Pregnancy Planning

Planning to become pregnant?

If you’re planning to have a baby it is advisable to be well informed and prepared to provide the best care for yourself and your baby. Most pregnancies invariably go smoothly. Commonsense and scientific evidence tell us a healthy body is the best environment to achieve implantation of the fetus and carry it to term.

Getting pregnant

Most normal, fertile couples achieve a pregnancy within the first 12 months of trying. It can take up to 6 months after stopping the contraceptive pill for ovulation to resume. Women over 35 or who smoke can take twice as long to conceive. Intercourse 3 to 4 times a week at ovulation time maximizes the chances of contraception

Nutrition

It is important to have a well-balanced and nutritionally sound diet. Women should aim for an ideal weight before conception. A high-fibre, low –fat diet is the basis of good health. Eat freshly cooked or freshly prepared food. Drink lots of water.

Folic acid before pregnancy

Folic acid reduces the risk of having a baby with a neural tube defect such as spina bifida. Those at high risk include those with a family history, diabetes or on anti-epileptic medication, but folic acid supplements are advisable for all pregnancy women. Those at risk should take 5 mg daily at least one month before pregnancy and ideally for 12 weeks. All other women should have 0.5 mg tablets daily 12 weeks before conception for 3 months after.

Exercise

Sensible, regular, non-contact exercise is important. Avoid high-level exercise and getting overheated.

Serious Infections

Most conceptions have ideal outcomes but the fetus can be affected by certain infections,especially in the early stages of pregnancy, so it is wise to try to reduce the risk of contacting these infections while trying to become pregnant and throughout the pregnancy.

These infections include rubella, varicella, hepatitits B, syphilis, toxoplasmosis, listeria,cytomegalovirus and HIV. It is advisable to have blood test for rubella, varicella, syphilis, hepatitis B and HIV.

Vaccination

Rubella aquired in utero is a big concern. Most women these days have been vaccinated and are probably immune but this immunity can wear off.

It is advisable to be tested before becoming pregnant and given the vaccine if not immune. It is also advisable not to become pregnant within 3 months of being vaccinated.

Listeria and Toxoplasmosis

These infections, which are potentially fatal to the fetus, are caused by organism present in contaminated food, either uncooked or undercooked. Infected cats can transmit toxoplasmosis. If contracted during pregnancy, it has a high fetal death rate (30% to 50%)

To prevent listeria infection avoid unprocessed foods such as unpasteurized milk, soft cheese, cold processed meats, raw seafood and smoked seafood. Also carefully wash raw vegetables, thoroughly cook all food of animal origin, reheat leftover foods and ready-to-eat food until steaming hot and always thoroughly clean utensils after preparing uncooked food.

To avoid toxoplasmosis, pregnant women should get another person to clean cat litter boxes daily, wear disposable rubber gloves for handling soil likely to be contaminated with cat’s faeces and carefully wash hands after gardening or handling raw meat.

Smoking, alcohol and other drugs

You should not smoke during pregnancy and ideally quit 3 months before conception. Avoid exposure to passive smoke and get a smoking partner to cooperate.

The National Research Council advises against drinking alcohol before and during pregnancy. Alcohol and other social drugs especially amphetamines, can cause deformities in the child. Stop other recreational drugs and discuss over-the-counter drugs with your doctor. Caffeine intake should be reduced.

Genetic counseling

Genetic or development disorders need to be considered if there is a past obstetric history, a family history or advanced maternal age (generally considered over 35)

Genetic disorders include thalassaemia, cystic fibrosis, haemophilia, Down syndrome and Tay-Sachs disorder. Your doctor will advise about testing of yourself and your partner.

Blood Group

It is a good idea to know the blood groups of both sex partners so the Rhesus factor is known. A negative blood group in the female combined with positive group in the male partner requires careful attention.

Checkpoint Summary

• Stop smoking, alcohol & other social drugs
• Reduce or stop caffeine intake
• Review current medications
• Follow a healthy diet rich in iron & calcium
• Take Folic acid for 12 weeks before conception
• Have a good exercise routine
• Ensure Rubella, varicella & hepatitis B immunity
• Consider genetic & family history
• Consider health insurance cover

" References = MURTAGH's Patient Education 5th Edition"