Pre-Pregnancy
Embarking on pregnancy is one of the most exciting and important events in most people's lives. Like all major events, planning and preparation can help maximise the chances of the pregnancy progressing smoothly. During this time, individuals and couples have the opportunity to make essential preparations and considerations.
The pre-pregnancy phase sets the stage for a positive and fulfilling pregnancy experience. If you’re planning on embarking on a pregnancy, it is worth considering the following:
1. Models of Care
Before getting pregnant, it's crucial to consider how you want to receive care during your pregnancy, specifically whether you prefer the public hospital system or private obstetrician care.
Public hospital care is typically free, although there may still be costs for blood tests, ultrasounds, etc. Opting for a private obstetrician like myself requires considering doctor fees and private hospital charges.
Most private health insurance policies cover hospital costs and partially cover doctor fees, but reviewing your policy for coverage details is essential. If you don't have insurance yet, arranging a policy before becoming pregnant is crucial. Take the time to compare different policies, as they can vary significantly.
Remember that waiting periods may apply before you are eligible for pregnancy-related claims. If you choose public hospital care, the hospital you attend is generally determined by your residential area, with limited choice over specific doctors or midwives who will be assigned to your care as part of a team.
2. Diet
Before pregnancy, it is crucial to maintain a well-balanced diet that incorporates foods from all five major food groups. Include regular servings of fruits, vegetables, legumes, meats, fish, milk, yogurt, and cheese. Limit the consumption of foods high in added sugars and saturated fats. Take caution with fish containing high levels of mercury, such as shark, marlin, swordfish, orange roughy, and catfish, which should be eaten no more than once per fortnight. Other fish can be consumed once or twice per week. You should avoid high-risk Listeria foods that can pose a risk to your unborn baby. These include soft cheeses, cold processed meats, bean sprouts, pâtés, raw eggs, and pre-prepared salads. Ensure meat is thoroughly cooked.
If overweight, consult a doctor for appropriate weight loss strategies before pregnancy, as severe dieting and weight loss during pregnancy are generally not recommended.
3. Exercise
As a general statement, the fitter you are when you embark on a pregnancy, the better you will cope with the rigours of pregnancy, birth and caring for a newborn baby. There are also additional health benefits to you and your baby from being fit, and maintaining fitness during pregnancy. Cardiovascular fitness, strength and flexibility are all important, and exercises that help strengthen your abdomen / core and pelvic floor are particularly important.
If you have been inactive for a long period of time, or if you have health issues, you should consult your doctor before you embark on a vigorous exercise program. If you are already pregnant, you should consult your pregnancy care provider to discuss appropriate exercise plans which take into account your stage of pregnancy and personal circumstances.
4. Other Lifestyle Factors
Smoking
Smoking is a health risk whether you are pregnant or not. When considering pregnancy, you need to be aware of the negative impacts of smoking on pregnancy. These include increased chances of miscarriage, preterm birth and stillbirth, and effects on fetal growth and placental function. Smoking during pregnancy also increases the risk of SIDS (Sudden Infant Death Syndrome) and childhood asthma, even if you don’t smoke after the baby is born.
There is no doubt that if you are a smoker, it is preferable to cease smoking before commencing your pregnancy rather than waiting until you are pregnant until you try to stop.
If your partner is a smoker, it can be much harder for you to quit. Although partner smoking may not have such significant risks to pregnancy, having a smoker in the house can also increase the risks of childhood problems like SIDS and asthma. You should discuss together the benefits of them ceasing smoking. If you both stop together, you will find it more manageable.
Quitting smoking can be difficult. If you are contemplating pregnancy, you may benefit from speaking to your doctor or contacting Quitline (137848 / 13 QUIT).
Alcohol
Whilst there is some debate on the subject, most experts (including the Australian National Health and Medical Research Council) recommend avoiding alcohol altogether during pregnancy. That is because we don’t know if there is a “safe” amount of alcohol consumption in pregnancy, and if so, what that safe level is.
It is undoubtedly the case that regular or heavy drinking during pregnancy has the potential to be harmful to an unborn baby and should be avoided.
Illicit Drugs
There are no illicit drugs that are considered safe in pregnancy. If you regularly use illegal drugs, you should consult your doctor or other health professional to discuss the best strategy for managing this issue before commencing your pregnancy.
5. Supplements
Folic acid
Folic acid supplementation has been shown to reduce the risk of several congenital disabilities, including spina bifida. You should take a multivitamin supplement containing at least 400 mg per day for at least one month before you fall pregnant and for the first three months of your pregnancy.
