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Blog | Alto Pharmacy

A healthy pregnancy begins well in advance of trying to conceive. Preconception health planning sets you up to feel your best while growing a baby, allowing you to work towards health goals and manage preexisting conditions that could potentially result in complications.

How to Have the Healthiest Pregnancy Possible

It can also help you make any necessary changes to your treatment plan — for example, if you take a medication that is considered unsafe during pregnancy, your doctor can help you safely transition to an alternative.

Below, we break down some of the most important steps to take as you focus on your health and wellness while building or growing your family.

1. Consult your doctor about your health history

As you begin to plan for a baby, schedule a doctor’s appointment to identify any health issues that can impact pregnancy — whether it’s your first, second, third, or fourth.

While chronic health conditions like diabetes, hypertension, thyroid disease, and asthma are sometimes linked to pregnancy complications, you can prevent health challenges during pregnancy by staying proactive about treatment. For those with diabetes, this means working with your provider to maintain healthy blood sugar levels before trying to conceive. The same goes for hypertension and blood pressure levels.

Read Navigating Pregnancy With Type 1 or Type 2 Diabetes

Be sure to discuss any past pregnancy complications, if relevant. Experiencing certain complications in a first pregnancy can increase your risk of having them again in a later pregnancy. These complications include:

This does not mean that a recurrence is inevitable. Proactively managing your risk before and during pregnancy is the most important thing you can do to prevent these complications.

You should also share any health issues that you experienced during postpartum, including mental health challenges.

Changing a medication regimen or treatment plan

A pre-pregnancy care checkup is also an opportunity to discuss potential changes to your treatment plan. Bring all medications you are currently taking with you to this appointment, including vitamins and herbal remedies.

Never stop taking a prescribed medication without first consulting your doctor. Many medications cannot be abruptly discontinued and require you to slowly titrate, or taper off, over a period of time

It is recommended to focus on preconception health at least three months prior to pregnancy. However, everyone has unique health needs, and you may need more time to prepare for a healthy pregnancy. Try, as much as possible, to be patient and give your body the time and space it needs.

2. Get all recommended vaccines and screenings

At the beginning of your family building journey, ask your doctor which vaccines are recommended for your age. Certain infections or illnesses can cause birth defects or pregnancy complications. Many of these can be prevented with vaccines. And since illness-fighting antibodies can pass through the placenta, vaccinated individuals can pass along immunity to their growing baby in the womb.

It’s important to stay up to date since the recommended timing of vaccines varies. Not all can be given during pregnancy while others can. Your doctor can clarify which vaccines are recommended before pregnancy, during pregnancy, and after delivery. (Two of the most important vaccines for pregnant women, the flu vaccine and the Tdap vaccine (tetanus, diphtheria, pertussis), can be safely administered during pregnancy.)

Additionally, sexually transmitted infections (STIs) including HIV, HPV, and viral hepatitis can cause pregnancy complications and harm a developing fetus. Fortunately, treatment can prevent transmission to a baby. Screening for these infections is a critical step in planning for a healthy pregnancy.

3. Take steps to live your healthiest life

In the months before trying to conceive, revisit your health habits and make any changes to your routine or lifestyle that can support the healthiest pregnancy possible. There are several key areas to focus on.

Several nutrients are especially important to consume in the months before pregnancy. 

The American College of Obstetricians and Gynecologists recommends taking a prenatal vitamin with at least 400 micrograms of folic acid every day for at least a month before pregnancy through the first trimester. This important nutrient supports a baby’s growth and development and can prevent certain birth defects.

Depending on your health history and previous pregnancies, your provider may advise you to increase your intake of folic acid with an additional supplement.

(You can add prenatal vitamins to your next Alto delivery!)

Calcium helps build a developing fetus’s bones and teeth. Dairy products including milk, cheese, and yogurt are the primary sources of calcium, but you can also get this nutrient from other sources including:

If you are concerned about your calcium intake, ask your doctor about calcium supplements.

Iron also helps support a healthy pregnancy. Some prenatal vitamins include iron. It can also be found in the following iron-rich foods:

In addition, be sure to eat foods that support your body’s absorption of iron, including the following fruits and veggies, which are rich in vitamin A and beta-carotene:

If you have anemia, your doctor may recommend additional iron supplements.

An omega-3 fatty acid called DHA, or docosahexaenoic acid, is important for fetal growth and development. It can be found in some foods such as fatty fish. Depending on your diet, your doctor may recommend taking supplemental DHA before and during pregnancy and in the postpartum period. Some prenatal vitamins contain DHA, but not all, so be sure to check the ingredient list.

