Deciding to have a baby
Deciding to have a baby brings with it a mixture of emotions for both men and women alike. It can be both daunting and exciting at the same time. This mixture of emotions can become quite overwhelming, especially when trying to understand and absorb the wealth of information available. This is normal and shouldn’t frighten you. Having a baby is a big decision. It’s life-changing and shouldn’t be taken lightly. There are ways to keep your emotions in check, maintain a realistic approach and achieve this wondrous accomplishment in your life.
For many, trying for a baby and getting pregnant is not a difficult process. Some women fall pregnant quite quickly, while others find the process takes a little time. This is normal – every woman is unique to some degree and her body will take to pregnancy differently. For others, difficulties get in the way and their fertility journey joins a different path to try and conceive.
The process almost always starts off simply – eat well, keep fit, load up on folic acid and pregnancy vitamins and initiate open communication between yourself, your partner and your doctor, nurse or midwife. Once you’ve decided to have a baby, preparing for the little one is the most ideal scenario and an important step for a healthy and happy pregnancy. It is never too early to get yourself ready for pregnancy.
What happens in the time before you conceive is just as important as after. There are plenty things you can do before and in between pregnancies to better your chances of having a healthy pregnancy and baby.
Tips to prepare for pregnancy
Protecting your pregnancy… even before you conceive
Pregnancy is a heavily physical change for a woman’s body. Getting the body ready for pregnancy can take a few months. Whether you’re trying for you first or third child, it is important to take the best possible care of the body your baby will grow and form in. A healthy pregnancy comes with a little effort and the result is a happy, heathy baby (and new mom, too).
Whether male or female, both can and should, prepare for pregnancy. Here are some tips to improve your chances of falling pregnant and having a healthy pregnancy:
- Medical conditions and disabilities: Your past or current health state, as well as your family history may have an impact on your pregnancy. Do you have a medical condition such as diabetes or epilepsy? Do you perhaps have a history of heart or circulatory problems, such as high blood pressure or thrombosis (blood clots)? Do you or your partner have any known hereditary conditions in the family, such as muscular dystrophy, cystic fibrosis or sickle cell anaemia? Perhaps, as a woman, you’ve had gynaecological problems, such as endometriosis, PCOS (polycystic ovary syndrome) or even experienced an ectopic pregnancy (where a fertilised egg implants outside the womb / uterus) in the past. Whatever the medical condition or difficulty, it is strongly advisable to speak with your primary health care provider (General practitioner / GP or gynaecologist) if you have a known problem or suspect one (either in yourself or your partner) before trying to get pregnant. If you or your partner has an inherited condition, your doctor can best advise on genetic counselling and testing. You may struggle to fall pregnant if you or your partner have a disability. In this instance, you may need specialist help. It is important to work side by side with your doctor if you have a disability and fall pregnant. Specialist advice and care will help to best ensure a safe and healthy pregnancy (and baby).
- Medications: Any medicines you are taking at the time of trying to get pregnant should be mentioned to your doctor. Some medications will have a direct effect on a developing baby. It is important not to simply stop taking medications as many can be phased out, changed or dosages amended. This will ensure that your own health is not compromised (if you are taking medicines to treat a specific or chronic health condition) and that what you’re taking won’t affect the development of a foetus. Whether you’re taking prescription or over-the-counter medications, always ensure that you inform your doctor and pharmacist of your intensions to fall pregnant. A pharmacist can also advise on safe alternatives. Try and avoid any medications for treatment that aren’t essential and take extra care when using herbal, alternative remedies or complementary therapies too. Recreational drugs (illegal substances) will have an adverse effect on a developing baby and should be avoided altogether. A male partner who indulges is such drugs should also avoid them altogether as they can affect a man’s sperm, which impacts a pregnancy negatively.
- Sexual health: Confidential advice is available if you or your partner are concerned about a sexually transmitted infection (STI). This includes whether you or your partner currently have an STI or either of you suspect some risk. Some STIs can affect your chances of getting pregnant and if not effectively treated and under control can be passed on to a baby, either during pregnancy or birth. A cervical screening test may be offered to you to assess any risk. If you or your partner have a sexual problem, a trained counsellor can assist. Whatever the problem or concern, don’t feel shy to talk about it with your health care provider. In many cases, your doctor or specialist can help, advise and ensure a safe and healthy pregnancy.
