fertility and preconception

Welcome to your fertility and preconception information.

Before you become Pregnant - Preconceptual Care

 
Thinking of having a baby? To give your baby the best start in life means making sure you are as healthy as possible before you become pregnant. Plan a year or so ahead if you can, so that changes to your diet, skincare and lifestyle have time to take effect. Many midwives now offer pre-conceptual advice along with a general pre-pregnancy health check-up.

 

Medical history

This will involve looking at your health and lifestyle; what you are eating, exercise habits and any possible exposure to potentially hazardous chemicals for both yourself and your partner.

He/she will also look at any existing conditions such as diabetes, lupus, high blood pressure or depression(PRODIGY 2004). It's also important to talk about any genetic problems in your family such as Down's syndrome, cystic fibrosis, muscular dystrophy etc..

Along with what kind of contraception you're using and whether you've had any ovulation or menstruation problems, terminations, miscarriages, ectopic pregnancies, delivery complications and the like.

Cervical smear

Check when you last had a cervical smear test done, and book in for one if you are due to have one within the next year. Smears are not normally done during pregnancy or for 6 months after the baby is born.

Urine analysis

If there is any chance that you may have a urinary tract infection (UTI), you may be asked for a urine sample so that it can be checked. UTIs have been associated with miscarriage, low-birthweight babies and premature labour, so if you have one you'll want to get it cleared up before you conceive.

Blood test

You may be given a blood test to look for anaemia or any other abnormalities, antibodies, rubella immunity and your blood group.

Blood pressure check

Pregnant women with high blood pressure (hypertension) are more likely to develop pre-eclampsia and have placental problems, so it's important to control high blood pressure before you conceive.

Screening tests

You can ask your doctor/midwife for screening tests for Hepatitis B, syphilis, HIV/AIDS and possibly clyamydia(PRODIGY 2004) . Being screened and treated (or in the case of HIV/AIDS, managing the disease) before you conceive can significantly increase your odds of a successful pregnancy.

Check your immunisation records

Many preventable infections can cause miscarriage, or birth defects. If you need to be vaccinated with a live viral vaccine, as for rubella (German measles), you should wait one month after the vaccination before trying to conceive(PRODIGY 2004). This is a precaution, as it is thought that your body needs time to eliminate the injected virus. You may also want to consider vaccination against chicken pox, which can cause problems for your unborn baby if you catch it for the first time in pregnancy(PRODIGY 2004). If you have already had this common childhood illness then you will already be immune. You may want to have a tetanus booster, and, if you're at risk for hepatitis B, you may wish to consider being vaccinated against that disease as well.

Parasitic disease check

Parasitic diseases such as toxoplasmosis are relatively harmless in adults but can be dangerous to newborns and a developing baby. Toxoplasmosis is most often transmitted through cat faeces, potting mix or undercooked meat. A simple blood test can determine whether you've already had it and are therefore immune. If not, you can take extra care to avoid eating and take extra care when handling raw or undercooked meat, wear gloves when you're gardening, and have someone else empty the cat litter tray(PRODIGY 2004). If you own a cat, you are very likely to be immune already.

Folic acid advice

Neural tube defects, such as spina bifida, can be prevented by taking a folic acid supplement and making sure that your diet contains foods rich in folates. Your doctor will advise you on how much folic acid you need to take every day. Most women who are trying to conceive are advised to take a 400 micrograms (mcg) folic acid supplement while they are trying for a baby and for the first 12 weeks of pregnancy. If you have a family history of neural tube defects or a chronic health condition, such as epilepsy, you may need to take a higher daily dose of 5 milligrams (mg)(PRODIGY 2004). Your doctor or midwife can give you a prescription for folic acid supplements, whether you need the normal or higher level daily dose.
Also consider omega 3 which has great benefits for pregnancy, baby and new mum. From improving fertility to increasing brain development for your developing baby, reducing the chances of a premature birth and decreasing the chances of postnatal depression.
 

Help to stop smoking, heavy drinking or drugs

There is plenty of evidence that smoking, street drugs, and heavy drinking are neither good for you nor your future baby and that the ideal would be to stop before you become pregnant(PRODIGY 2004). Your doctor may be able to offer you a place on a smoking cessation programme to help you quit before you conceive. If you are a heavy drinker or take street drugs, your doctor may be able to refer you on for some additional support to help you give your baby a healthy start to life(PRODIGY 2004).

Skincare and medications

Also consider the chemicals you are ingesting via skincare, many have known links to birth defects. Change to a safe natural pregnancy skincare system such as mahu before you become pregnant and use throughout pregnancy and while breastfeeding.
You may need to change medication and settle down with a new treatment before conceiving. For example, it's not safe to take medication for severe acne when you're pregnant. Common over-the-counter medicines, such as ibuprofen, are also best avoided during pregnancy(PRODIGY 2006), so question your doctor about any medicine that you usually take.

Genetic testing and counselling

The vast majority of babies are perfectly healthy; only about 1-2 per cent are born with a major or minor birth defect(based on statistics from ONS 2005 and SPCERH 2006). But you may be referred to a genetic counsellor if you, or your partner, have any risk factors, such as a family history of genetic disease.