Pregnancy planning

10 things to remember when you are planning pregnancy

Pregnant woman and her husband
Written by Ameya Bondre

Planning a pregnancy is not just about your preparedness or choosing the right time. You would need to consider various medical factors, tests and checkups, lifestyle changes, mental health factors and other aspects while planning pregnancy. Following are the ten things to remember:

  1. Meet your gynaecologist before conception:

Your doctor will inquire about your medical history, present health and any medications or supplements you are having. This is important to check as certain medications are not recommended or they can be harmful for the baby. Your doctor may recommend you to take multivitamins, give dietary advice, check if you have taken all vaccines especially tetanus, and previous history of chicken pox and rubella vaccination. She will also check for the presence of any sexually transmitted disease by performing some tests. If you have asthma, diabetes, thyroid disorder, high blood pressure or any major illness, you must discuss that with your doctor before planning a pregnancy. It is also important to check if you or your spouse are carriers of genetic disorders such as sickle cell anemia, cystic fibrosis or others – this will only require you to provide a saliva or blood sample to the lab. If you are a carrier, your child will have a 25% chance of inheriting the particular disorder. 

2. Folic Acid and Vitamin A:

Folic acid is essential for baby’s brain development and reducing the risk of birth defects such as ‘neural tube defects’. A tablet containing 400 microgram of folic acid is required in early pregnancy, but it is recommended to take the tablet 1 month before conception and continue taking it after becoming pregnant, as per your doctor’s advice. This will ensure that the baby’s brain development is optimal and there are no risks. On the other hand, the Vitamin A dose should not exceed 770 mcg RAE (2,565 IU) unless most of it is ‘beta carotene’. This is because an overdose of a different type of Vitamin A can lead to birth defects.

3. Understand the toxins:

  1. Smoking, drugs: Research shows that smoking and drugs can lead to miscarriage, premature birth and low-birth-weight babies. Tobacco affects fertility and can lower your spouse’s sperm count and passive smoking can reduce your ability to conceive. 
  2. Alcohol: While planning a pregnancy, it is wise to cut down even moderate drinking (i.e. one drink a day) because the smallest amounts of alcohol can harm the baby.
  3. Coffee: Caffeine’s toxicity has not been proven in studies but experts recommend a limited amount of caffeine due to the risk of miscarriage i.e. 200 mg per day or 1 cup of coffee, depending on the type of coffee. Please ask the quantity in one cup when you consume coffee outside, or refer the sachet for details.
  4. Fish: While fish is rich in omega-3 fatty acids, it is recommended that pregnant women eat up to two servings of fish (or 12 ounces) in a week, with low mercury levels, such as herring, trout, salmon and sardines. All other fish varieties may be avoided. Even fish caught in local waters should be avoided unless you are sure that there are no toxins. The nutrients in fish will have to be obtained from other dietary sources (e.g. vitamin D and protein). Omega-3 fatty acids are also present in soyabean, walnuts and flaxseeds.
  5. Work environment: If your job or occupation routinely exposes you to chemicals or radiation, then it is strongly advised to change the workplace. Also, some cleaning products, pesticides, solvents, and lead in drinking water from old pipes can be dangerous to a developing baby. It is worthwhile to check your blood lead levels and discuss the results with your doctor.

4.  Healthy weight and physical activity

While we know that 10-11 kilograms need to be gained on average during pregnancy, it all depends on the pre-pregnancy weight. Women with high body mass index (BMI) may have complications during delivery, while women with low BMI and poor diet may have low birth weight babies. It is important to discuss with your doctor, the appropriate target weight to be gained based on your current (pre-pregnant) diet pattern, physical activity and BMI.

While you are yet to become pregnant and you are not eating ‘for two’ yet, it is important to develop healthy eating practices so that dietary changes will not appear sudden to you, when you conceive. A minimum of 2 cups of fruit and 2.5 cups of vegetables daily, and enough of milk, calcium-fortified orange juice and yogurt, as well as beans, nuts, seeds, soy and meat products (for protein) are recommended.

Moderate exercise such as walking, cycling or weight training for 30 minutes or more, for 5-6 days a week is recommended to achieve the fitness and flexibility necessary to bear a pregnancy. Yoga or stretching exercises can also help.

5. Estimating your fertility:

You could either stop using birth control and let time take its due course before you conceive, or you could track your periods and use online tools like “ovulation calculators” to roughly estimate the days on which you would be most fertile.

6. Control the birth control:

In some cases, it is easy to stop contraception, for example, a barrier method like condoms. In the case of oral pills, for many women, fertility returns as soon as they stop using them. However, some women may take a month or so to start ovulating again. You’ll know that you are ovulating normally when you’re getting your period regularly. Do consult your gynaecologist if you have any difficulties in stopping the birth control method and resuming ovulation.

7. Avoid infections:

Since pregnancy is a low-immunity state, it is advised that you avoid unpasteurized food such as cheese or dairy products, or unpasteurized fruit juices, or undercooked fish or poultry. This prevents food-borne illnesses that increase the risk of miscarriage or stillbirth. Frequent handwashing is important, especially when preparing meals. Adequate refrigeration (2-4 C and freezer at -18 C) is necessary to preserve cold food. When you conceive, the TORCH screening test will be performed to screen infections i.e. TOxoplasma, Rubella, Cytomegalovirus and Herpes.

8. See your dentist:

Hormonal changes in pregnancy, particularly higher estrogen and progesterone levels, can cause swollen, red and painful gums when you floss or brush, because they react differently to the bacteria in plaque. Hence, meeting a dentist for a checkup and cleaning is important, especially if you haven’t done so in the past six months. It is advised to have that checkup while planning pregnancy.

9. Consider money matters:

It is important to consider the costs involved in pregnancy and childbirth such as consultation fees, expenses for tests, medicines, admission costs for delivery and cost of child care and vaccinations. Please check insurance plans that may help you in this respect.

10. Consider your mental health:

While hormonal changes and psychological factors lead to mental health symptoms in all pregnant women, it is recommended that you watch out for certain symptoms before planning pregnancy as they may aggravate during pregnancy. Examples are loss of interest and pleasure in things that you used to enjoy, changes in appetite or sleep patterns, a loss of energy, feelings of hopelessness or worthlessness, especially if they occur periodically or consistently. These symptoms must be reported to a psychologist, psychiatrist or a counsellor.

About the author

Ameya Bondre