Navigating Family Planning: Can You Take Wegovy While Trying to Get Pregnant?

Introduction
The journey to parenthood is often filled with anticipation, careful planning, and a deep commitment to ensuring the best possible health for both prospective parents and their future child. For many, this journey intersects with personal health goals, including weight management. Medications like Wegovy, a GLP-1 receptor agonist, have emerged as powerful tools in helping individuals achieve significant weight loss, transforming lives and improving overall metabolic health. However, their increasing popularity brings forth crucial questions for those considering starting or expanding their family: specifically, “can you take Wegovy while trying to get pregnant?”
This question is more vital than ever, as the profound impact of weight on reproductive health becomes increasingly clear, and the benefits of effective weight management intersect with the complexities of preconception and pregnancy care. Understanding the nuances of these medications in the context of fertility and pregnancy is not just about avoiding risks, but about making informed, proactive choices for a healthy future.
In this comprehensive guide, we will delve deep into the current understanding of Wegovy and similar GLP-1 medications, exploring their mechanisms, their potential influence on fertility, and the critical considerations for individuals who are trying to conceive or become pregnant. We will examine the scientific evidence, including insights from animal studies and the limited human data available, and outline the recommendations from health authorities. Our aim is to provide clarity and empower you with the knowledge to navigate this important decision. We will also discuss the essential role of personalized medical guidance and how a supportive framework, like the one we champion at TrimRx, can help you align your weight loss goals with your family planning aspirations. By the end of this post, you will have a thorough overview of this complex topic, guiding you toward informed conversations with your healthcare provider and a clearer path forward.
Understanding GLP-1 Receptor Agonists Like Wegovy
Glucagon-like peptide-1 (GLP-1) receptor agonists, often simply called GLP-1s, represent a groundbreaking class of medications that have revolutionized the approach to managing type 2 diabetes and, more recently, chronic weight management. Wegovy, which contains the active ingredient semaglutide, is one such medication that has garnered significant attention for its effectiveness in promoting substantial weight loss.
How GLP-1s Work in Your Body
At their core, GLP-1 medications mimic the action of a natural hormone in your body called glucagon-like peptide-1. This hormone plays several crucial roles in regulating metabolism:
- Blood Sugar Regulation: GLP-1 stimulates the pancreas to release insulin when blood sugar levels are high, helping to lower glucose. It also suppresses the release of glucagon, a hormone that raises blood sugar.
- Slowing Gastric Emptying: These medications slow down the rate at which food leaves your stomach. This leads to a prolonged feeling of fullness, which can reduce overall food intake.
- Appetite Suppression: GLP-1s act on the brain to reduce appetite and cravings, contributing significantly to weight loss.
This multi-faceted action makes GLP-1s highly effective not only for blood sugar control but also for sustainable weight reduction. For individuals living with obesity or excess weight, these medications can be transformative, leading to improved metabolic health markers and a better quality of life. At TrimRx, we believe in leveraging advanced medical science and modern technology to offer effective solutions, and medications like Compounded Semaglutide, Oral Semaglutide, and the branded Ozempic®, Mounjaro®, Zepbound®, and Wegovy® are key components of our personalized approach for eligible individuals. To discover if a prescription weight loss medication is right for you, we encourage you to take our free assessment quiz.
The Broader Impact on Health
Beyond weight loss, GLP-1 medications have shown promise in improving various health conditions often associated with obesity, such as blood pressure, cholesterol levels, and the risk of cardiovascular events. This broader health impact makes them a valuable option for many. Our journey at TrimRx began with a shared vision to help individuals embrace healthier lifestyles by merging cutting-edge telehealth innovations with effective weight loss solutions. Our platform is a user-friendly and supportive space where individuals receive personalized, medically supervised care—all designed to make sustainable weight loss attainable and tailored to the individual.
Weight Loss and Fertility: A Symbiotic Relationship
The relationship between body weight and reproductive health is deeply intertwined and often complex. For many individuals, achieving a healthier weight can be a significant step toward improving fertility and increasing the chances of a healthy pregnancy.
The Impact of Weight on Reproductive Health
Both excess weight and being underweight can disrupt the delicate hormonal balance necessary for optimal reproductive function.
