Planning for pregnancy
Time to think about having a baby? Financial constraints, health, career and lifestyle choices and sheer timing can all impact on when or whether you decide to start a family, writes Susanna Nelson.
Health for two
You should approach your pregnancy like an athlete approaches a big race – build your health and stamina knowing that when you’re in the thick of it, it’s going to be challenging and exhausting at times.
The first thing to do is to talk to your GP about your plans, and get a full check-up including a Pap smear. Find out if any medications you are on might affect your pregnancy or your ability to conceive – and get your partner to do the same.
This is a good time to discuss your family medical history and any concerns you might have. Your GP will also be able to tell you which vaccinations you’ve had, and which you will need.
Some essential vaccines, such as the rubella (or German measles) vaccine, can be dangerous to pregnant women and need to be given some months before you get pregnant. Other vaccines have additives, which you may not want to be sharing with your unborn child.
Things to avoid
It is crucial to stop smoking, drinking and taking any social drugs at this time. There is no safe level of alcohol consumption in pregnancy and alcohol can cause intellectual impairment and disability in your child. Smoking is unhealthy whether you’re pregnant or not (no surprises here), but it affects your chances of being able to conceive, and during pregnancy and beyond can result in low birth weight, an increased risk of miscarriage and stillbirth and sudden infant death syndrome (SIDS).
Caffeine consumption should be moderate, and it pays to look into some of the other dietary research related to pregnancy – particularly regarding listeria, toxoplasmosis and other increased risks.
Boost your vitamin intake
Certain vitamins and nutrients become very important in pregnancy – for example, folate, iodine, iron and vitamin D. Folate in particular is known to be protective against the foetus developing spina bifida and other neural tube defects.
It can be difficult to get a sufficient level of folate from your diet, so you should start taking a supplement around three months before you plan to conceive and continue with it until the end of the first trimester, during which the spinal chord and brain develop.
Vitamin D, which comes from exposure to sunlight, is very important in the absorption of calcium. Pregnant women have an increased need for this vitamin, as well as for iodine and iron, because of the needs of the developing foetus. If you feel that your diet and lifestyle will provide insufficient quantities of these and other vitamins, speak to your GP about taking supplements.
Finally, get fit and stay healthy in the lead up to a pregnancy. While exciting, the nine months of pregnancy can take a toll on your mental and physical health. Drink lots of water and eat a balanced diet – try to keep your weight in the healthy range for your height, because both underweight and obesity can be causes for fertility problems.
“One of the most important messages to get across to couples in pre-pregnancy planning is an understanding of the importance of the diet and level of wellbeing of both parents at the time of conception,” says GP and AMA Victoria spokesperson for maternal and child health Dr Lorraine Baker.
“This is instrumental in determining the health of the foetus and then their child. Factors such as obesity and diabetes are relevant at conception.
“If parents have the opportunity to plan a pregnancy, optimising their own health is of paramount importance and that includes things like regular exercise, balanced meals, a healthy weight, and certainly for the woman optimising her folate intake and consumption of certain other vitamins.
“In an ideal world we’d all be living healthy lives the whole time. But as soon as a couple start the conversation about when they will be having a baby, they should start paying attention to their own personal health and wellbeing.”
Getting pregnant successfully is all about timing. For some months before you intend to get pregnant, it’s important to chart your menstrual cycle. Some women are well aware of the pattern of their cycle, either because it is regular or because they’ve paid attention.
Your cycle starts on the first day of your period and ends the day before your next period – the average cycle is 28 days, but varies from individual to individual. Some women have regular 35 day cycles, some much shorter.
The length of your cycle becomes very important when you are planning to conceive, because at some point in the middle of that cycle, you will ovulate – and the days immediately preceding and following the day of ovulation are your most fertile days.
Ovulation takes place roughly 14 to 16 days before the first day of your next period, regardless of the length of your cycle. If your cycle length is 21 days, ovulation will probably occur at day seven – if your cycle length is 35 days, it may occur at day 21. Of course this only works if you have a clockwork cycle.
A more accurate way of predicting ovulation is the Billings method, where a woman analyses the consistency of cervical mucus at various times of the month. When ovulation occurs, the mucus is of a certain consistency, known as the ‘egg white’ consistency, and this is the most fertile time of the month. Ask your GP for more information on this method.
What about my career?
It is important to examine your contract and know your entitlements – particularly given the introduction of the Federal Government’s paid maternity leave scheme.
Most employers will only pay company-funded maternity leave after you have been with the company for a minimum period – this is usually around four months, exclusive of your gestation period (the nine months during which you are pregnant), meaning you have to have been with the company for at least a year by the time your child is born.
If you’re considering getting pregnant in the next year, it pays to examine your contract and also to take this into account if you’ve been considering leaving a job and taking up a new position.
If you intend to return to the workforce before your child starts school, and for many women this will be the case, it pays to think long and hard about child care. Are you financially prepared for it? Is it going to be an emotional wrench to leave your child in the hands of someone else during the working week? Is it financially viable when compared with the alternatives – working part time and saving on childcare expenses by looking after the child yourself, or calling on the help of relatives?
When is it too late?
A lot of women with established careers worry about the time limit on trying for a baby, and what the risks are of age-related infertility.
“This can be a very negative arena for discussion,” Dr Baker says. “Lots of women conceive spontaneously in their late 30s, but if people are talking about planning a pregnancy after the age of 35, you can’t plan for it. You just have to hope that it will happen in those years.
“In real terms, fertility declines quite rapidly after the age of 35, so if you start planning a child in your late 30s, it’s important to realise there’s a much bigger risk of requiring intervention to achieve the pregnancy.
“But between the ages of 25 and 35, most couples will conceive – it’s definitely not peak fertility, but it’s a plateau. If we’re talking about optimum fertility, for women it’s 22 to 25 years of age, which in a Western society isn’t compatible with embarking on a career.”
Dr Baker’s final word is to understand that you’re at the mercy of your biology and getting pregnant isn’t an exact science. But by revamping your diet, monitoring your cycle and managing your finances and career, you’ll be well placed come the arrival of good news.