- Rubella (German Measles): Infections such as German Measles while pregnant can be extremely harmful to a developing baby, especially during the first 12 weeks of pregnancy. A rubella infection can cause serious damage to a baby’s heart, eyes and ears, and it’s very important to check your immunity before trying to fall pregnant. Your doctor will test your level of immunity by means of a blood test (if you’ve already been vaccinated) or offer you a rubella vaccination (often in the form of the all-in-one MMR vaccine) to protect against an infection before trying to get pregnant (at least one month before falling pregnant).
- Contraception and birth control: There are many methods of birth control which you will likely decide to give up when trying to have a baby. Currently, no reversible method of contraception is known to cause infertility. Whether your choice was an oral contraceptive, injection or IUD (Intrauterine device), you can stop your choice of birth control and safely try to fall pregnant. You will need to take into consideration the type of birth control method you used when trying for a baby. Ovulation (releasing of an egg) can sometimes be delayed or irregular for a short time once hormonal contraception methods are stopped. A woman’s menstrual cycles and fertility will return to normal though and will not harm a developing baby.
- Folic acid: A daily dosage of 0.4 milligrams(or 400 micrograms), from the time you stop contraception or as soon as you receive the news of your pregnancy, is recommended. A member of the vitamin B family, folic acid is necessary for a baby’s development during the early weeks of pregnancy. A healthy dosage can help prevent abnormalities of the neural tubes, spinal cord and the brain (such as spina bifida and anencephaly). A higher dosage may be recommended if you have had a previous pregnancy affected by spina bifida, are currently managing conditions such as diabetes or epilepsy, or you or your partner have a neural tube defect (NTD). In these instances, it is best to let your doctor advise you on the appropriate dosages. Foods rich in folic acid include the green, leafy variety (vegetables) and some breads and cereals with added folic acid content.
- Healthy eating: A nutritious diet is also very important. Both men and women can benefit from eating a variety of foods that include starch (potatoes, pasta, bread, rice and cereals), plenty of fruits and vegetables (fresh, dried, frozen, tinned or juiced), protein (meat, beans, eggs, pulses and nuts), dairy (milk, yoghurt and cheese) and fish. When trying to conceive, foods to avoid include unpasteurised milk and cheese, soft or raw eggs, soft cheeses (such as Brie), undercooked or uncooked or cured meat (including patè) and shellfish (mussels and prawns). These foods, which may contain harmful bacteria, can cause severe food poisoning which may lead to miscarriage, stillbirth or damage to a developing baby. It is important to wash your fruits and vegetables thoroughly before consuming to avoid any bacterial infections or toxoplasmosis (an infection caused by a parasite). Other harmful foodstuffs include vitamin A containing supplements (such as cod liver oil and liver) and some types of fish with a high level of mercury (swordfish, marlin or shark). Peanuts (or foods containing peanuts) should also be avoided if you or your partner have a severe allergy or are asthmatic. Drinks that contain caffeine (coffee, tea, energy drinks and sodas) should be taken in moderation. Chocolate also contains caffeine and should be enjoyed on a moderate basis.
Other important tips for both men and women
Preconception health is as important for men as it is women. There are plenty things men can do for the better of their own health, as well as for the woman and children who may be in their lives. Top tips to consider include:
- Planning: As part of a couple wanting to start a family, planning is as much a part of a man’s responsibility as it is a woman’s. Both can benefit from have a reproductive health plan that is based on their own personal values and goals, as well as resources (such as ensuring that you are both financially sound as this can reduce stress levels for both parties). Ensure that you are comfortably able to achieve these goals as best you can.
- Prevention is better than cure: Be mindful about your sexual health and risk factors that contribute to STIs and STDs (sexually transmitted diseases). A pregnancy does not protect a woman or her growing baby against the damaging effects of an infection. It is better to prevent an occurrence than to treat an infection. Consequences of an STD are significantly more serious for a pregnant woman and her growing baby and can even be life-threatening. Protect yourself and your partner in any way possible, and ensure that you are both screened and treated as soon as possible if an infection occurs. An STD may also cause infertility in both men and women.
- Go for regular check-ups: Be sure to keep yourself in shipshape and see your GP and /or gynaecologist for regular check-ups. Ensure that any medical conditions that arise are effectively treated and that you have appropriate vaccinations to prevent other problems from occurring.
