Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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A woman's health needs continue to evolve from her teen years through her golden years. Being active, eating well, and getting your recommended health screenings are the foundation for good health at any age.


Did you know that up to half of all pregnancies are surprises? While you may not be planning to become pregnant, it's still important to protect and improve your health. The time between conception and when a woman knows that she is pregnant is especially important – when good health practices can make a real difference.

A surprise pregnancy can change your life. If you don't want to get pregnant, take some time to review your birth control options. We can help you choose the best option for you and your lifestyle.

If you are planning to get pregnant in the near future, please schedule a visit with us. We want to help make sure that your body is ready to welcome a new baby. We will help you focus on specific issues that could affect your pregnancy, even before you know you are pregnant. We can discuss:

  • Prescription and over-the-counter medications
  • Keeping any chronic conditions under good control
  • Tests for certain illnesses you may not know you have
  • Your immunization status and possible toxic exposures
  • Lifestyle issues such as nutrition, exercise, alcohol, and tobacco use

We hope that you make these healthy choices even if you are not planning to become pregnant. These tips are for every woman and can help you stay as healthy as possible.

Take 400 Micrograms of Folic Acid Every Day

If you are of childbearing age, take 400 micrograms (400 mcg or 0.4 mg) of folic acid every day, even if you are not planning to become pregnant. Since many pregnancies are surprises, this is good advice for all women between the ages of 18 and 45. The easiest way to do this is by taking a standard multivitamin daily.

Studies show that folic acid plays an important role in lowering the risk for certain birth defects (called neural tube defects), if it is taken before conception and through the first 3 months of pregnancy.

You can also get your folic acid in:

  • Dark green leafy vegetables (spinach, Swiss chard, kale)
  • Citrus fruits (strawberries, oranges, and orange juice)
  • Whole-grain breads and cereals
  • Legumes (beans, peas)
  • Fortified breakfast cereals

Eat Healthy Foods Every Day

  • Eat whole grains, fruits, and vegetables daily.
  • Cut down on fats like butter, margarine, sauces, gravies, mayonnaise, salad dressing, and sour cream and baked goods such as pastries, cookies, and crackers.
  • Choose lean meats and poultry (chicken or turkey without skin).
  • Don't eat large fish, such as shark, swordfish, tilefish, and king mackerel, because they contain high levels of mercury. The U.S. Food and Drug Administration advises that women of childbearing age, pregnant women, nursing mothers, and young children can safely eat 12 ounces per week of cooked fish. You can eat shellfish, canned fish, smaller ocean fish, or farm-raised fish. Eating safe fish is an important part of a healthy, balanced diet.
  • Eat less fried food. If you eat out or go to fast food restaurants, try to select healthier options from the menu.
  • Snack healthy. Choose fresh fruit, raw vegetables, yogurt, or popcorn (without butter) instead of high-calorie foods like chips, candy, or soda.
  • Drink 8 to 10 glasses of fluid daily. This includes water, milk, and soup.
  • Limit caffeine drinks (coffee, tea, and soda). Recent studies have linked caffeine use to an increased risk of miscarriage. Try switching to decaffeinated beverages. If you do use caffeine, limit it to 1 cup of coffee or 2 cups of tea a day. Don't forget that many sodas contain caffeine. They also contain the amount of sugar equivalent to a candy bar. If you choose soda, consider switching to the caffeine-free and sugar-free varieties.
  • Some herbal supplements are not considered safe in pregnancy. Please talk with us about any supplements you are taking.
  • DHA (also called omega-3 fatty acids, fish oil) is a necessary structural component of the brain and eye. One to 2 weekly servings of fish (as described above) will help you get the DHA you need. If you do not eat fish, talk to us about whether you should be taking a DHA supplement.

Maintain a Healthy Weight

A big part of staying healthy is being at a healthy weight. If you are trying to have a baby (conceive), healthy weight becomes even more important.

  • Underweight women may have a harder time getting pregnant and are more likely to have smaller babies who may have problems during labor and after birth.
  • Overweight women may also have a hard time getting pregnant. Additionally, they are more likely to experience high blood pressure or diabetes during pregnancy and are more likely to have a C-section. Overweight women are more likely to have delivery complications affecting the health of the baby and mom.

Reaching and maintaining a healthy weight now, before trying to get pregnant, can reduce these risks. The best way to be at a healthy weight is by healthy eating and being physically active.

Be Physically Active on Most Days

If you exercise for at least 150 minutes a week, or 30 minutes on most days, you are reaping the many health benefits of regular exercise. Continue to make exercise a priority so you can stay healthy for yourself and for your loved ones.

If you are not already physically active on most days, now is a good time to start. You will feel better overall, have more energy, stress less, and sleep better. Try to develop a regular moderate exercise program. You can begin slowly and build up gradually. A 5 or 10-minute walk is a good start. Try to set a goal of exercising at least 30 minutes per day on most days. If you have a health condition, please check with us before you begin any exercise program.

If You Smoke, Quit Now

If you smoke, one of the most important things you can do to improve your health is quit smoking now. Smoking may make it harder for you to get pregnant. Women who smoke are more likely to have problems in pregnancy and childbirth, like premature babies or babies that are underweight. Once the baby is born, studies show that there is also an increased risk for SIDS (crib death) for babies exposed to secondhand smoke.

If you or your partner want to quit smoking, there is help. Tobacco cessation programs give you the tools you need to quit smoking. Learn more about our range of proven quit tobacco services at your local Health Education Center or call the Wellness Coaching Center to make a telephone appointment with a wellness coach at 1-866-251-4514.

