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Planning for pregnancy

This factsheet is for women who are planning to have a baby, or for anyone who would like information on how to prepare for pregnancy. It also includes information for men planning to become fathers.

Being fit and healthy maximises your chances of a healthy pregnancy. By the time you have missed your first period, you are two weeks pregnant. So, it's best to prepare for a pregnancy before trying to conceive, and to follow the advice that is given to pregnant women.

Details

  • Stopping contraception Stopping contraception

    If you’re planning a pregnancy, you will need to think about stopping the contraception you have been using. If you use barrier methods of contraception, such as condoms or diaphragms, it’s possible for you to become pregnant as soon as you stop using these. You may worry that some other methods of contraception you have been using could affect your chances of getting pregnant. However, most women find that their fertility levels and periods return to normal in a short period of time.

    You will regain your normal fertility quickly when you:

    • stop taking the contraceptive pill
    • have a contraceptive implant removed
    • have an intra-uterine device (coil) removed, including one that releases hormones

    If you were using the contraceptive depot injection, your periods and fertility may take longer, up to 12 months in some women, to return to normal than after other methods of contraception are stopped.

    If you do get pregnant very soon after stopping hormonal contraception, there is no need to worry because this will not harm your baby.

  • When is the best time to conceive? When is the best time to conceive?

    If couples have sexual intercourse two to three times a week without using contraception, more than eight in 10 will become pregnant within the first year of trying for a baby. Some people believe that timing sex to be close to ovulation is the best strategy for getting pregnant, but this is not necessarily the case. Regularly having sex every two to three days prevents the pressure and stress that can occur if you try to time it with ovulation. Stress on either partner is known to affect the chances of conceiving.

    If you've been trying for a baby for a year without getting pregnant, you and your partner should see your GP. If you’re over 35 or you have infrequent or no periods, visit your GP sooner.

  • Healthy weight Healthy weight

    Before you try to conceive, aiming for a healthy weight will increase your chances of ovulation. A healthy body mass index (BMI) for adult women is between 19 and 25. See our BMI calculator to work out what your current, pre-pregnancy BMI is.

    If your BMI is over 29, losing excess weight will improve your chances of ovulation. It’s not advisable to try to lose weight if you’re already pregnant, so planning to lose excess weight in advance of conceiving is important.

    If your BMI is under 19, you may find that you have irregular or no periods. This can indicate that you aren’t ovulating regularly. Aiming to increase your weight to within the healthy range is likely to help regulate your ovulation and periods, which improves your chance of conceiving.

    You may find that joining a group programme that includes exercise and dietary advice for reaching and maintaining a healthy weight increases your chances of pregnancy.

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  • Healthy eating Healthy eating

    Eating a healthy diet before pregnancy means that your body has adequate stores of vitamins and minerals. A nutritious, well-balanced diet includes eating a variety of the following foods.

    • Plenty of fruit and vegetables (at least five portions a day), which can be fresh, frozen or tinned.
    • Starchy foods, which includes bread, pasta, rice and potatoes.
    • Protein, such as lean meat, fish, beans and lentils.
    • Plenty of fibre, which can be found in wholegrain breads, fruit and vegetables.
    • Dairy foods, such as milk, yoghurt and cheese, which are a good source of calcium.

    Drink enough fluids every day, but limit your intake of caffeine-containing drinks, such as coffee, energy drinks and other fizzy drinks. Also try not to eat or drink too many foods that are high in sugar, salt or fat.

    There are certain types of food that can increase your risk of food poisoning caused by bacteria. As well as making you ill, these bacteria can cause serious problems in your unborn baby. The Department of Health advises that women who are planning pregnancy, or who are pregnant, should not eat:

    • soft, mould-ripened cheeses, such as Camembert and Brie
    • blue-veined cheeses, such as Stilton and Roquefort
    • pâtés (including vegetable pâté)
    • uncooked or undercooked ready-prepared meals
    • uncooked or cured meat, such as salami
    • raw shellfish, such as oysters
    • unpasteurised milk or cheeses
    • uncooked or lightly cooked eggs and egg products, such as soft-boiled eggs or home-made mayonnaise

    There are other foods that you shouldn’t eat because of risks associated with substances found in them. Don’t eat the following foods when you're pregnant.

