Factsheet

Pre-Pregnancy Planning

Date   22 January 2008

If you're planning to have a baby it is advisable to be well informed and prepared to provide the best care for yourself and your baby.

Commonsense and scientific evidence tell us a healthy body is the best environment to achieve implantation of the fetus and carry it to term.

HOW LONG SHOULD IT TAKE TO CONCEIVE?

Most normal, fertile couples achieve a pregnancy within the first 12 months of trying. It can take up to six months after stopping the contraceptive pill for ovulation to resume. Women over 35 or who smoke can take twice as long to conceive. Intercourse 3-4 times a week at ovulation time maximises the chance of conception.

NUTRITION

It is important to have a well-balanced and nutritionally sound diet. Women should aim for normal weight before conception. A high fibre, low fat diet is the basis of good health. Eat freshly cooked or freshly prepared food.

FOLIC ACID

Folic acid reduces the risk of having a baby with a neural tube defect such as spina bifida. Those at high risk include those previously affected and those with a family history, diabetes or on anti-epileptic medication.

Folic acid supplements are advisable for all women. Those at risk should take 5mg daily at least one month before pregnancy and ideally for three months. All other women should have 0.5mg tablets daily three months before conception, continuing for three months after.

EXERCISE

Sensible, regular, non-contact exercise is important. Avoid high-level exercise and getting overheated. Most conceptions have ideal outcomes but the fetus can be affected by certain infections, especially in the early stages of pregnancy, so it is wise to try to reduce the risk of contracting these infections while trying to become pregnant and throughout the pregnancy.

These infections include rubella, syphilis, toxoplasmosis, listeria, cytomegalovirus and HIV.

Rubella
Rubella (German Measles) acquired in utero is a big concern. Most women these days have been vaccinated and are probably immune but this immunity can wear off.

It is advisable to be tested before becoming pregnant and given the vaccine if not immune. It is advisable not to become pregnant within 28 days of being vaccinated.

Listeria
This is caused by bacteria which are wide spread in nature and can contaminate food. It has been found in many fresh and unprocessed foods such as unpasteurised milk, soft cheeses, cold processed meats, pate, raw seafoods and smoked seafoods. If contracted during pregnancy it has a high fetal death rate (30-50%).

The best advice is to

• avoid the above products
• carefully wash raw vegetables
• thoroughly cook all foods of animal origin
• reheat left over foods and ready-to-eat food until steaming hot and
• always thoroughly clean utensils after preparing uncooked food.

Toxoplasmosis
This is a parasite with a similar effect to listeria. It is acquired by close contact with infected cats or eating uncooked or undercooked meat. Pregnant women should get another person to clean cat litter boxes daily, wear disposable rubber gloves for handling soil likely to be contaminated with cats' faeces and carefully wash hands after gardening or handling raw meat.

Smoking, alcohol and other drugs
You should not smoke during pregnancy and ideally quit three months before conception. Avoid exposure to passive smoke and get a smoking partner to co-operate.

The National Research Council advises against drinking alcohol before and during pregnancy. Stop other recreational drugs and discuss over-the-counter drugs with your doctor. Caffeine intake should also be reduced.

Genetic Counselling
Genetic or developmental disorders need to be considered if there is a past obstetric history, a family history or advanced maternal age (generally considered over 35).

Genetic disorders include thalassaemia, cystic fibrosis, haemophilia and Tay-Sachs disorder. Your doctor will advise about testing of yourself and your partner.

Blood Group
It is a good idea to know the blood groups of both sex partners so the Rhesus factor is known. A negative blood group in the female partner combined with a positive group in the male partner requires careful attention.

CHECKPOINT SUMMARY

• Stop smoking
• Stop alcohol and other social drugs
• Reduce or stop caffeine intake
• Review current medications
• Follow a healthy diet
• Take Folic acid for three months before conception
• Develop a good exercise routine
• Ensure rubella immunity
• Have a Breast check and Pap Smear
• Eat freshly cooked and prepared food
• Consider genetic and family history
• Consider health insurance cover
• Visit the dentist

This Fact Sheet is presented with kind permission from Professor John Murtagh and Australian Doctor Reference - Australian Doctor 12 April 2002

For further information

Contact the Healthline on 1300 658 886.