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Planning for pregnancy

This factsheet is for women who are planning to have a baby, or for anyone who would like information on how to prepare for pregnancy. It also includes information for men who plan to become fathers.

Being fit and healthy maximises the chances of a healthy pregnancy. By the time you have missed your first period, you are two weeks pregnant. So, it's best to prepare for a pregnancy before trying to conceive, and to follow the advice that is given to pregnant women.

Click on the tabs below for more information about planning for pregnancy.

Published by Bupa's Health Information Team, April 2010.

About

About

Stopping contraception


If you're planning a pregnancy, you will need to think about stopping the contraception you have been using. You may worry that some methods of contraception will make it difficult to get pregnant, however most women's normal level of fertility and periods return very quickly.

You will regain your normal fertility quickly when you:

  • stop using barrier methods of contraception, such as the condom and diaphragm
  • stop taking the contraceptive pill
  • have a contraceptive implant removed
  • have an intra-uterine device (coil) removed, including one that releases hormones
If you use contraceptive depot injections, your return to fertility may be delayed after you stop them. The time it takes to become fertile again varies between women, but it may be up to 12 months.

When is the best time to conceive?


More than eight in 10 couples who have regular sexual intercourse and don't use contraception will conceive in the first year of trying for a baby. Having sex every two to three days is the best way to conceive. Trying to time intercourse with ovulation (when an egg is released from your ovary each month) can put both you and your partner under stress and this is unlikely to help you conceive.

If you've been trying for a baby for a year without getting pregnant, you and your partner should see a doctor. If you are over 35 or you have infrequent or no periods, visit a doctor sooner.

Healthy weight


If you smoke or you're underweight or overweight (BMI less than 18.5 or over 25) you're more likely to have trouble conceiving. Try to lose weight, if you need to, before you become pregnant - it's important not to diet to lose weight when you're pregnant.

Healthy eating


Eating a healthy diet before pregnancy means that your body has adequate stores of vitamins and minerals. A nutritious, well-balanced diet includes:

  • plenty of fruit and vegetables (at least five portions per day), which provide vitamins and fibre
  • starchy foods such as potatoes and whole grain cereals, bread and pasta
  • protein such as lean meat, fish and pulses
  • dairy foods such as milk and yoghurt, which supply calcium
It's best to limit your intake of sugary, salty and fatty foods.

Pregnant women can become anaemic, so make sure you eat plenty of iron-rich foods. These include red meat, pulses, fortified breakfast cereals, dried fruit, bread, and green vegetables.

A well-balanced and varied vegetarian diet should provide all that you need, but you may find it harder to eat enough iron and vitamin B12. It's a good idea to speak to a doctor or another healthcare professional about ways to increase your intake. Also ask for advice if you are on a vegan or any other restricted diet.

There are certain foods that you shouldn't eat pre-pregnancy because they put you at risk of food poisoning or may harm the baby if you do become pregnant. These include:

  • liver and large quantities of vitamin A in supplements such as fish liver oils
  • unpasteurised dairy products
  • raw or soft-cooked eggs
  • patés, including vegetable paté
  • soft cheeses such as brie or camembert
  • blue cheeses such as stilton or roquefort
  • swordfish, marlin and shark
  • any more than two tuna steaks (170g raw) or four tins of tuna (140g drained) per week

Folic acid


Folic acid (one of the B vitamins) is the only pre-pregnancy vitamin supplement that women who are eating a balanced diet need to take.

You need folic acid for the development of healthy red blood cells. Adequate intake of folic acid also reduces the risk of your baby being born with a neural tube defect, such as spina bifida. The neural tube develops very early in pregnancy, during the first few weeks after fertilisation. At this point, you may not have even realised you're pregnant.

It's important that you start taking folic acid supplements as soon as you start trying for a baby or realise you are pregnant. The recommended dose is 400 micrograms (0.4mg) daily, which you should take as well as meeting the recommended intake of 200 micrograms in your diet. Good sources of folic acid include fresh dark green vegetables such as broccoli, peas, brussel sprouts and chick peas. Many breakfast cereals are fortified with folic acid and it's also found in wholemeal bread.

A higher dose of 5,000 micrograms (5mg) of folic acid is recommended for women who have previously had a baby with a neural tube defect, are taking medicine for epilepsy, or have diabetes, thalassaemia or coeliac disease. If you have a family history of neural tube defects, then you should also take the higher dose. Speak to a doctor about folic acid before trying for a baby if any of these apply to you.

