A: Dear Amy,

Congratulations on your pregnancy! Along with the excitement and joy of being pregnant come the inevitable fears and worries of parenthood. It is very normal to think about the risk of health problems with your baby, both now and after your child is born. Luckily, nature does an incredible job: the vast majority of babies are born perfectly healthy. Only a small percentage of babies are born with some kind of problem.

By taking excellent care of your health, you can increase your chances for a healthy pregnancy and hopefully reduce some of your fears. The first step in lowering your risks is beginning prenatal care with a doctor or midwife. Your health care provider will review your medical history and your family’s history as well. Tell your provider whether any members of your extended family or your husband’s family have had congenital or inheritable diseases. Your provider can decide whether special blood tests or genetic counseling are in order. If chromosomal testing of your baby is recommended, you will be offered an amniocentesis or CVS (chorionic villus sampling) during your pregnancy. These tests determine whether a baby’s chromosomes (genes) are normal.

Your health care provider will be interested in many aspects of your own health, such as your history of medical conditions like diabetes or high blood pressure, which could affect your pregnancy. Inform your medical practitioner of any medications, vitamins or herbal supplements you used immediately before finding out you were pregnant or during your pregnancy. You should be completely open about your lifestyle choices; alcohol, smoking and street drugs could affect the health of your baby and should not be combined with pregnancy. Based on a review of your medical history, your provider will make appropriate recommendations to help you have the healthiest pregnancy possible.

In addition to your regular prenatal exams and screening tests, you should receive an ultrasound exam during your pregnancy. Ultrasound can provide a visual picture of your baby. Most health care providers order this exam between 16 and 20 weeks gestation to screen for structural birth defects. Spinal problems, urinary tract disorders, and heart defects are examples of problems that can be identified by ultrasound.

Once you have established regular prenatal care, obtained appropriate screening and diagnostic tests, and made any recommended lifestyle changes, you will have optimized your chances for a healthy pregnancy. If your tests are normal, your concerns will likely diminish. If you still feel overcome by fear, or find yourself obsessing about your baby’s risks of birth defects, you should consider professional support. Many anxious patients benefit from counseling, group instruction, meditation or hypnotherapy. Talk to your health care provider about your concerns to learn about the resources in your area that could be helpful.