Planning for pregnancy

A common question asked by many women is what they need to do prior to getting pregnant. This is to ensure as much as possible to maximise the chances of a good and safe outcome for their baby and themselves. It is a cliché to say that one should maintain good health and eat a well-balanced diet to assist in this endeavour. But what does this all really mean and is this all that one needs to do?

These days it is not sufficient to simply “remain healthy”. Whilst maintaining a good physical and dietary regime, there are many other things one may want to consider in trying to achieve the best result one can have. Some of these include:

  1. Ensuring adequate and appropriate immunisation.  Everyone knows about rubella ( German measles) and chicken pox. I also would recommend mumps, measles and if time permits, Hepatitis B immunisation.
  2. Folic acid supplementation has been shown to be important in reducing the incidence of spinal tube abnormalities in the foetus. All women are recommended to have at least 500 mcgm. daily of folic acid supplementation. This should commence at least 1 month before conception. These days many multivitamins have been configured with this in mind for pregnancy supplementation.Those with a family history or who themselves have had an affected baby, or they may be taking medications that increase the risk of spinal defects will require a higher dose of folic acid, typically 5 mgm. daily.
  3. Weight management. Having the correct weight for you is important not only in helping to minimise risks of medical conditions developing in pregnancy, but can also improve one’s fertility. Women who are significantly overweight risk the development of diabetes and high blood pressure to mention a few of the complications.
  4. Good control of pre-existing medical conditions.  If you have any significant medical conditions e.g. diabetes, thyroid dysfunction, you need to ensure that they are under good stable control before embarking on a pregnancy. If need be check with your family doctor or specialist.
  5. Medications may need to be altered prior to commencing a pregnancy. Whilst many medications are suitable to take in pregnancy, some are taboo as they can cause significant risks to the developing foetus. You may need to change the medication you are on and special advice will need to be sought on this. It is important never to suddenly stop your medications even if you find you are unexpectedly pregnant. It is better to speak with your family doctor as a matter of urgency if you are concerned.
  6. Genetic testing. Now there are many tests available to check to see if you or your partner carry specific abnormal genes that may affect the foetus. This can be looked for by a simple blood test.Many genetic conditions which can be very severe, usuallyr equire 2 genes to be present. If only one gene is present, then the eprson with that gene is called a carrier. In this case, it is important to check to see if her aprtner is also carrying a similar gene, If both are carriers then there is a significant risk the baby could be affected . Should this be the case, then options of management can be discussed.In other situations, if you are concerned about the possibility of a family member having a genetic condition, it may be possible to check this before you embark on a pregnancy. Such checks may take time and may include the need to check other family members.If you wish to consider having genetic tests performed, it is important to have this looked at early, possibly many months before starting to try for a pregnancy.
  7. A good exercise regime is helpful in improving one’s well-being. It does not need to be heavy exercise. Sometimes simple activities like walking for 30 minutes 2-3 times a week or taking up swimming may be all you have time, or the inclination for. More strenuous exercise at the gym could be undertaken with the help of a personal trainer.One area most ignored by women are pelvic floor exercises. These are some of the most important muscles to be strengthened. They endure a great deal of stress and possibly trauma during pregnancy and childbirth. This can result in long term weakness leading to bladder and bowel incontinence and prolapse over time.
    Whilst I routinely offer an assessment of the pelvic floor muscles in early pregnancy, I would recommend an assessment of your pelvic floor function prior to pregnancy. This would detect weaknesses or problems and options of management found to improve this.
  8. A healthy balanced diet is important. These days, many diets are fashionable. The simple measures of taking adequate protein, fats, carbohydrate and vitamins cannot be underestimated. Too often we have busy lives and it is not uncommon to rely on the availability of fast foods to sustain us. This should be minimised as much as possible. If in doubt, the help of a dietician can be useful.

The best source of information in pre pregnancy care would be your family doctor. However, where there are complex conditions, then I would be pleased to be able to provide advice as well.

These notes reflect my personal opinion and are intended for general advice only. It should not be used for any one individual case. You should consult your own doctor to determine the appropriate management of your own individual situation.