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:
- 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:
- 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.
- 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.
- 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.
- 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.
- 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.
