We know that not all birth defects can be prevented. But, we also know that women can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. Make a PACT, a commitment to yourself, to get healthy before and during pregnancy by actively trying to plan ahead, avoid harmful substances, choose a healthy lifestyle, and talk with your healthcare provider. Here's more about the PACT you can make to help avoid birth defects:
1. Plan ahead
- Get 400 micrograms (mcg) of folic acid every day. Folic acid is a B vitamin. If a woman has enough folic acid in her body at least one month before and during pregnancy, it can help prevent major birth defects of the developing brain and spine (anencephaly and spina bifida). Women can get folic acid from fortified foods or supplements, or a combination of the two, in addition to a varied diet rich in folate.
- See a healthcare professional regularly. A woman should be sure to see her doctor when planning a pregnancy and start prenatal care as soon as she thinks that she is pregnant. It is important to see the doctor regularly throughout pregnancy, so a woman should keep all her prenatal care appointments. If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Use these checklists to help you write down your goals, whether you are planning a pregnancy or trying to get and stay healthy overall.
2. Avoid harmful substances
- Avoid alcohol at any time during pregnancy. Alcohol in a woman’s bloodstream passes to the developing baby through the umbilical cord. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including wine and beer. Drinking alcohol during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities. These disabilities in the child, which occur because the mother drank alcohol during the pregnancy, are known as fetal alcohol spectrum disorders (FASDs). The best advice for women is to stop drinking alcohol when trying to get pregnant. Learn more about alcohol and pregnancy
- Avoid smoking cigarettes. The dangers of smoking during pregnancy include preterm birth, certain birth defects (cleft lip or cleft palate), and infant death. Even being around tobacco smoke puts a woman and her pregnancy at risk for problems. Quitting smoking before getting pregnant is best. For a woman who is already pregnant, quitting as early as possible can still help protect against some health problems for the baby, such as low birth weight. It’s never too late to quit smoking. Learn more about smoking during pregnancy
- Avoid marijuana and other drugs. A woman who uses marijuana or other drugs during pregnancy can have a baby who is born preterm, of low birth weight, or has other health problems, such as birth defects. Marijuana is the illicit drug most commonly used during pregnancy. Since we know of no safe level of marijuana use during pregnancy, women who are pregnant, or considering becoming pregnant, should not use marijuana, even in states where marijuana is legal. Women using marijuana for medical reasons should speak with their doctor about an alternative therapy with pregnancy-specific safety data.
- Prevent infections. Some infections that a woman can get during pregnancy can be harmful to the developing baby and can even cause birth defects. Check out our 10 tips for preventing infections before and during pregnancy.
- Avoid overheating and treat fever promptly. During pregnancy, a woman should avoid overheating and treat fever promptly. Overheating can increase a woman’s chance of having a baby with a neural tube defect. It can be caused by a fever or exposure to excessive temperatures (like getting in a hot tub) that increases a woman’s core temperature. Protecting against infections, treating fever promptly, limiting environmental exposures known to increase core body temperatures (like getting in a hot tub), and consuming 400 micrograms (mcg) of folic acid every day can help reduce the chance of having a baby born with a neural tube defect.
3. Choose a healthy lifestyle
- Keep diabetes under control. Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the pregnancy. It can also cause serious complications for the woman. Proper healthcare before and during pregnancy can help prevent birth defects and other poor outcomes. Learn more about diabetes and pregnancy
- Strive to reach and maintain a healthy weight. A woman who is obese (a body mass index [BMI] of 30 or higher) before pregnancy is at a higher risk for complications during pregnancy. Obesity also increases a pregnant woman’s risk of several serious birth defects. Even if a woman is not actively planning a pregnancy, getting healthy can help boost her health and her mood. If a woman is overweight or obese, she should talk with her doctor about ways to reach a healthy weight before she gets pregnant. Learn more about healthy weight
4. Talk with your healthcare provider
- Talk to a healthcare provider about taking any medications. We know that certain medications can cause serious birth defects if they are taken during pregnancy. For many medications taken by pregnant women, the safety has been difficult to determine. Despite the limited safety data, some medications are needed to treat serious conditions. If a woman is pregnant or planning a pregnancy, she should not stop taking medications she needs or begin taking new medications without first talking with her healthcare provider. This includes prescription and over-the-counter medications and dietary or herbal products. Learn more about medication and pregnancy
- Talk to a healthcare provider about vaccinations (shots). Most vaccinations are safe during pregnancy and some vaccinations, such as the flu vaccine and the Tdap vaccine (adult tetanus, diphtheria and acellular pertussis vaccine), are specifically recommended during pregnancy. Some vaccines protect women against infections that can cause birth defects. Having the right vaccinations at the right time can help keep a woman and her baby healthy. She should talk to her doctor about which vaccines are recommended for her during pregnancy. Learn about vaccinations during pregnancy
- Pregnant women are more prone to severe illness from the flu, including hospitalizations and even death, when compared to women who are not pregnant. Pregnant woman with flu also have an increased risk of serious problems for their pregnancy, including preterm birth. Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy has been shown to protect both the mother and her baby (for up to 6 months after delivery) from the flu.
Pregnancy is an exciting time, but it also can be stressful. Knowing that you are doing all that you can to get ready for pregnancy, staying healthy during pregnancy, and giving your baby a healthy start in life will help you to have peace of mind.
- Kerr SM, Parker SE, Mitchell AA, Tinker SC, Werler MM. Periconceptional maternal fever, folic acid intake, and the risk for neural tube defects. Annals of epidemiology. 2017;27(12):777-782.e771.
Content last updated December 5, 2019