Planning for Pregnancy
Useful information for prospective parents
The decision to have a child is an important one. For some people it is difficult to decide when the right time is, and for many no time is ever going to be perfect. Lots of people feel apprehensive, even though they are confident in their decision to have a child. Some of the issues you could consider:
• Are you ready?
• If you have a partner, are they ready?
• Have you discussed how you will share the parenting of a child?
• Have you considered the economic, emotional and lifestyle changes that will occur, and what support you will require?
For some people there is a delay between making the decision to have a baby and actually getting pregnant. Difficulties in conception can be due to either male or female problems.
A woman’s fertility largely depends on her age, with men having a less obvious age-related decrease in fertility. A woman is most fertile between the ages of 17 and 25, with a gradual decline into her 30s and a sharp decrease in fertility after the age of 35. Even for a woman in her 20s it is normal to take up to a year to conceive. Seek professional advice early if you are concerned that you may have a fertility problem.
Lifestyle choices
Whether you are male or female, there are many good reasons for preparing yourself for pregnancy
Smoking
It is best to give up smoking before trying to conceive. People who smoke are less fertile than non-smokers, and women who smoke also have a higher risk of miscarriage. Smoking during pregnancy interferes with the blood supply to the baby, resulting in low birth weight babies and babies of lower intelligence. There is no safe level of smoking, and the more you smoke the higher the risks (don’t forget there are risks involved with passive smoking too). Babies born to smoking mothers have a greater chance of dying soon after birth, and a greater risk of cot death.
Alcohol
Most doctors recommend that women avoid alcohol altogether if they are pregnant, though some women may still choose to have an occasional glass. There is evidence that an excessive amount of alcohol (more than 10 standard drinks per week) can seriously harm an unborn baby (risks for the baby include brain damage, slower growth, learning disabilities, stillbirth, and miscarriage). ‘Binge’ drinking on even a single occasion during pregnancy has been shown to cause damage to some babies. Excessive alcohol consumption can also reduce male fertility.
Prescription drugs
If you are taking any prescribed medication or health supplements on a regular basis, tell your doctor that you are planning a pregnancy, as some can affect both male and female fertility. In some cases women may be advised to change to a different medication or stop taking it altogether to avoid affecting the developing foetus. This includes people taking drugs to treat epilepsy, and anti-thyroid drugs.
Recreational drugs
People using drugs are strongly advised to stop before trying to conceive, and to talk to a health professional if they are having difficulty doing so. Abrupt withdrawal from drugs during pregnancy may lead to miscarriage or premature labour. Use of drugs has been linked with congenital abnormalities, miscarriage and low birth weight babies. Street drugs are often mixed with other substances that could also have a harmful affect on you and your baby. Women who inject drugs may put themselves and their baby at risk of contracting hepatitis B and C and HIV.
Caffeine
Caffeine is a drug found in coffee, tea, cola and some other soft drinks, chocolate and chocolate drinks. Some studies have linked high caffeine consumption in pregnancy with miscarriage, still-birth and low birth weight babies. As there is uncertainty about what is a safe level of caffeine during pregnancy, try to cut down if you drink a lot of coffee, tea or cola drinks.
Other things to avoid
Women who think they could be pregnant are advised to avoid having x-rays and avoid exposure to chemicals such as pesticides.
Diet and exercise
All men and women are encouraged to exercise regularly and eat a healthy diet to improve fertility.
A reasonable level of physical fitness is important to cope with the extra demands placed on a woman’s body during pregnancy. It is safe for women to continue with their normal exercise program at this time and into the early stages of pregnancy, but it is recommended that women do not go water skiing, scuba diving, or use water slides once they are pregnant. Raising body temperature by doing prolonged exercise or the use of saunas can also be harmful to a pregnancy. Being overweight can reduce fertility for some women and cause problems during pregnancy such as diabetes and high blood pressure.
