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ONLINE DOCUMENT: BEING A GOOD MOTHER STARTS EVEN BEFORE A WOMAN BECOMES PREGNANT

Motherhood got its much-deserved time in the national spotlight last Sunday as Americans celebrated the achievements, sacrifices, trials and tribulations of the female side of the parental equation.

Most of the emphasis on Mother's Day, of course, was about what moms did for us all as children and continue doing after we become adults.Now, as if motherhood were not protracted enough, there has been growing recognition that the job of being a good mother starts even before a woman becomes pregnant. Likewise for grandmotherhood.

Remember that the egg, or ovum, that became you and me developed while our grandmothers were pregnant with our mothers. Each woman is born with a life's supply of eggs that develop during her own prenatal existence. A pregnant woman's lifestyle and environment may affect the genetic endowment of these immature eggs.

Women considering pregnancy have sought medical advice for decades. But during the last few years, a medical concept termed "preconception care" has become more organized, and has been endorsed by government health agencies and medical organizations.

The U.S. Public Health Service concluded in 1989 that the state of a woman's health before she becomes pregnant has important effects on the outcome of pregnancy. "Preconception care" should be a national health priority, it said.

Thanks to groups like the March of Dimes Birth Defects Foundation, more women have become aware of preconception care. Most seek care informally through their own physicians. But hospitals, family planning clinics, health departments and other organizations have started organized programs.

Preconception care involves identifying the reproductive risks for women before they become pregnant, reducing the risks and promoting a healthy lifestyle.

It is based, in part, on recognition that the fetus is most sensitive to a mother's lifestyle and environment during the first few weeks after conception. Many women don't even know that they're pregnant at this point. So they've got to be living a healthy lifestyle day to day if pregnancy is a possibility.

Nothing may illustrate the situation better than folic acid, one of the B vitamins. Researchers have established that inadequate intake of folic acid increases the risk of severe birth defects termed "neural tube defects."

To reduce the risk, women must have adequate folic acid in their blood right after conception. The Food and Drug Administration finally acted on that knowledge in April. The FDA said it will require that folic acid be added to breads, flours, corn meal, pasta, rice and other grains starting in 1998.

Preconception care can reduce many other risks to the fetus. For instance, it can help control metabolic diseases like diabetes that can affect the fetus and a number of other conditions. These include iron deficiency anemia, hepatitis B, gonorrhea, chlamydia, syphilis, HIV infection and toxoplasmosis.

Physicians can review the medications taken by a prospective pregnant woman to identify drugs harmful to the fetus (such as lithium, gold compounds, warfarin and valproic acid.)

Nutritional and other lifestyle patterns also can harm the fetus. Babies born to underweight women who gain little weight and to severely obese women both are at risk for health problems. Fetal alcohol syndrome, caused by excessive alcohol consumption during pregnancy, is a leading known cause of mental retardation.

Cigarette smoking increases the risk of low birthweight, spontaneous abortion and many other problems. Preconception counseling can help women stop before pregnancy.

A free brochure with tips for a healthy pregnancy and baby entitled "Think Ahead" is available from local chapters of the March of Dimes. Many other books and articles are available at local libraries.

Routine visits to the physician are a good time for talking about how to prepare for motherhood before pregnancy.

(Distributed by Scripps Howard News Service)