Prenatal Planning

As I’ve discussed, my wife Jennifer and I are planning to have a baby. While not pregnant yet, we’ve decided where we (probably) want to deliver the baby, and we’ve verified that our high-deductible insurance will cover emergencies related to the delivery and infant. Assuming a normal birth, we’ve already saved ample funds in our Health Savings Account to pay for the prenatal care and delivery, and we’ll have our full deductible saved well before delivery.

Obviously another big key is for Jennifer to prepare her body for pregnancy. As a point of general health, we checked Jennifer’s cholesterol counts. Jennifer also went to the dentist so she won’t need to do that during pregnancy.

Jennifer started taking a prenatal vitamin; her book What To Expect When You’re Expecting suggests that Vitamin B6 can help alleviate morning sickness, and obviously other vitamins are also important. A midwife at Mountain Midwifery suggested that Costco fish oil is a good source of Omega 3 fat, so we’re sticking with that (as opposed to an algae based form of the fat, which is considerably more expensive, even for the Target brand).

One thing I’d never heard of is an “Rh factor” test. According to What To Expect, “In a pregnancy, if the mother’s blood cells do not have the Rh factor [an antigen] (she’s Rh negative) while the fetus’s blood cells do have it (making the fetus Rh positive), the mother’s immune system will view the fetus… as a ‘foreigner.'”

Conveniently enough, PrePaidLab offers the Rh test, so Jennifer signed up for it. So if she tests negative, then apparently I also need to get tested.

While we were at it, we thought we’d get her level of Vitamin D tested. (PrePaidLab also offers that test.) The Vitamin D Council has more general information. One study suggests that a deficiency in the vitamin can cause underweight babies. A second study seems to confirm those results. Another concern is that a deficiency can harm the child’s bone health.

One big question we have is how much fluoride Jennifer should be taking. According to our dentist, she should be drinking regular tap water for its fluoride content during pregnancy and breast feeding, so as to give the child enough of the mineral for strong teeth. A child needs it for several years thereafter, according to my dentist. I’ve heard the claim that fluoride per se is bad, but such claims strike me as unsubstantiated hysteria. However, it’s unclear to me exactly how much fluoride Jennifer should be taking, and when she should be taking it. (If anybody has good, objective evidence on the matter, please share in the comments.)

Tracy Ryan of Mountain Midwifery suggested that Jennifer should have gone off the birth control pill long ago (and in general she prefers the IUD to the pill). But Jennifer is off of it now, so she’ll have at least a complete cycle without the extra hormones.

The next step is the obvious one.



Lady Baker April 26, 2010 at 3:41 PM

FYI, you might be able to save the cost of the rh test if she’s ever donated blood (it would be noted in those records). Also, it’s almost never an issue with a first kid. If sensitized, an rh- mom can attack a subsequent rh+ fetus. (If there has ever been a miscairrage early enough that the mom didn’t know, she can be sensitized for a first child.). Just sharing from my high risk maternity nursing background :). Rachel
P.S. This may not bs the best time for her, but donating blood could be a free way for you to find out your blood toe and rh status. It’s a bigger needle, but still just one poke.

Pamela Clare April 27, 2010 at 9:25 AM

Enjoy that next step. Very exciting!

Jenn Casey April 27, 2010 at 2:03 PM

It’s been a while since I’ve revisited the fluoride issue, but I read about it years ago and decided against consuming too much of it. We get bottled water, and I switched at that time to non-fluoridated. This was when my oldest child was a baby. None of my kids have had issues with cavities (anecdotal, so fwiw). I have chosen to have their teeth treated topically with fluoride at their dentist appointments. But none of us drink fluoridated water, and I didn’t drink it while pregnant (except for the first time) or nursing.

PDM April 30, 2010 at 9:23 AM

The National Academy of Sciences did a thorough review on fluoride in 2006. They documented numerous deleterious effects of fluoride on many organ systems including increased potential risk for bone fractures (the well characterized disease of skeletal fluorosis) possibly increased risk of osteosarcoma, reduced IQ, thyroid dysfunction, endocrine dysfunction and others all 300 pages is online if anyone cares to confirm it. Of course don’t forget fluoride induced dental fluorsosis (i.e. teeth mottling and a sign of toxic exposure to fluoride – the rate has increased dramatically subsequent to widespread water fluoridation with the CDC and others putting the prevalence somewhere around 30%) The NAS study ended with recommending that the EPA should more strictly regulate fluoride. Their findings mirror those in the peer-reviewed medical literature, while Harvard trained toxicologist Phyllis Mullenix also extensively documented behavioral changes in mice upon exposure to blood levels of fluoride not far greater than those experienced through water fluoridation and other sources of exposure. Former, well credentialed EPA scientists have been fired for bucking the political line on this issue. Meanwhile 90% of the fluoride placed into our water supply is not industrial grade sodium fluoride, it is silicofluorides, quite simply, scraped from the sides of Florida phosphate plant smokestacks. If it weren’t thrown into the water supply it would have to be disposed of as hazardous waste. You can read more on this starting here,

Ari April 30, 2010 at 9:40 AM

Sorry, PDM, but those claims are entirely unbelievable. I do not doubt that too much fluoride is harmful, and that is all the cited science demonstrates. But too much of anything is harmful. Too much Vitamin D is harmful, too much protein is harmful, too much iodine is harmful, yet all of those things are necessary for life.

The question is, are modest amounts of fluoride useful in building strong teeth, without causing serious side-effects? To date, I have seen exactly zero evidence demonstrating that moderate levels of fluoride are unhealthy. -Ari