Our Toxic World
Who is Looking After Our Kid's?
CHAPTER I
Preconception care
"Start at the beginning," "as you sow, so shall you reap," "planning makes it happen" and "your future is directly dependent on your ability to think clearly, concentrate and stay on track." These are cliches we've all heard but rarely thought about when planning to have children. When applied to our children's health, they translate into two very powerful words: preconception care.
The Preconception Care Program, developed by the Foresight Foundation, is an organized program that identifies and reduces reproductive risks before conception and prepares both parents for the pregnancy. Its goal is to ensure that prior to conception, a woman and her partner are both healthy and practicing lifestyle behaviors with the aim of having a healthy baby.
We need a preconception care program for a number of reasons. Consider that according to the Center for Disease Control, the United States ranked 23rd on the International Ranking for Infant Mortality in 1991
For every 1,000 live births, there are 9.8 infant deaths before age one. During the past five years little has changed to improve those statistics. This nation has one of the highest infant mortality rates in the world The miracle of modern technology has allowed us to save some very sick children but it has not improved the quality of life for many of them and in some instances it has only guaranteed a lifetime of health problems We have not perfected having healthy babies but we perfected the technology for helping babies that would have died
Low birth weight for gestational age affects one in 15 babies and has been implicated in failure- to thrive babies Eleven percent of our babies are born prematurely and according to Iams, Johnson and Creasey (Clinical Obstetrics & Gynecology Journal 1988) more than 75% of perinatal mortality and morbidity in infants without congenital anomalies are caused by complications of prematurity
Consider also that hospitalization costs for low birth weight infants in the United States ranges from $16,136 to $174,278 compared to $2,923 for initial hospital costs of a normal weight baby. The figures were supplied by the March of Dimes
The March of Dimes states that 30 to 40 percent of birth defects are linked to known medical, genetic, environmental and psychosocial factors that can be, to some degree, prevented.
In 1989 Congress passed a law which designated the '90s as "The Decade of the Brain" (1) The text begins: "Whereas it is estimated that 50 million Americans are affected each year by disorders and disabilities that involve the brain" The law then lists such disorders and disabilities, including those "resulting for prenatal events" and continues with: "Whereas it is estimated that treatment, rehabilitation and related costs represent a total economic burden of 305 billion annually." The law ends by stating "The president is authorized and requested to issue a proclamation calling on public and private institutions as well as the people of the United States to observe the decade with appropriate programs and activities."
Congress also published a 360 page report on neurotoxicity which documents the grounds for this legislation emphasizing treatment and prevention. (2) It is interesting to note that a survey of individuals in whom long-term disabilities originated prior to age 18 and were receiving Social Security showed that in 75% percent of the cases the defect had its origin before birth. Disabilities included cerebral palsy, mental retardation, epilepsy, visual and auditory impediments, disorders of speech and poor school performance.
It is also estimated that roughly 40% of all pregnancies in the United States are unplanned. Those that are planned actually start preparation for a healthy baby after conception has already taken place. In the biological sense the life process, and the hazard to development of the life process,begins about 100 days before conception, when both the male and female germ cells (sperm and egg) begin their maturation process. It is at this time that both the sperm and the egg are most vulnerable to toxins, nutritional deficiencies and radiation.
The answer to all these difficulties lies in changing one little word:"unplanned." We must plan for healthy babies, and we must begin before conception occurs.
Fast, effective and inexpensive, The Preconception Care program is the ultimate risk management program for prospective parents who want to do all they can to insure a healthy baby.
The program has five basic components. Ideally it begins four to six months before conceiving. This enables time for tests to be completed and evaluated, and for both potential parents to optimize their own health.
Parents first meet with a Preconception Care counselor who assists with filling out forms. (See index)
After reviewing these intake forms with the patients, the doctor will do a general physical examination of each potential parent, including a battery of routine tests designed to determine general health, nutrient levels, and for Chlamydia, a silent venereal disease prevalent in men and women that can be contracted without sexual contact.
