So you are trying to conceive a baby. Now is the time for you and your partner to take a really good look at your lifestyle and perhaps make a few changes so your body is in tip-top condition to conceive and sustain a healthy pregnancy.
Not all pregnancies are planned, so some women can only start to monitor their health in relation to their baby once they are already pregnant. However, for couples who plan their pregnancies, preconception care can help them to make the necessary changes in advance.
Now is the time to assess your lifestyle. General health, poor diet, lack of exercise and other factors, such as smoking or drug use, can cause harm to an unborn baby.
Although preconception care focuses mainly on the mother's health, there are also changes that the father can make.
It is also important when trying to conceive to ensure that any long-lasting health problems that you have are controlled as effectively possible before you become pregnant. Chronic (long term) health problems, such as diabetes, asthma and epilepsy, can cause an increased risk of many complications for both mother and baby during pregnancy and labour.
It's also a time to note any other genetically inherited conditions (those that are passed on from the parents). Couples with a high risk of having a baby with a genetic condition should be given support and advice.
How long will it take me to become pregnant?
The time it takes to conceive will vary drastically from couple to couple, but on average, for every 100 couples who have sex two to three times a week:
• around 30 will conceive within one month,
• around 60 will conceive within six months, and
• around 85 will conceive within one year.
The remaining couples take longer, and some may need medical help to conceive. A small number of couples may not be able to conceive at all if one, or both, of them is infertile.
What about previous contraception methods? Will they affect my chances of conceiving?
The type of contraception you have been using does not usually have an effect on your ability to conceive, or how long it takes. However, women who have been having the progestogen-only injection may find that their normal fertility is delayed and that they cannot conceive for up to a year after their last injection.
What if I have already suffered a miscarriage?
Women who have suffered miscarriage often go on to have a healthy pregnancy and baby. If you have had three or more miscarriages consecutively, you should see your GP who can refer you to a gynaecologist. They will be able to investigate whether or not your miscarriages are being caused by an underlying health problem.
Take care of yourself
It's important to make sure your pregnancy goes as smoothly as possible, and to ensure your baby is as healthy as possible, so make sure you take good care of yourself by following these guidelines:-
Alcohol
Despite all the media and medical advice surrounding alcohol and pregnancy, it is probably best to avoid drinking alcohol completely if you are planning a pregnancy, and also during pregnancy. If you are trying to conceive, you may be unaware that you are pregnant until several weeks into the pregnancy, so you should stop drinking alcohol before any damage can be done. Drinking alcohol while pregnant can be harmful to your unborn baby, and binge drinking in early pregnancy may be particularly harmful. Heavy drinking during pregnancy is associated with low birth weight and many other serious birth defects, such as heart problems and delayed development.
If you really feel you would like a drink alcohol while you are pregnant, limit your intake to no more than one to two units, once or twice a week in order to minimise the risk to your baby. You should never get drunk while pregnant.
Your body weight
Latest findings now suggest that women who are overweight or obese are more likely to need a Caesarean section, and are at higher risk of having a premature or still born baby.
Overweight or obese women also have a higher risk of developing pre-eclampsia, a condition in which pregnant women develop high blood pressure, as well as protein in their urine and fluid retention. Pre-eclampsia is usually mild but, in rare cases, it can cause serious harm to the mother and growth problems in the unborn baby.
If you are overweight or obese, before trying to become pregnant, it is best to get as close to your ideal weight as you can. You are considered to be overweight if you have a body mass index (BMI) of between 25 and 29.9, and you are considered to be obese if your BMI is 30 or more.
Folic acid
Taking folic acid supplements before and during pregnancy can reduce the risk of your baby being born with a neural tube defect (NTD). Folic acid supplements are available from pharmacies. Neural tube defects, such as such as spina bifida, affect the growth of your baby's brain and spinal cord, so that they do not develop properly.
You should take 0.4mg of folic acid daily if you are trying to conceive, and you should continue this until your 12th week of pregnancy, while your baby's spine develops. However, you have a higher risk of having a baby affected by an NTD, if:
- either you, or your partner, has an NTD,
- you have had a previous pregnancy affected by an NTD,
- you have coeliac disease (a condition caused by a sensitivity to gluten),
- you are diabetic, or
- you are taking antiepileptic medication.