- Obesity and Overweight: Carrying excess weight, particularly around the abdomen, can lead to hormonal imbalances. This often involves increased estrogen production and insulin resistance, which can interfere with ovulation. Conditions like Polycystic Ovary Syndrome (PCOS), a common cause of infertility, are strongly linked to obesity and insulin resistance. For individuals with PCOS, weight loss can be particularly impactful in restoring regular menstrual cycles and ovulation. Obesity also increases the risk of pregnancy complications such as gestational diabetes, preeclampsia, and preterm birth.
- Underweight: Conversely, being significantly underweight can also disrupt the menstrual cycle, leading to irregular periods or even amenorrhea (absence of menstruation). The body may perceive a state of “stress” or “starvation,” shutting down non-essential functions like reproduction to conserve energy.
How Weight Loss Can Enhance Fertility
For individuals struggling with obesity or overweight, even a moderate amount of weight loss can lead to remarkable improvements in reproductive health:
- Hormonal Balance: Losing weight can help rebalance hormones like estrogen and insulin, which are critical for regular ovulation and menstrual cycles.
- Improved Ovulation: For those with irregular periods or anovulation (lack of ovulation), weight loss can restore consistent ovulation, making conception more likely.
- Reduced Pregnancy Risks: Entering pregnancy at a healthier weight can significantly lower the risk of various complications for both the birthing parent and the baby, including gestational diabetes, preeclampsia, and the need for a C-section.
While the benefits of achieving a healthy weight for fertility are clear, the method of weight loss and its timing, especially when using medications like Wegovy, require careful consideration. At TrimRx, we understand that sustainable weight loss should be achieved through science, empathy, and a transparent approach. We focus on providing compassionate care that respects every individual’s unique journey, combining advanced medical science with modern technology.
Can You Get Pregnant While Taking Wegovy or Other GLP-1s?
A common question that arises for individuals on GLP-1 medications is whether these drugs prevent pregnancy. The straightforward answer is no: GLP-1 medications are not contraceptives and do not prevent pregnancy. If you are sexually active and capable of becoming pregnant, it is absolutely possible to conceive while taking Wegovy or similar medications.
This fact, combined with the potential for improved fertility as a result of weight loss from these medications, means that individuals planning to become pregnant must be particularly proactive in their family planning discussions with healthcare providers.
Potential Interactions with Birth Control
An important consideration that has emerged with the use of GLP-1 medications is their potential interaction with oral contraceptives. As discussed, GLP-1s work by slowing gastric emptying, meaning food and medications stay in the stomach longer.
If you are taking oral birth control pills, this slowed digestion could potentially affect how these pills are absorbed into your bloodstream. While specific extensive research on this interaction is still evolving, there is a theoretical concern that the effectiveness of oral contraceptives could be reduced, increasing the risk of unintended pregnancy.
Given this possibility, if you are taking Wegovy or another GLP-1 medication and rely on oral birth control, it is crucial to:
- Discuss with Your Provider: Talk to your healthcare provider about this potential interaction. They may recommend an alternative form of contraception that is not affected by gastric emptying, such as an IUD, implant, or injectable birth control.
- Consider Backup Methods: Until you have had this discussion and potentially adjusted your birth control method, using a backup contraception method (like condoms) is a wise precaution.
For individuals who have experienced irregular menstrual cycles due to obesity or PCOS and then begin GLP-1 medication, the return to regular ovulation can be an unexpected side effect that increases fertility, further emphasizing the need for robust contraception if pregnancy is not desired. Our commitment to transparent service means we highlight these important considerations, empowering you to make informed decisions about your health journey. For those exploring their options for managing their weight, we invite you to take our free assessment quiz to see if you qualify for our personalized programs.
Wegovy and Pregnancy: What the Research Says
The most critical question for many is the safety of taking Wegovy, or any GLP-1 medication, during pregnancy. The current guidance is clear: for most individuals, these medications are not recommended during pregnancy, and careful planning is essential if you are trying to conceive.
Official Recommendations and Pregnancy Categories
According to the prescribing guidelines from the U.S. Food and Drug Administration (FDA) for Wegovy (semaglutide), it should be discontinued at least two months before trying to conceive. This recommendation is based on the understanding that the medication can remain in your system for a period after the last dose, and it prioritizes fetal safety.
