Pre-pregnancy planning

by LukeAdmin

 by Dr Georgia Page

Are you thinking of starting a family or perhaps you are ready to try again? Pregnancies are not always planned but when it comes to healthier outcomes it is best to think ahead. There are a lot of things to consider before trying to get pregnant so it’s a good idea to book an appointment with your doctor for a pre-conception consultation a few months beforehand. 

A Healthy Lifestyle
A healthier you is not only beneficial for you and your baby but it can increase your chances of falling pregnant. A well-balanced diet and regular exercise program is a good start to achieve this. Women in the healthy weight range (BMI between 20–25) have a better chance of falling pregnant compared to women that are overweight or underweight. It can also reduce risk of complications such as hypertension, pre-eclampsia and gestational diabetes. 

Smoking can affect fertility, and this includes exposure to passive smoking. It can also increase chance of miscarriage, ectopic pregnancy and genetic abnormalities. Men can have a lower sperm count if they smoke. 

Minimising alcohol consumption is also important and research suggests heavy drinking can affect fertility, time taken to fall pregnant, and reduce the chances of having a healthy baby. Abstinence at conception and during pregnancy is recommended because a safe level of alcohol consumption hasn’t been establish.

We know a lot of people can’t live without their caffeine hit , but there is some evidence that consuming more than 500mg of caffeine per day can increase the amount of time it takes to conceive. Aim to cut back to less 200mg of caffeine per day (which is equivalent to 1 – 2 expresso coffees). Don’t forget caffeine is present in tea, chocolate, coca-cola and other energy drinks. 

When it comes to recreational drugs – we know that stopping these prior to falling pregnant is the best thing you can do for your baby. 

Pre-Pregnancy Supplements 
It is recommended that women take 400 micrograms of folic acid and 150 micrograms of iodine at least one month prior to conception to reduce the risk of some birth defects. Some women with certain medical conditions such as diabetes or epilepsy may require higher doses of folic acid so please check with your doctor. Many of the commercially available pre-pregnancy multivitamins have the recommended amount of supplements but please read the label or check with a health professional. If you have a well balanced diet you should get all the other nutrients required during pregnancy but if you are at risk of a vitamin deficiency you may require additional supplementation such as iron, vitamin D or vitamin b12. 

Medication Review 
Talk to your doctor about any prescription or over the counter medications that you are taking. Your doctor will be able to tell you if your prescribed medication is safe to continue to take during pregnancy or if is best to stop. Some over the counter medications such as vitamins or herbal supplements can be harmful to the unborn baby so it is important to check these also. You can also call Mothersafe: NSW Medication in pregnancy and breastfeeding hotline on 1800 647 848 if unsure. 

Health Checks
It is important that you are in good general health and your health checks are up to date. This may include cervical screening test, breast, blood pressure, dental and skin checks. Some medical conditions can affect fertility such as Polycystic Ovarian Syndrome, Endometriosis or Sexually Transmitted Infections (STI’s) so it is important to discuss with your doctor if you have these conditions (but please don’t worry – a lot of women with these conditions have no problems falling pregnant). 

Ensure any underlying health conditions are well managed prior to falling pregnant such as thyroid disease, high blood pressure, diabetes, asthma, epilepsy and mental health conditions. These conditions may require specialist input early prior to falling pregnant. 

Pre-conception Blood Tests and Immunisations
Your GP can check that your vaccinations are up to date and also check your immunity against infections that can be harmful to your baby. Immunity against Rubella (german measles) and Varicella (chicken pox) is important prior to pregnancy and can be checked with a simple blood test. If you are not immune you can be vaccinated for these infections but it is important to wait 1 month before trying to get pregnant after having a Rubella or Varicella vaccination. This is because they are live vaccines and cannot be given during pregnancy. The whooping cough vaccine and influenza vaccine are recommended during pregnancy however if you are planning on falling pregnant during flu season it is fine to have the influenza vaccine prior to falling pregnant. 

Your doctor may also order other blood tests pre-conception such as thyroid function tests, a full blood count, or STI screen. The tests ordered may depend on your medical history. 

Genetic Carrier Screening
If you have a family history of any genetic disorders please discuss with your doctor. Parents to be can be screened before they try for a baby to see if they carry genes that could cause health problems in their baby. ‘Genetic Carrier Screening’, is a blood test that can screen for carriers of cystic fibrosis, spinal muscular atrophy and Fragile X Syndrome. It is available for not just those with a family history and costs approximately $400. There are other screening tests available but it is a complex topic so requires a detailed discussion prior to having. 

It’s all about Timing! 
Now that we are all healthy and ready for pregnancy next comes the fun part! While some couples fall pregnant straight away, it can take a while for others to conceive. It is important to try and relax and enjoy the process! Understanding your menstrual cycle, timing of ovulation and having sex during your ‘fertile window’ can increase your chances of falling pregnant. The fertile window is the day of ovulation and 5 days beforehand (as sperm can survive for 5 days). Ovulation occurs 14 days prior to the first day of your period so if you have a 30 day cycle ovulation occurs on day 16 and the ‘fertile window’ would be day 11 to day 16. There are many ovulation Apps available on smart phones to help calculate your fertile window and the best time to have intercourse. 

Age is a big factor in fertility and the chance of having a child is much greater under the age of 35. Younger women also have more and healthier eggs. Women under 30 years have a 20% chance of getting pregnant each month but by age 40 this decreases to 5%. 

If falling pregnant is taking a little longer – don’t panic. Statistically 95% of women with no fertility issues fall within 12 months, which means for 5% of women if can take longer. If you have been trying for 12 months and you have not fallen pregnant please see your doctor (or if you are over the age of 35 and have been trying for 6 months). Your partner may need to have a sperm test also. 

Being the healthiest you can be before falling pregnant is so important and can increase your chances of conceiving and having a healthy baby. This includes not only your physical health but your mental health too. Plan ahead , visit your health professional for advice a few months prior to trying and we look forward to congratulating you soon! 

Resources
www.jeanhailes.org.au/health-a-z/fertility-pregnancy
Mothersafe: NSW medications in pregancny and breastfeeding service 1800 647 848 
www.yourfertility.org.au/ 

Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has a fabulous team and they pride themselves on delivering good quality health care, with that special personal touch. For more information call 43654999, check the website www.yourfamilydoctors.com.au or like them on facebook. 

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