Whatever you call it – up the duff, knocked up, a bun in the oven or eating for two, before getting pregnant there are a couple of things worth considering. Now because I am a doctor and I’m not supposed to get judgmental, I’m not questioning whether it is a good thing for you at this time in your life career or relationship, nor will I question the choice of you partner, I’ll leave that discussion to your Mum. What I would like to suggest is the opportunity to chat about some of the medical issues around pregnancy and if there are tests or other things that need to be done beforehand.
If this is your first pregnancy, there is a lot of information out on the internet. You will find everyone has their own opinion on many aspects of pregnancy from trying to predict the gender of your baby, what foods to eat and avoid, how generally how to live your life.
If this is not your first pregnancy, many authorities suggest waiting at least 18 to 24 months before planning to try again.
New technology means you can and your partner can undertake genetic screening. Certainly if there a family history of a chromosomal or genetic disorder, testing has been recommended by RANZCOG.
For everyone else, screening for carrier status for common genetic conditions are available at a price. These may include conditions such as cystic fibrosis, spinal muscular atrophy and fragile X syndrome. This article from The Conversation discusses whether you may or may not want to spend your money. And what would you do if you discovered both of you were carriers?
Although having a pap smear during pregnancy is not difficult and wont cause a miscarriage, it may be worthwhile getting it done beforehand. Remember that this year how we do cervical cancer screening has changed. And whilst we are talking about pap smears we should mention preventing, screening for and treating sexual transmitted infections, viral hepatitis and HIV.
Do you both need to make some lifestyle changes? Remember, to make a healthy baby it is often said you need healthy sperm and a healthy egg, Not unsurprisingly, a lot of things that many people do on a daily basis can have an adverse effect on a pregnancy. There are some obvious things, like smoking tobacco and cannabis, drinking alcohol and using other drugs.
If you are eating a healthy diet then this is a good start. You may need to be a bit more careful with food preparation to avoid germs such a Listeria and Toxoplasma. The “avoid food list” usually contains paté, soft cheeses (eg feta, brie, blue vein), prepackaged salads, deli meats and chilled or smoked seafood. In addition some fish may contain high levels of mercury which is toxic.
Should you take extra vitamins? Currently there is good evidence for taking extra folic acid and iodine, but if you are eating a healthy diet then multivitamins, including those pregnancy vitamins, are probably a waste of money.
Challenging yourself to keeping to a healthy weight through regular exercise and a healthy diet can help make pregnancy safer. Maintaining a healthy weight may improve the chance of getting pregnant or fecundity. For some women this may mean gaining weight or for others loosing weight.
Prescriptions medications, and I’m not just talking about the contraceptive pill can affect a pregnancy and may need to changed. Medications available over the counter or from the naturopath may also need to be discussed.
We should also talk about known medical illness like asthma, epilepsy, high blood pressure and diabetes before embarking on a pregnancy. How’s your mental health. Are there any pregnancy problems that seem to run in your family?
Do you need to see a dentist? There is some evidence that having periodontal disease can can have an adverse effect on your pregnancy.
Are your immunisations up to date? Some immunisations can’t be used in pregnancy as they contain live virus. These include Rubella and Chickenpox. Both of these illnesses can cause harm to your developing baby and a vaccination will provide protection from these illnesses. Other vaccinations such as influenza and whopping cough (pertussis) are recommended in pregnancy.
Have you planned an overseas holiday when you could be pregnant? Will it be safe to fly, will the airline let you fly. Would you travel insurance cover you having a baby out side of Australia. What would you do if you went into premature labour in Mongolia? Malaria can be bad for a pregnancy. There are some uncertainties around other infectious diseases such as Zika and Dengue fever, to name but a few.
Are there any test that need to be done apart from those mentioned already? I would usually check your blood group and consider other tests as guided by the consultation.
Now lets talk about how you need to have sex to get pregnancy…..oh you already know that. And when is the best time to have sex for a baby not just fun? Great.