Iodine
Iodine is vital as an ingredient for the production of thyroid hormones. Thyroid hormones are responsible for a range of body metabolism functions and, during pregnancy, can impact your baby’s brain development.
In Australia, iodine intake has decreased in recent years. Seafood, bread, dairy products, seaweed and eggs are good sources of dietary iodine. In addition, for women who are planning a pregnancy, pregnant, or breastfeeding, the National Health and Medical Research Council recommends taking a supplement containing at least 150 micrograms per day.
If you have a pre-existing thyroid condition, these recommendations may not apply to you, and you should discuss your specific requirements with your doctor before commencing a pregnancy.
6. Vaccinations
Several infections can cause problems if they occur during pregnancy. Some of these can be prevented, or their effects minimised by vaccination. These include rubella, chickenpox and influenza (“the flu”). Most people in Australia are vaccinated against these conditions. However, even if you have been vaccinated in the past for these diseases, your immunity can reduce over time, and you should consider consulting your doctor to assess your need for vaccinations if you are planning to get pregnant. Some vaccines can be given safely during pregnancy; others are best avoided during or immediately before pregnancy. Your doctor will be able to advise you on which vaccines you should have and their relative safety in pregnancy.
7. Tracking Your Ovulation
Knowing when you're ovulating can be helpful for women to increase their chances of conceiving. It can be even more critical for women with irregular periods as ‘peak’ fertility days may fall outside the typical 28-day cycle.
To track when you may be ovulating, find out when the first day of your last period was. This can be considered day one. Assuming a roughly 28-day cycle, your fertile window is usually between Day 10 and Day 15. This, however, is a rough guide as every woman is different. If your cycles are longer or shorter than 28 days or irregular, you must discuss with me or your general practitioner when your most fertile time is.
8. Health Check
Having a pre-pregnancy health check-up before you start trying to get pregnant is often a valuable way of optimising your health for pregnancy. You can address any questions you have about the issues discussed above. If you have any health problems, I can consult on how to manage these leading into pregnancy. This may also include a review of any medications you are taking to ensure that they are appropriate and safe for pregnancy. Sometimes medications must be changed, which is best done before you fall pregnant. I may also discuss the option of doing some blood tests to assess other aspects of your health in preparation for pregnancy. If you’re overdue or nearly due for a pap smear or breast examination, getting these done before your pregnancy is preferable. You can also discuss any concerns you may have. If you have had any previous episodes of mental health disorders (e.g. anxiety, depression, psychosis), developing a care plan is essential, as sometimes pregnancy can cause these conditions to worsen temporarily.
You may have your pre-pregnancy check with your general practitioner/family doctor or an obstetrician, such as myself. If you have specific concerns about pregnancy, it may be helpful to discuss them with me. If you choose to see me, you will need a referral from your general practitioner. If you don’t have a referral, you will not receive any Medicare rebates, and the visit will be more expensive.
As one of Melbourne’s leading obstetricians, I am specifically trained and experienced in handling all aspects of pregnancy, including high-risk pregnancies. In my private practice, I care for all pregnant women and take a holistic approach towards pregnancy care from the onset.
Prepare For Pregnancy with Dr. Stephen Cole
As one of Melbourne’s leading obstetricians, I am specially trained and experienced to handle all aspects of pregnancy, including high risk pregnancies. In my private practice, I care for all pregnancy women and take a holistic approach towards pregnancy care from onset.
Pre-Pregnancy FAQs
What tests should I get done before getting pregnant?
I recommend all women test for Rubella, Hepatitis C, Hepatitis B, Syphilis and HIV infection before or during pregnancy. At your first prenatal visit, you should have your blood tested for antibodies, blood type and other conditions or disorders that may affect your pregnancy. Checking before pregnancy to see if you are anaemic or have low iron is often helpful and allows time to correct any problems identified. If your cervical screening test (pap smear) is overdue, it is wise to do that before pregnancy.
Should I go to the doctor before getting pregnant?
Before trying to conceive, it’s a good idea to visit your family doctor to discuss the process to ensure you have the healthiest pregnancy possible. Your doctor can provide the proper tests and recommend a private obstetrician like me to guide you throughout your pregnancy.
When should I see my doctor after a positive pregnancy test?
Finding out you’re pregnant can be very exciting. You should call your doctor to schedule your first prenatal appointment as soon as possible after a positive home pregnancy test. During this appointment, your doctor can confirm the pregnancy and begin the planning stages.