    • Large quantities of liver, liver products, vitamin supplements that include vitamin A and fish liver oils because these all may contain levels of vitamin A that can harm your unborn baby.
    • Fish, such as shark, swordfish, fresh tuna and marlin because they contain relatively high levels of methylmercury. This might affect your unborn baby’s nervous system.
    • More than two medium size cans of tuna a week because of the high levels of mercury they may contain.

    Previous advice from the Department of Health stated that you may choose not to eat peanuts during pregnancy because of the risk of allergy developing in your baby. However, newer research has led to this advice changing because there is no clear evidence that avoiding peanuts has any effect on whether your baby develops a peanut allergy.

    Folic acid

    You will be advised to take 400 micrograms (400µg) daily of folic acid from the time you stop contraception until week 12 of pregnancy.

    Folic acid helps to prevent your baby developing serious problems of the brain and nerves (such as spina bifida). You may be at a higher risk of having a baby with spina bifida if you have had a previous pregnancy affected by it, or you have a family history of spina bifida. If you take medicines for epilepsy, have diabetes, coeliac disease or thalassaemia, your risk is also increased. If you’re affected by any of these, you may be advised to take a higher dose of folic acid, up to 5 milligrams (5mg) daily. Talk to your GP, who can prescribe you higher doses than you can buy over the counter.

    Vitamin D

    Vitamin D is mainly produced in your body when your skin is exposed to sunlight. If you rarely spend time outdoors with your skin uncovered, you may be more at risk of vitamin D deficiency. The Department of Health recommends that all pregnant women take a daily supplement of 10 micrograms (10µg) of vitamin D.

  • What to stop before trying for a baby What to stop before trying for a baby

    Smoking

    It’s important to try to stop smoking when planning to get pregnant. If you or your partner smokes, it can reduce your fertility.

    If you smoke during pregnancy, you will have a greater risk of:

    • miscarriage
    • stillbirth
    • giving birth too early (premature birth)
    • complications during and after pregnancy and labour
    • having a low birth weight baby

    If your baby has a low birth weight or is born prematurely, he or she is more likely to have health problems and is at higher risk of sudden infant death syndrome (SIDS, or cot death).

    If you or your partner needs help, support or practical advice on giving up smoking, you can talk to your GP, practice nurse or midwife. You may be able to get help and advice from your pharmacist.

    Alcohol

    It’s best not to drink any alcohol when you’re trying to get pregnant and during the whole of your pregnancy. Alcohol, even in small amounts, may harm your unborn baby and lead to problems including damage to his or her facial features, brain, heart and kidneys, as well as learning difficulties and behavioural problems in later life.

    If you do choose to drink alcohol, you can reduce the risk to your baby by limiting the amount you drink to no more than two units of alcohol, once or twice a week. Don't get drunk. You can check your alcohol consumption using our alcohol calculator.

    Medicines

    If you take medicines for any reason, tell your GP that you’re planning to get pregnant because some medicines may affect your developing baby. Don’t stop any medicines you have been prescribed until you talk to your GP because this could affect your health.

    If you need to take a painkiller while you’re trying for a baby or once you’re pregnant, paracetamol is recommended. However, if you find paracetamol ineffective, occasional, single doses of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, have not been shown to have negative effects on conception or pregnancy, up to week 30. From week 30, there is evidence that NSAIDs can cause pregnancy complications, so these must only be taken under supervision by a doctor and with regular monitoring of your unborn baby.

    If you buy any medicines from a pharmacy, always check with your pharmacist to see if these are safe to take while trying for a baby, or when pregnant. Check that any herbal or alternative remedies, or complementary therapies are safe to use during pregnancy, or while trying to get pregnant. Very few of these types of medicine have been established to be safe in pregnant women. Ask your doctor, nurse, midwife or pharmacist about these. Keeping the use of all medicines to a minimum during pregnancy is advised.

  • Hazards at work Hazards at work

    It’s possible that substances you’re exposed to at work may put your health or the health of your unborn baby at risk. Certain chemicals, such as mercury and lead, or radioactive substances, such as X-rays, have the potential to be harmful to your baby. Your physical working environment, such as if you work at height, do heavy lifting, are on your feet all day or work alone, may also be more risky if you’re pregnant. It’s important that you speak to those who are responsible for health and safety in your workplace. Your role at work may need to be adjusted while you’re pregnant.

