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Before and Between Pregnancy

Spouses, partners, family members, and friends play an important role in improving the health of Oklahoma’s babies. Encourage and support a woman’s healthy choices before, during and between pregnancy.

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About half of all pregnancies are unplanned. Getting healthy before getting pregnant greatly increases a woman’s chances of having a healthy baby. Living a healthy lifestyle helps ensure good health.

Things that you can do to be healthy include:

  • Maintain a healthy weight. Being overweight or obese can lead to high blood pressure and diabetes which can cause problems for mother and baby.
  • Get tested and treated, if needed, for sexually-transmitted diseases (STDs). It is also important that sexual partners be tested. STDs pose special risks for pregnant women and their babies.
  • Stop drinking if you are pregnant or want to become pregnant. Alcohol can harm an unborn baby even before a woman knows she’s pregnant. There is no safe level of alcohol for pregnant women. For help, call the Reachout hotline 1-800-522-9054.
  • Quit smoking. Smoking increases chances of miscarriage, stillbirth or infant death. For help with quitting, call 1-800-QUIT-NOW (784-8669).
  • Stop the use of illegal drugs. When pregnant anything you eat, drink, or smoke affects you and your baby. For help, call the Reachout hotline 1-800-522-9054.
  • Take a multivitamin with 400 micrograms (mcg) of folic acid. Folic acid helps prevent birth defects in babies.
  • Lower stress levels. Eating well, exercising, and getting plenty of rest can help reduce stress and improve overall well-being. Very high levels of stress may contribute to pre-term birth or having a low birth weight baby.
  • Know your family health history. If you or your partner has a family history of health problems or birth defects, you may need to see a genetic counselor. You may also need to have special tests to see if these problems could be passed to your baby.

Source: March of Dimes

SoonerPlan is Oklahoma’s family planning program for uninsured women and men. The program is available for both men and women, who are U.S. citizens or qualified immigrants living in Oklahoma, age 19 or older, not enrolled in SoonerCare and meet income qualifications. SoonerPlan provides birth control information and supplies for men and women, as well as physical exams for family planning and related lab tests including pregnancy tests. You may obtain an application for SoonerPlan from your local county health department (call 1-800-426-2747 for locations), your local county Oklahoma Department of Human Services office (call 405-521-2779 for locations), the Oklahoma Health Care Authority website, or from a variety of family planning providers/clinics.

The Oklahoma Family Planning Program provides services related to reproductive health, including birth control. Services are available for males and females of reproductive age. Services are provided on a voluntary and confidential basis and services will not be refused based on inability to pay. Contact your local health department or visit or call (405) 426-8111 for more information.

Yes, a variety of healthy food choices is important before, during and after pregnancy. It’s important to learn and practice good eating habits, to provide not only for your needs, but also for a baby’s needs (in case you get pregnant), and also to prevent possible harm to an unborn baby. For information on Women, Infants and Children Supplemental Nutrition Program (WIC), call 1-888-OKLAWIC (655-2942).

The B vitamin in folic acid helps to prevent neural tube defects (NTDs).The neural tube begins to form the baby's brain and spine two to three days after the missed menstrual period and is fully formed within about 10 days (27 days after conception). This is before many women even know they are pregnant.

If the neural tube fails to close, two serious birth defects can occur. Anencephaly, absence or deficiency of a major portion of the cranial vault (skull), results in stillbirth or death shortly after birth. Spina bifida, a visible sack or epithelial defect (opening in the spine), causes varying degrees of disability related to paralysis, lack of bowel and bladder control and hydrocephalus. With the help of medical care, babies born with spina bifida reach adulthood.

All women who can become pregnant need to consume 400 micrograms (0.4 milligrams) of synthetic folic acid each day to reduce their risk of having a pregnancy affected by a NTD. Most multivitamins sold in the U.S. have the amount of folic acid women need each day. The daily consumption throughout childbearing years is critical, because the developing baby needs the folic acid before the mother would recognize the pregnancy. Since half of all pregnancies are unplanned, daily intake of a multivitamin containing 400 micrograms of folic acid, along with foods fortified with folic acid and eating a balanced diet is crucial for prevention of birth defects. Foods containing folic acid include orange juice, leafy green vegetables, and enriched breads and cereals. Folic acid also helps to prevent cancer and promote heart health.

Smoking harms nearly every organ of the body. Cigarette smoking accounts for nearly 1 of every 5 deaths each year in the United States. Smoking causes nearly 80% of all lung cancer deaths in women. Smoking also increases a person’s risk of heart disease and stroke. On average, smokers die 13 to 14 years earlier than non-smokers.

Women should stop smoking before they stop using birth control. Having a healthy baby is more likely if a woman is tobacco free. Smoking during pregnancy increases risks of a preterm delivery, low birth weight baby, miscarriage, stillbirth or infant death. Smoking during and after pregnancy may cause Sudden Infant Death Syndrome (SIDS). Pregnant women should avoid exposure to secondhand smoke.

Be a quitter. People who stop smoking greatly reduce their risk of disease and early death. There are free services to help with quitting. Call 1-800-QUIT-NOW (784-8669) or ask your healthcare provider for assistance.

