The thought of a new arrival in the family is always exciting. Couples and their families look forward to this joyous event and the birth of a baby is cause for celebration.
It is a known fact that a planned pregnancy is safer than an unplanned one. Despite this, four in ten pregnancies are unplanned.
So why does a pregnancy have to be planned, especially since it is not a disease? The wellbeing of the mother, both physical and mental affects the mother and baby, directly and indirectly during and after the pregnancy.
Here a few things you ought to do and know before you fall pregnant
Visit Your Doctor
“Pregnancy is not a disease so why should I see a doctor before I fall pregnant. After all, my mother and grandmother hardly saw doctors”.
True, pregnancy is not a disease, but optimal outcomes for the mother and the baby can only be achieved by taking the best possible care before, during and after the pregnancy.
Your doctor will take a detailed history regarding your health – present and past and any medical conditions that you may have. He or she will enquire about any diseases in both families and seek relevant details of your past pregnancies. The doctor will also discuss the medications that you are taking, vaccinations and supplements.
Medical and Hereditary Conditions
Some of the medical conditions that can affect a pregnancy are Hypothyroidism (problems with the thyroid gland), Epilepsy, Diabetes and Hypertension. It is important that pre-existing diseases are well controlled and tests are done to confirm that you are healthy. For e.g. If you conceive with uncontrolled diabetes the risk of the baby having a malformation or defect is three times more. If you are an epileptic there is a chance that your baby may be born with an abnormality due to the drugs you are taking and due to the disease itself. So your regular medication may need to be changed and you will need to take 5 mg of Folic Acid instead of 400mcg.
A detailed personal, family and past pregnancy history will help screen for hereditary and genetic conditions for which you and your partner may need genetic counselling. Screening for conditions like Beta Thalassemia Trait which is common in certain communities in India is also important.
Vitamins and Supplements
Folic Acid is a B vitamin which is vital for the healthy development of the baby’s nervous system. It helps prevent serious abnormalities of the brain and spinal cord such as Anencephaly and Spina bifida in about 70% of women who take it. This has to be taken as a daily supplement of 400 mcg for at least 3 months before you fall pregnant. If the pregnancy is unplanned, take it as soon as possible and continue till the 12th week of pregnancy.
You may also need Vitamin D supplementation, check with your doctor.
Diet and Exercise and Healthy Weight
Trying to change lifestyle habits is difficult for most people. However planning a pregnancy is a good motivator, since you will be doing this for the health of your baby as well as yourself.
Start by eating healthy. Include protein foods such as pulses, bean, nuts, chicken, meat, fish and eggs. Rice, cereals, pasta and potatoes make up the starch component in your diet. Aim to include at least 5 portions of fruits and vegetables daily. Dairy products such as milk, curd and paneer should form a part of your diet. Drink plenty of water and avoid carbonated drinks and processed products.
If you do not exercise regularly, this is the best time to start –for both you and your partner. Regular exercise will improve your health, reduce your risk of having gestational diabetes in the pregnancy, reduce stress, and help you cope better with the pregnancy and labour. Walking, swimming and yoga are recommended. Avoid contact sports and sports in which there is a risk of falling or losing your balance.
If you are overweight or obese, it may be a good idea to reduce your weight before you embark on a pregnancy. Being overweight or obese can increase your risk of high blood pressure, gestational diabetes and blood clots during pregnancy. It can also contribute to difficult vaginal deliveries as the baby may be big.
Most of the development of the baby takes place in the first three months of the pregnancy. Hence it is important to avoid all (including over the counter medication), except essential medication in this period.
If you are on regular medications for a medical condition, be sure to tell your doctor that you are planning a pregnancy. They may need to be modified. If you do fall pregnant unexpectedly, while on regular medication, do not stop the medication but talk to your doctor as soon as possible.
German measles or Rubella infection (this is a mild flu like infection with a rash)
in the first three months of the pregnancy can cause serious harm to the baby’s brain, heart, eyes and ears. Therefore it is important to have the Rubella blood test before pregnancy to determine whether you need the rubella vaccination. You should have this injection at least 1 month before you start trying for a pregnancy.
The other vaccinations to consider are Hepatitis B, Chicken Pox and Tdap (Tetanus, Diphtheria and Pertussis).
Of course stopping contraception would aid falling pregnant! Once you stop contraception your periods and fertility will return to normal. Sometimes your periods may be a bit irregular for a short time. If you fall pregnant soon after stopping contraception or while on it, there is no need to panic, as it will not harm the baby.
It would be best for you and the baby if you and your partner stopped smoking. Continuing to smoke pre pregnancy can reduce your fertility. Smoking during pregnancy can cause miscarriages, preterm birth, low birth weight and still birth. Babies whose parents smoke are at a higher risk of chest infections, cough and Sudden Infant Death syndrome.
Alcohol can damage sperm production and excessive drinking can lead to impotence. Prior to and during the pregnancy, the safest approach is not to drink at all. In an unplanned pregnancy women worry about binge drinking before conception. A single episode of binge drinking is unlikely to be harmful to the baby.
Psycho active substance use must be discontinued while trying for a pregnancy and throughout the pregnancy.
Pregnancy in itself is rather overwhelming. Not only because there are so many physical and hormonal changes, but also because there seems to be a complete emotional makeover. If you go through periods of anxiety and depression you need to talk to your doctor about this. If you are already on medication your doctor will tell you if it is safe to continue the same or change to a safer drug. Regular follow up with the counsellor or psychiatrist is recommended, especially during and after the pregnancy.
It is equally important for your partner to be healthy and follow healthful practices. Exercise, healthy diet, avoiding smoking, alcohol and drug abuse is a part of his commitment to the pregnancy.
After all he is going to be a parent as well!
You are Almost There
One last piece of advice: Remember:
30% of women will conceive within one month
75% will conceive within six months
80 – 90% will conceive within one year
10 – 20 % will take longer or may need help
So, please be patient and don’t rush to your doctor after trying for fifteen days!