  • Issues to discuss with your GP Issues to discuss with your GP

    Existing medical conditions

    Before you plan to try for a baby, it’s important that you speak to your GP if you have any medical conditions, such as diabetes, epilepsy, heart or circulatory problems. The prescription medicines you take for any medical condition may need to be altered in dose, type or gradually stopped. Don’t stop taking any prescribed medicines without seeking advice from your GP because this could put your health at risk.

    If you have any gynaecological problems, such as endometriosis, polycystic ovary syndrome, or have had an ectopic pregnancy (when the fertilised egg implants outside the womb, often in the fallopian tube), it will be useful to talk to your GP because these conditions may affect your chances of conceiving and your GP may be able to refer you for more specialist advice from an obstetrician or gynaecologist These doctors specialise in identifying and treating conditions in women. A gynaecologist specialises in reproductive health. An obstetrician specialises in pregnancy and childbirth.

    Genetic counselling

    If you or your partner have any hereditary conditions in your families, such as sickle cell anaemia, thalassaemia, cystic fibrosis or muscular dystrophy, let your GP know. He or she can refer you for genetic counselling. This involves speaking to a genetic counsellor who is a specialist in inherited conditions and who can work out your chances of passing on a hereditary condition to your baby.

    Immunisations

    Rubella is a mild viral infection that is commonly caught by young children, causing a rash and making them generally feel unwell. Most children in the UK are now vaccinated against rubella but it’s still possible that you could get infected. The infection is most serious if you catch it in the first 12 weeks of pregnancy because it can lead to serious damage to your baby’s heart, eyes and ears.

    Once you’re vaccinated against rubella, the immunity usually lasts for life. However, it’s important to find out before your conceive if you’re still immune. This can be checked by having a blood test. If it’s found that you’re lacking immunity to rubella, your GP will recommend you have the vaccination. You need to wait a month from when you’re vaccinated until you try to get pregnant.

    Another vaccination you may be offered if you’re planning a pregnancy is against chickenpox. If you’re a health professional working with people who are unwell, or if you work or live with people who have weakened immune systems, for instance, people who have HIV/AIDS, you can be vaccinated against chickenpox.

    If you haven’t been vaccinated against hepatitis B, you may choose to have this vaccination if you live or work with people who may have this disease.

  • Advice for fathers Advice for fathers

    Try to keep your BMI below 29 because being overweight can affect your fertility. See our BMI calculator to work this out.

    Smoking can lower your sperm quality. Choosing to quit smoking will increase the number of healthy sperm you can produce, as well as having other health benefits. Once your baby is born, to protect him or her from the effects of passive smoking, don’t start smoking again.

    Too much alcohol can also damage sperm quality, so you’re advised to cut down on drinking to increase your chances of conceiving.

    Sperm production can be affected by high temperatures. If you’re trying for a baby, there may be an advantage to wearing loose-fitting underwear and trousers to keep your testicles at a lower temperature, but this has not been proven.

  • FAQs FAQs

    How do I know when I am ovulating?

    Answer

    You're most fertile around ovulation, which is when an egg is released from one of your ovaries. You can learn to identify when you're ovulating by keeping track of any changes to your vaginal secretions. These secretions vary in consistency throughout your menstrual cycle. It can be difficult to measure when you're ovulating, so don't worry if you're unsure.

    Explanation

    The length of the menstrual cycle varies from woman to woman (from 21 days to 35 days), but on average it's 28 days. However long your menstrual cycle is, you will usually ovulate 10 to 16 days before your next period. The time from the first day of a period to the day of ovulation varies between women.

    One menstrual cycle is the time from the first day of your period to the day before your next period starts. So, the first day of your period is also the first day of a new menstrual cycle.

    After your period, an egg grows and develops in one of your ovaries before being released (this is known as ovulation). Once an egg has been released, it travels from your ovaries through your fallopian tubes. At the same time, your womb lining thickens, ready to receive a fertilised egg. If intercourse has taken place, the egg may be fertilised by a single sperm. Your fertile time lasts for eight to nine days of each menstrual cycle, ending once an unfertilised egg dies. This is because sperm can survive in your body for up to seven days after intercourse, so you can still get pregnant if you have sex up to seven days before you ovulate. If no fertilisation has taken place, the egg dies after around 24 hours. Between 10 and 16 days after ovulation, your womb lining is then shed as a period and a new menstrual cycle begins.