- Substance abuse: Smoking, alcohol consumption and drug abuse is high on the list of harmful things, especially to an unborn baby. In excess, all of the aforementioned substances can harmfully affect your own health too. Smoking (even second hand smoke that is inhaled) can lead to a higher risk of giving birth to baby with a low birthweight. An estimated 20% of low-birth-weight births, 8% of preterm deliveries, and 5% of all delivery deaths are linked to smoking during pregnancy. When trying for a baby, it’s a good idea to be mindful of your smoking or drinking habits as excess can affect your fertility (men and women). Drugs, especially the recreational variety, should be avoided. If you suffer from addiction, it is wise to seek professional help and get your problem under control before considering having a baby.
- Toxic substances: Exposure to synthetic chemicals, metals, fertilisers, sprays and even cat or rodent faeces can cause harm to the reproductive systems of both men and women. Exposure can also make it more difficult for a couple to conceive. Harmful materials and toxic substances should be avoided as best you can, particularly in the workplace and in the home.
- Infertility: Problems with infertility in both men and women can happen due to illness or injury. Where possible, you can help prevent the development of issues that will cause infertility. For a man things that will affect his overall health, as well as number of sperm include heavy alcohol use, recreational drugs, type 1 diabetes, smoking, age, obesity, mumps, hormonal problems, kidney disease, medications (prescription, over-the-counter and herbal supplements) and even radiation treatment or chemotherapy.
- Watch your weight: When your weight leans toward either being unhealthily over or under the normal BMI (Body Mass Index), problems with your overall health arise. An unhealthy individual won’t ensure a healthy pregnancy. Ensure that your lifestyle (not short-term changes) includes good eating habits and regular exercise to help you stay in control of your overall health and wellbeing. A healthy you will ultimately mean a healthier baby during pregnancy and following birth.
- Know your family health history: Your family’s health history will be important for your child’s health. Genetics can play a role in some conditions. There may very well be a hereditary condition or serious health concern in your family. Ensure that you know all that you can find out and share this history with your medical professional. The more you know, the better.
- Get mentally healthy: Having a baby is not just about what physically happens or changes in our lives. How we think, feel and act is a big adjustment too. To be at your most prepared, you need to feel good about your life, as well as value yourself and our partner. Worries, anxiety, and stress will come with the package – having a baby is a major life change, after all, but if these concerns don’t interfere with your daily life, you should be able to handle the changes that will come your way. Where your thoughts and emotions do become problematic, seek professional help before trying to get pregnant.
- Supporting your partner: If you’re lucky enough to have someone special to share this experience with, supporting each other is vital. There are things, as a couple, you can do together to support each other and make things easier for you to be able to conceive. If your partner is trying to clean up their diet or increase their fitness levels, join them. You’ll both reap the benefits. If there is a medical condition involved, support and encouragement from your significant other is essential.
Getting pregnant (conception)
Finding your most fertile time
Part of your planning, especially if you are a woman wanting to have a baby, involves your menstrual cycle. A woman’s cycle is the process during which an egg develops and is released from an ovary. The uterus lining (womb / endometrium) thickens in preparation for a potential pregnancy. If pregnancy does not happen, the uterus lining sheds (this is when you have your menstrual period).
The number of days in a woman’s menstrual cycle is calculated from the first day of her period to the day before the beginning of the following one. Normally, the average length for a regular cycle is 28 days. Some women have shorter or longer cycles, and cycles ranging from 21 to 35 days are also considered normal.
When a woman has her period, about 20 eggs begin to develop in the ovary. Oestrogen (hormone) causes the lining of the uterus to thicken and cervical mucus to become clearer, wetter and stretchier. If a woman were to fall pregnant this process would allow for sperm to easily reach an egg for fertilisation.
An ovulation period will happen around 10 – 16 days before the start of a woman’s next period. Occasionally, more than one egg is released (usually occurring within 24 hours of the first egg being released). When more than one is fertilised, a multiple pregnancy occurs (twins, triplets etc.). Ovulation triggers the production of progesterone, a second hormone in the body. This prepares the lining of the uterus even further by making it spongy, thick and laden with nutrients – an ideal environment for a fertilised egg to be implanted.
Once the ovulation process is done, cervical mucus returns to normal (thick and sticky). An egg will be reabsorbed in the body if it is not fertilised, and increased hormone levels will also reduce.
You can determine your most fertile time in the following ways:
- Take note of changes in your cervical mucus: Your cervical mucus will be thick, sticky and creamy at the beginning and end of the monthly cycle. Just before and during ovulation, this becomes wet, clear, slippery and stretchy (just like raw egg white). This is your most fertile time of the month.
