Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand, and today I'm going to be joined by Laura Redenius, Nurse Practitioner at Riverside's Primary Care Associates Bourbonnais, to give us some tips on planning for pregnancy.

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Host: And we're back with Laura. Thanks for being here today.

Laura Redenius, FNP-BC: Yes. Thanks again for having me.

Host: Of course. So, to get started, can you just tell us a little bit about yourself?

Laura Redenius, FNP-BC: Yeah. So, I have worked as a registered nurse for 15 years. I did a little stint in women's health at the beginning and then primarily worked in labor and delivery and postpartum and nursery and I've joined, I enjoyed every minute of it, but thought I would, learn a little bit more in life and proceeded to get my Nurse Practitioner degree in Family Medicine.

Host: That's great. So you're the perfect person to have on for this episode. You've got all the answers. So jumping right in, what are the first steps someone should take when they start thinking about getting pregnant?

Laura Redenius, FNP-BC: So some of the first steps I think someone should take when considering getting pregnant would be to just review their overall health. I think there are a few questions they need to ask themselves. Have they had a well exam by their primary care provider in the last year? Are they up to date on their vaccinations? Are they maintaining a healthy weight? Do they smoke, drink alcohol, do illicit drugs, or surround themselves by people who do this?

And are there any previous illnesses, disease, are they under control? All of these affect someone attempting pregnancy and having a successful healthy pregnancy.

Host: Got it. So those are good things to start off with. How important then, like, would you say that preconception health is? Are there specific health checks that you should consider before trying to conceive or just like that overall, like a primary care visit?

Laura Redenius, FNP-BC: Yeah. So I think you should start off with a primary care visit just to check your overall health, and they can also answer questions in regards to potential preconception. There are primary care providers out there who do preconception visits, or you can see your OB GYNE.

Preconception health is very important to promote a healthy pregnancy for mom and baby. Most of the questions I just listed above tie to this question, but providers are looking at overall general health along with performing a few blood test screenings. Some screenings your provider may order, for example, would be screening for elevated blood pressure, screening for any sexually transmitted infections, cervical screenings performed, immunity screenings, diabetes screenings.

If any of these are out of normal range, it can increase the risk for a miscarriage and further complications during the pregnancy.

Host: So that makes sense. So those are kind of the things that your provider would be looking at to make sure you're healthy. And then, like, additionally, what role would, like, nutrition and diet play in preparing for pregnancy? Are there, like, key nutrients you should start to up and include or, like, vitamins be incorporated into that?

Laura Redenius, FNP-BC: To start off with, a healthy weight is where we really need to start with pregnancy. Being underweight or overweight affects a pregnancy significantly. In regards to questions in regards to nutrition and diet with pregnancy, that preconception appointment is so good to make because your provider can answer all these questions. Otherwise, you're relying on looking at websites and unsure if these are legitimate information. I mean, have we all gone to three different websites and they've told us three different things?

Host: Well, absolutely every day. Yeah.

Laura Redenius, FNP-BC: Now we're talking about growing a human being inside of us. So I think we want to make sure that all the information is very legit. So the most important thing I want to touch base on would be supplementation with prenatal vitamins. So prenatal vitamins help with preventing anemia and your basic prenatal vitamins should have enough folic acid, which is 400 micrograms in it, and that should be started at least a month before pregnancy.

And that's for anyone who is not sick with any other previous diagnosis, like hypertension, diabetes. This prevents neural tubal defects, so any abnormalities that would develop with the infant's brain or spinal cord. For someone who has those other comorbidities, such as diabetes, or they have a history of neural tubal defects, they're recommending 4,000 micrograms, and that to be started 3 months prior to pregnancy.

So that's where having that preconception visit is such a great thing to be able to answer all the questions and it helps your partner be able to ask questions on what they need to do to for their health.

The other things that are addressed which are extremely important would be if you're vaping, cigarette smoking, intaking any marijuana or illicit drug use, and then other foods to avoid would be caffeine, alcohol, unpasteurized cheese, raw meat, raw eggs, raw shellfish, and any fish with mercury, which would be shark, mackerel, tilefish.

So, like I said, preconception visit, all these answers there for you.

Host: Yeah, definitely. That's a lot to like take in right now, but if you're, you know, at your own visit, you can kind of address the things that might pertain to you and your lifestyle, because, you know, I don't know anywhere to get shark, but, but, you know, maybe somebody does.

So that, that's awesome. And I think you kind of touched on this a little bit, but what kind of lifestyle changes, if there's something that you didn't add in before, would you recommend someone make if they're preparing for pregnancy?

Laura Redenius, FNP-BC: Start moving. Exercise is so important to just general over health. You have to have a healthy mom in order to have a healthy pregnancy and a healthy baby. So the recommendation is at least 150 minutes a week of moderate intensity activity. Being overweight can contribute to factors just in regards to not being able to conceive. If it is difficult for you to lose weight, make an appointment with your provider.

We can help you guide you to a healthier lifestyle and give you other resources to help you. Just being in a normal weight can also prevent complications during pregnancy, along with preventing just generalized discomforts in pregnancy.

Host: Awesome. Okay, so this is kind of like switching gears a little bit. Going from like, okay, these are the things I want to do as I'm starting to think about getting healthier and getting to a place where you want to try to conceive. But when someone is kind of more ready or, getting closer to that, how can someone track their ovulation and fertility to increase their chances of conceiving?

Laura Redenius, FNP-BC: So if a couple decides that it's time that they want to attempt to conceive, I would say don't stress. Stress and worrying and just not making it fun. Like, enjoy your time together. This could potentially be in nine months that there's three of you. Right. So enjoy the time together and try to make it as stress free as possible.

