Planning for pregnancy

Published July 2018 | 4 min read
Expert contributors Dr Wendy Burton, Chair of the Royal Australian College of General Practitioners Antenatal; Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle 
Words by Karen Burge

Starting a family is an exciting time in your life. Here’s what you should know before you try to conceive.

If you’re trying to fall pregnant there are things you can do to improve your chance of having a healthy pregnancy and birth.

Experts agree that looking after your health before falling pregnant is important. While there are some clear lifestyle changes that are highly recommended, such as giving up smoking, things like losing weight (if you need to) can also make a positive change. And it’s not just about the woman, men can boost their health pre-conception too.

Health check

Before you try for a baby, visit your GP for a health check and chat, advises Dr Wendy Burton, chair of the Royal Australian College of General Practitioners Antenatal and Postnatal Care Specialist Interest Network.

“This is an opportunity to review your personal and family history, as a number of checks and blood testing may be recommended,” she says. “Women should speak to their GP 3 months before they begin to attempt falling pregnant, but women who have significant health issues should speak to their GP well in advance.”

Some areas your doctor might look into include your:

• blood group
• immunisation status (such as rubella, chicken pox and whooping cough)
• other medical conditions including blood pressure, asthma or diabetes that need to be controlled
• heart health
• sexually transmitted infections
• cervical screening
• height/weight
• any pre-existing medical conditions.

“Depending on your family history, genetic testing may be recommended or you can request it," Dr Burton explains.

Your GP will also talk about some of the key lifestyle changes you may need to make, such as giving up smoking, alcohol and other drugs, staying physically active and eating a balanced diet.

Essential supplements

Dr Burton says women should start taking folate (a B-group vitamin) and iodine supplements before conceiving. A daily dose of folic acid (the synthetic form of folate) should be taken at least 1 month before you fall pregnant and throughout the first 3 months of pregnancy (to reduce the baby’s risk of neural tube defects, such as spina bifida).

University of Newcastle Professor in Nutrition and Dietetics, Clare Collins, explains that folate is like ‘a helper nutrient for making DNA’. “DNA is like the backbone of every single cell in your body. And when you’re growing a baby, there’s a lot of activity happening, so you need lots of folate.”

Iodine, she adds, is essential for your baby’s nervous system and brain development. Women also need it for their thyroid function.

Pregnancy and breastfeeding is a time where your body may need additional nutrients. Get advice from your doctor.

Healthy weight

It’s estimated that around half of Australian women of reproductive age are carrying too much weight. If this is a concern for you, and you have time to make an improvement before conceiving, it’s helpful to do so, advises Professor Collins.

Recent research published in the Medical Journal of Australia noted a rise over the past 25 years in first-time mums being overweight or obese. This can put a mother-to-be at risk of complications, including unplanned caesarean delivery, gestational diabetes, pre-eclampsia and cardiovascular disease later in life. It may also impact the health of babies, who can have higher rates of neonatal complications and childhood obesity, and an increased risk of metabolic disease as adults.

The study involved more than 42,000 women with single pregnancies giving birth at the Royal Prince Alfred Hospital in Sydney between 1990 and 2014. Authors found that for overweight/obese women, moving down one Body Mass Index (or BMI) category during 2010-2014 would have prevented:

• 19% of pre-eclampsia cases
• 15.9% of macrosomia in newborns (larger than average birth size)
• 14.2% of gestational diabetes
• 8.5% of caesarean deliveries.

Speak to your GP or check in with an Accredited Practising Dietitian for support if excess weight is an issue for you.

Less well known is the effect that being underweight may have on your fertility. The late Professor Rose Frisch, former Associate Professor of Population Sciences Emerita at the Harvard School of Public Health, studied underweight women and found that if a woman’s BMI drops below 18 or 19 she can stop ovulating even though she may still get her period. So for some leaner women gaining body fat may be key.

Avoid alcohol

Alcohol is best avoided right from the get-go, even when you’re trying to conceive. Given you may not know exactly when you become pregnant it’s wise to stop beforehand.

The National Health and Medical Research Council, Australia’s peak health advisory body, recommends zero alcohol for women who are planning pregnancy, already pregnant or breastfeeding. This is because no amount of alcohol has been proven safe, says Professor Collins.

Men’s health

Dr Burton says men should keep their health in check during preconception too. Keep the acronym SNAP in mind, which refers to smoking, nutrition, alcohol (and other drugs) and physical activity.

“A GP may also give specific advice to the male partner, depending upon his personal and family history,” she adds.