Currently, semaglutide (the active ingredient in Wegovy) has not been assigned a specific FDA pregnancy category. However, the general caution aligns with what is often classified as a “Category C” drug, meaning that “risk cannot be ruled out.” This cautious stance is taken because there isn’t enough definitive human data to confirm safety, and animal studies have shown potential risks.
Limited Human Data and Ongoing Research
One of the significant challenges in providing absolute guidance on Wegovy and pregnancy is the limited amount of human research specifically on GLP-1 use during gestation. For ethical reasons, pregnant individuals are typically excluded from initial drug trials, meaning comprehensive data often lags.
However, research is ongoing. Pharmaceutical manufacturers are establishing pregnancy registries to collect data from individuals who have inadvertently become pregnant while taking these medications. These registries aim to gather crucial information on pregnancy outcomes, which will help healthcare providers make more informed decisions in the future. Small observational studies have also started to emerge, but more robust data is needed to draw solid conclusions.
Insights from Animal Studies
While human data is scarce, animal studies provide important preliminary insights into the potential effects of GLP-1s during pregnancy. The FDA’s prescribing information for Wegovy details findings from trials conducted on rats, rabbits, and monkeys:
- Rats: When pregnant rats were given semaglutide, they consumed less food and lost weight. Their offspring showed signs of impaired growth, defects in heart blood vessels, and bone abnormalities (in the skull, ribs, and vertebrae).
- Rabbits: Studies on pregnant rabbits administered semaglutide during organogenesis (the critical period of major organ formation) revealed early pregnancy losses and malformations in chest bones, as well as abnormal kidney and liver development at higher doses. The mother rabbits also experienced reduced food intake and less weight gain.
- Monkeys: Pregnant monkeys receiving semaglutide exhibited reduced food intake, weight loss, an increase in early pregnancy loss, and skeletal abnormalities in their offspring at higher doses.
It is crucial to remember that animal studies do not always predict what will happen in humans. However, these findings raise significant concerns and are a primary reason why healthcare providers advise extreme caution and recommend discontinuing Wegovy before and during pregnancy. The observed effects, particularly reduced fetal growth and malformations, are serious enough to warrant a conservative approach.
Weight Loss During Pregnancy: Generally Not Recommended
Separate from the medication’s direct effects, substantial weight loss during pregnancy is generally not recommended for most individuals. Pregnancy requires adequate nutritional intake and healthy weight gain to support the baby’s growth and development. Healthy weight gain targets are typically established based on pre-pregnancy BMI. Deliberate weight loss efforts, especially those that involve significant calorie restriction or medications that reduce appetite, could potentially deprive the fetus of essential nutrients.
Exceptions: Managing Type 2 Diabetes in Pregnancy
The discussion becomes more nuanced for individuals who are taking GLP-1 medications to manage type 2 diabetes. Uncontrolled diabetes during pregnancy can lead to severe complications for both the birthing parent and the baby, including:
- Increased risk of birth defects
- Preterm birth
- Miscarriage
- Preeclampsia
- Macrosomia (large baby), increasing delivery complications
- Diabetic ketoacidosis
In rare cases, a healthcare provider might weigh the benefits of continuing a specific diabetes medication against its potential risks, though this would be under strict medical supervision and typically with a strong preference for alternatives known to be safer in pregnancy, such as insulin or metformin. If you are managing type 2 diabetes and considering pregnancy, your provider can help you transition to a safe and effective treatment plan. Our platform at TrimRx offers a personalized approach, connecting you with providers who can assess your unique health needs.
What to Do If You Become Pregnant While Taking Wegovy
Discovering you are pregnant while actively taking Wegovy can be an overwhelming moment. It’s important to take a deep breath and understand that you have options and resources. Your immediate next step is crucial for both your health and the health of your pregnancy.
Immediate Action: Contact Your Healthcare Provider
As soon as you suspect or confirm pregnancy while on a GLP-1 medication like Wegovy, the most important action is to immediately contact the healthcare provider who prescribed your medication or your gynecologist/obstetrician. Do not attempt to adjust or stop your medication on your own without medical guidance.
Your provider will consider your individual health situation, including the reason you were taking Wegovy, your medical history, and the stage of your pregnancy, to help you determine the safest next steps.
Discontinuation of Medication
In most cases, and in line with FDA recommendations and current medical understanding, your healthcare provider will likely advise you to stop taking Wegovy as soon as pregnancy is confirmed. The animal study data, though not directly translatable to humans, suggests potential risks to fetal development that warrant this cautious approach. Your provider will guide you on how to safely discontinue the medication.
