Part I
The Game Plan
In this part . . .
âIâm not sure Iâm ready for thisâ is a normal reaction to finding out that youâre pregnant, no matter how long youâve been thinking about having a baby and no matter how long youâve been trying to conceive. Suddenly, youâre faced with the reality that your body is about to undergo some profound changes, and a baby is going to take shape inside you. Well, you may not feel ready, but preparing is easy enough. Ideally, your preparation begins with a visit to your caregiver a few months before you conceive. But even if youâre not that far ahead of the game, this part tells you some of the many ways you can plan ahead for the very important, very interesting next nine months (plus).
Chapter 1
From Here to Maternity
In This Chapter
Checking out your health and family history
Preparing your body for pregnancy
Making it happen: Conception basics
Congratulations! If youâre already pregnant, youâre about to embark upon one of the most exciting adventures of your life. The next year or so is going to be filled with tremendous changes and (we hope) unbelievable happiness. If youâre thinking about getting pregnant, youâre probably excited at the prospect and also a little nervous at the same time. If your pregnancy is still in the planning stages, check out this chapter to find out what you can do to get ready for pregnancy â first by visiting your caregiver and going over your family and personal health history. Then you can determine whether youâre in optimal shape to get pregnant or if you need to take some time to gain or lose weight, improve your diet, quit smoking, or discontinue medications that could be harmful to your pregnancy. We also give you some basic advice about how to conceive, and we touch on the topic of infertility.
Getting Ready to Get Pregnant: The Preconceptional Visit
By the time you miss your period and discover youâre pregnant, the embryo, now two weeks old or more, is already undergoing dramatic changes. Believe it or not, when the embryo is only two to three weeks old it has already developed the beginnings of its heart and brain. Because your general health and nutrition can influence the growth of those organs, having your body ready for pregnancy before you get pregnant really pays off. Schedule whatâs called a preconceptional visit with your caregiver to be sure your body is tuned up and ready to go.
Sometimes you can schedule this visit during a routine gynaecological appointment: When you go in for your annual Pap test, mention that youâre thinking about having a baby, and your caregiver will take you through the preliminaries. If you arenât due for your annual exam for several more months and youâre ready to begin trying to get pregnant now, go ahead and schedule a preconceptional visit with your caregiver. Bring along your partner, if at all possible, so both of you can provide health histories and learn what to expect from this adventure.
If youâre already pregnant and didnât have a preconceptional visit, donât worry â your caregiver will go over these topics at your first prenatal visit, which we discuss in Chapter 5. Taking a look at your history
The preconceptional visit is a chance for your caregiver to identify areas of concern so he or she can keep you and your baby healthy â even before you get pregnant. A multitude of factors come into play, and the caregiver is likely to ask you about the following:
Previous pregnancies and gynaecologic history: Information about previous pregnancies can help your caregiver decide how best to manage your future pregnancies. He or she will ask you to describe any prior pregnancies, miscarriages, or premature or multiple births â any situations that can happen again. For example, knowing whether you had problems in the past like preterm labour or high blood pressure is helpful for the caregiver. Your gynaecologic history is equally important because information like prior surgery on your uterus or cervix or a history of irregular periods also may influence your pregnancy.
Your family history: Reviewing your familyâs medical history alerts your caregiver to conditions that may complicate your pregnancy or be passed on to the developing baby. You want to discuss your family history because you can take steps before you conceive to decrease the chance that certain disorders, such as a family history of neural tube defects (spina bifida, for example), will affect your pregnancy (see the sidebar âWhy the hype on folic acid?â later in this chapter). In Chapter 8, we discuss in more detail different genetic conditions and ways of testing for them.
For those of you considering the use of donor eggs or sperm, keep in mind that the donorâs genetic history is just as important as any other biological parentâs. Find out as much as you can. Your lifestyle: Take stock of the things that you consider everyday pleasures that may put your babyâs health at risk. Recent studies have shown that alcohol, even in minute amounts, can have long-term effects on your developing baby. For more information about fetal alcohol syndrome contact the Canadian Centre on Substance Abuse at (800) 559-4514.
If you use recreational drugs, you may be able to get help stopping before you get pregnant. Ask your caregiver to refer you to an agency.
If you or your partner smoke, you should stop before getting pregnant. Speak to your caregiver about a referral to a smoking cessation program. You can also visit the Pregnets Web site at www.pregnets.org for information.
Your ethnic roots: Your preconceptional visit involves questions about your parentsâ and grandparentsâ ancestry â not because your caregiver is nosy, but because some inheritable problems are concentrated in certain populations. Again, the advantage of finding out about these problems before you get pregnant is that if you and your partner are at risk you have more time to become informed and to check out all your options (see Chapter 5).
Evaluating your current health
Most women contemplating pregnancy are perfectly healthy and donât have problems that can have an impact on pregnancy. Still, a preconceptional visit is very useful because itâs a time to make a game plan and to find out more about how to optimize your chances of having a healthy and uncomplicated pregnancy. You can discover how to reach your ideal body weight and how to start on a good exercise program, and you can begin to take prenatal vitamins with folic acid.
Some women, however, do have medical disorders that can affect the pregnancy. Expect your caregiver to ask whether you have any one of a list of conditions. For example, if you have diabetes, stabilizing your blood sugar levels before you get pregnant and watching those levels during your pregnancy are important. If youâre prone to high blood pressure (hypertension), your experts will want to control it before you get pregnant, because controlling hypertension can be time-consuming and can involve changing medications more than once. If you have other problems â epilepsy, for example â checking your medications and controlling your condition are important. For a condition like systemic lupus erythematosus (SLE), your caregiver may encourage you to try to become pregnant at a time when youâre having very few symptoms.
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