An integral part of The Preconception Care Program is the inclusion of environmental medicine. This field of medicine recognizes that our increasingly polluted environment is a major source of chronic illness and quiet cellular damage. These illnesses include reaction to well-known chemicals and to many seemingly harmless chemicals that are used in our homes, offices and work places. They are manifested as mental, emotional, and physical problems that range from headaches and depression to multiple muscle and joint aches and pains.
The Preconception Care's Environmental Program includes the detection of food sensitivities, allergies, and chemical sensitivities in both parents. Psychosocial substances such as caffeine, nicotine and recreational drugs are also discussed.
Nutrition counseling is an important component of the Program. Good nutrition is vitally important to all stages of life, especially before conception occurs. While those in medical science are aware of the consequences brought on by a profound state of malnutrition, we are only beginning to understand the potential impact of more subtle nutritional deficiencies on pregnancy. However, the evidence continues to build for a role in Preconception Care. On September 14, 1992, the United States Public Health Service recommended that all women of childbearing age take extra folic acid, a B vitamin, to prevent neural tube defects (NTD) that effect one to two of every 1,000 babies born each year. It is not enough to tell women to take the vitamin after they are pregnant because the birth defects occur when the fetus's spinal column is fusing, at about two weeks after the first missed menstrual period. Many women are still unaware they are pregnant at that time.
Fathers also must be nutritionally aware. The journal, Proceedings of the Natural Academy of Science (February 1992) published a study which demonstrated a direct relationship between a diet low in vitamin C and increased DNA damage in sperm cells. The consequences include infertility and decreased sperm function in perspective fathers and some birth defects and cancers in their offspring.
Nutritional deficiencies such as those mentioned above can have such a dramatic effect on the health of our children. There are other subtle nutritional deficiencies with equally high damaging impacts on pregnancy and birth.
The Preconception Care Program looks closely at the diet of both prospective parents. Recommendations are tailored to each couple's lifestyle and ethnic heritage. Depending on their dietary history, and the blood and hair test results, supplementation may be advised. The Program is based on the assumption that the best insurance for obtaining all the essential nutrients is to eat a wide variety of fresh, colorful, organically grown food. To meet that goal, patients
are guided in how to choose and prepare food and how to measure a serving size. They are further educated to know what nutrients are supplied by which foods and the function of those nutrients in the role of having a healthy baby.
The genetics portion of the Preconception Care Program provides couples with a family "pedigree" Knowledge of a couple's risk can be found by taking a complete family history which should include inquiring about previous occurrences in the family of mental retardation, birth defects, known genetic diseases, early death and chronic health problems in the first, second and third degree relatives of the couple in questions.
Such issues as ethnicity and consanguinity should also be addressed. That knowledge would best be acquired prior to that person's having children in hope of enabling those individuals who are at risk for having children with serious illnesses to make well informed decisions about their family planning. To this end, genetic counseling is an irreplaceable component of a program in preconception care.
Since it is important that the couple avoid pregnancy until they have reached optimal health, appropriate family planning is essential. The timing of ovulation is a critical factor in the conception process. Prospective parents are taught the sympto-thermal method of fertility awareness which combines observations of cervical placement, cervical mucus, and basal body temperature. Books, films and individual counseling help parents to understand this method.
The knowledge that your baby's health was included in your family planning is but one of the benefits of The Preconception Care Program, and knowing that you did everything possible to have a healthy baby provides you with great peace of mind.
For more information about Preconception Care write to
Foresight-America Foundation
5724 Clymer Road
Quakertown, PA 18951
Phone: 1(800)-Let-Heal
1-215-536-1890References
1. 1 0 1 USC §58.
2. Neurotoxicity: Identifying and Controlling Poisons of the Nervous System. Washington, DC: US Congress, office of Technology Assessment; 1990