Starting a family is one of life’s biggest and most exciting milestones. Before you toss that contraceptive in the bin, though, there are a few things to consider! Like any big project, pregnancy is best approached with some forward planning. Your best chance at a healthy pregnancy is to be as healthy as possible at the time you conceive.
The following list will hopefully give you some pointers. It’s not intended to cover everything – each woman will have different needs.
If you aren’t sure what applies to you, ask a doctor for advice. The medical term for this is “pre-pregnancy counselling.” In an ideal world, every woman would have pre-pregnancy counselling. In fact, it’s strongly recommended by pretty much every women’s health group, from the World Health Organization on down. If you and your partner are both healthy, start by seeing your GP. Consider seeing a Maternal-Fetal Medicine specialist if you have a chronic medical problem, a previous pregnancy complication, or there are serious conditions that run in your family.
Quit smoking! This should be obvious. We know it’s hard, but it’s one of the best possible things you can do for both you and your baby. Smoking reduces your fertility and increases miscarriages. It makes several pregnancy complications more likely, including ectopics, large bleeds, premature birth and stillbirth. Smoking increases the risk of baby being dangerously small, by starving baby of blood and oxygen in the womb. That’s not to mention all the other health risks smoking poses. There is a lot of support available to help smokers quit – start by talking to your GP.
Start exercising. You should be doing at least 30 minutes of exercise, on at least 5 days of the week. It’s important to have a mix of aerobic and strength training. Regular exercise has lots of benefits, both physical and psychological. Incorporate activities that you can continue throughout pregnancy – walking, swimming, yoga and Pilates are all great.
Pelvic Floor exercises. Your future self will thank you! A strong pelvic floor reduces your risk of incontinence and prolapse and helps your recovery post-birth. Start now and keep going through pregnancy and beyond. For more information see https://www.continence.org.au/pages/pelvic-floor-women.html
Healthy diet. There’s no magic “trying to conceive” diet. Aim for a balanced diet, with plenty of variety, lots of vegetables, whole-grains, lean protein, good dairy and good fats. Reduce your alcohol intake. Avoid too much sugar and processed food. Avoid fad diets – they’re usually expensive, overly restrictive, difficult to maintain and not based on any scientific evidence. If you aren’t sure what you should be eating, see a dietitian.
Start your folic acid supplement. All women who are planning a pregnancy need a folic acid supplement. Folic acid reduces the risk of your baby having a neural tube defect (NTD), for example spina bifida. Ideally, start taking folic acid 3 months before you try to conceive. (Even if you forgot, and you’ve just found out you’re pregnant, you should still start taking it). Most women need 0.4 mg per day. Some women have a higher risk of NTD and need a bigger dose of folic acid – we’ll write more about this in an upcoming post, but in the meantime check with your GP.
Things to consider
Start tracking your cycle. There are a number of good apps available to track your menstrual cycle. You want to start tracking for a couple of reasons. Firstly, if it turns out you have a very irregular cycle, that may need investigating. Secondly, you need to identify your fertile window (the days around ovulation). Once you start trying to conceive, make sure you are having sex during this window. Finally, once you are pregnant, the date of your last period will give an idea of how far along you are.
Cervical screening. Make sure you are up to date with your cervical screening (Pap smears). Women in their child-bearing years often miss cervical screening tests. There is a myth that you can’t have a cervical smear during pregnancy. Actually, it is safe to have a smear while pregnant. Having said that, if you’re due, get it done before conceiving just in case you need any follow-up biopsies or treatment.
Vaccinations. Make sure you are up-to-date with all your vaccinations. In particular, talk to your GP about checking your rubella (German measles) immunity. If you catch rubella during pregnancy, it can pass to your baby and cause serious complications. If you need the rubella vaccine, it has to be given at least one month before you fall pregnant.
Medication review. If you take regular medications, you need to know if they are safe in pregnancy. Medications may need to be stopped, swapped for a safer drug, or the dose adjusted. You should only change or stop your medication on a doctor’s advice though! Discuss your medications with your GP, physician or obstetrician. Don’t forget to discuss any over-the-counter medications or herbal remedies. Just because something is “natural” doesn’t mean it can’t affect your pregnancy.
Family history. Take the time to ask your close family, and your partner’s close family, about anything that runs in the family. In particular, ask if any babies have been born with problems, or if any of the women have had serious complications in a pregnancy. If the answer is yes, strongly consider pre-pregnancy counselling for advice specific to your circumstances.
Pre-conception genetic screening. This means testing you and your partner to see if you are carriers for certain genetic conditions, even if you don’t have a family history. This is a rapidly evolving field – some of these tests have only just become widely available. While it’s tempting to think “why not?” it’s important to approach these tests with some caution. It’s essential to understand the limitations of the test (what it can and can’t test for) and the implications of a positive result for you and your family. You should only undertake these tests if you have been well counselled by a doctor or genetic counsellor.
Specialist appointments. If you have any medical problems, or tests you’ve been putting off, or even a random symptom you’ve been trying to ignore, now is the time to get sorted! Talk to your GP or book in with your physician. It is always preferable to sort out health issues before you conceive. If you have a serious medical problem, notify your regular specialist and consider seeing a Maternal-Fetal Medicine specialist to talk about how your condition will affect your pregnancy.
Dentist appointment. It’s a good idea to have a dental check-up and any dental treatments before you conceive. There is a possible association between dental infections and pre-term birth. It is possible to have emergency dental work during pregnancy. However, you might need X-rays, medications or anaesthetic. You may also need to lie on your back for an extended period of time. It’s easier to do all these things before pregnancy.