    At the beginning and end of your menstrual cycle, your vaginal secretions will usually be sticky, creamy and thick. Your vagina and vulva (entrance to the vagina) will feel dry. At or around ovulation, when you’re most fertile, the vaginal secretions may become wetter, thinner and clearer with a texture like raw egg white (called 'fertile mucus'). Your vagina and vulva will feel wet. By monitoring these changes, you may be able to estimate when you’re ovulating. The best way to do this is to wipe your vulva with toilet paper every time you go to the toilet and look at the consistency of the secretions. The amount and quality of these secretions vary from woman to woman, and from one cycle to the next, so some women find it difficult to monitor them.

    Some women also notice a dip in their basal body temperature (their temperature when they wake after at least three hour's sleep) just before ovulation, followed by a rise afterwards. However, according to the Family Planning Association, this isn't a reliable way of pinpointing ovulation or planning a pregnancy.

    Another way to identify when you’re ovulating is to use an ovulation predictor kit, which you can buy from a pharmacy. The kit will detect a surge in your levels of luteinising hormone (LH), which is the hormone that triggers ovulation. Using the kit involves testing your urine on specific days in your menstrual cycle. The test can predict ovulation 24 to 36 hours in advance. You can ask your pharmacist for advice on using these kits.

    Some women may have regular mid-cycle spotting or abdominal (tummy) pain. These may be signs of ovulation, if other possible causes have been excluded.

    It can be difficult to measure when you're ovulating, so don't worry if you're unsure. The National Institute for Health and Clinical Excellence (NICE) recommends that having sex every two to three days is the best way to conceive, regardless of when you're ovulating.

    Which medical conditions can affect my chances of conceiving?

    Answer

    There are many different medical conditions that could affect your fertility and your chances of conceiving. Some of these conditions affect your reproductive organs, including your ovaries and fallopian tubes. Other long-term conditions that you may have and that you’re being treated for can affect your chances of conception and your likelihood of having a healthy pregnancy. Sometimes the medicines you take for these conditions can affect fertility or your unborn baby, so you will need to see your GP for advice before you try for a baby.

    Explanation

    Medical conditions can affect your reproductive organs making it more difficult for any sperm to meet an egg and fertilise it. Endometriosis is a condition in which the cells that make up the lining of your womb (uterus) spread within your abdomen. If these cells attach to or cause scarring in your fallopian tubes, they can become blocked so that the egg can’t be fertilised or flow towards your womb for implantation.

    Polycystic ovary syndrome is a hormonal imbalance also associated with a large number of small cysts on your ovaries. The cysts are eggs that didn’t get to ovulate and the lack of regular ovulation makes it more difficult to conceive.

    Sexually transmitted infections (STIs), such as chlamydia and gonorrhoea can damage your reproductive organs. They may also affect sperm production in men. If you or your partner are concerned that you may have an STI, see your GP or visit a sexual health clinic for tests and treatment. A complication of some STIs is that they lead to pelvic inflammatory disease in women. This condition has symptoms that include long-term pelvic pain and irregular periods. You may be able to be treated for pelvic inflammatory disease with antibiotics, which could improve your chances of conceiving.

    If you’re prescribed medicines for treating a long-term medical condition, these can affect fertility and pregnancy. Before you try for a baby, you will need to seek advice from your GP about any prescribed medicines you take. Your dose may need to be changed, or you may need to be given a different type of medicine that is safer for use in pregnancy. You may be advised to reduce or stop your medicines to protect your unborn baby. However, don’t stop taking any prescribed medicine unless your GP specifically tells you to. Not taking your prescribed medicines can put your health at risk and could affect your baby too.

    Will being overweight affect my pregnancy?

    Answer

    Yes, being overweight can lower your chances of conceiving. If you do get pregnant, being overweight can increase the risk of pregnancy complications and affect your child before birth, during labour and in later life.

    Explanation

    If your pre-pregnancy body mass index (BMI) is 25 or over, you’re considered to be overweight. See our BMI calculator to work out your pre-pregnancy BMI. The higher a woman’s BMI is before pregnancy, the greater the risk of complications during pregnancy, labour and birth.

