We are becoming more aware of the importance of the general wellbeing of both parents at the time of conceiving a pregnancy. We have therefore put together a checklist of things to consider when you are planning a pregnancy. Your GP, fertility specialist, obstetrician or gynaecologist are always happy to discuss these issues further.
There are many pregnancy supplements available in Australia, which are mostly of excellent quality. For people who follow a balanced diet the only supplements required are 400mcg of folate and 150mcg iodine daily, preferably for at least one month prior to conception and for the first 3 months of pregnancy.
Women in the following groups are advised to take a higher dose of folate (1.5-2mg/day):
A personal history (self or past pregnancy) of neural tube defect (NTD)
A first degree relative with a pregnancy with a NTD
Use of sodium valproate
Body mass index greater than 30 kg/m2
Diabetes mellitus (type 1 or type 2) women are advised to take 5mg of folate daily (high dose).
Some sources have recommended a vitamin D supplement as well, particularly for those at risk of deficiency (people who are dark skinned, veiled, see limited sunlight or have proven vitamin D deficiency). If you choose a vitamin D supplement, we recommend 1000iu cholecalciferol (D3) per day, or if you are deficient, discuss the dose with your doctor.
Further reading:http://www.fertilitysociety.com.au/wp-content/uploads/FSA-Micronutrient-Folic-Acid-Iodine-and-Vitamin-D- Supplements-Pre-Conception-and-During-Pregnancy.pdf
Screening tests & Immunisations
The following tests are recommended for women who are intending to become pregnant
- Full blood count
- Blood group antibody screen
- Syphilus, Hepatitis B, Hepatitis C, HIV, Rubella antibody tests
- Pap smear +/- sexually transmitted infection screen
These are performed prior to pregnancy if possible so immunisation against rubella or treatment of abnormalities can occur prior to pregnancy.
Many vaccinations are safe in pregnancy, but always tell your doctor before having an immunisation if you might be pregnant already. We recommend flu vaccination for all women hoping to conceive or already pregnant as influenza can be a very severe illness during your pregnancy.
For further reading:
Medical conditions such as heart disease, hypertension, diabetes, epilepsy, mental ill-health, hormonal and autoimmune conditions can have a significant impact on your pregnancy. Ideally we should optimise the management of these conditions before you become pregnant, often in conjunction with your GP and physician. If you are already pregnant and have underlying health problems, please make an appointment with your GP or obstetrician as soon as possible.
Some families have health conditions that can be inherited by the next generation. If you wish to reduce the chance of your children inheriting some conditions either pre-implantation genetic diagnosis using an IVF process, or early pregnancy genetic screening can be offered. Your obstetrician will discuss some of these issues with you and may offer genetic counselling, or carrier screening prior to you conceiving.
We recommend a dental check up in the pregnancy planning phase as there is an association between dental disease, prematurity and low birth weight. The hormonal changes of pregnancy can affect dental health, in particular gum disease.
For further reading:
Insurance and Financial Planning
To be cared for by our obstetric group practice private health insurance will be required. There are taxation advantages for some families with holding private health cover. Most insurance companies have waiting periods which apply to obstetric cover. It is also important that you assess if your baby will be covered by your policy, and whether changing to a family policy may be to your benefit.
The Medicare safety net can assist in reducing your out of pocket costs, which you need to register for with Medicare. You may also wish to assess your family budget and work out how expanding your family may impact on your finances.
Paid Parental Leave
Your current employer may have parental leave options, and the Australian Government offers paid parental leave to some families. It is useful to register before the birth of your baby to minimise the to-do list in those busy few weeks after a new baby is born!
Mindfulness & emotional wellbeing
Trying to conceive and being pregnant are extremely exciting times, but can also be stressful. Good mental and emotional health is vital and we recommend you include some activities in your life that will improve your general wellbeing. These will be different for everyone, but some ideas are a regular time to connect with your partner or loved ones, mindfulness or meditation training, regular exercise and downtime doing activities you enjoy.
Some resources you might find useful are: