Given that around 50 per cent of all pregnancies are unplanned, the following recommendations could well be adopted (or at least considered!) by all women of child-bearing age.
1. Visit your doctor
Your doctor can assess you, talk through any particular concerns you may have as well as organise appropriate tests and vaccinations. Your doctor can check your immunity to such infections as rubella and varicella (chicken pox). If you are not immune, you can be vaccinated (you will need to wait at least 4 weeks after rubella or varicella vaccination before attempting conception since these are live vaccines).
Your doctor may recommend doing a Pap smear if you have not done one recently. Tests for sexually transmissible infections may also be recommended as well as a blood test to determine your blood group, in particular whether you are Rhesus negative.
If you (or your partner) have any family history of heritable or genetic diseases that might affect your future offspring, now might be a good time to discuss these with your GP who can, when appropriate, refer you to a genetic counsellor or geneticist.
2. Up your folate intake
Folate is crucial for the development of the baby's 'neural tube', the part that becomes the baby's brain, spinal cord and surrounding bones. This neural tube is formed and closed in the first four to six weeks of pregnancy. Given that most women do not actually discover they are pregnant until at least six weeks of pregnancy, it is important not to wait until then to take the supplements. Taking a folate supplement can significantly decrease your baby's risk of developing a neural tube defect such as spina bifida. You should also ensure you include plenty of folate-rich foods in your diet, such as vegetables and fruits (eg. asparagus, spinach, broccoli, oranges, bananas, strawberries), legumes, cereals, nuts and yeast extracts. However even if you have a good balanced, nutritious diet, your baby will still benefit from the addition of a folate (also known as 'folic acid') supplement.
3. Make sure to get enough iodine in your diet
Iodine supplementation is also important since the thyroid gland requires iodine to make thyroid hormones, which are essential for the development of the baby's brain and nervous system both before and after birth.
If iodine intake is inadequate prior to conception and during pregnancy, the mother's stores may be insufficient to support healthy brain and nervous system development. Adverse effects on brain and nervous system development are generally irreversible and may have serious implications in terms of reduced IQ and mental capacity.
The main dietary sources of iodine are fortified bread, dairy and seafood. It is difficult to get sufficient iodine through diet alone and the thyroid can only store small amounts so topping up with a daily oral iodine supplement of 150mcg or taking a combined supplement (such as 'I-folate') is highly beneficial and recommended for women who are pregnant, breastfeeding or planning a pregnancy. Talk to your doctor first if you have a pre-existing thyroid condition and avoid kelp or kelp-based products (which have varying levels of iodine and may be contaminated with mercury and other heavy metals.)
4. Stop smoking
Quitting smoking can decrease your risk of miscarriage and your baby's risk of low birth weight, pre-term delivery, cleft palate, cross-eyes, weak lungs, weak immune system and obesity in childhood. The sooner you quit - or at least cut down - the sooner the benefits accrue. Download the free Quitbuddy app to help get you started.
5. Avoid alcohol
It is well known that excessive alcohol intake in pregnancy can cause FAS (foetal alcohol syndrome) in which babies are born underweight with characteristic facial anomalies as well as increased risk of heart problems, learning disabilities, language problems, attention, memory, hyperactivity and co-ordination problems. It is less well agreed the extent to which low level drinking may be harmful. However since no healthy level of drinking has been established, it is recommended that women avoid alcohol if they are or might become pregnant.
6. Avoid drugs
Recreational drugs should of course be avoided and even prescription drugs should be discussed with your doctor in the context of safety with possible future pregnancy.
7. Limit your caffeine intake
While small quantities of caffeine (such as one cup of coffee a day) are unlikely to be harmful, more excessive intake may delay conception and possibly increase miscarriage risk.
8. Be as healthy as you can be
A vital part of pre-pregnancy preparation is of course ensuring a healthy, balanced, varied diet and optimising nutrition, getting adequate exercise and achieving and maintaining a healthy weight. Getting plenty of sleep, rest and relaxation are also extremely important. And as much as possible aim to minimise stress.
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