Planning for a pregnancy
Pre-pregnancy: planning a pregnancy
So you are planning a pregnancy. Planning a pregnancy is a great idea, and means a better outcome for both you and your baby.
Before you get pregnant there some important things that you need to do:
- Check that you are up to date with your immunisation:
Measles, mumps, rubella vaccine
German Measles (rubella) is an illness that if contracted during pregnancy can cause serious abnormalities, such as deafness and blindness in the baby. You may have been vaccinated in the past, however the immunity can fade. A simple blood test can check your immunity and you can be re-vaccinated if needed. You should not get pregnant within 4 weeks of being revaccinated.
Chickenpox (varicella) can cause serious illness in you and your baby. A simple blood test can detect if you are immune. If not a short course of two vaccinations can be given that will protect you. You should not get pregnant within 4 weeks of being vaccinated.
Protection against serious illness caused by pneumococcal disease is recommended for women who are smokers or who have chronic heart, lung or kidney disease, or diabetes.
Whooping cough vaccine
Whooping cough (pertussis) can cause very serious illness and even death in babies who are less than 6 months old. It is now recommended that all pregnant women receive a whooping cough vaccination when they are between 20 and 32 weeks pregnant. A combination of antibodies being passed through the mother’s bloodstream, and the reduced risk of the mother contracting the disease makes this an ideal time to administer the vaccine.
Influenza (flu) can cause serious illness and we know that being pregnant increases the risk of flu complications, with the risk of serious complications being up to 5 times higher in pregnant women. Because of this, the flu vaccine is recommended and free for all pregnant women.
To access these vaccines and any blood tests involved you will need to see your GP.
- Check for sexually transmissible infections.
Some sexually transmissible infections (STIs) can cause serious illnesses in babies. If you have never had a test for STIs or have had a change of sexual partner since you last had a test for STIs, now is a good time to have one. You can have an STI screen at a sexual health clinic, family planning clinic, or with your GP. For more information on STIs see our section on sexually transmissible infections.
- Start taking a daily folate supplement.
Folate (also known as folic acid) is one of the B-group vitamins and is essential for the healthy development of a foetus in early pregnancy. Folate can reduce the incidence of serious defects known as neural tube defects (such as spina bifida). While folate is found naturally in foods, such as leafy green vegetables, broccoli, brussel sprouts, oranges, bananas, strawberries, and legumes, most women do not eat enough in their diet so taking a supplement is very important and always recommended. Taking 0.5mg (500mcg) of folate daily for 12 weeks before conception and during the first 12 weeks of pregnancy is advised. Folate is available in tablet form from any pharmacy. In some women, for example women with diabetes or epilepsy, a higher dose of folic acid may be recommended, if this is the case talk to your GP.
- Stop smoking, avoid social drugs, and avoid alcohol.
Smoking is well known to be very harmful to both you and your baby. Smokers take longer to fall pregnant, have more miscarriages, premature babies, and still births. Ask your GP for help to quit or call the Quitline on 134878. If you have a partner who smokes now is the time for them to stop smoking too. Passive smoking (second hand smoke) is also very harmful to both pregnant women, and their baby.
Social drugs such as MDMA, LSD, K, cocaine, heroin, ice, and even marijuana can cause serious harm to a developing baby and should be avoided throughout pregnancy. Pre-pregnancy is the best time to stop or reduce your use. If you need support with this talk to your GP.
Alcohol consumed in pregnancy can cause very serious and permanent brain damage in babies, alcohol should be avoided completely while you are trying to conceive and when you are pregnant.
- Eat a healthy balanced diet.
Eating a healthy balanced diet, which include all the recommended food groups, and which is rich in vegetables, fruit, and whole foods increases your chance of conceiving and will also mean that you are in the best shape you can be before you become pregnant.
- See your dentist for a check-up.
Dental disease and gum inflammation can increase the risk of premature birth so get a dental check-up now. It is best to have any x-rays or fillings done before you are pregnant.
- Check that any medications are safe in pregnancy.
If you are taking any regular medications check with your GP or pharmacist about whether they are safe to use in pregnancy. This includes any vitamin supplements and herbal preparations.
- Get moving with regular exercise.
The healthier you are the healthier you will be in pregnancy. Women who are in a healthy weight range find it easier to become pregnant and have fewer problems during pregnancy.
- Get your partner involved.
If you have a male partner get him involved in improving his health too. The health of your male partner will influence your chances of falling pregnant and of having a healthy pregnancy. Smoking affects sperm quality as well as general health. Your partner having a healthy diet, exercising, stopping smoking, and reducing alcohol intake will all help improve your chances of achieving a healthy pregnancy.
What should I do now?
See your GP. When you are planning a pregnancy is the best time to see your GP to discuss all the issues, and to make sure that you are in the best of health. If you don’t have a regular GP now is the time to find one. A GP is very important both during pregnancy and after you have had your baby.
What about falling pregnant?
Planning a pregnancy means that you have time to get as healthy as you can, as well as to learn about your menstrual cycle and when your fertile times are in order to increase your chances of falling pregnant.
How long does it take to fall pregnant?
The time it takes to fall pregnant can vary. Some women fall pregnant very quickly while others take longer. The average time it takes to fall pregnant is 6 months, and within a year 80% to 90% of women trying to become pregnant will have fallen pregnant. This can feel surprising, especially if you have been avoiding pregnancy and trying to avoid pregnancy by using contraception for a long time.
If you have been trying to fall pregnant for 12 months (or 6 months if you are over 35) and haven’t conceived you should see your GP to discuss possible investigations, and referral to a fertility specialist.
What is pregnancy anyway?
Pregnancy is where an egg (ova) that has been released from the ovary (this is called ovulation) is fertilised by a sperm and then implants into the uterus or womb (this is called implantation). It is not a pregnancy until the fertilised egg has successfully implanted.
Getting to know your menstrual cycle.
The menstrual cycle is the process of ovulation and menstruation which is controlled by hormonal changes that a woman’s body goes through in order to prepare for pregnancy. This usually occurs on a monthly cycle from puberty to menopause. Although it can vary a little, ovulation usually occurs around two weeks before the next period is due.
The average menstrual cycle is 28 days, but it can vary from between 20 days to around 42 days, or even longer. Some women have regular cycles while other can have quite irregular cycles. Women with long and irregular cycles can most certainly become pregnant, however it may take a little longer to get to know when your fertile period might be. If you are concerned about your menstrual cycle, for example if it is absent or extremely irregular, talk to your GP.
The egg and sperm.
When an egg is released at ovulation it is at its most fertile. It then lives for just 24 hours. Sperm however can easily live for 3 days, and sometimes even 5 or 7 days. This means that in order to increase your chances of becoming pregnant, you need to have sperm already ‘waiting’ for the egg when it is released at ovulation. To do this you will need to have sexual intercourse at the right time, and to do that you will need to get to know your menstrual cycle. You can do this by tracking your cycle and by learning the signs of being at a fertile time. For more information on this see the links below.
So when should I have sexual intercourse in order to become pregnant?
The best time to have sexual intercourse in order to increase your chances of becoming pregnant is before you ovulate. It is commonly recommended that you have sexual intercourse at least every second day from the last day of your period until it is just under two weeks before your period is normally due. You can of course have sex at other times too.
You can use cycle tracking apps, as well as other methods to increase accuracy around timing.
These include taking your temperature, checking fertile mucus and ovulation kits available in pharmacies.
If you are in a same sex relationship and trying to conceive with a known donor then the same timing and frequency applies. If you are seeing a fertility specialist to assist with donor conception, they will guide you on when in your cycle insemination should take place.