A healthy pregnancy is best achieved by optimising your health prior to falling pregnant. The aim of pre-conception care is to identify and modify any biomedical or social risks to a woman’s health and, potentially, to her pregnancy.
During a pre-conception assessment, your medical, surgical, gynaecological and obstetric history will be assessed, along with your family history, mental health history and social history (including nutrition, exercise, smoking, alcohol intake, and use of other drugs). Your doctor will also be interested to know of your immunisation history, and a panel of blood tests can be ordered to check your immunity to diseases that can cause problems if contracted in pregnancy, such as rubella and chickenpox.
For women with pre-existing medical conditions, your medical and medication history will be assessed. Some medications will need to be changed due to potential pregnancy complications, and those that are safe to use may need to have doses adjusted prior to or during pregnancy. The possible effects of your medical condition on your pregnancy, and your pregnancy on your medical condition, will be discussed with you. This mean you will have an idea of what to expect during pregnancy, and will know what changes may need to be made to “routine” pregnancy care for your individual needs. Rest assured that most women with well-managed pre-existing medical conditions can have healthy pregnancies and normal deliveries.
General advice for all couples who are planning pregnancy include eating a healthy, well-balanced diet, exercising according to the Department of Health’s guidelines (150-300 minutes of moderate intensity activity per week), achieving and maintaining a healthy weight, and avoiding cigarettes, alcohol and other drugs. For women, folate supplementation should start one month before trying for pregnancy – some women should take higher doses of folate than the general recommendation of 400 micrograms/day, so check with your doctor. In addition, women should take iodine supplements when planning pregnancy (150 micrograms/day). Blood tests may indicate that you need other supplements such as iron or vitamin D.
The Your Fertility website, which is part of a national public education program funded by the Australian Government Department of Health and the Victorian Government Department of Health, is simple to use and contains extremely helpful information about fertility-related lifestyle factors for both females and males, including the “Top 5” – age, weight, smoking, alcohol and timing – plus other factors you may need to consider.
Of course, even the best laid plans can sometimes go astray… and sometimes you are pregnant without much planning happening at all! Don’t worry, these assessments can also be done in early pregnancy, and a healthy lifestyle can be achieved at any time of life. If you need help with making these positive changes, referrals can be made to the appropriate allied health specialists to get you on the right track. I look forward to seeing you to help you plan your pregnancy, and to looking after your pregnancy when it happens!