Pre Pregnancy Counselling
Embarking on a pregnancy is one of the most exciting and important events in people’s lives.
Like all major events, planning and preparation can help maximise the chances of a pregnancy progressing smoothly and positively. If you are contemplating pregnancy I encourage you to come and see me in this early stage so that we can set you on the right track prior to pregnancy.
Pre-pregnancy visits provide an opportunity to optimise your health prior to pregnancy. This might involve a discussion around general issues such as genetic carrier testing, dietary health, exercise and vitamin supplementation to set you up for success in a future pregnancy, as well as discussing your hopes and expectations for pregnancy. If you have had complications or negative experiences in a previous pregnancy, a pre-pregnancy planning visit is an ideal opportunity to talk through your concerns, and create clear plans and expectations fro the future, which can be enormously reassuring.
Before getting pregnant, it's crucial to consider how you want to receive care during your pregnancy, specifically whether you prefer the public hospital system or private obstetrician care.
Public hospital care is typically free, although there may still be costs for blood tests, ultrasounds, etc. Opting for a private obstetrician like myself requires considering doctor fees and private hospital charges.
Most private health insurance policies cover hospital costs and partially cover my fees, but reviewing your policy for coverage details is essential. If you don't have insurance yet, arranging a policy before becoming pregnant is crucial. Take the time to compare different policies, as they can vary significantly.
Before pregnancy, it is crucial to maintain a well-balanced diet that incorporates foods from all five major food groups. Include regular servings of fruits, vegetables, legumes, meats, fish, milk, yogurt, and cheese. Limit the consumption of foods high in added sugars and saturated fats. Take caution with fish containing high levels of mercury, such as shark, marlin, swordfish, orange roughly, and catfish, which should be eaten no more than once per fortnight. Other fish can be consumed once or twice per week. You should avoid high-risk Listeria foods that can pose a risk to your unborn baby. These include soft cheeses, cold processed meats, bean sprouts, pâtés, raw eggs, and pre-prepared salads. Ensure meat is thoroughly cooked.
Other Lifestyle Factors
Smoking is a health risk whether you are pregnant or not. When considering pregnancy, you need to be aware of the negative impacts of smoking on pregnancy. These include increased chances of miscarriage, preterm birth and stillbirth, and effects on fetal growth and placental function. Smoking during pregnancy also increases the risk of SIDS (Sudden Infant Death Syndrome) and childhood asthma, even if you don’t smoke after the baby is born.
There is no doubt that if you are a smoker, it is preferable to cease smoking before commencing your pregnancy rather than waiting until you are pregnant until you try to stop.
If your partner is a smoker, it can be much harder for you to quit. Although partner smoking may not have such significant risks to pregnancy, having a smoker in the house can also increase the risks of childhood problems like SIDS and asthma. Together, you should discuss the benefits of them ceasing smoking. If you both stop together, you will find it more manageable.
Quitting smoking can be difficult. If you are contemplating pregnancy, you may benefit from speaking with me about this or contacting Quitline (137848 / 13 QUIT).
Whilst there is some debate on the subject, most experts (including the Australian National Health and Medical Research Council) recommend avoiding alcohol altogether during pregnancy. This is because we don’t know if there is a ‘safe’ amount of alcohol consumption in pregnancy, and if so, what that safe level is.
It is undoubtedly the case that regular or heavy drinking during pregnancy has the potential to be harmful to an unborn baby and should be avoided.
There are no illicit drugs that are considered safe in pregnancy. If you regularly use illegal drugs, please talk to me to discuss the best strategy for managing this issue before commencing your pregnancy.
Folic acid supplementation has been shown to reduce the risk of several congenital disabilities, including spina bifida. You should take a multivitamin supplement containing at least 400 mg per day for at least one month before you fall pregnant and for the first three months of your pregnancy.
Iodine is vital as an ingredient for the production of thyroid hormones. Thyroid hormones are responsible for a range of body metabolism functions and, during pregnancy, can impact your baby’s brain development.
In Australia, iodine intake has decreased in recent years. Seafood, bread, dairy products, seaweed and eggs are good sources of dietary iodine. In addition, for women who are planning a pregnancy, pregnant, or breastfeeding, the National Health and Medical Research Council recommends taking a supplement containing at least 150 micrograms per day.
If you have a pre-existing thyroid condition, these recommendations may not apply to you, and you should discuss your specific requirements with me prior to commencing a pregnancy.
Several infections can cause problems if they occur during pregnancy. Some of these can be prevented, or their effects minimised by vaccination. These include rubella, chickenpox and influenza (“the flu”). Most people in Australia are vaccinated against these conditions. However, even if you have been vaccinated in the past for these diseases, your immunity can reduce over time, and you should consider consulting your doctor to assess your need for vaccinations if you are planning to get pregnant. Some vaccines can be given safely during pregnancy; others are best avoided during or immediately before pregnancy. I can advise advise you on which vaccines you should have and their relative safety in pregnancy.
Tracking Your Ovulation
Knowing when you are ovulating can be helpful to increase your chances of conceiving. It can be even more critical for women with irregular periods as ‘peak’ fertility days may fall outside the typical 28-day cycle.
To track when you may be ovulating, find out when the first day of your last period was. This can be considered day one. Assuming a roughly 28-day cycle, your fertile window is usually between Day 10 and Day 15. This, however, is a rough guide as every woman is different. If your cycles are longer or shorter than 28 days or irregular, you should discuss with me or your general practitioner when your most fertile time is.
Pre Pregnancy Health Check
Having a pre-pregnancy health check-up before you start trying to get pregnant is often a valuable way of optimising your health for pregnancy.
You may have your pre-pregnancy check with your general practitioner/family doctor or an obstetrician, such as myself. If you have specific concerns about pregnancy, it may be helpful to discuss them with me. If you choose to see me, you will need a referral from your general practitioner
|What tests should I get done before getting pregnant?
|I recommend all women test for Rubella, Hepatitis C, Hepatitis B, Syphilis and HIV infection before or during pregnancy. At your first prenatal visit, you should have your blood tested for antibodies, blood type and other conditions or disorders that may affect your pregnancy. Checking before pregnancy to see if you are anaemic or have low iron is often helpful and allows time to correct any problems identified. If your cervical screening test (pap smear) is overdue, it is wise to do that before pregnancy.
|Should I go to the doctor before getting pregnant?
|Before trying to conceive, it’s a good idea to visit your family doctor to discuss the process to ensure you have the healthiest pregnancy possible. Your doctor can provide the proper tests and recommend a private obstetrician like me to guide you throughout your pregnancy.
|When should I see my doctor after a positive pregnancy test?
|Finding out you’re pregnant can be very exciting. You should call your doctor to schedule your first prenatal appointment as soon as possible after a positive home pregnancy test. During this appointment, your doctor can confirm the pregnancy and begin the planning stages.