Pre-pregnancy Planning and Healthy Pregnancy

There are a few things you need to know about looking after you and your baby.

How long should it take to conceive?

Most healthy, fertile couples become pregnant within the first 12 months of trying. Every month that a couple is trying to become pregnant there is about a 20% chance of a pregnancy. Women over 35 can take up to twice as long to become pregnant. You can increase your chance of becoming pregnant by having unprotected vaginal sex about three times a week before and at ovulation (the time when you are most fertile and an egg is released from your ovaries). For more information on when to have sex, see our fact sheet on maximizing natural fertility. See your doctor for advice if you have not become pregnant after trying for 12 months (or 6 months if you are over 35 years of age).

Nutrition

It is important to have a well-balanced healthy diet. A freshly prepared low fat, high fibre diet is the basis of good health. Women should aim for normal body weight before becoming pregnant.

Folic acid: Folic acid is a type of vitamin. Taking folic acid for at least one month before a pregnancy and then during pregnancy reduces the risk of having a baby with a neural tube defect such as spina bifida. Folic acid supplements are recommended for all women trying to get pregnant. Your doctor will give you advice on the right amount of folic acid for you.

Iodine: Iodine is essential for the production of thyroid hormones. These hormones are vital for the development of the brain and nervous system of the fetus, and in babies and young children. Many Australian women don't get enough iodine from the food they eat. Ask your doctor about the right amount of iodine for you.

Vitamin D: Women with reduced sunlight exposure, such as women who wear veils and those who use sunscreen on a regular basis, may be at risk of Vitamin D deficiency. Your doctor may test you for Vitamin D deficiency and advise you to take supplements.

Exercise

Sensible, regular, non-contact exercise is important, such as walking and swimming. It is best to avoid intense exercise and getting too hot.

Infections

Some infections before and during pregnancy are a risk to the pregnancy. These infections include rubella, syphilis, toxoplasmosis, listeria, cytomegalovirus and HIV. Having a fever in pregnancy can also be harmful to the pregnancy - if you have a fever, you should take paracetamol to bring the fever down. Pregnant women have an increased chance of complications if they get the flu. Your doctor will give you advice about having the flu vaccine.

Rubella: Rubella (German measles) infection in pregnancy is an important concern. Most women have been vaccinated against rubella and are immune but this immunity can wear off over time. You should be tested for your rubella immunity status before becoming pregnant. You can be vaccinated if your immunity is low - you should take care to avoid getting pregnant within 28 days of your vaccination.

Varicella: Varicella (chicken pox) infection in pregnancy can be harmful so you should consider vaccination before becoming pregnant. Your GP can check if you need this vaccine. You must take care to avoid becoming pregnant within 28 days of your vaccination.

Listeria: Listeria can cause miscarriage, stillbirth or premature birth if you get it during pregnancy. It is caused by common bacteria which can contaminate food. It has been found in many fresh and unprocessed foods such as unpasteurised milk, soft cheeses, cold processed meats, precut fruit and salads, pâté, raw seafood and smoked seafood.

To avoid listeria in pregnancy, it's best to:

• avoid the foods listed above
• carefully wash raw vegetables before eating them
• make sure all animal-based foods (meat and dairy) are cooked properly before eating them
• clean utensils well after preparing uncooked food

Toxoplasmosis: This Infection is caused by a parasite. If it is caught in pregnancy it can cause abnormalities such as deafness, visual impairment and low IQ or, rarely, death of the fetus. You get it by close contact with infected cats or by eating uncooked or undercooked meat. All meat should be well cooked through before eating. If you are pregnant, get someone else to clean your cat's litter box, and wear disposable rubber gloves when you are gardening to protect you from any cats' faeces in the soil. You should wash your hands carefully after gardening or handling raw meat.

Smoking, alcohol and other drugs

Smoking is not recommended during pregnancy. Ideally quit 3 months before becoming pregnant. Avoid exposure to passive ('second-hand') smoke. Caffeine intake should be reduced to a maximum of two cups of coffee a day (or four cups of tea). It is recommended to not drink any alcohol at all during pregnancy. Stop other recreational drugs (like marijuana or ecstasy) and discuss over-the-counter drugs with your doctor or pharmacist.

Genetic counselling

If you have had a child with a genetic disorder, if you have a family history of genetic disorders or if you're over 35 you are at higher risk of having a child with a genetic disorder. Genetic disorders include Down syndrome, thalassaemia, cystic fibrosis, haemophilia and Tay-Sachs disease. Your doctor can provide advice about genetic testing and counselling for you and your partner. Your doctor can also tell you about the tests that are available during pregnancy to detect some of these disorders.

Blood group

Your doctor will check your blood group. If you have 'Rhesus-negative' blood, you may require extra medical attention.

Checklist

• see your doctor for routine blood tests and a health check
• talk to your doctor about any medicines you are taking
• follow a healthy diet
• take folic acid, iodine and Vitamin D supplements as directed by your doctor
• develop a good exercise routine
• make sure you are up to date with rubella and varicella immunisations
• talk to your doctor about the flu vaccine
• have a cervical screening test if it is due
• stop smoking, alcohol and other social drugs
• reduce caffeine intake
• eat freshly cooked and prepared food
• speak to your doctor about your family history and genetic counselling

For more information

Family Planning NSW Talkline - www.fpnsw.org.au/talkline or 1300 658 886
National Relay Service (for deaf people) - 13 36 77
TIS National's immediate interpreting service - 131 450
Visit your nearest Family Planning NSW clinic - www.fpnsw.org.au/clinics
Pregnancy, Birth & Baby - www.pregnancybirthbaby.org.au or 1800 882 438
Mothersafe - www.mothersafe.org.au or 1800 647 848