Pre Conception Advice:
So you have decided that you want to try for a baby. In an ideal world all pregnancies would be planned to ensure that the mother and the father were in the best health before embarking on a pregnancy. Your chances of becoming pregnant and having a healthy pregnancy and baby are better if you and your partner are as fit and healthy as possible. What you eat, how much you exercise, and whether you smoke or drink alcohol are all-important factors to look at once you have decided to try for a baby.
Before you get pregnant:Before you try for a baby there are some things to consider that can help improve your chances of getting pregnant and having a healthy pregnancy. If you are planning to get pregnant, talk to your doctor, nurse or midwife – they will be able to advise you on pre-pregnancy and pregnancy health care.
Medical conditions:You can talk to your doctor about how your pregnancy might be affected if:
- You have a medical condition, such as diabetes or epilepsy
- You have a history of heart or circulatory problems, such as high blood pressure or thrombosis (blood clot in your leg, lung or brain)
- You or your partner have any hereditary conditions in the family, such as sickle cell anaemia, thalassaemia, cystic fibrosis or muscular dystrophy
- You have suffered from gynaecological problems, such as endometriosis, polycystic ovary syndrome (PCOS), or previous ectopic pregnancy (when the fertilised egg implants outside the womb, often in the fallopian tube).
If you or your partner have any disabilities, which may make it harder for you to get pregnant, you may need specialist help, and your doctor will be able to refer you to a specialist. If you have a disability and become pregnant, it is important that you speak to your doctor as soon as possible.
Medicines and drugs:
If you take medicines for any reason it is important to tell your doctor that you are planning to get pregnant, as some drugs may affect the developing baby. Don’t stop any medication you are taking for a medical condition until you talk with your doctor, as this may affect your health.
If you buy any medicines from the pharmacy, always check with the pharmacist to see if these are safe to take while trying for a baby or when pregnant. Avoid any treatment which is not essential. You should also check that any herbal or alternative remedies or complementary therapies are safe to use during pregnancy, or while trying to get pregnant. Ask your doctor, nurse, midwife or pharmacist.
Recreational (illegal) drugs, also known as street drugs, can affect the developing baby. Avoid taking them when you are trying to get pregnant or once you are pregnant. Your partner should avoid using them too as they can harm sperm.
Smoking and Alcohol:It is very important to stop smoking and limit your alcohol intake if you are planning a pregnancy. This will increase your chance of falling pregnant and will prevent your baby being harmed by either of these substances.
Weight:Being significantly over or underweight can reduce your chances of falling pregnant. There are also increased risks of developing certain medical conditions if you are obese during pregnancy (see section on ‘Pregnant or trying to get pregnant’ for more information). The best way to minimise these risks is to lose weight before you fall pregnant.
Sexual Health:If either you or your partner thinks you might have a sexually transmitted infection, or be at risk of getting an infection, you can get confidential advice and help from the Sexual Health Services, the Genitourinary Medicine (GUM) Clinic or your general practice. Some sexually transmitted infections can affect your chances of getting pregnant, and if not treated they can be passed on to your baby during pregnancy or birth.
Rubella:It is very important to have a German measles (rubella) test before you try to get pregnant, as infection when you are pregnant can harm your baby, particularly in the first 12 weeks of pregnancy. Rubella infection can seriously damage the baby’s heart, eyes and ears. If you have had a German measles vaccination, or the infection itself, you will probably be immune (protected against the infection) for life, but it is important to check before you become pregnant. Your doctor can do this with a blood test. If you are not immune, your doctor or nurse will give you a vaccination injection. You should have this injection at least one month before you start trying to get pregnant.
Stopping contraception:Once you decide to plan a pregnancy, you will need to think about stopping the contraception you have been using. Many women worry that some methods of contraception, such as the pill, injection or IUD, will make it difficult to get pregnant when they stop using them. No method of contraception causes infertility. You can get confidential advice and help from the Sexual Health Services or your general practice.
When you stop using contraception your periods and normal level of fertility will return, usually very quickly. Sometimes ovulation (releasing an egg) can be delayed or be irregular for a short time after stopping hormonal contraception. If you use the contraceptive injection, your periods and natural fertility will take longer to return than after other methods of contraception. Don’t worry if you get pregnant very soon after stopping hormonal contraception, this will not harm the baby.
Eating healthily:Think about what you eat. Eating a variety of foods, with as much fresh food as possible, helps to ensure that you get all the vitamins and minerals you need. A healthy diet is made up of:
- Starchy foods, such as potatoes, sweet potatoes, bread, pasta, rice and cereals
- At least five portions of fruit and vegetables a day (these can be fresh, dried, frozen, tinned or juice)
- Protein foods, such as meat, beans, chicken, eggs, pulses (for example, lentils), and nuts (see Foods to avoid for advice on peanuts)
- Dairy foods, such as milk, yoghurt and cheese (see Foods to avoid for advice on cheese)
- Fish (see Foods to avoid for advice on fish).
Folic acid and Vitamin D:
Medical advice for all women planning a pregnancy is to take a daily supplement of folic acid. You should take 400 micrograms of folic acid from the time you stop contraception, or as soon as you find out you are pregnant, until week 12 of pregnancy.
Folic acid is a member of the vitamin B family and is needed for a baby’s development in the early weeks of pregnancy. It helps to prevent serious abnormalities of the brain and nerves (such as spina bifida).
If you have had a previous pregnancy affected by spina bifida, or you or your partner have a neural tube defect, or you suffer from epilepsy, diabetes or coeliac disease, you should take a higher dose of folic acid. You should also take a higher dose if you are significantly overweight (BMI 30 or above). You should see your doctor to discuss this and get a prescription for the appropriate dose of folic acid.
As well as taking a supplement, you can eat foods that contain folic acid, such as green leafy vegetables, and breads and cereals with folic acid added to them.
It is also recommended you take 10 micrograms of vitamin D every day throughout your pregnancy and continue to do so following delivery if you are breast feeding.
Vitamin D is needed to keep your bones and teeth healthy. It also regulates the amount of calcium and phosphate in your body. If children do not have enough vitamin D it can cause their bones to soften and can result in bone deformities and affect bone development in children, known as rickets.
You can get supplements from pharmacies and supermarkets, or your GP may be able to prescribe them for you. If you want to get your folic acid or vitamin D from a multivitamin tablet, make sure that the tablet does not contain vitamin A (or retinol).
Pre-Conception traffic light - get ready for a healthy pregnancy:
What do you know about preconception health - mini quiz: