alcohol and Substance Use Help line:      1-877-327-4636

HIV and HIV Treatment In Pregnancy:      1-888-246-5840

Ministry of Natural Resources:                 1-800-667-1940     or at www.mnr.gov.on.ca

Ministry of the Environment:                     1-800-565-4923     or at www.ene.gov.on.ca

Visit the Healthy Housing section for more information on this issue.

Section References

Healthy Choices before Pregnancy:

1. March of Dimes Birth Defects and Mosby – Great Performance. (1995). Think Ahead.  Is There a Baby In Your Future?  Oregon:  Author.
    

2. Cefalo, R.C.,&  Moos, M.K. (1995). Preconceptional Health Care: A Practical Guide. 2^nd Ed.  St. Louis: Mosby-Year Book, Inc.
    

3. Chamberlain, G.  (1990).  Preparing for Pregnancy: A Health Primer for Parents-to-be.  Glasgow:  Harper-Collins Publishers Ltd.
    

4. Enkin, M., Keirse, M., Renfrew, M. & Neilson, J.  (1995).  A Guide to Effective Care in Pregnancy & Childbirth. New York: Oxford University Press.
    

5. Society of Obstetricians and Gynaecologists of Canada (SOGC).  (1998).  Healthy Beginnings: Your Handbook for Pregnancy and Birth.  Ottawa:  Author.
    

6. Motherisk Program with Best Start Algoma.  (1999).  Pregnancy Wallet Card: Motherisk Guide to the Safety of Products and Medication when Pregnant.  Toronto:  The Hospital for Sick Children.
    

7. Health Canada. (1997).  Asking to Listen: Helping Pregnant and Postpartum Women and Their Families to Quit or Reduce Smoking.  Ottawa:  Minister of Public Works and Government Services Canada.
    

8. Health Canada. (1996).  Smoking and High Risk Pregnant Women.  Ottawa:  Minister Supply and Services.
    

9. Royal College of Physicians of London.  (1992).  Smoking and the Young.  Lavenham: The Lavenham Press Ltd.
    

10. Community Health Research Unit (CHRU).  (2000).  The Effectiveness of Postpartum Smoking Relapse Prevention Strategies: A Systematic Review of the Evidence 1992-1999.  Ottawa: University of Ottawa.
     

11. Health Canada.  (2000).  Family-Centred Maternity and Newborn Care: National Guidelines.  Ottawa: Minister of Public Works and Government Services Canada.
     

12. Action on Women’s Addictions – Resource & Education. (1996).  Give and Take: A booklet for pregnant women about alcohol & other drugs.  Kingston: AWARE Press.
     

13. FAS Community Resource Centre.  (2000). “What is FAS?”  Factsheet.  FASCRC [online],
    www.come-over.to/FASCRC.com  [2000, August 16].
     

14. Austin, L. (1993).  Fetal Alcohol Syndrome: An Overview.  Edmonton:  Alberta Alcohol and Drug Abuse Commission Production and Distribution.
     

15. Hatcher, R.A. et al.  (1998) Contraceptive Technology. 17^th Ed.  New York: Irving Publishers Inc.

Environmental Hazards:

1. Society of Obstetricians and Gynaecologists of Canada (SOGC).  (1998).  Healthy Beginnings: Your Handbook for Pregnancy and Birth.  Ottawa:  Author.
    

2. Koren, Gideon. (1994). Maternal-Fetal Toxicology: A Clinician’s Guide, 2^nd ed.  New York:  Marcel Dekker, Inc.
    

3. Taskinen, H.K.  (1990)  Effects of parental occupational exposures on spontaneous abortion and congenital malformations.  Scandinavian Journal of Work and Environmental Health, 16, pp.297-314.
    

4. Barlow, S.M. (1986).  Reproductive Effects of Occupation: In Drug and Chemical Action in Pregnancy.  New York: Marcel Dekker, Inc.
    

5. Cordier, S., Deplan, F., Mandereau L and Hemon, D. (1992).  Paternal exposure to mercury and spontaneous abortions.  Obstet Gynecol Surv, 47, pp. 152-154.
    

6. March of Dimes Birth Defects and Mosby – Great Performance. (1995). Think Ahead.  Is There a Baby In Your Future?  Oregon:  Author.
    

7. Schrader & Kesner. (1993).  Male reproductive toxicology.  Occupational and Environmental Reproductive Hazards,  pp. 52-59.
    

8. March of Dimes Birth Defects Foundation. (1999). “VDT Facts,” Factsheet. March of Dimes Birth Defects Foundation [online], www.modimes.org/HealthLibrary2/factsheets/VDTFacts.htm  [2000, July 14].
    

9. National Institute for Occupational Safety and Health. (1999).  “The Effects of Workplace Hazards on Female Reproductive Health,” Publication No. 99-104.  NIOSH [online], http//www.cdc.gov/niosh  [2000, July].
    

10. Health Canada.  (2000).  Family-Centred Maternity and Newborn Care: National Guidelines.  Ottawa: Minister of Public Works and Government Services Canada.
     

11. Cefalo, & R.C., Moos, M.K. (1995). Preconceptional Health Care: A Practical Guide. 2^nd ed.  St. Louis: Mosby-Year Book, Inc.
     

12. Levitt, C.  (1993).  Preconception health promotion.  Primary care.  Clinics in Office Practice. 20(3):  537-49.
     

13. Motherisk Program with Best Start Algoma.  (1999).  Pregnancy Wallet Card:  Motherisk Guide to the Safety of Products and Medication When Pregnant.  Toronto:  The Hospital for Sick Children.   
     

14. Teitelman, A.M., Welch, L.S., Hellenbrand, K.G., Bracken, M.B. (1990).   Effect of maternal work activity on preterm birth and low birth weight.  American Journal of Epidemiology. 131(1): 104-113.
     

15. Scher, J., Dix, C. (1990).  Preventing Miscarriage:  The Good News.  New York: Harper and Row.
     

16. Canadian Institute of Child Health (CICH). (1997).  Environmental Hazards: Protecting Children.  Ottawa: Author.

For credit of this information, please refer to the preconception home page.