Pregnancy planning

This does not mean rushing out to the nearest baby store. It means getting into shape medically before getting pregnant and it includes both you and your partner. You want your body to be in peak condition so that when you do get pregnant you give your child the best possible start.

Pre-conception check up

Your first step should be to take a trip, with your partner, to your doctor for a pre-conception visit. This will enable you to make sure that you are up to date with your regular health screenings and immunisations, to discuss any concerns about the pregnancy that you may have and to decide on any lifestyle changes that may need to be made. Your doctor will be able to get a good picture of your overall health and any aspects of your medical history and your family’s medical history that could affect your pregnancy. You should also be asked if you are taking any prescription or over-the-counter medications, as well as any herbs or supplements, as these may have to be altered before or after conception.

If you, as the prospective mother, have a pre-existing medical condition, such as diabetes, asthma, lupus or high blood pressure, it is important for both you and your baby to make sure that the condition is under control before you get pregnant. For instance, women with diabetes must ensure that they have excellent control of blood sugar levels around the time of conception as this reduces the chance of the baby having a congenital abnormality.

Contraceptive pill

If you are taking the contraceptive pill, but are planning to get pregnant in the near future, your doctor may recommend using a barrier method of contraception, such as a condom or a diaphragm, for a few months before trying to conceive. This will give your body the time it needs to re-establish your normal hormonal balance; it can take up to several months for your periods to return to a regular pattern.

Exercise

Get into the routine of doing some regular exercise: visit the gym, swim or go for long, brisk walks together with your partner. You will need to have a reasonable level of physical fitness to cope with the new demands that will be placed on your body during a pregnancy. If you are healthy, it should be safe for you to continue with your usual exercise programme when trying to conceive and into the early part of your pregnancy. If you are overweight, lose weight now, rather than after you become pregnant. Being overweight may reduce some women’s fertility.

Nutrition

It’s obvious that the food you will be eating when you are pregnant will be nourishing your growing baby, but recent research has shown just how crucial an adequate food supply is to your baby during its first few weeks of development — which means that you must establish healthy eating habits before getting pregnant. You should try to eat more vegetables, fruits, grains, dairy products and foods rich in protein, and fewer artificial sweeteners and ‘empty’ calories (foods and drinks that are high in calories but don't contain useful nutrients). It is important to ensure you get an adequate intake of calcium (from foods such as dairy products or tinned fish with bones e.g. sardines or salmon) and iron (from eating meat, pulses and grains).

Folate

Pregnant women need to increase their intake of dietary folate to cover their own needs and those of the baby. Folate is found in many fresh fruits and vegetables (especially green leafy vegetables such as broccoli and spinach), as well as nuts, chickpeas and dried beans. In addition to consuming food folate from a varied diet, it is also recommended that women begin taking a supplement of 0.4 mg per day of folic acid for one month before conceiving and during the first 3 months of pregnancy to reduce the risk of having a baby with a neural tube defect, such as spina bifida.

It is important to take folate while you are trying to get pregnant because the baby needs adequate amounts of folate in the first weeks of life — when you may not know you have conceived — for normal neurological development. If you are having trouble eating during the early stages of pregnancy due to morning sickness, your doctor may advise you to take a daily supplement containing 0.6 mg of folate.

Iodine

Keep your iodine levels up as well, as this will reduce the risk of thyroid disease in both you and your baby. Iodine is found in seafood, vegetables grown in iodine-rich soil, and iodised table salt. There is a risk of intellectual disability in children born to women who are iodine deficient.

Multivitamin and mineral supplements

It can sometimes be difficult to eat a balanced diet when you are pregnant, especially if you have morning sickness. Look for supplements that are specifically designed for women who are pregnant or trying to conceive, with adequate amounts of all the things you need and without too much vitamin A, as this may harm the baby. Also, consult your pharmacist about whether the formula design is adequate.

Vitamin and mineral supplements can help you get:

  • the essential nutrients you and your baby will need, including adequate amounts of folate and iodine (as mentioned above) as well as iron;
  • nutrients that can help reduce the risk of problems (for example calcium may help reduce the risk of a serious pregnancy-related condition called pre-eclampsia); and
  • other nutrients that may help your health and the baby’s growth and development.

Caffeine

Try to cut down on your caffeine intake as it is not certain what level of caffeine is considered safe during pregnancy. Some researchers have found a connection between high caffeine intake and miscarriage, stillbirth and low-weight birth in babies.

Alcohol

Most doctors also recommend that you totally avoid alcohol during a pregnancy because it is not possible to identify what level of drinking is safe for pregnant women. Prenatal exposure to alcohol can have serious long-term health consequences for your baby, including learning disabilities, intellectual disability, behavioural problems and slower growth. The risk of stillbirth and miscarriage is also increased by excessive drinking. Additionally, alcohol can reduce the fertility of both males and females.

Smoking

Put simply, there is no safe level of smoking during pregnancy. The more you smoke, the more risks for you and your baby. Smokers are less fertile than non-smokers, and have a higher incidence of miscarriage and stillbirth. Smoking while pregnant interferes with the baby’s blood supply, which tends to result in low birth weight babies and babies with developmental problems. Babies born to mothers who smoke also have a greater chance of Sudden Infant Death Syndrome (SIDS). Your partner should also kick the habit: exposure to second-hand tobacco smoke can increase the risk of problems such as SIDS and having a low birth weight baby.

Rubella (German measles) vaccination

This viral illness can severely affected the baby if the mother contracts it while she is pregnant. Among other things, it can cause blindness and severe intellectual disabilities. Fortunately, the disease can be prevented with a vaccine; unfortunately, the vaccine cannot be given if you are already pregnant. Most women will have been vaccinated as children or teenagers, however, their immunity may have waned by the time they are ready to start a family. Consequently, it is important to have a simple blood test before you become pregnant to find out whether you need a booster shot.

Other vaccinations

Pertussis (whooping cough) vaccination

Whooping cough is a infection of the respiratory tract caused by the bacterium Bordatella pertussis. It can cause serious illness and may even be fatal. Babies can be vulnerable to infection before their first scheduled vaccination at 2 months of age, so your doctor may recommend that adults who will be in frequent contact with the baby have a booster dose of the vaccine. It is best for the mother to be vaccinated before conceiving (as the vaccine should not be giving in pregnancy) or as soon as possible after the baby is born.

Influenza vaccination

Experts recommend that influenza vaccine be offered to women planning a pregnancy, and to pregnant women who will be in their second or third trimester during the influenza season, including those in the first trimester at the time of vaccination.

Varicella (chickenpox) vaccination

Women who contract chickenpox for the first time in pregnancy are at risk of passing it on to their unborn child where it can have very serious effects. A simple blood test can tell if you are immune to chickenpox, and if not, vaccination before conception is advised. The vaccine should not be given during pregnancy, and women should avoid becoming pregnant for 28 days following vaccination.

Last Reviewed: 8 July 2009
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References

1. The Australian Immunisation Handbook. 9th edition. 3.24 Varicella.
2. The Australian Immunisation Handbook. 9th edition. 2.3. Groups with special vaccination requirements.
3. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. New College Statement: Vitamin and Mineral supplementation in pregnancy. July 2008
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