Don't Drink Alcohol or Use Recreational Drugs

Using alcohol or drugs like speed, heroin, or crack is harmful to your health. Using them during pregnancy can harm the baby. These drugs can cause a new baby to cry a lot or have problems eating, sleeping, or breathing. Later, the baby might have trouble learning. These drugs can also cause serious problems like birth defects or brain damage. They can even cause a miscarriage. There are programs to help you quit. Talk to us about what may be the best program for you.

Avoid Toxic Substances or Radiation

Certain chemicals and radiation are bad for your health. If you are around certain chemicals that are found in the home or workplace, it could make it more difficult to become pregnant and may harm your developing baby. Take precautions to decrease contact with chemicals and radiation. Make sure you wear rubber gloves and work in a well-ventilated area. You can also try to:

  • Follow safety recommendations for use of toxic chemical products (cleaners, solvents, pesticides, paint thinners).
  • Avoid contact with products containing lead or mercury (these can also be found in certain foods).

Have Regular "Well Woman" Exams

Regular "well woman" exams are an excellent way to take good care of yourself. We recommend that women have regular Pap tests, pelvic exams, and breast exams. Frequent screening for sexually transmitted diseases is also a good idea to protect yourself and your partner(s). If you have any unusual bleeding, pain, sores, or bumps near your vagina, please let us know. It is better to identify any health problems right away when they may be easier to treat.

Get Tested for Sexually Transmitted Diseases

Diseases that are transmitted through sexual contact not only affect your overall health, they can affect your ability to get pregnant and can also infect and harm a baby. Some examples of sexually transmitted diseases (STDs) are chlamydia, gonorrhea, genital herpes, HIV (the virus that causes AIDS), hepatitis B and C, and syphilis.

You can have an STD even if you don't have symptoms. Here are some of the more common symptoms.

  • Sores, bumps, or blisters near your vagina, rectum, or mouth
  • Burning or pain when you urinate
  • Pelvic pain 

If you have any of these symptoms, you should avoid having sex until you can see us for evaluation and treatment.

Get Vaccinated

Some infections can be prevented by immunization. Before you plan to get pregnant, ask us whether you should be immunized against rubella (German measles), chickenpox (varicella), or hepatitis. If you are not immune, you may want to receive the vaccinations before you get pregnant. Being exposed to these infections during early pregnancy could harm your baby. We recommend that you wait at least 1 month after being vaccinated before trying to get pregnant.

Whooping cough (also called pertussis) is a contagious disease that can spread easily from person to person through coughing. When babies get whooping cough, it can be life-threatening. You can get a Tdap (tetanus, diphtheria, pertussis) vaccine before you are pregnant, during pregnancy, or after giving birth to protect yourself against tetanus, diphtheria, and whooping cough. Partners and families can be vaccinated at any time but preferably before the birth of the baby so they don't infect their newborn. It is safe for mothers to get the Tdap vaccine while breastfeeding.

If you are not sure if you or your family members have been vaccinated, you can find out by viewing your Preventive Services online or by contacting us.

Additional References:

Intimate Partner Violence

If you think you're being abused or may be abusing someone else, you can get help by talking to us or:

  • Contact the National Domestic Violence Hotline, 1-800-799-7233 or 1-800-787-3224 for hearing/speech impaired.

If someone has hurt you before, it may happen again. Sometimes abuse can start when you become pregnant or after you have a baby. Abuse can cause health problems for you and your child.

  • Women who are abused while they are pregnant are not as healthy and often have more anemia, infections, and bleeding.
  • Babies born to abused women have a higher risk of low birth weight, premature birth, and death.

Seek Genetic Counseling to Minimize the Risk of Birth Defects

If you or any close family members (children, parents, sisters/brothers, aunts/uncles) have a history of birth defects or inherited conditions, you may have a higher chance of having a baby with such a condition. A genetic counselor can give you more information about the specific risks and possible tests you may choose to have. Getting your test results before trying to get pregnant will give you time to consider your options.

Manage Your Chronic Conditions

If you have a chronic medical condition, it is important to discuss this with us before you start trying to get pregnant. We want to help you successfully manage conditions such as:

  • Diabetes
  • High blood pressure
  • A seizure disorder
  • Depression
  • Other kinds of chronic illness  

It is best to have these chronic conditions under control before conceiving. If you take any prescription drugs, over-the-counter medications, or herbal remedies on a regular basis, please discuss this with us before you start trying to get pregnant.

Try to Avoid Taking Teratogenic Medications

Teratogenic medications are medications that increase the risk for birth defects if used during pregnancy. Many of these medications are commonly prescribed:

Medication useTeratogenic medicine
DiabetesCertain types of insulin
Depression and bipolar disordersLithium
High blood pressureACE inhibitors like Iisinopril or ARBs like Iosartan
High cholesterolCertain statins like Iovastatin
EpilepsyCertain anticonvulsants such as Dilantin (phenytoin)
Mild sedationValium and Ativan
CancerCertain cancer drugs and chemotherapy treatments

The list of medications above isn't comprehensive, but it contains some good examples of medications to avoid if you think you might become pregnant.

Some medications can be changed before pregnancy, while others should still be used because the potential benefits outweigh the risk.

If you are of childbearing age and think you may be taking a teratogenic medication, please discuss this with us. Please do not stop any medications without talking with us first.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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