Your Pre-Pregnancy Check-Up: What You Need to Know

The decision to have a baby is one of the most exciting and life-altering choices you’ll ever make. By planning ahead, you’ll have ample opportunity to get yourself in the best possible position for a healthy pregnancy.

We have compiled 12 important things to consider before making the leap.

Get private maternity health cover

All health insurance funds require you to have maternity cover for a minimum of 12 months prior to your baby’s arrival. Keep in mind that babies can come early — some very early — so allow time for this.

Take the time to compare health insurers and their different levels of cover, and check the fine print of each because cover can vary considerably. For example, some policies include IVF and some not; some allow your partner to stay in your suite, while others may not.

Get in touch with Glengarry Private Hospital if you have any queries.

See your GP for a pre-conception check-up

It’s a good idea to make an appointment around six months before you start trying for a baby. You should ask your doctor about:

Vaccinations
You may need boosters, even if you were fully immunised as a child. All women should have up-to-date vaccinations against rubella (German measles) with the MMR vaccine. This will need to be done at least one month prior to conceiving. Once you are already pregnant (or if you suspect you may be) you cannot be immunised against rubella because this is a “live” vaccine and poses a serious risk to your baby’s health.

Other immunisations you might need before falling pregnant include hepatitis B, chickenpox and influenza, while some should be administered during pregnancy. DTPa (tetanus, diphtheria and pertussis) is one such vaccine. This is an “inactive” vaccine, often recommended for the third trimester, as the antibodies are passed through the mother to the baby.

If you’re not sure what you’re vaccinated against, ask your doctor for a blood screening test. For more information, see your GP or visit the Department of Health’s immunisation website.

Questions to ask your GP
Depending on your personal circumstances, you should also ask your GP about:

• Testing for STIs
• A check for cervical abnormalities
• A blood test to check your iron stores
• Your current medications
• Pre-existing conditions such as diabetes, epilepsy, asthma, blood disorders, or heart problems
• Depression or other mental conditions
• Genetic disorders in your family.

When to see an obstetrician
You may need to see an obstetrician in certain situations. These include if you have high-grade cervical abnormalities; have had miscarriages or previous difficult or ectopic pregnancies; have had gynaecological surgery; or have suffered post-birth complications such as postpartum haemorrhaging.

Give up your vices

Smoking cigarettes, heavy drinking and “recreational” drug use all have negative consequences for your baby — many severe. Miscarriage, SIDS (Sudden Infant Death Syndrome), low birth-weight babies, premature delivery, birthing complications, growth restriction and developmental difficulties are all very real risks.

It would be ideal to quit smoking before trying to conceive as this improves fertility — you’ll have a better chance of falling pregnant — and it also reduces the risk of the baby being born prematurely. If you’re newly pregnant and still smoking, there are still positive health benefits if you give up now. For example, studies have shown that women who stop smoking early in pregnancy have babies with comparable birth weights to those born to non-smoking mothers.

And while the experts have warned about the dangers of drinking during pregnancy for many years, there are also negative effects when you’re trying, too. And it doesn’t just affect women’s fertility. In men, excessive drinking can decrease sex drive, lower testosterone levels and sperm quality, and may cause impotence. In women, heavy alcohol consumption can affect the menstrual cycle and ovulation, making it harder to conceive.

It’s quite common for women to have drunk alcohol, unaware they’re already pregnant. We cover this in our article ‘I didn’t know I was pregnant and I drank alcohol’. Find out more about reducing your cigarette and alcohol intake at quit.org.au and drinkwise.org.au.

Your pre-pregnancy diet

Considering pregnancy is one of the most nutritionally demanding periods the human body ever goes through, it pays to get settled into healthy habits early on.

In general, there’s nothing overly special you need to do. Make sure you’re getting a good amount of vegetables and fruits, complex carbohydrates, an adequate protein intake and a dose of good fats such as nuts and olive oil. Forget fad and unrealistic diets — moderation is the key here.

These changes don’t necessarily mean losing weight either. In saying that, if you are carrying excess weight, it would be worth seeing a nutrition professional to discuss your personal circumstances. Being overweight can significantly affect your pregnancy and labour, so it’s worth seeking advice early. Similarly, if you are underweight, you may also need to see your GP or a dietitian. Find an Accredited Practising Dietitian.

Pregnancy supplements

Your baby’s long-term health starts well before your positive pregnancy test. For women considering pregnancy, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends:

• Folic acid supplements at least one month prior to conception and for the first 12 weeks of pregnancy. This reduces the chance of neural tube defects such as spina bifida. Find out more about folic acid.
• An iodine supplement of 150 micrograms each day prior to conception, to aid with a baby’s brain and nervous system development. If you have a pre-existing thyroid condition, see your GP before taking these supplements. Find out more about iodine.

It depends on the individual as to whether other supplements are required. For example, vegan mothers-to-be may need to be checked for adequate vitamin B12 levels and women who wear full coverings should have their vitamin D tested. Or, calcium may be required for those who do not consume dairy.