If any of the above applies to you, you will need to take a higher dose of folic acid to help your baby's spine develop properly. You should take 5mg of folic acid daily before you conceive, and until the 12th week of your pregnancy.
If you have sickle-cell anaemia (where your red blood cells are unable to carry oxygen around your body properly) you should already be taking 5mg of folic acid daily as part of your treatment. It is important that you keep this up throughout your pregnancy.
Fish
Latest research now tells us to limit certain fish in our diet - swordfish, shark and marlin. It is also advisable to limit how much tuna fish you eat to two tuna steaks or four medium-size cans of tuna per week.
This is because these types of fish contain high levels of mercury, which can potentially harm a baby's developing nervous system.
If you need to relieve mild pain while you are trying to conceive, paracetamol is recommended as long as you take the lowest possible effective dose. You should only take ibuprofen while you are trying to conceive if it is recommended by a health professional.
Mum-to-be vaccinations and screening tests
As well as playing close attention to your diet and lifestyle, you also need to make sure that you are up-to-date with vaccinations, such as rubella and varicllea.
Advice for men
Men are advised to cut down on drinking alcohol and smoking because they have been shown to decrease the quality of sperm, and the chances of their partner conceiving. Some doctors suggest that wearing loose underwear helps sperm production by providing a cooler environment.
Risks of smoking
Smoking while pregnant can cause numerous health problems for your unborn baby, including an increased risk of miscarriage, early birth, and a reduced birth weight. There is also evidence that women who smoke while they are pregnant are more likely to have babies that die of sudden infant death syndrome (SIDs or cot death).
If you want to have a baby and you smoke, it is very important that you stop smoking before you become pregnant. Do not wait until you conceive because you may not know that you are pregnant until you are several weeks into the pregnancy and, by smoking, you will have already harmed your baby.
Research has shown that women who manage to stop smoking before they become pregnant are less likely to start the habit again. If you find it difficult to stop smoking, or you are already pregnant and still smoking, see your GP. They will be able to refer you to a smoking cessation service, who can advise you on the best ways to quit.
Risks of having a baby with an inherited disorder
However hard you try to cut down on your own risks, some health problems and conditions are inherited.
Inherited disorders such as sickle-cell anaemia, in which red blood cells cannot carry oxygen around your body properly, and cystic fibrosis, which stops the lungs and digestive system from working effectively. Another example of an inherited condition is Huntingdon's disease, which causes the brain to gradually deteriorate.
If you want to become pregnant, you should be offered screening for blood conditions to find out if you carry any blood diseases that could be passed on to your baby. Your GP will take a blood sample and you will need to fill out a family of origin questionnaire, which identifies people from high-risk populations.
Couples with a personal or family history of an inherited genetic condition, or those who have had a previously affected pregnancy, can be referred for genetic screening and counselling. This should ideally be done before you become pregnant, so it is important to see your GP before you begin trying to conceive.
Risks for older women
A woman's risk of having a baby with a chromosomal condition, such as Down's syndrome, increases as she becomes older. If you are 35-40 years of age, your chances of having a baby with Down's syndrome are around one in 270, compared with one in 1,500 if you are aged 20-30, and one in 50 if you are aged over 45.
There are no tests to can show whether or not you will have a baby with a chromosomal condition before you become pregnant. However, modern antenatal testing can be done during your pregnancy and can estimate the likelihood of your baby being affected. This may be carried out using an alpha-fetoprotein test, which measures the levels of alpha-fetoprotein (AFP) in your blood. If your AFP levels are low, it could indicate that your baby has Down's syndrome.
If you have a particularly high risk of having a baby affected by a chromosomal condition, or you have had an AFP test which shows that your levels of AFP are low, you may be able to have a diagnostic test that can definitely show whether or not your baby has a chromosomal condition.
Diagnostic testing can be carried out using amniocentesis, chorionic villus sampling (CVS), or by testing a sample of your baby's blood, which is collected from a vein in the umbilical cord using a thin needle passed through your abdomen.
Amniocentesis testing and chorionic villus sampling (CVS) are carried out in the same way, but amniocentesis takes samples of amniotic fluid (the fluid that surrounds and protects your baby in the womb), and CVS takes a sample of placenta, for testing.
These tests carry a small risk of harming your baby, but this is very rare and only occurs in less than 1% of cases.
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Tagged: Planning a Baby
