Getting ready for pregnancy
If you are trying for a baby, having a healthy baby and being in the best health that you can during pregnancy will be your goal.
Good antenatal care during pregnancy and birth is really important but so is the planning of a pregnancy and optimising the future mothers health.
Where to start?
If you are trying for a baby it is recommended to start taking folic acid in a dose of 400ug daily for a couple of months prior to conception. A single tablet of folic acid or a preparation containing folic acid as well as other vitamins and supplements recommended in the antenatal period are acceptable. Vitamin D is recommended during pregnancy but can be taken before. It is important only to take supplements that are recommended for pregnancy, and beware of general multivitamins that may contain too much vitamin A, which is not recommended in pregnancy.
Lots of women get very anxious about how long it takes to get pregnant, but getting pregnant is generally not something that happens immediately! It is normal for it to take the average couple up to 10 months to achieve a pregnancy so don’t panic if it doesn’t happen in the first 3 months.
The timing and frequency of intercourse are important but don’t get into a regime too early that will make you worry and think about it all the time; stop using contraception and just see what happens. After a few months of not getting pregnant you could think about concentrating intercourse between day 9 and 18 if you have a normal 28 day cycle, having intercourse every two days and not three times a day as the volume of semen is fairly important.
Seeking medical advice is appropriate after 12 months if you are under 35, or earlier if you are older.
Weight is a topical issue for most women, most of the time for many reasons other than health (which is the only important one!), but does matter when planning to have a baby. A woman’s BMI (body mass index) is important when trying to conceive as well as in pregnancy itself. Complications such as high blood pressure, miscarriage, blood clots and embolism as well as pregnancy diabetes are much more likely to occur in women who are overweight in pregnancy, as are more complicated births and babies being in the wrong position, so following a healthy diet and exercise programme pre pregnancy to get BMI below 25 is the best start to pregnancy. The average woman of normal weight will put on 25-35 pounds in pregnancy – a combination of extra water, increased blood volume, the baby, uterus, placenta and some body fat – so being of normal weight at the start encourages a healthy pregnancy and makes losing any extra pounds afterwards much easier.
Being underweight can also cause conception and pregnancy complications, so it is just as important to aim for a bodyweight in the normal range.
Smoking, drinking alcohol and using recreational drugs all have a negative effect on both mother and baby and it is important to get help and advice with these before embarking on pregnancy. Many women think they will be judged if they tell their healthcare professional about addiction problems – this couldn’t be further from the truth! We only want to give the best advice and support that we can to help you have good health in pregnancy and a healthy baby. If you choose your private pregnancy care with The Birth Team, we will offer you understanding and support; there is very little that we won’t have heard before, and we always create an environment where you feel able to be open with us.
Ensuring vaccinations especially German measles are up to date is important as German measles can have a devastating effect on the fetus
If you have a chronic medical condition such as asthma, arthritis or anaemia it is sensible to see your Gp or specialist as Folic acid may need to be prescribed in a higher dose. Some medications are unsafe in pregnancy and may need to be changed prior to conception or immediately after confirmation of the pregnancy. If you are on regular medication for a chronic medical condition don’t just stop if you find out that you are pregnant as this may not be the right thing to do- see your healthcare provider straight away and get advice.
Certain ethnic groups of people are recommended to have testing for genetic conditions; for example 1 in 40 Askenazi jews carry the Tay Sachs gene. Being a carrier of this gene carries no health risks but if a fetus inherits the gene from both parents the baby would have a lethal and life-limiting condition. The actual risk is 40 x 40 x4 ie the risk of both being carriers x the risk of the fetus getting both abnormal genes. So an untested at risk couple have a 6400 to 1 chance of having a baby with Tay Sachs disease.If one parent is tested for carrier status pre-pregnancy and is negative there is no risk. If the tested parent is positive, the other parent should be tested; if they are also positive then testing of the fetus should be offered in pregnancy.
Afro-Caribbean people can carry the gene for Sickle Cell disease which can cause symptoms just from being a carrier. A gene from each parent can cause full blown Sickle Cell disease, so if both parents are Sickle carriers or carriers of thalasaemia ( common in people of Mediterranean,Middle Eastern African and South Asian descent ) then proper advice and diagnostic options should be given. Carrier status can be discovered and worries dispelled prior to pregnancy.
Women have been having babies for many thousands of years successfully and preconception advice is to increase the chances of a safe and successful outcome; modern healthcare diagnosis and treatment has reduced the deaths of babies in the first month of life to 3/1000 in 2016 from 16/1000 in 1960, which is a great step forward. An important part of this is getting maternal health and wellbeing the best that it can be at the start.
Remember pregnancy is a state of normal good health rather than an illness and a healthy diet and exercise are an important part of the experience.
(If you are over 35 and thinking about having your first baby, keep your eyes on our blog on thebirthteam.com as there is one coming up about older first time mothers.)