- Temperature: A woman may like to keep track of her basal body temperature (this is your temperature when you awaken after at least 3-hours sleep). This can show you if you have ovulated (your basal temperature dips before ovulation and then rises thereafter). This isn’t the most effective way to assess when to try and conceive, but it can be useful.
- Using an ovulation kit: Many pharmacies stock these kits which can tell you when you may be most likely to begin ovulating. The kit involves testing urine on specific days in your cycle and monitoring cervical mucus.
- Ovulation calculator: You can also use an ovulation calculator to help you track your cycle and find your most fertile period in your cycle. Once you know when you are most likely to be ovulating, it is best to plan daily sexual intercourse during this period. Sperm can survive for between five and seven days in the female body, and as long as it is viable, you may become pregnant. Still, in order to have the highest odds of falling pregnant, regular intercourse is encouraged as the egg only lives for approximately 12 to 24 hours once released.
Confirming your pregnancy
The most reliable sign of pregnancy for women with a regular menstrual cycle is a missed period. A woman can still experience a shorter or lighter period than normal once falling pregnant.
A pregnancy test ‘looks’ for the hormone Hcg (human chorionic gonadotrophin). This is detected in the urine of a pregnant woman.
A pregnancy test can be done from the first day of a missed period. If it’s carried out any earlier, the test is not likely to be accurate at all.
If a woman’s periods are not regular, the earliest she can do a test is around 21 days from when last she had unprotected sex. For many women, a pregnancy test doesn’t show as positive until her period is at least a week late. A negative result can sometimes happen if the test was carried out too early or incorrectly, even though a woman may be pregnant.
It is best to visit your doctor if you suspect you may be expecting and have a pregnancy officially confirmed with a blood test.
Why is it taking time to fall pregnant?
You may be in perfectly good health and have a healthy sex life, but still struggle to fall pregnant. Several reasons may be affecting your ability to fall pregnant. It can be perfectly normal, but may be a little upsetting if you were particularly hopeful about falling pregnant quickly.
Factors that may contribute to pregnancy taking a little longer to achieve than expected can include:
- Ovulation: It can happen that ovulation may not occur every single month. If you have been taking oral contraceptives and recently stopped, your cycle can become irregular for a short time. This means that ovulation may be delayed. Contraceptive injections can also delay or cause irregular cycles for up to a year after stopping this birth control method. If your cycle is a concern, see your doctor to discuss whether or not it is something to really worry about.
- Implantation: Sometimes fertilisation of an egg simply doesn’t take place. Sometimes it does, but the egg doesn’t implant securely in the lining of the uterus, and is lost during a woman’s next period.
- Age: When people talk about pregnancy and age, the ‘biological clock’ tends to come up. It is often a source of great stress for many women once they reach their 30s. It is true that the chances of falling pregnant decrease with age and the quantity and quality of eggs begin to deteriorate. The same is true for men when it comes to their sperm (sperm production). Sperm production also loses quality and /or quantity through ill health or injury. Excessive heat, and tight-fitting underwear can also be problematic for men when it comes to their sperm. The benchmark age that has most women feeling uneasy is 35. It is true that it can take longer or become more difficult to fall pregnant around this age, but it’s not an impossibility at all. Many over the age of 35 have healthy pregnancies and babies.
Should I worry if I don’t fall pregnant after a year?
If you and your partner have been trying to conceive and feel that it is taking an unusually long time (more than a year if you’re under the age of 35 and 6 months if you’re over it), there may be a problem. See your doctor as soon as possible to determine what might be causing your inability to conceive.
Not every problem requires a fertility specialist. Your doctor will be able to advise on your sex life. He or she could possibly suggest that you have sex without using a contraception method 2-3 times a week, for at least a year before considering any specialist tests.
If there are any known medical or fertility problems, or you are over 35 and struggling, your doctor may refer you and your partner to a specialist within 6 months. If this happens, there is still hope on the horizon. Many couples can still conceive with a little help and guidance from a fertility specialist.
Can you get pregnant while on the pill?
Oral contraceptive pills as a birth control method are considered 99% effective in preventing a pregnancy. It is, thus, still possible for a woman to fall pregnant while taking an oral contraceptive. It is estimated at between 2% and 8% of women taking the pill who fall pregnant each year.