Planning your Pregnancy

I am planning to have a baby soon. What should now that will help me have a good pregnancy and successful outcome?

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Endeavour to be in optimal nutritional health before you conceive. It is common for pregnant women to become depleted of nutrients as a pregnancy advances. Remember, when you are pregnant you are feeding two not one!

Read up on what is a ‘good diet’. Have a healthy balanced diet with reasonable amounts of carbohydrates, protein, fat, minerals and vitamins. It is a good idea to commence a good quality pregnancy supplement about three months before you conceive to help you optimise your nutritional state.

If you have a history of iron deficiency anaemia or have heavy periods it is good idea to have a full blood count and iron studies before pregnancy. Try to correct any iron deficiency before you are pregnant, as there are increased demands on iron stores in pregnancy. See in Staying Healthy section of this website Supplements.

Iodine deficiency is an increasingly common problem in the community. There are increasing concerns about iodine levels in diet. Low iodine is associated with underactive thyroid, thyroid goitre and in extreme situations cretinism in a newborn baby. Have your iodine level checked,  have an optimal iodine intake and take an iodine supplement of your level is low.  See in Staying Healthy section of this website Iodine and Pregnancy.

Have foods rich in folic acid such as dark green leafy vegetables, whole wheat bread, lightly cooked beans and peas, nuts and seeds, sprouts, oranges and grapefruits, liver and other organ meats, poultry , fortified breakfast cereals and enriched grain products. Start taking folate supplements (0.5mg/day) three months before you decide to  conceive.   The oral contraceptive pill can interfere with folate absorption and so should be ceased about 3 months before conceiving. But it that doesn’t happen – relax! it is unusual to have a problem.  While Folic acid deficiency is a known cause of spina bifida, but this is a very uncommon in our community.  See in Staying Healthy section of this website Folate and folic acid – What’s the difference?

Achieve an optimal weight before conceiving

Try to be at your optimal weight before conceiving.

You will gain weight in pregnancy and it can be difficult to lose the extra kilos postnatally. There has been many a woman who has ‘lost her figure’ because of excess weight gain in pregnancy

To be overweight in pregnancy not only will mean the pregnancy is more uncomfortable for you but it increases your risk of conditions such as hypertension and diabetes in pregnancy.

It does have adverse implications for management of your pregnancy, such as making ultrasound scanning of your baby more difficult and less accurate as there is more adipose tissue in the abdominal wall. It is much more difficult and in some cases not possible to have an epidural anaesthetic in labour because of extra thickness of your back if you are excessively overweight. Being excessively overweight increases the difficulties and reduces the accuracy of external transducer monitoring your baby’s wellbeing in labour. It increases the difficulties and risks of labour, vaginal delivery and Caesarean section delivery. As well if you are excessively overweight there is more risk of infection and thrombosis postnatally and more.

It is also known that women who gain excessive weight during pregnancy are at higher risk of having overweight or obese children. Childhood obesity is on the increase and is associated with many health and psychological challenges for the child. As well if you don’t learn how to eat healthy before you are pregnant what hope do you have of your child eating healthy foods?

So do you best to optimise your diet and weight before you conceive and make it a new habit. It is worth it!

If you are struggling to know what to do have a chat with your  doctor and maybe a good dietitian.

See in the Question and Answer section of this website Weight Gain in Pregnancy.

Get you immunity right before conceiving

Get your doctor to check your immunity to rubella and chickenpox.vaccination

Although rubella is not dangerous for you, it can have very serious implications for your unborn baby if the infection is contracted during pregnancy (the risk being highest in the first three months). It can cause heart and brain defects, deafness and cataract in your unborn baby.

Chickenpox is usually a more an unpleasant illness as an adult and especially in pregnancy and in 10% can have maternal complications. As well there is possibility of your baby developing foetal varicella syndrome (FVS) is a serious complication resulting in the baby to be born developing major abnormalities

Have a blood test to determine if you are immune to rubella and chickenpox before you start trying to conceive. If you are not immune, you should have vaccination. You should wait for three months after your vaccination before conceiving.

See also in the Question and Answer section of this website Chickenpox and pregnancy

Get fit before conceiving

It is a good idea to get as fit as possible before you conceive. This is because pregnancy will reduce your stamina. You will find when you are pregnancy that you will not be able to do what you did before pregnancy and will fatigue more easily. Exercise can simply mean regular walks. If you go to a gym tell your trainer you are planning to conceive soon so she can give you an appropriate exercise regime.

Past medical and pregnancy history

If you have a personal history of difficulty in conceiving, miscarriage (especially if more that one), significant health issues, previous difficult deliveries, or you or your husband/partner has a family history of an inherited condition, it will be good you have a pre-pregnancy consultation with me so the impact (if any) of your personal or family history on your planned pregnancy can be determined and steps can be taken as necessary increase your chances of a successful pregnancy outcome.

Get the right Health Fund cover before conceiving

While I am happy to manage you in your pregnancy if you are not in a health fund, planning pregnancyit will be more expensive for you.

I suggest that you make sure you have appropriate health fund cover. I suggest you are covered for maternity in a private hospital. Remember there is usually a 12 month waiting period between joining the fund and when you are covered. So I suggest you get this organised now.

Be very wary of certain websites which look like they are there so you to compare health funds. Be especially wary of those websites where you need to enter your personal details (name, contact details, etc.) before getting information. They are likely to be bias and to only represent only certain funds, which are  likely not be the best funds to join.

The best web site I have found where you can easily compare the various health funds and cover options is the Federal Government website which is located at http://www.privatehealth.gov.au/dynamic/compare.aspx. You can also give my office a call and ask my secretary for advice as to which funds give the best cover for pregnancy.

Will my contraception delay my getting pregnant?

  • Barrier contraception: (condom and diaphragm) will not cause any delay with conception.
  • Billings method and withdrawal  will not cause any delay with conception.
  • IUCD: A Multiload IUCD should not result in any delay with conception. A Mirena IUCD can interfere with ovulation in minority of woman and so there can be some delay for a few with onset of ovulation after removal.
  • Oral contraceptive pill: A combined pill suppresses ovulation. There can be delay with the onset of ovulation which does not relate to how long you have been on the pill. This delay can be for up to two years occasionally and so sometimes ovulation induction is indicated. A progestogen-only pill will suppress ovulation for a minority of users and so for most it will not cause delay with conception.
  • Depot Provera: While repeat injections are indicated each three months for contraception, this does not mean ovulation will occur three months after an injection. For some women there can be considerable delay and so for some ovulation induction is indicated.

When can I get pregnant?

Ovulation is normally in the middle of your monthly cycle (around day 14 if you have a 28 day cycle).   Your egg will live for about 12-24 hours after ovulation. If conception is to take place it must be fertilised by your partner’s sperm in your body within this time. Sperm can live for up to 10 days inside your body. If you have sex a day or so before ovulation, your partner’s sperm will have time to travel up the fallopian tubes and will be waiting when your egg is released. So the chances are highest if you have sex on the day before ovulation. See also in the Blog section of this website Calculating EDC.

Posted by Dr Gary Sykes on -

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