Planning for Pregnancy
Pregnancy can be a nerve-racking time but preparing for it well can go a long way to calm any anxiety and give you the best chance of a healthy pregnancy and baby. The earlier the preparation the better, ideally concentrating your efforts on being fit and healthy at least three to six months before conception.
A healthy diet
A well-balanced diet is key to any person's health, but it is especially vital before and during pregnancy. Aim to start this diet at least four months before you begin trying to conceive.
Choose a diet that includes good portions from different food groups. This involves eating plenty of different types of vegetables and fruit, as well as whole grains and cereals, food high in calcium, and protein-rich food such as lean meat, fish, eggs, nuts, legumes and dairy products.
As with most diets, fresh, unprocessed food is much better than processed foods that are higher in unhealthy additives such as sugar and salt.
A healthy, well-balanced diet is recommended before, during and after pregnancy. Some women will need specific supplements as well.
All women should take at least 0.5 milligrams (mg) of folic acid for at least the month before a planned pregnancy, and for the first 12 weeks of their pregnancy, to lower the risk of neural tube defects and spina bifida (incomplete development of the baby’s brain, spine or spinal cord).
Women that have an increased risk of neural tube defects should take a 5mg daily dose of folic acid. A 5mg dose of folic acid is important for women who:
Take anticonvulsant (epilepsy) medication,
Have poor food absorption
Who have had a previous pregnancy or a member of their (or their partner's) family affected by a neural tube defect.
A healthy exercise program improves fertility, particularly for people who are overweight or obese. 30 minutes or more of moderate intensity exercise, such as walking, swimming or yoga, is recommended on most days of the week. Working out with your partner can be beneficial for both of you. Exercise should be continued into your pregnancy, unless you have been instructed otherwise.
Having a healthy weight is important during pregnancy as women who are underweight or overweight have a higher risk of problems during pregnancy and delivery. The more a women is overweight or underweight, the larger the risk of problems.
Being overweight (a BMI above 25) or obese (a BMI over 30) can reduce fertility and may increase the risk of miscarriage and other serious problems for the baby. These risks include diabetes, pre-eclampsia (high blood pressure), excessive bleeding and developing blood clots. Delivery complications such as higher anaesthetic risks and greater likelihood of requiring a caesarean section are associated with carrying too much weight.
Women who are very underweight may have reduced fertility, and may deliver underweight and under-nourished babies.
Due to the significant benefit to the mother and her future baby, it is recommended that steps such as diet changes and exercise should be taken to lose weight in a healthy and sustainable manner. We advise obese women to not try for pregnancy until steps have been taken to reduce weight.
It is vital to be aware of any long-term medical problems that may impact pregnancy and discuss how to manage them with your doctor prior to conception. These conditions shouldn't prevent a smooth pregnancy and a healthy baby, but certain health conditions need to be monitored in order to minimise risks. For example, for women with diabetes, better blood sugar control lowers the risk of harm to the baby during the first three months of pregnancy.
Check your medication
All current medications should be reviewed for their impact on pregnancy and some medicine may need to be changed, including over-the-counter medications. Discuss this process with your doctors and consult them before stopping long-term medication abruptly.
A healthy environment
You can't control all environmental factors but you should check and reduce the risk of exposure to toxins, infections or radiation for both you and your partner in the household or during recreational activities. Some jobs, such as those that regularly expose you to chemicals or radiation, can be hazardous to you and your unborn child.
Travelling abroad may expose women and their partners to infections or diseases that are not present in their home country and could negatively affect their pregnancy. Research travel destinations and seek specific medical advice if you are concerned that you are travelling to a high-risk area.
Smoking cigarettes affects the quality of a woman’s eggs, tends to lower oestrogen levels and reduces the number of reserve healthy eggs. Smoking can also weaken the quality of sperm and reduce a man's sperm count. Even secondhand smoke may negatively affect your ability to get pregnant.
Smoking during pregnancy can harm the placenta, which plays a vital part in the baby’s nourishment and ability to remove waste. Smoking may restrict the growth of the baby in the mother’s womb as the placenta cannot function effectively. This increases the risk of health issues, such as childhood obesity and diseases in later adult life.
Babies of mothers who smoke are at risk of problems both before and after birth. It is important to stop smoking before trying for pregnancy. Seek help from your doctor to quit.
Alcohol reduces fertility in men and women and can harm the developing baby. The safest option for women who are pregnant or planning a pregnancy is to not drink alcohol at all.
Any additional chemicals from illegal drugs can severely damage the delicately-balanced processes of fertilisation and a baby's early development. There are no safe levels of drug taking for a mother or baby and help should be sought to quit.
Consulting a doctor before trying for a baby is important. This allows your doctor to make sure that:
Any existing medical condition is well controlled
You are up to date with appropriate vaccinations, such as vaccines for German Measles (Rubella) and chickenpox. These infections can cause serious harm to the baby if they occur during pregnancy. Women should be vaccinated a minimum of four weeks prior to becoming pregnant, which means using a reliable method of contraception.
You have a blood pressure check and general examination and, where appropriate, breast examination and a cervical smear.
If there is a significant risk of a chromosomal or genetic condition based on you or your partner’s family history or ethnic background, then pre-pregnancy genetic testing and counselling is advised. This is especially important for inherited diseases such as Sickle Cell Disease (SCD), Cystic Fibrosis, Muscular Dystrophy, and Thalassemia.
A review of the outcomes of any previous pregnancies (e.g. pregnancy loss, children born with health problems, mother having gestational diabetes) is beneficial to determine whether there are any measures which could reduce the likelihood of recurrence.
Men's health is vital for their wellbing as future fathers. Obesity, cigarette smoking, excessive alcohol use, certain medications, illicit drug use and a poor diet all may affect a man’s fertility and pregnancy outcomes. A healthy lifestyle with regular exercise and a balanced diet, highlighted above, are just as crucial for men.