How to get your body ready for a baby

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Giving your baby the best start in life means getting your own health sorted well before you become pregnant. Your general wellbeing, and any medication you're taking, can all affect your chances of having a healthy pregnancy.

It's worth making adjustments to your lifestyle too, such as eating a balanced diet and taking more exercise.

Should I see my doctor before I try to get pregnant?

Yes. It's worth visiting your doctor before you become pregnant. If you have a long-running medical condition such as epilepsy, asthma or diabetes, then seeing your doctor is a must.

You may need to make some changes to your treatment before you conceive. This is because some types of medication are harmful to an unborn baby. For example, it's not safe to take some medications for severe acne when you're pregnant. If you're changing your treatment, you may need time for your body to adjust.

Arrange an appointment with your doctor at least three months before you want to conceive. If you have a medical condition, it's important that it's controlled as effectively as possible before you become pregnant. Some over-the-counter medicines, such as ibuprofen, are also best avoided, because they're not safe in early pregnancy.

What can I expect at a pre-pregnancy check-up?

Your check-up is an opportunity to talk through any health concerns or worries you may have.

Your doctor will probably ask you about:
  • Your health and lifestyle.
  • Your eating habits.
  • Any problems with your periods.
  • How much exercise you do.
  • Whether your job involves working with hazardous substances.
  • Your wellbeing, for example, whether you are suffering from depression, or have done so in the past.
If you're overweight, with a body mass index (BMI) of 23 or higher, your doctor will recommend that you try to lose weight. Losing weight may increase your chances of conceiving and will mean that you'll have a healthy start to your pregnancy.

If you're underweight, talk to your doctor about healthy ways to increase your BMI. You're more likely to have an irregular menstrual cycle if you have a low body weight. If you're missing periods, you won't release an egg (ovulate) during each cycle. A healthy BMI is between about 18.5 and 22.9.

Your doctor will also want to know about any existing health conditions you may have, such as:

Depending on your health and symptoms your doctor may also to rule out conditions such as low thyroid levels, PCOS, uterine fibroids and endometriosis.

It will be helpful if your doctor also knows about:
  • Any genetic conditions in your family. Tell your doctor if you have a family history of Down's syndrome, sickle cell disease, thalassaemia or cystic fibrosis, so she can arrange further support and advice.
  • Your contraception. Most contraceptive methods, once you stop using them, shouldn't affect how long it takes to conceive. But if you've been using the contraceptive injection, it may take up to one year after your last injection for your usual fertility to return.

Your doctor may also ask about any terminations, miscarriages or ectopic pregnancies you've experienced. You may find it hard to go over painful memories. Try to bear in mind that knowing about what's happened in the past will help your doctor to ensure you get the best care.

Will I need any medical tests?

It depends on your circumstances and general health. Your doctor may suggest you have any of the following tests:

Blood tests

If your doctor is concerned you may be anaemic, she'll advise you have a blood test.

Depending on your ethnic background and medical history, you may also have a test for genetic disorders such as sickle-cell anaemia, Tay-Sachs disease and thalassaemia.

If you're not sure whether or not you're immune to rubella, you'll be offered a blood test to check for sure.

Your doctor may also want to check if you've had toxoplasmosis and a simple blood test can determine whether you've already had it. If you've had toxoplasmosis before, you can't catch it again.

Urine tests

Having certain substances in your urine can give your doctor an early sign of conditions which may cause problems for you and your baby. 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. So if your doctor suspects any problems it's best to get them cleared cleared up before you conceive.

Screening tests for STDs

Your doctor may also recommend screening tests for sexually transmitted diseases, including:
Having treatments for STDs before you conceive can greatly increase your odds of a successful pregnancy.

Cervical smear

Check when you last had a cervical smear test, and get one done if you're due to have one within the next year. Smears aren't normally done during pregnancy. This is because pregnancy can cause changes to your cervix, making the results difficult to interpret.

Should I have any vaccinations before trying for a baby?

Many preventable infections can cause miscarriage or birth defects, so make sure your vaccinations are up to date. If you're not sure, a quick blood test will reveal whether you've been vaccinated against diseases such as rubella (German measles).

If you need to be vaccinated with a live viral vaccine, as for rubella, you should wait one month after the vaccination before trying to conceive. This is a precaution, as it's thought that your body needs time to get rid of 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. If you have already had this common childhood illness then you will already be immune.

If you're in a high risk group for hepatitis B, you may want to consider being vaccinated against that disease as well.

Also speak to your doctor if you need a tetanus booster. The Tetanus Toxoid (TT) vaccine is given during pregnancy to prevent tetanus to you as well as your baby.

Should I take any pre-pregnancy supplements?

As soon as you decide to try for a baby, start taking a daily supplement containing 5mg of folic acid. Taking folic acid has been found to greatly reduce the risk of neural tube defects, such as spina bifida.

It's particularly important to have enough folic acid in the early weeks of pregnancy, when you may not even realise you're expecting. The early weeks are when your unborn baby's brain and nervous system are developing fast.

Also, let your doctor know if you:
  • have a family history of neural tube defects
  • have diabetes
  • have coeliac disease
  • take medicine for epilepsy
  • have a body mass index (BMI) of over 23

Once you are pregnant, your doctor may recommend additional supplements based on your health.

What about smoking, drinking or taking drugs?

Smoking, drinking and illegal drugs can all cause health problems for your baby, and increase the risk of miscarriage. So it's well worth quitting now, rather than once you know you're pregnant.

Your doctor may be able to offer you advice or recommend a support group to help you stop before you conceive.

Experts can't be sure about a safe level of alcohol for an unborn baby. However, if you're planning a pregnancy you should avoid alcohol altogether.

If you do decide to drink, stick to no more than one or two units, once or twice a week, and don't get drunk. If you feel you need help cutting down the amount that you drink, talk to your doctor.

If you take illegal drugs, your doctor can refer you for some extra support to help you give your baby a healthy start to life.

To help you keep track of all your tests and vaccinations, print off our physical readiness checklist.

It's not just your body you need to get ready. Find out which lifestyle changes are advisable too.

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References


Barrowclough D. 2009. Preparing for pregnancy. In: Fraser DM, Cooper MA. eds. Myles textbook for midwives. 15th ed. Edinburgh: Churchill Livingstone, 173-188

CKS. 2007. Preconception: advice and management: clinical topic.

CKS. 2009. Urinary tract infection (lower) in women: clinical topic.

EUROCAT. 2011. Congenital anomaly subgroups: European surveillance of congenital anomalies. Eurocat prevalence data tables.

Lloyd C. 2009. Medical disorders associated with pregnancy. In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives. 15th ed. Edinburgh: Churchill Livingstone, 361-396

NHS Choices. 2010. Preconception.

NICE. 2005. Long-acting reversible contraception. National Institute for Health and Clinical Excellence. Clinical guideline 30.

NICE. 2010. Weight management before, during and after pregnancy. National Institute for Health and Clinical Excellence. Public health guidance 27.

OTIS. 2010. Ibuprofen and pregnancy.
Diane Rai
Diane Rai is BabyCenter India's Editor.

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