A Woman’s Perspective: What to Consider Before You Conceive
For couples planning a pregnancy, when to conceive and how to have a healthy pregnancy are the two questions most often asked health-care providers. Today, the answers to these questions require a global, local, and personal information-gathering perspective.
For example, because of the current outbreak and transmission of the Zika virus, a discussion with a medical practitioner on when to try to conceive will include asking if you or your partner recently returned from areas where the virus is found. If so, abstinence is recommended for at least eight weeks. Further, if the male partner has symptoms of the Zika virus, the period of safe abstinence is six months. These recommendations are from the World Health Organization (WHO) scientists, now finding the virus lingers longer than previously thought in blood and other body fluids, including semen.
The truth is there are myriad healthcare-related suggestions — and what I like to call “reproduction tango realities” — that couples planning a pregnancy should ponder before trying to conceive. Here are just a few.
Three months before trying to conceive >>
• Schedule a preconception medical check-up for yourself and your partner. During this exam, your health-care provider will go over your and your families’ health histories. Genetic testing from companies like 23andMe and Counsyl may be suggested for additional evidence-based knowledge-sharing, as well as partner pregnancy counseling and decision making.
Your immunizations will be questioned to be sure they are up-to-date. Chickenpox and rubella are of concern the most. If you’re not immune, vaccinations should happen at this time as both chickenpox and rubella are “live” vaccines — not recommended after conceiving. At this exam, too, if you are a woman with a chronic health condition — such as high blood pressure, thyroid disease, diabetes, epilepsy, depression, heart disease or lupus — a pregnancy healthcare management program will be discussed.
• Purge your medicine cabinet of products with ingredients that could affect fertility or harm your baby once conceived. It is highly likely your medicine cabinet is filled with over-the-counter herbal products and medications that you take for such things as allergies, constipation, or headaches — many of which would be unsafe to take once you and your partner start trying to conceive, and for a mom-to-be to take while pregnant. Be sure to ask your doctor what’s safe and what’s not.
• Pick a “start trying to conceive date” — and if your thought is to use birth control pills as your form of contraception until then, reconsider and switch to another method. This is because some women begin ovulating immediately after stopping oral contraceptives, but others do not. It may actually take several months for you to begin ovulating, so best to think ahead and plan for what might happen.
• Get a dental check-up to see if you have gum disease, which is associated with preterm delivery. If you need dental treatments, X-rays, or medications, it is important to take care of these activities before you start trying to conceive.
Two months before trying to conceive >>
• Start reducing your unhealthy-fat intake and now consider taking a multivitamin if you don’t already. Make sure you and your partner have a variety of vegetables and fruits as well as whole grains in your diet every day. Increase the consumption of foods containing iron and calcium. Would-be dads should get plenty of folic acid, zinc, and vitamin C, too, as they are all nutrients vital for optimal sperm production and quality.
• Try to get to within 10 pounds of goal weight before becoming pregnant, then switch to a maintenance diet of about 1,800 calories a day while trying to conceive. Obese mothers face an increased risk of gestational diabetes, high blood pressure, oversize babies, and Caesarean section. Underweight women are at risk of going into preterm labor, experiencing fertility problems, having a low-birth-weight baby or becoming anemic.
• If you have a regular fitness routine before trying to conceive, by all means, continue but if not, consider starting a cardio routine program that can be continued after conceiving. If you’re into marathons or extreme sports, consult a physician to make sure your activities won’t affect fertility or pregnancy. Being physically active once you’re pregnant can help relieve pregnancy aches and pains — and you typically gain less weight, do not go overdue and have quicker labors. It also boosts your energy, helps you sleep, improves your mood, and helps you cope with stress.
One month before trying to conceive >>
• Stop smoking if you smoke; this goes for you and your partner. A woman who smokes or is exposed to secondhand smoke is less fertile and faces an increased risk of stillbirth, miscarriage, preterm delivery, and having a low-birth-weight baby. Most people don’t realize children of mothers who smoke are at higher risk for many health problems, including sudden infant death syndrome (SIDS).
• Note your alcohol or marijuana intake. The March of Dimes and the Centers for Disease Control and Prevention recommend partners stop both once starting to try to conceive. Alcohol can bring down sperm counts; marijuana can decrease sperm density and motility and increases the number of abnormal sperm. Of importance, moms who drink during pregnancy face an increased risk of miscarriage, stillbirth, and having a low-birth-weight baby or one with potentially severe birth defects.
• Watch caffeine intake — excessive intake (more than 300 mg daily) has been linked to fertility problems as well as to an increased risk of miscarriage, preterm delivery, and a low-birth-weight baby. As with most things, moderation is key.
When “start trying to conceive” date comes — and beyond >>
Experts agree women actively trying to get pregnant or who are pregnant should avoid raw fish and fish high in mercury; deli meats, undercooked meat or seafood; unpasteurized soft cheeses; all foods made with raw or lightly cooked eggs; herbal teas, milk and juices; and raw vegetable sprouts. You should not be around paints, solvents or pesticides; or do such activities as cleaning a cat box or rodent cage.
Experts agree would-be dads should wear boxers to assure a lower scrotal temperature (a more sperm-friendly environment). They are also told to keep their turned-on laptop off their lap during the day for the same reason. Would-be dads should avoid cycling for more than two hours a day, six days a week.
The Marin Independent Journal welcomed Dr. Lizellen La Follette as their health columnist from 2015-2018. Her A Woman’s Perspective column appeared every fourth week in the Journal during these 3 years.