Many couples choose to keep their plans for pregnancy relatively secret, for lots of reasons, including a fear of not getting pregnant, and the classic questioning by well meaning relatives about “how are things going? Any news?”. There are a number of things to consider and plan when planning, some of which might not be well known to people who haven’t previously tried to get pregnant. While we will discuss some general concepts and thoughts below, please remember that this is not medical advice, and not necessarily suitable for you. Please do discuss with your GP or obstetric team rather than just following our thoughts.
Family Doctor/General Practitioner
This is a sensible first step, and one which is applicable to almost everyone who is considering pregnancy. Talk to your doctor in advance of “trying” to determine any particular health needs you may have. For some people, pre-existing conditions may affect your chances of fertility or the progress of your pregnancy. There may be ways to optimise these conditions to give you the best chance of a healthy pregnancy. Your diet may not provide the right nutrients for your baby, so having a few someone blood tests pre-pregnancy may help guide some simple supplements which might help.
If you are on any regular medications, it is important to tell your GP about all of them along with the pregnancy plan. Some may need to be adjusted or even changed to a different medication which is safe for use in pregnancy. It is also a wise move to make sure you are up to date with your cervical screening. The cervix plays a very important role in pregnancy, a simple test can ensure all is well.
Some infections (including sexually transmitted infections) can affect fertility as well as the unborn baby. Getting checked and treated can be a major step toward successful pregnancy as well as improving your own health.
Your GP is also usually a great guide to the local services. Choosing between public, private, shared care, community midwifery and other options is a huge decision, and one which your GP should aid. They will know what services are in your area, and what the pros and cons of each option are for you.
Supplements
A developing baby needs some particular nutrients as well as a generally well nourished mother. Specifically, 0.5mg folic acid should be taken every day for at least 1-3 months before conception to reduce the chance of neural tube defects (such as spina bifida). Other important nutrients are vitamin D (particularly if you are dark skinned, wear a veil, don’t go out in the sun or have a history of low levels), iron (especially if you have a history of anaemia or have low iron intake in your diet), calcium (of particular importance to check in vegans and those who avoid dairy), iodine, vitamin b12 (especially vegans and vegetarians) and several more which may be necessary based on your medical and dietary history.
Diet
There are two main components of the pregnancy diet. First, eat a healthy and nutritious diet which will help to sustain the life of both the mother and the growing baby. Second, avoid eating food or drink which may cause harm to you or the baby.
There are many different guidelines regarding which foods are safe and which are not safe in pregnancy. Different couples will interpret the guidelines with different vigour to each other. Our approach is to be careful with all meals and snacks, tolerate some significant dietary changes for the time you are trying and the time you are pregnant, but to always remember that the mother needs to have adequate nutrition to look after herself and the baby. We found this guide to be sensible and manageable, although most health departments will provide you with similar information.
Many women adopt the diet (for example, avoiding foods which may carry listeria) once they are pregnant. You should think about what changes you plan to make, and certainly consider adopting them during the “trying” phase, as you may not be immediately aware you are pregnant from the day you conceive, and loading your gut up with listeria or other potentially harmful pathogens seems an unnecessary challenge to a new pregnancy. A pregnant woman’s immune system is suppressed compared to usual, so as well as the baby being at risk, the mother may also be more susceptible to infection while pregnant.
Alcohol
Like diet, rules about alcohol in pregnancy are interpreted differently by different couples. There aren’t many good studies to demonstrate how much alcohol in pregnancy is “too much”, although there are also not good studies demonstrating that “a little bit is fine”. In general, most major authorities advise no alcohol during all stages of pregnancy. A major concern regarding alcohol and pregnancy is fetal alcohol syndrome, a condition which can harm the development of the baby, including their cognitive function. Alcohol in pregnancy is also linked to increased rates of stillbirth and miscarriage. A sensible general rule is that no alcohol is the safest option, ideally even when you are trying, as alcohol can affect fertility. Additionally, the very early stages of pregnancy are a vital time of development for a baby. If there is a chance a woman might be pregnant, alcohol at this time could potentially have a significant effect before she even knows she is pregnant.
High alcohol intake in men can affect sperm production, so both of you should consider cutting down or stopping your intake while trying to get pregnant.
Exercise
Exercise in pregnancy and while trying to get pregnant forms an important part of you and your baby’s health. While every situation is different and certainly starting new sports and increasing your activity needs to be done sensibly, the old advice of avoiding exercise during pregnancy did not generally contribute to a healthy pregnancy. It makes sense to talk your plans through with your GP or obstetric/midwifery team, but maintaining your health and fitness during pregnancy helps your baby, helps you during the delivery and recovery, and helps set or maintain some healthy habits as you become a bigger family. (Finding time to start new exercise regimes soon after having a baby is hard, trying to keep to a regime you have been doing for months or years will seem more manageable.)
Vaccines
Many vaccines are completely safe during pregnancy, and some are advised to be taken in pregnancy to provide optimal protection for the baby, such as flu and whooping cough. There are some vaccines which are not ideally suitable for pregnant women. If you may need to have an immunisation in the next year, it is worth checking with your GP whether it is advisable to have it prior to becoming pregnant.
Dentist
It is frequently recommended that women visit the dentist while pregnant, as good oral health is important to protect the baby from infections, as well as maternal health being important overall. Some dental treatments and investigations are not advised during pregnancy, so if you are planning to get pregnant it makes sense to get a checkup and get any issues dealt with before becoming pregnant.
Smoking
Now is a great time to stop. Both of you. For so many reasons. Having a child means you want to be around to watch them grow, and you feel a great responsibility to be around. Stopping smoking increases the chances of you being around as they grow up. Fertility is adversely affected by smoking, and the risk of miscarriage, stillbirth, and long term effects on the baby are all higher with maternal smoking. The oxygen levels of blood going to the developing baby will be improved if you stop. The effect of passive smoking on children is significant; you are affecting their health in the short term and the long term by smoking.
So stop. We’d suggest cutting down, but we can’t. We know the right thing to do is stop.
Relax
Being told to relax doesn’t necessarily help much, but when planning a pregnancy, think through what stressors are present in your life and whether there are ways to reduce these. As well as thinking about stressors, think about what things help you achieve peace and relaxation. Can you build them into your routine? Stress has been associated with difficulty in fertility and difficulty during pregnancy. It is impossible to avoid during pregnancy, but if there are ways to limit stress and achieve relaxation, find them and plan for a relaxing time.
We wish you a happy and healthy pregnancy.
