Every parent-to-be worries about the possibility of birth defects. While the risk is slight—affecting only about 3 percent of babies—it remains high enough to cause concern. Some of the most common birth defects include heart problems; neural tube defects, such as spina bifida (defect of the spine) and anencephaly (defect of the brain); and orofacial clefts, such as cleft lip and cleft palate. Other well-known birth defects include

• Down syndrome, marked by mental retardation
• cystic fibrosis, a lethal lung affliction
• Tay-Sachs disease, characterized by neurological deterioration
• phenylketonuria, which may cause brain damage unless infants follow a specific diet.

To date, we understand the causes of only 30 to 40 percent of birth defects. Genetics, environmental agents, German measles (rubella), and syphilis are some of the implicated factors.

Ready to Start a Family?

First, talk with a qualified healthcare practitioner to learn how to have a healthy pregnancy and reduce your baby’s risk of birth defects. You have more control over your child’s well-being than you may realize.

If a woman chooses to get a measles or chickenpox vaccination, “she should do it at least 90 days prior to conception,” advises Janet Zand, ND, LAc, author of Smart Medicine for a Healthier Child and A Parent’s Guide to Medical Emergencies. Dr. Zand recommends that a woman start taking a multivitamin at the same time.

In addition, take the following steps to reduce risk to your unborn child:

• Stop smoking now. Smoking during pregnancy is associated with learning disabilities, oral cleft, gastroschisis (narrow opening in the abdominal wall), and craniosynostosis (premature closure of the bones of the skull).
• Avoid alcohol. Imbibing during pregnancy can lead to fetal alcohol syndrome, which is characterized by mental retardation, central nervous system problems, facial anomalies, and delayed growth.
• Talk to your doctor before using medications. The Centers for Disease Control and Prevention (CDC) reports that approximately 82 percent of women of childbearing age take some medication. Unfortunately, we have insufficient information about the safety during pregnancy of  most drugs approved by the FDA.

Don’t use herbs during the first trimester, advises Aviva Jill Romm, an herbalist, midwife, and author of Naturally Healthy Babies and Children and The Natural Pregnancy Book. Herbs with potent oils, such as peppermint (Mentha piperita) and eucalyptus (Eucalyptus globulus), can be toxic to the fetus. Blue cohosh (Caulophyllum thalictroides), coltsfoot (Tussilago farfara), butterbur (Petasites hybridus), and comfrey (Symphytum officinale) are also contraindicated during pregnancy. In addition, Romm recommends taking no more than 4,000 IU of vitamin A daily since more could be toxic to the fetus.

• Avoid exposure to toxic substances, including cleaning solvents, paint, certain insecticides, mercury, and lead. To minimize risks, pregnant women should avoid raw fish and shellfish and should not be exposed to cat feces. Let someone else empty the litter box.
• Avoid extreme heat, as found in saunas, hot tubs, or sweat lodges, Romm warns. Extremely high body temperatures may cause neural tube defects.
• Eat a well-balanced diet. Naturopath and author Michael T. Murray, ND, recommends a diet rich in whole foods. Avoid trans-fatty acids (found in processed foods and many margarine products) and nitrites and nitrates (found in cured and smoked meats) because they may harm the fetus. While the omega 3s in fish are important for a baby’s brain development, avoid certain species (king mackerel, shark, swordfish, and tilefish) that are high in mercury. (For information on the safety of fish and other foods during pregnancy, visit www.marchofdimes.com, and click on “Pregnancy & Newborn Health Education Center.”)

Good Nutrition Counts

What nutrients are especially important for the fetus? The clear champion against birth defects is folic acid. Up to 70 percent of all neural tube defects could be prevented if women got sufficient folic acid before and during pregnancy, finds the March of Dimes.

Folate is plentiful in dried beans and other legumes, oranges, orange juice, peanuts, and green, leafy vegetables. Interestingly, folic acid is more easily absorbed when it comes from supplements and fortified foods. Don’t wait until you’re pregnant. “Women should start taking folate several months before they conceive,” says Romm.

Other important nutrients include

• antioxidants, including vitamin E, which may help ease the oxidative stress that the body endures during pregnancy, especially for diabetic mothers. Birth defects have been associated with even slight oxidative stress.
• iron, magnesium, niacin, and plant protein, deficiencies of which have been linked with spina bifida. In addition, iron-deficiency anemia may lead to premature birth. On the other hand, too much iron can cause harmful oxidation.
• choline, betaine, and methionine, which appear to decrease the risk of neural tube defects.
• fish oil, a source of omega-3 fatty acids, which may protect against premature delivery and thwart the development of allergies in the fetus. In addition, the fetus needs the docosahexaenoic acid (DHA) in fish oil for its developing eyes and brain, adds Dr. Murray.

Don’t Forget

Pregnancy is life changing, and birth defects are a legitimate concern. If you are a would-be parent, figure out what you can control and what you can’t. Although you can’t change the genes you pass on to your child, you can watch what you eat, avoid exposure to harmful substances, and work closely with your doctor. While there are no guarantees, these strategies will all increase the likelihood of giving birth to a healthy, robust baby.