Discussing Pregnancy Options
If you become pregnant while on Wegovy, you will have various options regarding the pregnancy itself. Your healthcare provider is there to support you through these discussions, providing unbiased information and care. You can choose to continue the pregnancy or explore other options, such as an abortion.
- Continuing the Pregnancy: If you decide to continue the pregnancy, your provider will initiate comprehensive prenatal care. This will involve close monitoring to ensure the healthiest possible outcome for both you and the baby. They may recommend additional screenings or monitoring due to the medication exposure. Managing underlying health conditions, such as blood sugar levels, will become a primary focus, possibly with alternative medications proven safe for pregnancy.
- Considering Abortion: If you choose to explore abortion, it’s important to know that GLP-1 medications are not known to significantly interfere with the effectiveness of abortion pills. While the first abortion pill (mifepristone) is taken orally and theoretically could be affected by slowed gastric emptying, the second pill (misoprostol) is typically absorbed sublingually, buccally, or vaginally, bypassing the digestive system. You would not typically need to stop your GLP-1 medication to have a safe and effective medication abortion. Your provider can offer guidance and support through this process.
No matter your decision, your healthcare provider will offer compassionate care and respect your unique journey. At TrimRx, we are committed to providing unlimited support throughout your health journey, ensuring you have the resources and guidance needed for informed decisions. Our comprehensive service includes doctor consultations, medication (if eligible), lab work, unlimited support, and shipping, all with no hidden fees, to ensure peace of mind.
Wegovy and Breastfeeding: Safety Considerations
Beyond pregnancy, another important consideration for new parents is the safety of using Wegovy while breastfeeding. The question of whether the medication passes into breast milk and its potential effects on a nursing infant is a significant concern.
Limited Human Data
Similar to pregnancy, there is currently limited human research on the use of semaglutide (Wegovy’s active ingredient) during breastfeeding. This means we don’t have definitive data to confirm:
- Whether Wegovy is excreted into human breast milk.
- What effect, if any, it might have on a breastfed baby.
- Whether it impacts milk production in the birthing parent.
Insights from Animal Studies
Animal studies have offered some preliminary information. For instance, one study found small amounts of semaglutide in the milk of lactating rats. While this suggests the possibility of transfer, it is not a direct indication that the same will occur in humans or what the clinical implications would be if it did.
Personalized Guidance is Key
Given the lack of conclusive human data, the general recommendation is to exercise caution. If you are breastfeeding or planning to breastfeed and are considering taking Wegovy, or if you are already on Wegovy and wish to breastfeed, it is absolutely essential to discuss this with your healthcare provider.
Your provider will help you weigh the potential benefits of continuing Wegovy for your own health against any theoretical risks to your baby. They can discuss alternative weight management strategies that are known to be safe during lactation or help you make an informed decision about pausing medication if necessary. Our approach at TrimRx emphasizes personalized care, ensuring that every decision is made in consultation with a qualified medical professional who understands your unique circumstances.
Planning for Pregnancy While on Weight Loss Medication: A Proactive Approach
For individuals considering pregnancy who are currently taking or planning to start weight loss medications like Wegovy, a proactive and well-thought-out approach is key. This involves careful timing, open communication with your healthcare team, and the establishment of sustainable healthy habits.
Timing is Everything: Discontinuing Medication Before Conception
As previously noted, the FDA recommends discontinuing Wegovy at least two months before trying to conceive. This window allows the medication to clear from your system, minimizing potential exposure to the developing fetus during the critical early stages of pregnancy. Other GLP-1 medications may have slightly different recommended washout periods (some as short as 4-8 weeks), so it’s vital to consult your specific medication’s guidelines and your provider.
If you are actively trying to become pregnant, or even if you are just contemplating it in the near future, bringing this up with your prescribing doctor is paramount. They can help you create a timeline for safely tapering off or discontinuing the medication and discuss alternative strategies for managing your weight or any underlying conditions during this transitional period.
Sustainable Weight Management Beyond Medication
One of the challenges often faced by individuals discontinuing GLP-1 medications is the potential for weight regain. These medications work by helping to regulate appetite and metabolism, and when they are stopped, the body may revert to its previous patterns. This is why a critical part of pre-conception planning while on weight loss medication involves developing and solidifying sustainable lifestyle habits.
