Preventing Birth Defects: Insights from a Midwife

Feature Story: Sara Donnelly, CNM

When it comes to preventing birth defects, preparation starts well before conception. According to Sara Donnelly, CNM, maintaining overall health through routine preventative care—such as physicals, dental cleanings, and annual gynecological exams—lays a solid foundation for a healthy pregnancy. “A healthy, active daily lifestyle is equally important,” she explains, emphasizing the value of making intentional choices around nutrition and physical activity.

The Role of Nutrition
Donnelly recommends focusing on a diet rich in fresh, high-protein foods, fruits, vegetables, and whole grains, while reducing processed and fast foods. “We all face barriers to healthy eating, like financial strain, transportation challenges, or even a lack of basic health knowledge,” she acknowledges. “But every small effort adds up. Even reducing the amount of unhealthy food and drinks you consume is a step in the right direction, even if complete elimination isn’t realistic.”

She also advises avoiding substances like alcohol, tobacco, nicotine products (including vaping and smokeless tobacco), marijuana, and other drugs before and during pregnancy, as these can significantly impact fetal development.

The Importance of Physical Activity
"Many of us assume our, often times very busy, job and lifestyle are enough to keep us healthy,” Donnelly notes, “but intentional physical activity makes a real difference.” She recommends incorporating at least 150 minutes of moderate activity, such as brisk walking, each week. Not only does this improve physical health, but it also supports mental and emotional wellness, which are crucial for a healthy pregnancy.

Planning for Pregnancy
For those planning to conceive, Donnelly highlights the importance of starting a prenatal vitamin containing folic acid and DHA at least three to six months before trying. “If the pregnancy is unplanned, you can start as soon as you suspect or confirm you’re pregnant,” she says. Scheduling a preconception visit with an OBGYN can also help identify and address any potential risk factors, creating a plan to optimize health for pregnancy.

Routine prenatal care is equally critical, serving as an opportunity to monitor both the pregnant person’s health and the baby’s development. "This is where we asses for potential risks and create a plan together with the patient to help support ongoing mental and physical wellness," Donnelly explains.

Lifestyle Habits and Fertility
The same principles that support a healthy pregnancy also enhance fertility. Healthy eating, regular exercise, and avoiding substance use all contribute to increasing the likelihood of conception. Weight management is another factor. “For individuals with a BMI over 30, even a 5% reduction in weight can significantly improve fertility,” Donnelly notes. She stresses that these changes don’t need to be drastic. “Small, intentional adjustments over time can make a big impact.”

For those struggling with weight-related issues or other challenges, preconception appointments or consultations with a primary care provider can provide tailored guidance. “Ultimately, it comes down to the urgency of the individual or couple to conceive,” she adds. “But we know these lifestyle changes are critical not just for fertility, but also for reducing risks throughout pregnancy, labor, and birth.”

By focusing on small, consistent changes, prospective parents can set the stage for healthier pregnancies and brighter futures for their children.