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Reference Guide
Pregnancy & Prenatal Care

Pregnancy & Prenatal Care

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According to the CDC National Center for Health Statistics, there were 3,664,292 births in the US in 2021. However, infertility can make becoming pregnant a challenge. The CDC also notes that 19% of married women, 15-49 years of age, with no history of prior births, are unable to conceive after trying for 1 year, with 26% having issues becoming pregnant or being able to carry the baby to term. 

Infertility is a shared concern for both men and women, and can be caused by hormonal or genetic disorders, or dysfunction of the reproductive system. Additionally, certain modifiable lifestyle factors can increase infertility risk such as heavy alcohol use, smoking, steroid use, illicit drug usage, obesity, underweight, and physical or emotional stress. 

While altered hormonal balance affects both male and female fertility, it is especially significant for women and has been noted to be a major contributor to infertility. Important hormones influencing fertility include:

  • Follicle-stimulating hormone (FSH) - manages egg production and the menstrual cycle in women, and directs sperm production in men.
  • Luteinizing hormones (LH) - contributes to the menstrual cycle and egg production in women, and can lead to low sperm counts in men.
  • Gonadotropin-releasing hormone (GnRH) - production of FSH and LH
  • Estrogen - assists with embryo implantation in uterus
  • Progesterone - leads to thickening of uterus for embryo
  • Testosterone - influences FSH, and sperm count in men
  • Thyroid hormone (TH) - influences menstrual cycle and ovulation, and can increase risk of miscarriage and premature birth in women, and can affect sperm quality and motility for men.

You can also learn more about reproductivity longevity with Dr. Kalea Wattles here:  Functional Medicine and Fertility: A Comprehensive Approach to Reproductive Longevity with Dr. Kalea Wattles

Along with gut and nutrition status being important aspects of health and wellness, assessing and improving gut functioning, enhancing nutrient and diet intake, and making certain lifestyle changes has potential to help with fertility issues.

Determining pregnancy can often begin with an “at-home” pregnancy test kit and experiencing signs such as a missed menstrual period, fatigue, nausea and vomiting, and fatigue. Pregnancy testing involves assessing urine (more commonly) or blood for a particular hormone, human chorionic gonadotropin (hCG), with its presence usually indicating pregnancy. A more specific quantitative hCG blood test can be ordered to detect a pregnancy earlier and also, to determine fetal age. 

During pregnancy, prenatal care testing encompasses assessments to monitor the health of, and provide best care for, mother and baby. This can include tests such as complete blood counts, blood typing, urinalysis, urine culture, testing for specific infections, and glucose screening for gestational diabetes at various points during the pregnancy. Additional screening for birth defects and health concerns may be warranted depending on health history and risk factors, and are determined by healthcare providers in conjunction with the parents.

What do Pregnancy & Prenatal Care Tests measure?

Pregnancy & Prenatal Care tests focus on analyzing blood and urine samples for hormones and markers that can establish pregnancy, and help identify concerns or indicate health of mother and baby. Some examples of tests available through Rupa Health include:

Mothers are often also tested for certain diseases such as rubella, hepatitis B and C, sexually transmitted infections, human immunodeficiency virus, and tuberculosis, that have potential to cause complications during pregnancy. A urinalysis and culture are routinely included to rule out a UTI or screen for possible diabetes mellitus.  Examples of such tests available through Rupa Health include:

In addition to these tests, a physical examination, and a detailed health and family history are beneficial in monitoring health and wellness during pregnancy. Ultrasounds are also usually ordered at various points in the pregnancy to determine due date and monitor health and growth of the baby. 

Depending on the mother’s status and health and family history, certain conditions may be of more concern and should be monitored for such as gestational diabetes, high blood pressure, iron deficiency, and mental health issues during and post pregnancy.

Treatment Plans

Pregnancy treatment plans focus on caring for the mother and growing baby, and often also includes support and preparation for the upcoming birth and labor. Assessing gut health and nutritional status can be helpful in making optimal diet choices for the mother pre, during, and post pregnancy.

For mothers with potential for gestational diabetes, maintaining a healthy weight, exercising, limiting sugars, and monitoring blood sugar are important aspects of their care planning. Mothers with a history of high blood pressure should be encouraged to eat healthy, attain adequate exercise and sleep, and limit stress as much as possible.

Treatment plans useful during pregnancy and also beneficial when trying to conceive focus on healthy nutrition and lifestyle including:

  • Nutrient-dense diet consisting of foods that provide nutrients such as folate, iron, calcium, omega 3, and healthy fats, proteins and carbohydrates
  • Recommended supplements include prenatal vitamins, probiotics, folate
  • Ginger can be helpful for morning sickness
  • Adequate and appropriate exercise
  • Stress management 
  • Sufficient sleep and rest
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