Since heavy caffeine consumption can affect fertility, it is recommended to reduce your intake to 200-300 mg per day.

Aim for about 150 minutes of moderate physical activity per week, incorporating some muscle-strengthening exercises.

Being underweight or overweight can cause health issues during pregnancy. Try to reach and maintain a healthy weight in the months before trying to conceive. Your provider is an important resource and can advise you on whether your weight may impact your pregnancy.

Smoking, drinking alcohol, and using certain drugs — including misusing prescription medication — can cause serious health issues during pregnancy like preterm birth and birth defects. When planning for a future pregnancy, do not be afraid to ask for any support needed to give up harmful behaviors. Your provider can offer resources. 

It’s also important to avoid secondhand smoke during pregnancy.

Genetics are a factor in your baby’s health and the progression of your pregnancy. Prior to pregnancy, discuss your family’s health history as well as your partner’s with your provider. This allows them to identify any genetic risk factors.

Some couples and individuals may be referred to a genetic specialist for reasons such as the following:

A family history of a genetic condition, birth defect, chromosomal disorder, or cancer

Two or more pregnancy losses or a stillbirth

Having given birth to a child with a genetic condition, birth defect, or intellectual disability

These risk factors do not guarantee that your baby will develop a health condition or that you will have a complicated pregnancy. Genetic testing can determine the likelihood of passing on a genetic issue to a child. A genetic specialist can help you understand your options for testing.

5. Prioritize your partner’s health as well

Preconception health concerns both parents. Male partners should also take steps to become as healthy as possible, which will improve their own reproductive health and fertility. This includes limiting their alcohol intake, quitting smoking or using harmful substances, and eating a healthy diet. (These lifestyle factors have been linked to issues with sperm production.)

Other important steps for male partners to take before trying to conceive include getting screened for STIs and consulting with a provider about family health history and medication use.

Alto Pharmacy can support you in preparing for a healthy pregnancy, however that looks for you. From delivering prenatal vitamins straight to your doorstep, supporting you in managing a chronic condition, or helping you navigate fertility treatment, we make it as simple as possible to focus on your health.

We offer free, same-day delivery and in-app medication management tools like reminders and auto refills. Additionally, our pharmacists are available to answer any questions you may have about medications or side effects.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Living with type 1 or type 2 diabetes does not prevent a healthy pregnancy. Thanks to insulin therapy and effective blood sugar management options, many women with diabetes successfully navigate pregnancy, childbirth, and postpartum. While there are some pregnancy risks and challenges tied to type 1 diabetes specifically, careful planning and proactive diabetes management throughout pregnancy can keep you and your baby healthy.

Navigating Pregnancy With Type 1 or Type 2 Diabetes

Here’s an overview of what pregnancy with type 1 or type 2 diabetes may look like — from fertility to childbirth and beyond — to help you explore your family building options.

Many people with diabetes wonder how the condition will impact their fertility. Having diabetes does not mean you will have more difficulty conceiving. Consistently high blood sugar levels are the main way that diabetes can make it challenging to get pregnant. 

Some research has found that women with type 1 diabetes are more likely to have irregular menstrual cycles or delayed ovulation — factors that affect your fertility — but these health issues are also linked to elevated blood sugar. 

High blood sugar can be managed, and informing your doctor of your plans to build or expand your family early on can help you maintain healthy blood sugar levels before you start trying to conceive.

While every pregnancy carries the possibility of complications, type 1 diabetes is linked to the following.

Preeclampsia — Preeclampsia is a pregnancy complication characterized by high blood pressure that can result in liver or kidney damage. Women with type 1 diabetes may face a greater risk for this complication since they often have higher baseline blood pressure before pregnancy.

Insulin resistance — Hormonal changes during pregnancy can make your body less effective at using insulin, resulting in decreased glucose produced from the liver. (This can lead to the development of gestational diabetes in women without preexisting diabetes during pregnancy.) As the placenta grows, insulin resistance increases. This can affect your blood sugar levels.

Miscarriage — Women with type 1 diabetes have a higher risk for miscarriage — the loss of a baby before 20 weeks — or stillbirth — the loss of a baby after 20 weeks. Birth defects caused by high blood sugar may be a contributing factor.

Macrosomia — Macrosomia refers to a newborn with a higher-than-average birth weight, which can make childbirth more difficult for a mother.

Birth defects affecting your baby’s heart, brain, spine, kidneys, digestive system, limbs, and mouth

In addition, without effective diabetes management, pregnancy can intensify preexisting diabetes-related complications.

