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 made easy
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.
And 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 practitioner to go over your family and personal health history. Then you can discover 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 the easiest way to conceive, and we touch on the topic of infertility.
Getting Ready to Get Pregnant: The Preconception 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. Book whatâs called a preconception visit with your practitioner (usually your GP or practice nurse) 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 a well-woman check, mention that youâre thinking about having a baby, and your practitioner will take you through the preliminaries. If you arenât due for one of these checks and youâre ready to begin trying to get pregnant now, go ahead and book a preconception visit with your practitioner, and bring along the father-to-be, if at all possible, so both of you can provide health histories â and know what to expect from this adventure.
If youâre already pregnant and didnât have a preconception visit, donât worry, because your practitioner will go over these topics at your first antenatal visit, which we discuss in Chapter 6.
Taking a look at your history
The preconception visit is a chance for your practitioner to identify areas of concern so that she can keep you and your baby healthy â even before you get pregnant. A multitude of factors come into play, and the practitioner is likely to ask you about the following:
Previous pregnancies and gynaecological history: Information about previous pregnancies can help your practitioner decide how best to manage your future pregnancies. She will ask you to describe any prior pregnancies, any miscarriages or premature births, multiple births â any situations that can happen again. For example, knowing whether you had problems in the past, like pre-term labour or high blood pressure, is helpful for the practitioner. Your gynaecological 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 practitioner 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 having a family history of neural tube defects (spina bifida, for example), will affect
your pregnancy (see the sidebar âWhy the sudden hype on folic acid?â later in this chapter). In Chapter 9, we discuss in more detail different genetic conditions and ways of testing for them.
Your ethnic roots: Your preconception visit involves questions about your parentsâ and grandparentsâ ancestry â not because your practitioner is nosey, 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 for one of these problems, you have more time to become informed and to check out all your options (see Chapter 6 for more on this topic).
Evaluating your current health
Most women contemplating pregnancy are perfectly healthy and donât have problems that can have an impact on pregnancy. Still, a preconception visit is very useful because itâs a time to make a game plan and to find out more about how to optimise 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 programme; you can decide what you want to do about your alcohol intake; you can get help to stop smoking if you need it; and you can begin to take folic acid (see the sidebar âWhy the hype about folic acid?â for more about this).
Some women, however, do have medical disorders that can affect the pregnancy. Expect your practitioner to ask whether you have any one of a list of conditions. For example, if you have diabetes, stabilising your blood sugar levels before you get pregnant and watching those levels during your pregnancy are important. If you usually take tablets to control your diabetes, youâll probably be advised to switch to insulin during your pregnancy. Diabetes For Dummies by Sarah Jarvis and Alan L. Rubin (Wiley) provides more information on how to handle diabetes and pregnancy.
