Preparing for pregnancy

If you’re thinking about having a baby, it’s best to get your body in tip-top working order so it’s fully prepared for pregnancy. The following advice will help get you on the road to parenthood

If you are hoping to become pregnant there are a few things you can and should do to improve your general health and so help your pregnancy to progress smoothly. Most pregnancies are not planned, however, and still progress normally, resulting in a healthy mother and baby.

Get physically fit

Generally speaking, women who are physically fit have easier pregnancies and births. Pregnancy places a lot of physiological demands on your body because ligaments become soft and loosen under the influence of pregnancy hormones. (This looseness accounts for many of the aches and pains associated with later pregnancy.) Since you should not start a demanding new fitness programme once you are pregnant, the time to act is before conception. Getting ready to have a baby is as good a reason as any to make healthy lifestyle changes.

Watch your weight

You should try not to be too overweight when you conceive for three reasons. Firstly, women who are markedly overweight when they conceive are at increased risk of developing diabetes during pregnancy.

Secondly, the extra weight gained during pregnancy is difficult enough to lose after birth without having even more to worry about. Thirdly, if you are very overweight, it will be more difficult for your carers to scan and feel the baby to check its progress.

Take folic acid supplements

In terms of specifics, folic acid supplementation is the only factor in a woman’s diet that has been shown conclusively to improve a baby’s chances of being born healthy. It is particularly important for women who have previously had a baby with a neural tube defect such as spina bifida, or anencephaly. If you fall into this category, you should begin supplementation (4 mg/day) two months before conception and continue taking it for the first twelve weeks of pregnancy. This will not eliminate the risk, but will reduce the chance of recurrence by more than two-thirds. For women who have not previously had an affected baby, there is good evidence that a multivitamin preparation containing a much lower dose of folic acid (0.4 mg/day) protects against neural tube defects and indeed all other congenital malformations apart from cleft lip and/or palate. If you didn’t know about these supplements before getting pregnant, or forget to take them, don’t worry. Only a small percentage of women actually take supplements before pregnancy and the vast majority have no problems. Spina bifida is a rare occurrence, even without pre-pregnancy folic acid and multivitamin supplementation.

Don’t smoke

You should not smoke before, during or after pregnancy. Smoking is directly harmful to your own health, causing lung cancer and other chronic respiratory conditions like emphysema and bronchitis. It also predisposes you to other types of cancer, such as cancer of the cervix. Smoking affects your and your partner’s fertility adversely and thus can make conception more difficult. Once you are pregnant, smoking reduces both food and oxygen supply to your baby, so give up now.

Finally, smoking may result in the premature birth of your baby and low birth weight. Your partner should also refrain from smoking. Smoking affects sperm viability and passive smoking can be harmful to you.

Don’t drink too much

Heavy drinking can reduce male sperm count; prolonged excessive drinking can harm a developing foetus. Both of you should moderate your alcoholic intake when trying to get pregnant. Don’t worry if you have been drinking moderately in the early stages of pregnancy, as it appears that you would need to be drinking heavily throughout pregnancy to harm your baby.

Check your medication

Certain drugs prescribed for particular illnesses or ongoing conditions may be associated with or directly cause abnormality in a developing foetus, for example, retinoic acid (Roaccutane) or tetracycline antibiotics for skin acne. If you are taking medication, it is wise to check with the prescribing physician or obstetrician regarding their continued use while you are trying to conceive and during pregnancy. It may be that the dosage or type of medication needs alteration before pregnancy. Some drugs may even act as incidental contraceptives. Never stop taking any medication without consulting your doctor first. Medication taken for the control of epilepsy is particularly important.

Ensure you are immune to rubella

If you are contemplating pregnancy you should ensure that you are immune to rubella (German measles) because contracting this disease during pregnancy, particularly in the early stages, may cause significant damage to the developing foetus. The risk to the baby appears to reduce sharply after 16 weeks of pregnancy. In most Western societies, immunisation is offered to all schoolchildren and congenital rubella is extremely rare as a result. However, immunity may disappear later, so it is best to check your immunity before trying for a baby. All pregnant women are routinely tested for rubella and if found not to be immune are offered immunisation immediately following pregnancy, before they conceive again.

Find out if you have had chickenpox

Try to find out before you get pregnant whether or not you have had chickenpox because it has the potential to harm the baby in early pregnancy. A routine blood test will show if you have had the disease; in that case your baby will be completely protected. If you have not had chickenpox you should avoid children with the disease while you are trying to get pregnant and for the first 12–14 weeks of pregnancy.

Have a cervical/pap smear

Every woman who is sexually active should have a cervical smear at least every three years. More frequent reviews may be required if there has been an abnormality in the past. If you have not had a cervical smear in the last two years, you should have one before embarking on pregnancy. Smear abnormalities are generally easily treated on an outpatient basis, but may deteriorate if left untreated for a long time. A mildly abnormal smear can safely be reviewed after your pregnancy. Since treatment is more complicated during pregnancy and so is better avoided, it is best to confirm a normal smear before becoming pregnant.

Midwife Maggie Evans offers the following diet advice to women who are preparing their bodies for pregnancy.

Ideally, it is best to consider an overhaul of your diet at least three to four months before you plan to have a baby, so that you and your partner are in tip-top condition to produce a healthy offspring. A poor diet during pregnancy is linked to low birth weight babies – although these babies are born around their due date, their growth is stunted and they may be more susceptible to heart disease, high blood pressure and diabetes in adult life. Poor nutrition is also linked to recurrent miscarriage, infertility and birth defects. Equally important, nutrition affects the development of your baby’s brain, especially during the last three months, so eating healthily all the way through your pregnancy is crucial.

Understanding what constitutes a healthy diet is rather like putting fuel in your car – you need to ensure it is the right kind to get maximum performance.

Balanced diet

Generally, you need to include foods from the major food groups – proteins, fats and carbohydrates. Stick to the recommended five a day portions of fruit and vegetables – if you can manage more that is excellent. Even a glass of fruit juice or some vegetable soup can help to boost your intake. You should aim to eat 2-3 portions of protein food per day from meat or vegetable sources. Vegetarians should combine a variety of vegetable sources of protein to ensure a full complement of essential amino acids necessary for health eg. nuts, seeds, pulses, rice, whole-grains or try quinoa which looks like a grain but is actually a seed containing all the essential amino acids. Make sure you drink plenty of plain, unsweetened water per day..

Foods to avoid

Some foods are best avoided during pregnancy as they may pass on an infection to your baby or cause abnormalities. These are: unpasteurized milk and cheese; blue-veined and ripened soft cheeses; pâté, liver and mayonnaise made with raw eggs. Steer clear of highly refined and processed food – they usually contain large amounts of salt, sugar, trans-fats plus artificial flavourings and preservatives, some of which have been linked to infertility and birth defects. Sugar has no nutritional value and only results in a see-saw effect on blood sugar levels leaving you feeling drained and exhausted. The effect of a small amount of alcohol on a developing baby is unknown, so is best avoided in pregnancy; some studies show a detrimental effect from caffeine too, so try to limit your coffee/tea intake.

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