baby

Trying for a baby? Here are 8 things you need to consider, according to a doctor.

Deciding to start a family is an exciting but daunting time. There is a lot to think about and you will likely have a bunch of questions. 

How do I track my menstrual cycle? Can I keep running? What should my partner be doing to help me? What if it's just not happening?

So, we spoke to Melbourne medical practitioner and mother-of-two, Dr Preeya Alexander, who shared eight things to consider if you're trying for a baby.

Here's what she had to say:

1. Talk to your GP in person or via Telehealth.

The first thing I always say when patients come to see me is, 'It’s so wonderful you are here!' because there are still many people who are not aware how important preconception care is. In fact, 50 per cent of Australian women are missing out on preconception care.

Dr Preeya Alexander. Image: Supplied. 

I just wish every woman knew that seeing her GP six to 12 months before trying to conceive can have significant positive impacts on pregnancy, maternal and infant health. If you are thinking of coming off contraception, that’s the time to have a chat!

Elevit's new 'Ask a Doctor' service aims to help more time-poor women access preconception care from home. It’s a free online service where you can have a text chat with a GP. It doesn’t replace the need for your GP, you still need to see someone to get bloods done and to make sure your cervical cancer screening test is up to date for instance, but it will hopefully see the rates of women engaging in preconception care climb.

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I always remind patients that preconception care can improve pregnancy outcomes and positively change the health trajectory for an infant. As a GP, it’s my little window of opportunity to intervene and improve outcomes for a woman and her baby.

2. Get to know your menstrual cycle and signs of ovulation.

I always chat to patients about getting to know their body and cycle so they can track when they are ovulating.

I explain the basics of the menstrual cycle to my patients and reiterate some key points (I don't assume everyone knows about the menstrual cycle and what day 1 or 14 is). 

The first day of the cycle is the day your period starts, this is the date we will ask you for when trying to calculate pregnancy dates later. If you are a woman who has a 28-day cycle, then you tend to ovulate around day 14. If you have a longer cycle, you will probably ovulate later. 

Ovulation means one of your ovaries throws an egg off. This egg only survives for 12 to 24 hours (if pregnancy does not occur).

Many women know when they are ovulating because of changes to physical symptoms like vaginal discharge (it can become slippery and like raw egg white) or increased libido. The basal body temperature also increases around ovulation so some patients use temperature tracking to know when they might be ovulating. 

You are most likely to conceive (when the sperm meets the egg) in the day or two before you ovulate. Sperm can survive in the female reproductive tract for up to five days (yes, that long) and so having sex every second day in the week before ovulation can increase the chances of pregnancy.

If you need more help, there are plenty of apps that log your cycle dates and symptoms at various points and help point out your most fertile period.

Listen: Mia chats to Leigh Campbell about her fertility journey. Post continues below. 

3. Consider your diet and make sure you are getting all the right nutrients.

When we talk about preconception care, diet is a big factor. 

If a woman is eating a well-balanced and varied diet, she is hopefully getting all the essential nutritional building blocks like Vitamin B12, folate and iodine which can impact on the pregnancy and pregnancy outcomes. 

We talk about the concept of the first 1,000 days which covers the time from conception to when a child is two years of age. This is when things are very adaptable, when small tweaks to diet, starting the right supplements, and ceasing medications (which could be harmful), can make a big difference on the health outcomes for mum and baby in pregnancy.

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There is no safe level of alcohol during pregnancy or when you are trying to conceive. So, if you are trying, it is worth being conscious of your alcohol intake.

Once you conceive, we also have a whole chat about listeria and pregnancy safe foods.

4. Keep up with your exercise routine but always listen to your body.

If you were active before pregnancy then you can continue doing those activities, but you may need to listen to your body and adjust activities like weights or pilates as the pregnancy progresses.

During pregnancy, I recommend you avoid high-risk contact sports. 

If a patient is sedentary before pregnancy and not exercising day to day, we try to build some physical activity ideally in preconception or early pregnancy starting low and building up as tolerated. 

Exercise has so many benefits in pregnancy – it can reduce the risk of blood pressure issues, gestational diabetes and have a positive impact on mood and night-time sleep quality.

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Being active in pregnancy is wonderful for both mum and baby!

5. Start taking supplements.

In Australia, the guidelines recommend all women take a supplement with at least 400 micrograms of folic acid and 150 micrograms of iodine daily for four weeks before they try to conceive.

Folic acid has been shown to reduce the risk of neural tube defects like spina bifida and iodine is essential for development of the infant’s brain and thyroid.

Some women require additional supplements containing iron, Vitamin B12 or Vitamin D, but be guided by your health professional as they make these decisions depending on your medical history and/or blood results.

6. It can be a stressful process, so look after yourselves.

I have lived this stage of preconception, and it can be stressful

I find the shift from "I can’t possibly get pregnant" in our teenage years, to "I need to be pregnant right now, today, not tomorrow" in later years so bizarre. 

It’s as if a switch flicks overnight. I lived the switch flick and see it constantly in my consulting room. I work with patients for years on contraception then see the sudden flick.

Trying for a baby can be emotionally taxing but I remind my patients to have some fun with it initially and remember that sex can still be fun even if you are trying to make a baby. 

I also always remind my patients of the figures; that for heterosexual couples who have regular unprotected sex, 92 per cent will conceive after one year of trying.

And we have so many options if things aren’t working out... so breathe.

7. Get your partner involved in preconception care.

Men can do some simple things to improve sperm quality. If you are smoking, quitting can improve sperm quality given that smoking can damage the DNA in sperm. There are plenty of ways health professionals like pharmacists and GPs can support you to quit. 

Limiting alcohol intake and avoiding medications like anabolic steroids (which some people use to improve muscle bulk) is recommended. Regular exercise is great for improving sperm quality, as is eating a diet high in fruit and vegetables.

Often, we only focus on women during preconception consults, but male partners can do many things to improve the chances of a successful pregnancy.

For same-sex couples, please speak to your GP because there are so many options and early referral to a fertility specialist can open doors for sperm, egg, or embryo donor options.

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8. Don’t believe everything you read on the internet!

I get asked this often – and no, certain sexual positions will not guarantee a certain gender child. Full stop.

And finally Dr Preeya Alexander says…

Please see your GP early: either six to 12 months before you try to conceive or when you come off contraception for preconception care. It improves pregnancy outcomes!

The Ask a Doctor service is operated by doctors between 9am – 5pm AEST, and a response time of two minutes is guaranteed. Women can pose questions outside of these hours too and will be responded to upon the chat line re-opening. 

Women can simply log on to elevit.com.au/askadoctor via smartphone or computer, sign up or log in, select the doctor they wish to chat with, and start a text chat. 

Images and documents can also be uploaded as needed.

Feature Image: Getty.

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