You know, sometimes we have family or friends in our lives who have a difficult time conceiving and so then we just assume we're going to have the same problem. Or maybe a month went by and we're like, Oh, we didn't, you know, conceive this month. So remember, everyone's different. Making that preconception appointment at this time would be great, mainly because your provider can let you know when it's time to start using those ovulation tracking methods and if any further evaluation is needed.

Host: Got it. So you recommend starting off not even necessarily using any tracking methods because it adds additional stress to it. Interesting. Cool.

We are going to take a quick break to talk about finding a primary care provider. Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

And we are back. This kind of plays into what I just said, but what advice do you have for managing stress and mental health during this preconception period?

Laura Redenius, FNP-BC: So make sure you have someone you can talk to during your pregnancy, or if you've had stress previously that relieving factors that you can do, going for a walk, talking to someone, meditation, whatever works for you. You know, your mood can change so easily in one minute from another when you're pregnant and you need to remind yourself that that's okay. You're growing a human inside of you. You're allowed to have these ups and downs. Just know the person that you can talk to can be anyone. It can be your partner, it can be your family, friend, it can even be your provider.

Your provider can give you resources to potential counselors, therapists locally. We have lots of them and they're great to help guide you into what's best for you to help manage your stress.

Host: Great. Are there any common misconceptions about preparing for pregnancy that you would like to debunk?

Laura Redenius, FNP-BC: Yeah, so I've heard a few. Uh, one is, you can't work out when you're pregnant or that's too much. You shouldn't be doing that. Yeah. So what you do on a normal daily basis is what you should continue doing. You know, somebody who runs a marathon, they can keep doing that if that's their norm. If they're going to start exercising, then start out slow and gradually work your way up.

If you feel like you're out of breath, you're having any chest pain, anything out of the ordinary, stop doing what you're doing. But we promote movement. So another one is if you don't get pregnant right away, you must be infertile. This isn't true. Like I said, everyone's different. Take a deep breath and make that appointment with your primary care provider or your OBGYN if you have any questions or concerns.

There are a few myths during pregnancy that I would like to debunk. Okay. And I'm eating for two. Sure. I'm pretty sure I used this one, especially with my first pregnancy. It's definitely not true. So you only need about 300 extra calories in the second and third trimester. Otherwise, you should just be eating a normal, healthy diet.

Sure. Drinking lots of water. Stay away from pop and caffeine and all that bad stuff. And then, finally, the last misconception during pregnancy I would like to debunk because I do feel like it is a very serious comment is, oh, one glass of wine will be okay and it won't hurt my baby. So previously, I do remember, oh yeah, one glass of wine is not going to be detrimental to your pregnancy.

The fact is, is there is no true amount of alcohol that can be deemed safe for pregnancy. So we say absolutely no alcohol. Obviously no illicit drug use during pregnancy to promote a healthy pregnancy.

Host: Good. I feel like all of those were good things that I've heard. Definitely the eating for two thing, you hear that a lot. And just, oh, take it easy, that kind of thing. So I feel like I've been seeing more of that on like social media lately of the opposite of that, what you said, saying that you should be continuing what, whatever your norm is. But I feel like that was a more old school thought that a lot of people would share.

 Okay, so how can potential parents involve their partners in the preparation process for pregnancy?

Laura Redenius, FNP-BC: Yeah. Ways you can involve partners in the preparation for pregnancy would be to go into your preconception appointment, have that, has that gotten really annoying to hear today?

No. It's just so important. And, just, it, like I said, offers so much information, so offer them to bring their own questions. It's, not just an appointment for the one who's about to be pregnant. This way they can learn things that you may need to work on, you being the patient, and work on things in order to live a healthier lifestyle and they can be a part of these changes. So let's say your partner is the one who always makes dinner. Maybe you need to be on a low sodium diet. Okay, well, now they understand why versus I don't want to eat a low sodium diet, right?

But now they know why and they can help promote that healthy pregnancy. Now during pregnancy, a way to involve their partner would be to take classes together. I know Riverside Birthing Center offers several classes that would be a great for parents to take together. They offer a class called Best Beginnings Preparing for Childbirth, which just literally helps you understand what's going to happen during this, this pregnancy.

Basic Baby Care, so helps ease that anxiety prior to the baby coming. Prenatal Breastfeeding classes, and there's a class called Real Parent Talk where people can just express how they feel amongst each other. All these classes will help ease any anxiety regarding pregnancy, labor, and they also promote community support because you never know who you're going to make friends with and maybe eventually you'll go on a play date with them.

Host: Absolutely. Those kind of support group kind of places are just meeting people is, great. People in your same situation, and your same world. That's awesome. So my last question for today was, what are some signs that it might be time, and I know that, we should be seeing our provider for our preconception visit, right?

But say maybe you already did that and then you've been trying. What are some signs or like what kind of timeline would you say that it would be time to seek help from a specialist or go back to your provider and say, Hey this hasn't worked?

Laura Redenius, FNP-BC: Yeah. So if you've got a year without using any form of contraceptive, so you've attempted pregnancy for a year and without any success, then I would say start with your OBGYN and you could even state doing that at six months.

So maybe they can run some lab tests and do other tests such as ultrasounds to make sure there's not a structural abnormality make sure that the partner does not have any other issues that need to be addressed. So you could do that at the six month mark or, after a year they may start discussing other options with you. But your OBGYN is going to provide the information on where you need to go further from there.

Host: Great. Thank you so much. Is there anything else you want to add about all this today?

Laura Redenius, FNP-BC: No. Just thanks again for having me.

Host: Of course. Thanks for joining us. And thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.