- Nutritional Planning: Work with a nutritionist or dietitian to establish a balanced, nutrient-dense eating plan that supports both weight maintenance and reproductive health. This is not about restrictive dieting but about making informed food choices.
- Regular Physical Activity: Incorporate consistent, moderate exercise into your routine. Physical activity is beneficial for weight management, hormone regulation, and overall well-being.
- Mindset and Support: Understand that weight management is a continuous journey. Developing healthy coping mechanisms, stress reduction techniques, and a supportive network can be invaluable.
At TrimRx, we believe that sustainable weight loss extends beyond medication. Our personalized programs emphasize holistic well-being, providing access to resources that encourage healthy lifestyle changes. Our GLP-1 Daily Support and Weight Loss Boost supplements are available for immediate purchase to complement your journey and support overall wellness, even as you plan for major life changes like pregnancy. You can explore GLP-1 Daily Support here and Weight Loss Boost here.
The Role of Your Healthcare Team
Planning for pregnancy while managing weight, especially with medication, requires a multidisciplinary approach. Your healthcare team might include:
- Primary Care Physician/Endocrinologist: To manage the GLP-1 medication and any underlying conditions like type 2 diabetes.
- Ob/Gyn or Fertility Specialist: To provide guidance on reproductive health, conception, and prenatal care.
- Registered Dietitian/Nutritionist: To help develop a sustainable and healthy eating plan.
This collaborative approach ensures that all aspects of your health are considered, leading to individualized care that aligns with your family planning goals. We emphasize that TrimRx works exclusively with FDA-registered and inspected pharmacies for the shipping of weight loss medications and does not provide actual medical supervision. Our comprehensive service includes doctor consultations, medication, lab work, unlimited support, and shipping with no hidden fees, all orchestrated through our network of affiliated medical professionals.
For those exploring their options, our platform makes it easy to begin your journey. Take our free assessment quiz to see if you qualify for a personalized treatment plan, including access to medications like Compounded Semaglutide, Oral Semaglutide, Ozempic®, Compounded Tirzepatide, Oral Tirzepatide, Mounjaro®, Zepbound®, and Wegovy®. This step is crucial for determining eligibility and receiving a plan tailored to your unique needs and health goals.
The TrimRx Difference: Your Partner in a Healthier Future
At TrimRx, our core mission is to empower individuals to achieve their health goals through safe, effective, and personalized weight loss solutions. We understand that your health journey is unique, especially when it intersects with significant life events like family planning. Our brand is built on empathy, innovation, trustworthiness, support, results-orientation, and personalization, values that guide every aspect of our service.
Our Story and Values
Our journey at TrimRx began with a shared vision: to help individuals embrace healthier lifestyles by merging cutting-edge telehealth innovations with effective weight loss solutions. We recognized the need for a user-friendly and supportive space where individuals could receive personalized, medically supervised care designed to make sustainable weight loss attainable and tailored to their unique circumstances. We firmly believe that sustainable weight loss should be achieved through science, empathy, and a transparent approach, ensuring that you feel understood and supported every step of the way.
A Personalized and Comprehensive Approach
We offer compassionate care that respects every individual’s unique journey. By combining advanced medical science with modern technology, we provide a holistic solution for weight management. Our commitment to transparent service means our approach remains consistent, regardless of dosage changes or specific medication pathways. Your well-being and safety are our top priorities.
Our comprehensive service includes everything you need for a successful and supported weight loss journey:
- Doctor Consultations: Connect with qualified medical professionals who provide personalized assessments and treatment plans.
- Medication Access: For eligible individuals, we offer a range of prescription weight loss medications provided through FDA-registered and inspected pharmacies. These include:
- Compounded Semaglutide
- Oral Semaglutide
- Ozempic®
- Compounded Tirzepatide
- Oral Tirzepatide
- Mounjaro®
- Zepbound®
- Wegovy®
- (Note: Branded medications like Ozempic®, Mounjaro®, Zepbound®, and Wegovy® are FDA-approved. Compounded medications are not FDA-approved, but the pharmacies we partner with for shipping are FDA-registered and inspected.)
- Lab Work: Essential diagnostics to ensure your treatment plan is appropriate and safe for your health profile.
