Once you and your partner have decided that you want to have a baby you both need to concentrate on getting yourselves fit and healthy before you conceive. Ideally you should start preparing yourselves at least three to six months before conception.
Whether this is your first baby, you've had problems with a previous pregnancy or either of you have any health concerns it is a good idea to see your doctor for a pre-conception check up. This is especially important if you have a long-term medical condition, as this will need to be really well controlled before you start trying to become pregnant. A planned pregnancy will maximize your chance of having a healthy pregnancy and baby.
This is also the time to discuss any long-term medication that you may be taking for certain conditions e.g. hypertension, epilepsy, diabetes or thyroid disease. The medication may need to be stopped or changed to a different medication before you become pregnant, so your doctor may want to refer you to a specialist. It is very important not to stop prescribed medications unless you are told to by your doctor as stopping some medications, for example, for asthma, can be dangerous.
It is important to have a blood test to check whether you are immune to rubella (German measles). If you are not immune you can be vaccinated – you’ll be advised not to become pregnant until the vaccine virus has cleared from your blood, which takes about three months.
If you have been pregnant before, this is an ideal time to review your previous pregnancies and any problems you may have experienced so that your future care can be planned. Some conditions such as preterm birth, gestational diabetes, pre-eclampsia or excessive bleeding after the birth are more likely to recur in a future pregnancy, therefore hospital monitoring and specialist care may be required.
If you needed forceps, ventouse or a C-section in a previous pregnancy or your baby had a problem at the birth or if you had a history of mental health issues, either before, during or after a pregnancy this should be discussed at your pre-conception check up. If there is history of inherited problems an appointment can be made for you to see a genetic counsellor to discuss your risk in a future pregnancy and to find out what screening tests are available.
Smoking can affect both male and female fertility. Women who smoke tend to have lower oestrogen levels than non-smokers and this can lead to irregular ovulation. Even if this does not occur, nicotine and other cigarette toxins can reduce the chance of fertilisation. Male smokers often have a lower sperm count and the quality of their sperm is generally poorer which makes fertilisation less likely. So, by giving up smoking you both can increase your fertility and your chances of successful conception.
Smoking during pregnancy will put the baby at risk and can also affect the mother’s health, so stopping now will benefit you and your baby.
Drinking alcohol can affect the production of healthy sperm and eggs. In men, drinking alcohol can lead to a lower sperm count with high numbers of the sperm they do produce being abnormal. Ideally, a man should stop drinking on a regular basis for at least three months before conception to allow healthy sperm to develop.
Although in women drinking rarely prevents ovulation, it can cause the pregnancy to fail and will certainly increase the risk of miscarriage. In pregnancy, alcohol can restrict foetal development and may also lead to malformation.
Because fertilisation and the early development of a baby are controlled by delicately balanced processes in the body, any additional chemicals entering your body can upset this balance. Therefore drugs, whether legal or illegal, are potentially hazardous to fertility and the development of the unborn baby.
Even caffeine, taken in excess, can affect your chances of conception. You should always seek advice from a health professional who knows you are trying to conceive before taking over-the-counter medications, natural remedies and supplements.
Being significantly under or over-weight can affect your fertility and can cause complications in pregnancy. If possible, your weight should be within 7 kgs of the ideal range for your height before you become pregnant.
If you are underweight there is a risk that your baby will be small and may have problems during labour and after the birth. If you are overweight you are more likely to develop diabetes or high blood pressure during pregnancy.
A healthy diet is important for both you and your partner’s fertility and for maintaining a healthy pregnancy. Eliminating ‘junk’ food and eating a balanced diet for a least four months before you start trying to conceive will help to correct any nutritional deficiencies either of you may have. Eat plenty of fruit and vegetables, protein-rich food such as chicken, fish and pulses, and whole grains. Drink 8 glasses of water a day and cut down on drinks containing caffeine such as tea and coffee.
Extensive studies have shown that folic acid, found naturally in citrus fruit, green leafy vegetables and some fortified breads and cereals, can significantly reduce the risk of neural tube defects, such as spina bifida. A daily supplement of 400mcg of folic acid should be taken for at least three months before becoming pregnant and until the 12th week of pregnancy.
If you have a past history of a baby with a neural tube defect, such as spina bifida, or you are on anti-epileptic medicines or your BMI is over 30 you may require a higher dose. Your doctor will advise you.
As well as folic acid, taking a multivitamin and mineral supplement, designed especially for pregnancy, will ensure that you are getting the vitamins and minerals you need to sustain a healthy pregnancy. Ask your pharmacist for advice.
Regular exercise, such as brisk walking or swimming, carried out for 20 minutes three times a week, will get you fit before conception and help your body cope better with the demands of pregnancy.
Make sure you have plenty of rest and relaxation and try to avoid high stress levels. Too much stress can upset sex hormone levels and the normal menstrual cycle. Men under stress are more likely to have poor sperm quality and may suffer from premature ejaculation or have problems maintaining an erection.
It is important to prevent pregnancy until you are ready for conception by using a method that doesn’t affect your fertility. All hormonal contraception works by inhibiting the natural fertility cycle and the time it takes for fertility to return to normal after stopping depends on the type you have been using.
The body usually recovers quite quickly from use of the combined oral contraceptive pill, progestogen -only pill, implants and the intrauterine device. However, if you have been having progestogen injections it can take between six and 18 months for ovulation to return to normal.
Barrier methods such as the condom or diaphragm and spermicides are medically safe and instantly reversible which makes them ideal for use during the pre-conception stage. Natural family planning – or fertility awareness – is another good form of contraception during this time and it has the added advantage of helping you to understand your fertility pattern. But it is important to remember that it can takes between three and six monthly cycles to learn your fertility pattern, so this method should be combined with a barrier method until you are confident about using it.
For conception to take place you need to make love around the time of ovulation – this is when an egg is released into the Fallopian tube ready for fertilization by a sperm. Ovulation usually takes place 12-14 days before your period starts.
This means that if you have a regular 28-day menstrual cycle the most fertile time of the month is likely to be a around day 14. However, if you have an irregular monthly cycle this can make working out your fertile period more difficult. An ovulation predictor kit can help you identify your fertile period, or you can learn fertility awareness to help you recognise your changing fertility.