Physical Preparation for Pregnancy

Pregnancy is a period of amazing changes in the woman's body. The body prepares itself to sustain and then deliver a baby into the world. Your physical readiness for this can be assessed by your doctor based on your and your family's medical history, reproductive history and social lifestyle factors. These assessments should preferably happen atleast 3 months before you start trying to get pregnant. Based on this, a strategy is identified to control or eliminate the risk factors for pregnancy. It is not ideal to meet your doctor only after you are pregnant, as in some cases treatment for these conditions have to start early in the process.e.g. taking folic acid for avoiding neural tube defects should be started 1-2 months before conception.

The following is a non-comprehensive list of conditions that can be handled better with preconceptional care.

Diabetes

Diabetes increases the risk level of both the mother and fetus. The risks can be mitigated by maintaining the glucose at an optimum level during conception using diet control and in some cases insulin.

Epilepsy

The vast majority of women with epilepsy have no problems during pregnancy. Let your doctor know about your condition and the medications you are taking during preconceptional counseling. If you are taking anticonvulsant medications, your doctor may prescribe folic acid supplementation and recommend dosage.

Hypertension

Women with their blood pressure level greater than 135/85 mm Hg are considered hypertensive. Obesity is an important risk parameter in hypertension. Women with chronic hypertension should consult with their doctors ahead of pregnancy. The doctor may perform some tests to assess renal, blood and cardiac functioning. She may also recommend lifestyle changes including -

• Weight reduction
• Changing eating habits. Eat more fruits and vegetables and reduce the amount of saturated fat consumed.
• Increased physical activity like walking or jogging for about 30 minutes per day
• Stop drinking
• Stop smoking

Neural-tube defects

The neural tube is the initial stage of what will ultimately be the Central Nervous System comprising the spinal cord and the brain. This defect can develop early in the pregnancy as the neural tube is formed. The doctor may prescribe folic acid from before pregnancy till the end of the first trimester to reduce the risk of the foetus developing neural tube defects. It is important to start folic acid supplementation before conception as generally the foetus is already 2-3 weeks old before you realize that you are pregnant and further delays could cause the medication to be ineffective.

Reproductive History

If the woman has a history of abonrmal pregnancy outcomes like pregnancy loss and preterm delivery or pregnancy related complications like preeclampsia(pregnancy-induced hypertension) the doctor can analyse the cause for these prior results and make appropriate recommendations.

Maternal Age

Pregnancy in women over 35 years is generally a much more planned process. During consultations with your doctor, the woman's physical health is assessed. In cases where the woman is fit and healthy, maternal age does not play a big part during pregnancy. Other factors to be discussed include complications due to maternal conditions like hypertension and diabetes.

Alcohol

Although many experts do not object to low alcohol consumption, no conclusive proof has been established as to what is a safe level of alcohol consumption. What is established, is the harmful effect on the baby of consuming large amounts of alcohol especially binge drinking. Harmful effects include mental retardation, growth delays and heart defects. So, dont worry too much about that one glass you had at your friend's birthday bash or the glass of wine you had before you realized you were pregnant. But definitely stay away from too much alcohol consumption.

Smoking

Smoking has been shown to decrease the sperm count in men. Smoking also has a direct impact on the growth of the foetus. Smoking increases the risk of low birth weight babies, in addition to increasing the risk of having a complicated pregnancy. So, get ready for your pregnancy by quitting smoking. You will not find a better reason to quit.

Environmental Exposures

Example of concerns here are factory workers who are exposed to industrial chemicals and people residing nearing farms etc. where exposure to pesticides is high.

Medications you are on

Review the list of medications you and your spouse are taking with your doctor during your consultation. Some medications can have undesirable side-effect like decreasing the sperm count in men or affect the growth of the foetus in its early stages. So, make sure all medication you take is pregnancy-safe.

Weight

Obesity can lead to reduced fertility rates and can be a contributing factor to many diseases like diabetes, hypertension, heart disease etc., leading to a difficult pregnancy. Due to the nutritional requirements of the mother and foetus during pregnancy it is not advisable to lose weight during pregnancy. On the other end of the scale, infertility can be a problem in women who are significantly under-weight as well. So, it is very important to get your weight within the normal range before you get pregnant.

To determine if your weight is optimal, use the BMI(Body Mass Index Calculator). BMI is calculated as weight in kgs divided by height in metres squared, i.e., if your weight is 60 kgs and your height is 1.60 metres, your BMI is calculated as 60/(1.6*1.6) kg/m2 = 23.44. Normal BMI is considered to be in the range of 18.5 to 24.9 kg/m2; overweight is a BMI in the range of of 25 to 29.9 kg/m2; and obesity is a BMI of 30 kg/m2 or greater.

Diet

Many vegetarian diets are deficient in protein. Vegetarians should take care to intake the required amount of protein in their daily diet. Consult a dietician to determine if you need any supplements. Women with very low calorie intake and dietary disorders like anorexia and bulimia are putting their fertility under risk and should discuss remedial options with their doctor.

Caffeine

Consumption of caffeine in large quantities should be avoided. While there is no conclusive proof yet, studies show that consumption of low quantities of caffeine, upto 2 cups a day, does not impact pregnancy.

Exercise

A normal, healthy pregnant woman can undertake moderate intensity exercises for upto 30 minutes a day. However, check with your doctor on your individual condition before starting any exercise regimen. Women with hypertension, for example, may be better off avoiding too much physical activity.

Supplements

Folic acid should be taken upto the end of the first trimester and reduces the risk of the baby having neural tube defects. Your doctor may prescribe additional supplements based on your needs.