These risks are manageable, however, it’s important to prepare for pregnancy in advance of trying to conceive and to stay vigilant about diabetes management throughout this journey. Preconception planning allows you to work toward health goals and ensure that you have an appropriate care team and medication protocol in place.

When planning a pregnancy, consult your healthcare provider before trying to conceive to review your blood sugar levels, make any necessary adjustments to your treatment plan, and evaluate potential diabetes-related health complications. If you become pregnant unexpectedly, contact your provider as soon as you learn of your pregnancy to discuss blood sugar monitoring, medication changes, and other factors that can lower your risk of pregnancy complications.

Here are some action items to focus on in the months leading up to conception. This is intended to be a high-level guide. Consult your care team for a more individualized plan.

Your A1C levels are your average blood sugar levels over a period of two to three months. Your blood sugar levels can impact the development of your baby’s organs during the first 8-12 weeks of your pregnancy, so it’s even more important to maintain healthy blood sugar levels before pregnancy. As you plan for pregnancy, ask your doctor to clarify your A1C goals and how long to maintain them before you try to conceive.

Review your treatment plan and make necessary medication adjustments

Not all medications and supplements are safe to take during pregnancy. Speak with your care team about each medication and supplement you take before trying to conceive. Never stop taking a prescribed medication without first consulting your doctor.

Since there are considerations specific to type 1 diabetes during pregnancy, you may want to look for a healthcare professional who works at the intersection of diabetes treatment and maternal health.

Consider working with an endocrinologist — a physician who treats hormone-related conditions such as diabetes — who focuses on treating pregnant women with diabetes. Alternatively, some OB/GYNs have specialized training in managing diabetes during pregnancy.

You may also benefit from working with a diabetes educator, a healthcare professional certified to coach individuals living with diabetes. They can offer individualized guidance about navigating pregnancy with the condition.

Vigilant monitoring of your insulin needs and blood sugar levels is the most important thing you can do to have a healthy and safe pregnancy. As your pregnancy progresses, pay attention to changes in how much insulin you need. Many women with diabetes experience lower blood sugar during pregnancy. Continue to revisit your treatment plan with your care team and confirm the recommended dosage and frequency of insulin. 

There are diabetes supplies that can make it easier to check your blood sugar more frequently. Many pregnant women with diabetes use a continuous glucose monitor (CGM), an electronic device that collects glucose readings every five minutes throughout the day. Talk to your doctor to learn if a CGM is an appropriate option for you.

Most individuals with diabetes require more insulin throughout pregnancy since insulin resistance typically increases as your pregnancy progresses. You may find it helpful to use an insulin delivery method that eliminates the need for multiple daily injections such as an insulin pump. Additionally, an insulin pen allows for faster administration of insulin injections throughout the day.

Having a birth plan in place can help you prepare for any scenario during labor and delivery. Here is some diabetes-related information to include.

Who will monitor your blood sugar levels during and after labor and delivery?

What diabetes supplies do you need to pack in your bag, if delivering at a hospital or medical facility?

What is the procedure for women who use an insulin pump at your chosen hospital or medical facility? (if applicable)

What is the procedure for women who use a CGM at your chosen hospital or medical facility? (if applicable)

Blood sugar levels can fluctuate during labor and delivery. They often rise during labor but drop just before or immediately after delivery. Your care team can help you prepare for these possibilities. If using an insulin pump or CGM, speak with your doctor about protocol for continuing to wear these devices during delivery.

Many women assume that they will struggle with breastfeeding due to their diabetes. However, you can breastfeed while living with type 1 or type 2 diabetes. The condition may delay breast milk production but this should improve with time.

Keep in mind that breastfeeding takes up energy, which can affect your blood sugar levels and insulin needs. Some research has found that lactation can increase the risk of overnight hypoglycemia, or severely low blood sugar. Make sure that someone around you understands the signs of hypoglycemia and how to address it.

Above all, remember that you aren’t alone in navigating the challenges of type 1 or type 2 diabetes during pregnancy. In addition to your care team and loved ones, the following organizations can help you connect with other women who understand this experience.

Beyond Type 1 and Beyond Type 2 are global online communities for individuals living with diabetes.

JDRF is a destination for type 1 diabetes support and community, with opportunities to connect locally with those affected by type 1 diabetes.

A diabetes pharmacy partner you can rely on

At Alto, we make it as easy as possible to manage diabetes throughout your family building journey. We offer free, same-day delivery of medications and supplies right to your doorstep, and our dedicated diabetes team is here to answer any questions you may have.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

Blog

How to Have the Healthiest Pregnancy Possible

Navigating Pregnancy With Type 1 or Type 2 Diabetes

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