Recent research has highlighted the importance of an adequate nutrient supply to the baby in the first few weeks of its development. It is important to get into healthy eating habits before you conceive. Poor nutrition for the foetus can lead to later development of conditions like high cholesterol, high blood pressure and diabetes. A recommended balanced diet should include:
• at least two portions of fruit and five serves of vegetables per day
• complex carbohydrates such as wholegrain bread, rice, cereals, potatoes and pasta
• protein rich foods such as lean meat, fish, eggs, milk, cheese, pulses, nuts/seeds
• small amounts of oils such as olive oil, soya oil and oils found in fish like sardines
• calcium rich foods such as yogurt, milk, cheese and calcium enriched soya milk.
Diets containing iodine (found in seafood and iodised salt) reduce the risk of thyroid disease in mother and baby. There is a risk of brain damage in babies born to mothers with an iodine deficiency.
Listeria is a bacteria that may be found in raw salads, some soft cheeses and pre-prepared meat products. While it is rare, listeria poisoning may lead to miscarriage. For more information talk to a health professional.
Folate
A deficiency of folate in the diet is associated with an increased risk of babies being born with neural tube abnormalities (eg spina bifida). Although folate is found in most fresh fruit and vegetables, it is recommended that women take a supplement of folate (0.5 mg per day) in the 4-6 weeks before conception and during pregnancy.
Women’s health and pregnancy
Before becoming pregnant it is a good idea to be up-to-date with your routine health screening. If your Pap smear is due it is advisable to have this done and know the results before trying to get pregnant. You may want to take this opportunity to ask your doctor about issues relating to your medical history that may affect your pregnancy.
Rubella
The rubella vaccination aims to protect you from German measles and is usually given to girls in Year 7 or 8 at school. If you are unsure whether or not you were vaccinated at this time a blood test will show if you are immune. If you are not immune to rubella and have a vaccination, it is recommended that you do not get pregnant for 1 month to avoid any potential harm to the baby.
Chickenpox
Chickenpox during pregnancy can lead to complications for the baby. If you have never had chickenpox a safe and effective vaccine is available. If you had chickenpox as a child you don’t need to be vaccinated. If you are unsure whether you have had it or not your doctor can organise a test to find out.
Diabetes
The physical stresses of pregnancy usually demand very close supervision of a woman's diabetes by the woman and her doctor. For women who are diabetic, excellent control of blood sugar levels around the time of conception reduces the risk of the baby being born with a congenital abnormality.
Sexual health
Sexually transmissible infections
As many sexually transmissible infections (STIs) have no symptoms for men or women, it is possible to have one and not know it. STIs like chlamydia, gonorrhoea and syphilis can be passed onto the baby at birth. For this reason it is a good idea for both partners to consider testing before trying to conceive. For women, having unsafe sex while pregnant can put them at risk of passing on an infection to their baby.
Genital herpes
If a woman has her first ever attack of genital herpes during pregnancy there is a risk that the baby can become infected before it is born. However, for women who have had a previous history of herpes there is a risk to the baby only if it is born vaginally at the time of an outbreak in the mother. If this happens, you may be advised to use antiviral drugs or to have a caesarean section delivery to reduce the risk of your baby becoming infected, and the overall risk for anyone with long-standing herpes is low.
HIV
Some blood-borne viruses like HIV and hepatitis can be passed onto the baby before birth, causing serious problems. If you are HIV positive or have hepatitis talk to your doctor - this risk can be minimised by anti-viral treatments, having a caesarean section birth, and not breastfeeding the baby.
A note about genetic disorders
Genetic disorders or conditions refer to disorders that a child inherits from its mother or father. Cystic fibrosis and club foot are examples of genetic disorders. If you or your partner have a family history of genetic disease, counselling may be helpful to determine the risk of passing it on to your child. In light of that information, counselling may also help you decide whether or not to go ahead and conceive. There are reliable tests available that can detect genetic diseases and conditions very early in pregnancy. Early detection of disorders may help couples plan for the future.
For more information about planning a pregnancy contact the Sexual Health Helpline on
9227 6178 or 1800 198 205 (country callers) or email.
Page last updated Wed, 30 Aug 2006 15:36