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Ideally, the doctor and both partners should begin planning together one year before conception. This includes physical exams and reviews of medical histories and lifestyles of both future parents. Simple laboratory tests can also be done. These will all help let your doctor know of any risks and give time to correct problems. This will also be a time for you to learn how to have the best pregnancy and delivery possible.
The doctor looks at a wide range of factors during the medical history. The age, race, family medical history and type of employment of both partners may all affect a pregnancy. Previous infections or surgery may cause problems conceiving or keeping a pregnancy. Diabetes, high blood pressure, epilepsy, thyroid problems and asthma need early attention. Information about previous pregnancies, deliveries and children all help in the advance planning.
Your doctor may ask about menstrual periods, sexual activity and gynecological problems and use this information to give you advice about getting pregnant.
A woman's examination before pregnancy should include her height, weight and blood pressure. Her heart, lungs and spine are checked to assess her general health. Breast examination, which is difficult to do during pregnancy due to breast changes, can be done at this time too. A pelvic or internal exam will show any conditions that could interfere with pregnancy.
A man's examination should include checking for things that may interfere with fertility such as diseases and abnormalities of the penis and the testicles.
During the examination, your doctor will take a pap test to send to the lab. Problems that show up on this test are more easily managed before pregnancy than during. Samples may be taken to test for infections, including sexually transmitted diseases. A urine sample is often tested to look for problems with the kidneys or other body systems.
The doctor might order blood testing for Rubella immunity (the ability to fight german measles infection), hepatitis, HIV and other infections. Immunizing against these diseases is better done before pregnancy. Blood tests can help show how well-nourished you are and point out some hereditary blood disorders important in childbearing. The blood type of both partners identifies the risk of some problems during the pregnancy and newborn period.
There may be other lab tests, based on your past history or that of your family and heritage. You will be told which tests are important for your situation.
Good health in the three months before becoming pregnant is important. You should be at your ideal body weight, eating well, exercising regularly, reducing stress and avoiding substances that can harm you and your baby. From the 17th to the 56th day after conception, your pregnancy is at greatest risk of harm. During this time, most women have not yet seen their doctor for their first pregnancy visit. Many do not even know yet that they are pregnant. If you are trying to become pregnant, it is wise to assume that you may be at any time and avoid taking risks.
Study Canada's Food Guide to Healthy Eating and try to follow it. If you have a problem with important foods such as milk products, talk to your doctor about these. Once pregnant, your appetite may change and you might not be able to eat as well in the first three months of pregnancy. This is normal and not a risk to your baby or you.
Cigarette smoking of any amount, including second-hand smoke, is extremely hazardous in pregnancy. It has been shown to be a factor in miscarriages, stillbirths, premature births, growth restrictions, fetal distress in labor, crib death, placental hemorrhage and poorer school performance in children.
Drinking alcohol in pregnancy is now the chief cause of mental retardation in the United States. There is no known safe level of alcohol that can be taken in pregnancy. It should be avoided completely.
Caffeine - commonly found in coffee, tea, soft drinks and chocolate - reduces fertility even if taken just once a day. Most doctors advise cutting back caffeine during pregnancy to less than three cups per day. More than eight cups per day is linked with miscarriage, prematurity, malformations and possible growth restrictions.
Most women know they should avoid using drugs in pregnancy. Of course, this includes all illicit drugs such as marijuana and cocaine that have devastating effects on babies. Over-the-counter medicines such as vitamins and cough and cold preparations should be checked with your doctor before use. Creams used for treating disorders like cold sores and warts can also be a problem.
There are many medicines that are considered safe in pregnancy. These are the ones doctors can prescribe as needed. They include several antibiotics, asthma medications and drugs used to treat other medical conditions.
There are common hazards to be aware of while trying to get pregnant or in early pregnancy. These include some of the chemical agents that may be found in the workplace or at home. Chemicals used in cleaning, hobbies, the garden or the garage may be a problem. Check with your doctor. Heat sources that raise your body's temperature above 38.8°C can cause birth defects. In particular, be careful about hot tubs, electric blankets, saunas and hot work environments.
You may want to discuss your job with your doctor to learn if it has any added risks for your pregnancy. Your job might need to be changed to reduce heavy lifting, to switch a shift schedule, to avoid loud noises and to improve back care.
Don't despair if your period comes and you realize that you are not pregnant. Just continue to enjoy your healthy lifestyle. It is not unusual to take a full year to get pregnant. For this reason, you may prefer not to tell those around you that you are trying to get pregnant. They can sometimes watch you like a hawk and make your life miserable. Remember miscarriage is very common even in healthy normal couples and it is unusual for a woman to have recurrent miscarriages.
Once pregnant, you may notice several symptoms, including fatigue. You may need 10 to 12 hours of sleep each night, but if you fight this need, you are more likely to end up nauseated. Listen to the signals Mother Nature gives you. Drink water when you are thirsty. Eat whatever appeals to you when you are hungry, even at 3 a.m. Sleep lots and adjust your exercise if your tolerance level drops.
Often women find their breasts are so tender and their energy levels so low that they have no sex drive. This will likely settle in the second three months of pregnancy, allowing the return to a normal sex life. Both partners will usually find it helpful to keep communicating what they are feeling with their mate.
Arrange to see the doctor who is caring for you early in your pregnancy. Continue to follow the healthy choices you made in the critical time before your pregnancy.
FAMILY HEALTH is written with the assistance of |
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