- Unlimited Support: Ongoing guidance and assistance to help you navigate challenges and celebrate successes.
- Shipping: Convenient delivery of medications directly to your door.
- No Hidden Fees: Our transparent service ensures you know exactly what to expect.
To begin your personalized weight loss journey and determine your eligibility for these prescription medications, we invite you to take our free assessment quiz today.
Immediate Support for Your Wellness Goals
We also understand that sometimes you need immediate support for your overall wellness during your weight loss journey. For those moments, or as a complement to your personalized plan, we offer quick-access supplements that do not require a quiz:
- GLP-1 Daily Support: Designed to support your body’s natural processes.
- Weight Loss Boost: Crafted to provide additional support for your weight management efforts.
These supplements are available for immediate purchase to help you maintain momentum and support your health.
Whether you are exploring options for long-term weight management, or navigating the complexities of family planning while considering weight loss medications, TrimRx is here to be your trusted partner. We are dedicated to providing the resources, support, and care you need to make informed decisions and embrace a healthier, more vibrant future.
Conclusion
The decision of whether one can take Wegovy while trying to get pregnant is a deeply personal and medically complex one, requiring careful consideration and expert guidance. As we’ve explored, while GLP-1 medications like Wegovy are highly effective for weight management and can indirectly improve fertility by addressing weight-related hormonal imbalances, their use during preconception and pregnancy carries significant caveats.
Current medical consensus, supported by animal studies and a cautious approach due to limited human data, strongly advises against taking Wegovy during pregnancy. The recommendation to discontinue the medication at least two months before attempting conception underscores the importance of minimizing potential fetal exposure to potential risks. Furthermore, interactions with oral contraceptives and the general recommendation against intentional weight loss during pregnancy highlight the need for comprehensive planning.
Ultimately, navigating this intersection of weight loss, medication, and family planning requires open, honest dialogue with your healthcare provider. Your medical team can help you weigh the risks and benefits, craft a personalized plan for safely discontinuing medication, explore alternative weight management strategies, and ensure optimal health for both you and your future child.
At TrimRx, we stand as your dedicated partner, offering clinically proven, personalized weight loss solutions rooted in science, empathy, and transparent care. We are committed to supporting you through every phase of your health journey, providing access to medically supervised care and comprehensive resources. If you are considering weight loss medications and have questions about family planning, or simply wish to explore a pathway to sustainable weight management, we encourage you to take the vital next step. Take our free assessment quiz today to determine your eligibility for our personalized prescription programs. For immediate support for your wellness goals, explore our GLP-1 Daily Support and Weight Loss Boost supplements. Your journey to a healthier future, aligned with your deepest aspirations, begins with informed choices and unwavering support.
FAQ
How long after stopping Wegovy can I try to conceive?
The U.S. Food and Drug Administration (FDA) recommends discontinuing Wegovy at least two months before you begin trying to conceive. This allows the medication sufficient time to clear from your system, minimizing any potential exposure to the developing fetus during early pregnancy. Always consult with your healthcare provider to create a personalized timeline and plan that is appropriate for your specific health situation.
Does Wegovy affect the effectiveness of birth control?
Yes, GLP-1 medications like Wegovy work by slowing gastric emptying, which means food and oral medications, including birth control pills, may remain in your stomach longer. This could potentially affect how oral contraceptive pills are absorbed, possibly reducing their effectiveness and increasing the risk of unintended pregnancy. It is crucial to discuss this with your healthcare provider. They may recommend using a non-oral form of contraception or a backup method while you are taking Wegovy.
Is losing weight during pregnancy recommended?
No, generally, intentional weight loss is not recommended during pregnancy for most individuals. Healthy weight gain is essential to support the proper growth and development of the baby. Your healthcare provider will guide you on appropriate weight gain targets based on your pre-pregnancy body mass index (BMI). If you have concerns about your weight during pregnancy, discuss them with your provider, who can help you manage your nutrition and activity safely.
What should I do if I discover I’m pregnant while on Wegovy?
If you find out you are pregnant while taking Wegovy, the most important step is to contact your healthcare provider immediately. Do not stop the medication on your own. Your provider will assess your situation, including the stage of your pregnancy and your health history, and will likely advise you to discontinue Wegovy. They will then discuss your pregnancy options and ensure you receive comprehensive prenatal care or other appropriate medical guidance.
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