Preparing for Pregnancy
There are many things you may consider before trying to conceive for example finances, family support and previous experiences. One very important subject to review is your physical wellbeing. The healthier you are, the higher your chances are of remaining well throughout your pregnancy, childbirth and postpartum journey and the more likely you will have a healthy baby.
Some key things to consider are:
- Dietary supplements (including folic acid)
- Healthy eating (including food safety during pregnancy)
- Weight management
- Diabetes control
Dietary Supplements for Pregnancy
It is very important that you eat a nutritious diet before and during your pregnancy but there are some nutrients that you and your baby require that cannot be provided by diet alone. The country that you live will determine which dietary supplements are recommended. For more information about which pregnancy supplements are recommended in your country speak with your GP or maternity care provider.
Most countries recommend women take folic acid from four weeks before trying to conceive and continue for the first 12 weeks of pregnancy. Folic acid helps to protect the baby against neural tube defects such as spina bifida. 0.8 milligrams daily is the usual dose. If your pregnancy is unplanned and you have not been taking folic acid, start taking it immediately and continue until the end of the twelfth week of your pregnancy.
In New Zealand it is recommended that women take iodine supplements for the full duration of pregnancy and while breastfeeding. Iodine helps to protect the baby’s brain development. The reason it is recommended as a supplement is that studies have shown that the soil in New Zealand is deficient in iodine which means the food that is grown in New Zealand soil is also deficient in iodine. 150 micrograms is the usual dose.
Vitamin D is required for healthy bone and muscle development and the main source is sunlight. It is also found in certain foods such as oily fish, eggs and milk. Some women may be advised to take vitamin D supplements; for example those who live in countries with very little sunlight or who have dark skin, spend little time outside, have minimal skin exposed when outside, have kidney or liver disease or are taking certain medications. The requirement for vitamin D supplementation is often assessed on an individual basis so should be discussed with your maternity care provider or GP.
Eating Well For Pregnancy
Having a nutritious and well balanced diet before you become pregnant will help set you up to have a healthy pregnancy. By adopting good eating habits before pregnancy it will be easier for you to continue eating well throughout your pregnancy which will help you to gain a healthy amount of weight as your baby develops.
There are some foods that should be avoided during pregnancy. It is a good idea to stop eating these foods when you start trying to conceive.
Exercise Habits Before Pregnancy
Exercise is important to help you stay physically fit for pregnancy, childbirth and afterwards. If you don’t already exercise regularly it is a good idea to get into the habit before pregnancy because it is something that will be recommended throughout your pregnancy. You will find more information about exercise during pregnancy here.
Weight Management Before Pregnancy
An ideal BMI for conception is between 18.5 and 25.
Having a BMI over 25 increases the chance of birth defects such as neural tube defects (e.g. spina bifida); and of other complications occurring during the pregnancy including gestational diabetes, problems associated with high blood pressure, labour and birth complications and miscarriage and stillbirth.
Having a BMI below 18.5 increases the chance of preterm birth and having a low birth weight baby.
Before you try to conceive you will increase the chances of a healthy outcome for you and your baby if you can bring your BMI into or closer to the healthy range. If you are struggling to conceive you may find that achieving a healthy weight could help. There are resources here that can support your weight management efforts.
Diabetes Control Before Pregnancy
If you have pre-existing diabetes it is essential that you aim for good blood sugar level control before trying to conceive. There is an increased risk of a baby being born with congenital malformations (birth defects) to a mother with poor diabetes control. The more common birth defects among babies with mothers with poor diabetes control include heart defects, neural tube defects (e.g. spina bifida), cleft lip and/or palate, skeletal malformations and central nervous system defects.
If your HbA1c is below 50mmol/mol the chance of your baby having a congenital malformation is much closer to that of a woman who does not have diabetes. The higher your HbA1c is at the time of conception, the greater the risk of your baby being affected by a congenital malformation. If you continue to have high blood sugar levels throughout your pregnancy you may encounter other complications such as pre-eclampsia, polyhydramnious and birth complications; and your baby may be affected by complications such as macrosomia, hypoglycaemia and increased jaundice.
Your GP or diabetes service will help you to manage your diabetes so you can improve your blood glucose control and lower your HbA1c. There may also be a pre-pregnancy diabetes service in your local area. This is something that you could also ask your GP about.
Alcohol Consumption Before Pregnancy
No amount of alcohol is known to be safe during pregnancy so it is best to stop drinking it at the same time that you start taking folic acid (4 weeks prior to trying to conceive) and avoid it throughout the full duration of pregnancy. Some serious irreversible effects of alcohol consumption at any point during pregnancy include pyhsical and/or neurological abnormalities that are classified as fetal alcohol spectrum disorders.
Smoking Before and During Pregnancy
Any amount of smoking during pregnancy increases the risk of harm to babies such as growth restriction, prematurity, psychiatric illness and cot death. If you can stop smoking before you get pregnant and remain smoke-free after you have given birth you will improve the chances of good health for you and your baby. Many countries now offer free smoking cessation support – contact your GP for information.