#JanuaryJoy – Family Planning

A while back, following one of the medical posts I have written, a reader who shall remain nameless ;) wrote to me and asked me to do a pre-conception post. I think a lot of women skip that pre-natal trip to the GP to ask advice before they get pregnant as so much is freely available on the internet and they feel they might be wasting our time. In fact nothing is more important than staying healthy and never more so than when creating a new life.


Image Credit: Baby Space

This isn’t intended to freak anybody out, nor to make those who simply got on with it and got pregnant feel bad. I figured that 2013 might well be the year that many of you have decided will be the year you’ll try to get pregnant, so thought this might be useful to stash away and read when the time comes. I won’t be covering getting pregnant as if you’re struggling that’s definitely one for your GP, and if you’re not then, well, I guess you knew what to do ;)

So here’s my check list of things to think about both from a health and sensible point of view.

1. Take Folic Acid
Number One on any pre-conception list has to be Folic Acid. Taking 400mcg of Folic Acid daily from the day you decide to start trying (all pregnancy vitamins contain the correct amount, or you can buy it alone,) will help prevent neural tube defects, or Spina Bifida. You might not think it’s important, but Scotland saw a nasty rise in Spina Bifida births in recent years when folic acid usage took a dip. The neural tube is the part of the baby that forms the spinal cord and surrounding structures and as the foetus develops it arises from the cells folding around the developing cord. This takes place from conception to 12 weeks, and if it doesn’t happen properly can cause problems below the level of the defect (with the bladder, bowels or legs for example) and babies born with deformities in their back. All these things can often be corrected but prevention is better than cure, especially as most people don’t know they’re pregnant until 4-6 weeks. It’s never too late to start taking folic acid if you find out you’re pregnant and haven’t been taking it, but it’s better even if you think there’s an outside chance of an accident happening to be covered all the same. (NB! Women with some conditions such as epilepsy are recommended to take a higher dose of 5mg daily – check with your GP if you are unsure.)

Now we have covered my number one issue, onto the other stuff.

2. Get in shape.
To give yourself the best possible chance of pregnancy you need to be fit and healthy, which also gives you a head start on enjoying your pregnancy. If you’re overweight, think about trying to shift a few pounds as obesity makes a pregnancy higher risk and can affect your chances of getting pregnant in the first place too. Whether you stop drinking entirely is up to you, but reducing your alcohol intake to an occasional glass won’t hurt and if you smoke it goes without saying, just stop.

3. Review your medications.
Plenty of medications are fine to take in pregnancy and often we have to weigh up the pro’s of mum being happy and healthy against the possible risks to the baby, but some are not, including anti-depressants, anti-epileptics and acne treatments. Unsurprisingly there is always a lack of evidence for drug use in pregnancy as nobody tests drugs on pregnant women, so the advice will often be to stop if you can. In the case of essential drugs however like anti-epileptics, it’s often just a matter of switching to a baby friendly variety in good time before you get pregnant. Diabetics should also see their GP prior to trying to concieve.

4. Get your cervical smear.
You can’t have a smear early, (and don’t forget you’re due one every three years from the age of 25,) but you also can’t have one when you’re pregnant, or for 3 months after having a baby as the cells the test samples are different due to the hormones of pregnancy. If you’re trying and a reminder comes through, don’t delay!

5. Lastly, check you are up to date with your jabs.
Once pregnant you will be offered (correct at time of posting, Jan 2013,) a flu jab and whooping cough vaccine. However your immune system is slightly suppressed whilst pregnant and catching some diseases like rubella or measles can seriously damage an unborn baby. We’re seeing a big risk in incidence of these diseases due to the fear over MMR vaccines some years ago now. If you aren’t sure if you have been vaccinated, check with your GP and get up to date.

One last thing. You may not be ready to try for a baby yet but if it’s on the cards in the next few years you might want to re-think your contraceptive choices. Especially if you’re a little older, it pays to be able to start trying as soon as possible from when you discontinue your chosen contraceptive, so you want one that’s immediately reversible rather than taking ages for your fertility to return. The main one to watch out for is the Depo Provera contraceptive injection. This can take several months to fully leave the system before your fertility comes back and you start ovulating again, so I don’t recommend it for women thinking of having a family in the next 12-24 months, or even between babies, unless you’re happy to deal with a long wait. When coming off the pill your periods can take a few months to settle into a normal pattern but it’s not a widely recognised problem. The coil, Mirena or IUS and implant are all immediately reversible.

Do let me know if this was useful and of course, remember, reading this is no substitute for a chat with your GP – we really enjoy seeing people for chats like this – it’s our job! Now I’d love to hear if any of you have been thinking about getting ready for trying, or if you’re already a mum or pregnant, how did you prepare? (Feel free to write anonymously if you want to stay private.)

Happy weekend readers!

Love,
Rebecca
xo

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