Advice for fathers


Smoking and drinking alcohol can affect the quality of sperm, so men should stop smoking and drink no more than three to four units of alcohol per day. Men should also try to maintain a BMI of less than 29 because being overweight can reduce fertility. There is a link between increased scrotal temperature and reduced sperm quality, so it might be a good idea to wear loose-fitting underwear, although it's uncertain whether this will improve fertility.

What to stop before trying for a baby

What to stop before trying for a baby

Smoking


Try to stop smoking before attempting to become pregnant. Smoking reduces fertility by affecting ovulation in women and reducing sperm count and sperm motility in men.

Smoking during pregnancy increases the risk of premature birth, low birth weight and cot death.

Alcohol


Too much alcohol may decrease fertility in men. For women, heavy drinking, especially binge drinking, can cause problems for a developing baby, leading to poor growth, intellectual impairment or birth defects (fetal alcohol syndrome). The effects of small amounts of alcohol in pregnancy are not clear, but doctors know that it does cross the placenta and may affect the baby's developing brain.

It's best not to drink alcohol if you're trying to conceive, or at any stage during pregnancy. This is particularly significant during the first three months of pregnancy, when important organs such as the brain are forming. Alcohol in the first three months also increases the risk of miscarriage. If you do decide to drink alcohol, have no more than one or two units of alcohol, once or twice a week.

Medicines


Some medicines can affect fertility and may be harmful to the baby if you become pregnant. You should speak to a doctor if you take prescribed medicines and ask a pharmacist or doctor for advice about any other medicines. If you take regular medication, it's important to talk to a doctor before you stop taking it.

Hazards at work


Some working environments can have an impact on fertility. You may be risking your health or the health of your baby if you work with X-rays, chemicals or lead. Speak to a doctor, midwife, or the personnel department at work if you are routinely exposed any of to these. Your employer is legally bound to provide a safe working environment for you, and for some women this might mean changing roles during pregnancy.

Issues to discuss with a doctor

Issues to discuss with a doctor

Existing medical conditions


You should speak to a doctor before trying to conceive if you have any medical conditions. He or she can give you advice about long-term conditions such as asthma, diabetes or epilepsy, or past conditions such as a deep vein thrombosis (DVT). A doctor may refer you to a specialist for advice before you become pregnant.

Pregnancy affects some conditions, and others can affect the developing baby. You may need to change or stop taking your usual prescription medicines.

Immunisations


Rubella (German measles) used to be a common childhood illness but many children are now immunised against it. If you're infected with rubella during pregnancy, especially in the first three months, there is a high risk of the baby being deaf, blind or having heart or other abnormalities. You can have your rubella immunity checked with a blood test if you aren't sure whether you have been immunised or had the infection in the past. A doctor can give you an immunisation if you need it. You will be advised not to become pregnant for one month after the immunisation.

If you're a health professional who works with patients, a doctor can check whether you're immune to chicken pox, and give you an immunisation if you're not. You will also get a chickenpox immunisation if you're a close contact of someone who has a weakened immune system.

You may also be offered an immunisation against hepatitis B, for example if you live with someone with the disease or you work with people who have it.

Genetic counselling


A doctor may refer you for specialist genetic counselling if you or your partner has a family history of genetic or chromosomal disorders, such as cystic fibrosis or Down's syndrome.

Sources

Sources

  • Planning a pregnancy. Family Planning Association, April 2007. www.fpa.org.uk
  • Long-acting reversible contraception. National Institute for Health and Clinical Excellence (NICE), 2005 www.nice.org.uk
  • Pre-conception - advice and management. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 19 December 2009
  • Fertility: assessment and treatment for people with fertility problems. National Institute for Health and Clinical Excellence (NICE), 2004 www.nice.org.uk
  • The Pregnancy Book, 2009. Department of Health. www.dh.gov.uk
  • Trying for a baby. Eatwell. www.eatwell.gov.uk, accessed 20 December 2009
  • When you're pregnant: Vitamins and minerals - Folic acid. Eatwell. www.eatwell.gov.uk, accessed 19 December 2009
  • Alcohol - problem drinking. Compliations. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 20 December 2009
  • Antenatal care: Routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk

This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. This content was compiled by Bupa based on clinical information and practice current as at the stated date of publication. Content is likely to reflect clinical practice in a particular geographical region (as indicated by the sources cited) – accordingly, it may not reflect clinical practice in the reader’s country of habitation. This content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Photos and videos are only for illustrative purposes and do not reflect every presentation of a condition.

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