    Complications that happen more often in overweight pregnant women include:

    • miscarriage
    • diabetes that begins in pregnancy (gestational diabetes)
    • high blood pressure in pregnancy that can lead to fits (pre-eclampsia)
    • a blood clot in a vein (venous thromboembolism)
    • needing to have labour started artificially (induced labour)
    • needing to have a caesarean section
    • more risk of anaesthetic complications, if you need to have an epidural or other anaesthesia during your labour
    • wound infections

    Babies of overweight mothers are at increased risk of:

    • stillbirth
    • being born with a birth defect
    • being born prematurely
    • growing larger than would be expected for the length of pregnancy, which can cause complications during labour and birth
    • dying soon after being born

    Babies who are born to mothers who are overweight before and during pregnancy are more likely to become obese as they get older and are at a higher risk of developing conditions such as diabetes.

    You can reduce these risks by losing excess weight before you try to conceive. Making an effort to eat more healthily, keeping an eye on portion sizes and maintaining regular exercise before and during pregnancy will help you to lose excess weight. You need to aim to lose any excess weight before you try to conceive because losing weight once you're pregnant isn’t advisable.

  • Resources Resources

    Further information

    Sources

    • The Pregnancy Book 2009. Department of Health. www.dh.gov.uk, published 29 October 2009
    • Planning a pregnancy. FPA. www.fpa.org.uk, published 2010
    • Contraception. FPA. www.fpa.org.uk, published March 2011
    • Contraception – combined hormonal methods – management. Prodigy. www.prodigy.clarity.co.uk, published September 2007
    • Contraception – progestogen-only methods – management. Prodigy. www.prodigy.clarity.co.uk, published September 2007
    • Long-acting reversible contraception. National institute for Health and Clinical Excellence (NICE), October 2005. www.nice.org.uk
    • Pre-conception – advice and management – management. Prodigy. www.prodigy.clarity.co.uk, published July 2007
    • Fertility: assessment and treatment for people with fertility problems. National Institute for Health and Clinical Excellence (NICE), February 2004. www.nice.org.uk
    • Infertility – management. Prodigy. www.prodigy.clarity.co.uk, published October 2007
    • Antenatal care – uncomplicated pregnancy – management. Prodigy. www.prodigy.clarity.co.uk, published March 2011
    • Vitamin supplementation in pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published August 2009
    • Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), March 2008. www.nice.org.uk
    • Vitamin D – advice on supplements for at risk groups. Department of Health. www.dh.gov.uk, published 2 February 2012
    • Quitting smoking in pregnancy and following childbirth. National Institute for Health and Clinical Excellence (NICE), June 2010. www.nice.org.uk
    • Joint Formulary Committee. British National Formulary. 62nd ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain; 2011
    • Nonsteroidal anti-inflammatory drugs (standard or coxibs) – prescribing issues – management. Prodigy. www.prodigy.clarity.co.uk, published June 2008
    • Use of non-steroidal anti-inflammatory drugs (NSAIDs) in pregnancy. UK Teratology Information Service (UKTIS). www.uktis.org, published October 2008
    • FAQs. Health and Safety Executive. www.hse.gov.uk, accessed 27 January 2012
    • Endometriosis – management. Prodigy. www.prodigy.clarity.co.uk, published June 2009
    • Polycystic ovary syndrome – management. Prodigy. www.prodigy.clarity.co.uk, published October 2009
    • Ectopic pregnancy – management. Prodigy. www.prodigy.clarity.co.uk, published February 2010
    • Rubella – background information. Prodigy. www.prodigy.clarity.co.uk, published December 2009
    • Bodyworks: your guide to understanding reproduction. FPA. www.fpa.org.uk, published March 2011
    • Natural family planning: your guide. FPA. www.fpa.org.uk, published April 2010
    • Genital chlamydia general information. Health Protection Agency. www.hpa.org.uk, accessed 5 September 2011
    • Gonorrhoea general information. Health Protection Agency. www.hpa.org.uk, accessed 16 September 2011
    • Gonorrhoea. FPA. www.fpa.org.uk, published July 2008
    • Pelvic inflammatory disease – management. Prodigy. www.prodigy.clarity.co.uk, published August 2009
    • Management of women with obesity in pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published March 2010
    • Weight management before, during and after pregnancy. National Institute for Health and Clinical Excellence (NICE), July 2010. www.nice.org.uk
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    Produced by Bupa Health Information Team, March 2012.

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