Male partners can improve their own reproductive health and overall health by limiting alcohol, quitting smoking or illegal drug use, making healthy food choices, and reducing stress. Studies show that men who drink a lot, smoke, or use drugs can have problems with their sperm. These cause problems with getting pregnant. It is equally important for men and women to support their partner’s healthy choice to be alcohol, tobacco and drug-free.

Male and female partners should be screened and, if necessary, treated for sexually transmitted diseases (STDs) to help make sure infections are not passed to female partners. Also he/she should talk to his/her doctor about his/her own health, family history, and any medicines he/she uses.

People who work with chemicals or other toxins should be careful not to expose women, infants, or young children to them. For example, people who work with fertilizers or pesticides or are exposed to lead should change out of dirty clothes before going near women, infants or young children. Soiled clothes should be handled and washed separately. If there is a risk for lead contamination, soiled clothes should be washed in a separate washer if possible.

Source: Centers for Disease Control and Prevention

One in four women is in an abusive relationship. Abuse can be physical, sexual, verbal, or emotional and may include not being allowed to have food, money, transportation, or access to health care.

Often there is a cycle of violence with tension building (blaming, anger, jealousy), followed by battering, either verbal or physical, after which the abuser may deny the violence, make excuses, buy gifts and promise to never do it again. It is important for women to realize that domestic violence is serious and can result in death.

Pregnancy is often the starting point for violence in a relationship or the violence may become worse during pregnancy. Abuse can lead to pre-term birth and a low birth weight baby.

Leaving an abusive relationship can be very hard. It may take time to feel ready. Call 1-800-799-7233 (SAFE) for help. Domestic violence is never okay and it’s not your fault!

Depression is a common problem during and after pregnancy. About 13 percent of pregnant women and new mothers have depression.

Depression is more than just feeling “blue” or “down in the dumps” for a few days. It’s a serious illness that involves the brain. With depression, sad, anxious, or “empty” feelings don’t go away and get in the way of day-to-day life and routines. These feelings can be mild to severe. The good news is that most people with depression get better with treatment. Treatment may include medication along with counseling. But if you’re pregnant or thinking about becoming pregnant, talk with your healthcare provider about which medications are safe to take during pregnancy.

When pregnant or after having a baby, women may be depressed and not know it. Some normal changes during and after pregnancy can cause symptoms similar to those of depression. But if any of the following symptoms of depression last for more than 2 weeks, call the doctor:

  • Feeling restless or moody
  • Feeling sad, hopeless, and overwhelmed
  • Crying a lot
  • Having no energy or motivation
  • Eating too little or too much
  • Sleeping too little or too much
  • Having trouble focusing or making decisions
  • Having memory problems
  • Feeling worthless and guilty
  • Losing interest or pleasure in activities you used to enjoy
  • Withdrawing from friends and family
  • Having headaches, aches and pains, or stomach problems that don’t go away.

The doctor can decide if the symptoms are caused by depression or something else.

Call 911 or your doctor immediately if you have thoughts of harming yourself or your baby! You can also call the Reachout hotline at 1-800-522-9054.

Source: U.S. Department of Health and Human Services, Office on Women’s Health 1-800-994-9662 TDD: 1-888-220-5446

It’s not too late. Start taking prenatal vitamins now that can be purchased where other vitamins are sold. You can decrease your risks for poor pregnancy outcomes for you and your baby the sooner you stop any unhealthy habits like smoking or drinking alcohol. It is very important to see a healthcare provider as soon as possible. If you don’t have health insurance that covers pregnancy, you apply for SoonerCare online or visit the nearest county health department for assistance.

Preterm labor is labor that occurs before the 37th week of pregnancy. (Most pregnancies last 38-42 weeks). Your estimated due date is 40 weeks after the first day of your last menstrual period or a little more than 9 months.

Three groups of women are at greatest risk of preterm labor and birth:

  • Women who have had a previous preterm birth
  • Women who are pregnant with twins, triplets or more
  • Women with certain uterine or cervical abnormalities

The signs of preterm labor include:

  • Contractions (when your abdomen tightens like a fist) every 10 minutes or more often
  • Change in vaginal discharge (leaking fluid or bleeding from your vagina)
  • Pelvic pressure—the feeling that the baby is pushing down
  • Low, dull backache
  • Cramps that feel like your period
  • Abdominal cramps with or without diarrhea

If you experience any of these symptoms, call your health care provider. You don’t need to have all the symptoms to have preterm labor. Take action even if you have only one symptom or if you feel something’s not right. Your provider may tell you to:

  • Come into the office or go to the hospital
  • Stop what you're doing. Rest on your left side for one hour
  • Drink 2-3 glasses of water (not coffee or soda)

Don’t wait until it’s too late. If you have any questions or concerns, call your healthcare providers immediately.

Source: March of Dimes

Contact Information

Jill Nobles-Botkin, APRN-CNM
Administrative Program Manager

Mailing Address:
Oklahoma State Department of Health
Perinatal and Reproductive Health Division
123 Robert S. Kerr. Ave Suite 1702
Oklahoma City, OK 73102-6406

Physical Address:
Oklahoma State Department of Health
Perinatal and Reproductive Health Division
123 Robert S. Kerr. Ave
Oklahoma City, OK

Phone: (405) 426-8111

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