Seek advice before taking any supplements because sometimes it may be unnecessary or even unhelpful. Iron is a good example. Adequate iron intake is certainly essential in pregnancy, but GPs will routinely check iron levels at the first antenatal appointment anyway.

Your psychological health

If you suffer from a pre-existing mental condition, book in to see your healthcare professional — whether this is a psychologist, psychiatrist, counsellor or your GP. You’ll want to find out:

• How pregnancy may affect your existing mental health
• Information about medications you’re currently taking. You should also find out whether you can keep taking them throughout pregnancy or, if not, when it will be safe to resume after baby’s birth
• Whether you need to change treatments. Don’t stop taking medication without the guidance of your doctor
• Safety nets and where to go to if you struggle with your mental wellbeing during pregnancy
• Support services once you have given birth.

Stress can affect your chances of conceiving, so take steps to reduce your worries now. This applies to everyone, whether you have a pre-existing condition or not. We suggest things like mindfulness, meditation and gentle exercise to help calm your mind. And embrace whatever it is that you find de-stresses you, whether it is a hobby, walks in nature, reading or spending more downtime with your family and friends.

Rest assured, you’re not alone if you’re nervous about the changes that are to come. Bringing a baby into the world is an enormous, wonderful life alteration and everyone is nervous to some degree.

Watch your caffeine intake

While there are many warnings about consuming caffeine before and during pregnancy, there simply is not enough concrete scientific evidence at this stage to make a blanket recommendation.

We do, however, suggest heavy coffee drinkers cut back for one good reason: a lot of women cannot tolerate caffeine in pregnancy and the withdrawal symptoms won’t be pleasant when you’re newly pregnant. Caffeine is also a common culprit in raising anxiety levels, so if you’re struggling to conceive or you’re someone who suffers anxiety, this would be a good move for both your mind and body.

Also remember that caffeine is found in chocolate, fizzy drinks, tea, and even some herbal teas. These all add up over the course of a day. The recommended maximum intake is 200mg per day (approximately three shots of espresso).

Increase physical activity

There’s no need to become fanatical about fitness or weight loss, but it would be helpful to increase your physical activity if you lead a very sedentary life or only move your body every so often.

Exercise helps during pregnancy in several ways, including:

• Increasing energy levels when you are exhausted
• Reducing ankle swelling
• Stabilising your moods and ensuring better mental health during and after pregnancy
• Improving core muscles and the pelvic floor
• Weight control during and after pregnancy
• Reducing the risk of gestational diabetes and pre-eclampsia
• Enduring the rigours of birth.

To find out more about exercising during pregnancy, read this article written by one of our Glengarry obstetricians, Dr Mark Sillender.

Track your ovulation

It can be very helpful for women to know when they are ovulating, to give themselves the best chance of conceiving. This is even more important for women who have irregular periods because peak fertile days may fall outside of the typical 28-day cycle. It’s not uncommon for women’s cycles to range from 21 to 40 days.

To track your cycle, find out when the first day of your last period was. This is day one. Your fertile window lasts between days 10 and 15, with the ‘peak’ fertility day on around day 14. Keep in mind that this is a rough guide because every woman is different.

Try to have intercourse at least two to three times per week to increase your chances, but you don’t necessarily need to try right on your peak ovulation day. This is because you are more likely to conceive in the day or two before ovulation. Speak to your GP, an obstetrician or midwife to find out more.

What are you eligible for?

Right now, women can take advantage of the 18-week Australian Federal Government’s parental leave scheme as well as workplace maternity leave, if it is offered by their employer. New fathers may also be eligible for the Government’s Dad and Partner Pay.

In many cases, you must be employed for a year before the baby’s birth to be eligible for maternity leave. Also check how much annual leave and sick leave you are entitled to — you may find you need it if you have medical conditions during pregnancy or have morning sickness that you’ll require time off for.

Financial planning

Babies can cost a surprising amount of money. Having some savings means you can stress less about finances and concentrate more on life with your newborn.

Although you would assume you have 36 to 40 weeks to save, there are many reasons why these plans can be thrown off course. You may need time off for illness, you mightn’t be able to work right up until your due date or may even have to stop work five or six months into your pregnancy, and you’ll have to spend money on appointments and buying things for your baby’s new life too: clothes, a carrier, nappies, etc.

Nobody can tell you how much money you’ll need because everyone leads different lives. How much do you need to live within your current means? Do you have mortgages and loans to pay? Can you survive on one wage, and when are you planning to go back to work? These are all things to consider when saving funds for your baby’s arrival.

Go off contraceptives

While this seems glaringly obvious, it may take a while for your fertility to return after you cease contraception. Usually, this is around the time of your next natural period, around four weeks after stopping, and most women find their fertility has returned to normal after three months. Of course, some people can fall pregnant the day after they stop the pill, and there are women who fall pregnant while still on contraceptives, so anything is possible.

It might be worth waiting a month after finishing your contraception so you can better track your cycle and be more certain of your due dates, should you fall pregnant quickly.

At Glengarry Private Hospital, we provide comprehensive maternity care service to assist you during the antenatal period of your pregnancy, the birth of your baby, your postnatal period and any parenting education that you may require. Find out more about our facilities.