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Health considerations

If you suffer from a chronic (long-term) health condition, such as diabetes mellitus, heart disease, or epilepsy, you can, of course, still have children. It's important, though, to talk things over with your doctor before you become pregnant, so you can get the best possible care and help.

Asthma

Health considerations
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This is the most common respiratory problem in mums-to-be and is usually controlled by bronchodilator drugs and inhaled steroids. Asthma drugs don't seem to be a risk to the health of the growing baby, although thrush, which is often made worse by pregnancy, can be a side effect for the mother, and sometimes labour may start early. If you do suffer from asthma, take extra care of yourself while you're pregnant. Any stress and tension, as well as dust, pollen, and pollution, can cause breathlessness, and strain your already hard-working heart.

Consider epilepsy

This condition affects one in every 200 people. Epilepsy can vary from a momentary loss of consciousness to grand mal seizures. Research has found that the effect of pregnancy on the frequency and intensity of seizures varies - 50 per cent of mothers with epilepsy are unaffected, 40 per cent note slight improvement, and 10 per cent are worse. If you suffer from epileptic seizures, talk to your doctor before you hope to conceive. There's a slightly increased risk of neural tube and other defects linked to anti-epileptic drugs, including sodium valproate, lamatrigine, carbamazepine, and phenytoin. Your doctor can advise you.

Changing the drug treatment can increase the risk of seizures, but women with epilepsy are usually advised to optimize the drugs they take before pregnancy, not during it. While you're pregnant you'll keep on with any drug treatment, but you'll need to be seen frequently by a neurologist or other specialist who can adjust your drug dosage. Anti-epileptic drugs prevent absorption of folic acid, so it's very important to take high doses of folic acid supplements (5mg a day) before you conceive as well as after, to help lower the risk of birth defects. All pregnant women on sodium valproate or phenytoin are also advised to take vitamin K supplements from 36 weeks of pregnancy to help mature the baby's liver.

Diabetes mellitus

Diabetes can cause the baby to be abnormally large or have heart and respiratory problems, and complications for the mother include chronic thrush and pre-eclampsia. It's essential for a woman with pre-existing diabetes to have good glucose (sugar) control at conception as the baby is at a greater risk of abnormalities if sugar levels are high. Anyone at risk of gestational diabetes (diabetes that develops in pregnancy) can have a blood test to check for the condition.

Consider heart disease

If you suffer from any kind of heart condition your doctor will give you specific advice about your pregnancy. Generally you'll be told to get plenty of rest - put your feet up in the afternoon for at least two hours, and spend ten hours in bed at night. Most women with heart disease have easy, spontaneous labours. During labour the extra strain on the heart is intermittent and, in total, is less than that imposed upon it during the third trimester. There's usually no reason why a woman with heart problems should need induction or a Caesarean section.

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Posted 30.06.2010

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