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Planning for a Pregnancy

For many women and their partners, there is no opportunity to prepare for pregnancy. However you and your partner might have an opportunity to think and to talk about pregnancy long before it happens.

Having time to prepare gives you a chance to think about things like:

  • what it will be like
  • how it will change your life
  • how it will affect your relationships, your job and other people in your family.

You can’t plan for everything, no matter how well laid our plans, there can be all kinds of unexpected twists and turns on the journey to becoming a parent.
It is important to prepare, but it’s also good be open and to accept that things won’t always go as planned. There are many things you can do to prepare and, hopefully, this section will help you to do so.

Planning for a baby

If you are planning to become pregnant, it’s important that you and your partner (if you have one) are as healthy as possible before you start trying. Your GP can help with a pre-conception health check.

Book in to see your doctor 3-6 months before trying to become pregnant. Your doctor will help you plan for your pregnancy.

A pre-conception health check usually includes:

  • a medical history and a general examination
  • blood tests to check your haemoglobin level, blood group, immunity for German measles (rubella) and chickenpox (varicella), hepatitis B + C and human immunodeficiency virus (HIV)
  • tests for any sexually transmissible infection (STI)
  • cervical screening test (CST): It is recommended that your CST is up to date but can be undertaken safely in early pregnancy.
  • advice about lifestyle changes that will improve the chance of pregnancy and the health of the baby (lifestyle factors you may need to change include your weight, physical activity, alcohol consumption, recreational drug use, and whether you smoke)
  • advising about folate and iodine supplements before conception and during pregnancy for the health of your baby
  • referral to a specialist if either partner has a pre-existing medical condition that might affect the chances of pregnancy, or pregnancy health
  • a review of any prescription medicines either partner may be taking
  • referral for genetic counselling if needed
  • information about health services and choices of pregnancy care.

Pre-conception checklist:

Lifestyle Considerations

  • Medications

    While some medications are safe to use before and during pregnancy, others can affect your chances of getting pregnant, cause problems during pregnancy, or harm your baby.

    Your doctor will give you the best advice about what medications are safe to take before and during pregnancy and can often suggest safe substitutes to take while you’re trying to get pregnant.

    It may be essential to continue using a medication, such as when the medication helps to manage a long-term condition like asthma, diabetes, depression, or seizures. Without the medication, your health or your baby’s health could be at risk.

    There are some medications that should be used with caution or avoided when trying to get pregnant or when you are already pregnant.

    Speak to your doctor about the safety of any medications and drugs you and your partner are taking, before you try to get pregnant.

  • Nutrition, weight and exercise

    A healthy diet and regular exercise can improve both male and female fertility.

    Being overweight, obese or underweight can affect a woman’s fertility. Obesity can also lower fertility in men. A healthy weight increases your chance of getting pregnant, having a healthy pregnancy and healthy baby. If you’re overweight, losing even a few kilos can improve your fertility.

    It’s not about having a perfect body – just a healthy body, because healthier parents have healthier babies.

    Regular activity and a well-balanced diet including fresh fruit and vegetables will help you prepare for a healthy pregnancy.

    What does regular exercise mean?
    Experts recommend being active every day to prevent unhealthy weight gain and to maintain a healthy weight. This can be done by either:

    • 2.5 to 5 hours of moderate intensity physical activity each week, such as a brisk walk or swimming.
    • 1.25 to 2.5 hours of vigorous intensity physical activity each week – such as jogging, aerobics, fast cycling, soccer or netball. An equivalent combination of moderate and vigorous activities each week.
    • You can also include muscle-strengthening activities on at least two days each week.
    • Pelvic floor exercises are recommended before, during and after pregnancy as they can protect against weak bladder, a common problem for women after childbirth.

    What does healthy eating look like?

    • Eating a wide variety of healthy foods helps to keep you in good health and protects you against chronic disease.
    • Eating a well-balanced diet means eating a variety of foods from each of the 5 food groups daily, in the recommended amounts.
    • Cut back on discretionary foods (including chips, biscuits, fatty meats, pastries, cakes, fast foods and confectionary) and only eat them in small amounts.
    • Eat regular meals and limit unhealthy snacking.

    Ask your doctor to check if you are a healthy weight. If you need to lose or gain weight, talk with your doctor about the best way to do this.

    Weight, fertility and pregnancy health – Department of Health, Victoria State Government.

  • Folic acid, iodine, and vitamin D supplements

    Folic acid and iodine are needed for the healthy development of your baby’s brain and nervous system and reduces the baby’s risk of neural tube defects e.g. spina bifida. It can take time to build up these nutrients.

    Folate: is a B vitamin that is found in some foods. Folic acid is a synthetic version of the vitamin that you can take as a supplement.
    Folate support the baby’s brain and spinal cord to develop properly, during the very early stages of pregnancy. It is difficult for women to get enough folate in their diets.
    Therefore it is recommended that women take at least 400 micrograms of folic acid each day, starting at least one month before conceiving and during the first few months of pregnancy. Your doctor will recommend the right dose for you during pregnancy

    Folate-rich foods include green leafy vegetables, cereals with added folate, fruit (bananas, strawberries + avocado), dried beans and peas.

    Iodine: is needed to make thyroid hormones. These hormones support your baby’s bone and brain development. You need to make about 50% more thyroid hormones when you are pregnant, so you will need extra iodine.
    It is recommended that women intending to become pregnant 150mcg of iodine a day for one month before pregnancy and for the first three months after becoming pregnant.

    Iodine- rich foods include bread, eggs, dairy, iodised salt, seaweed and seafood (eat 2-3 serves of small fish per week. One serve is 150 grams.)
    Women who take the recommended doses of folic acid and iodine reduce the risk of some serious birth defects.

    Vitamin D supplements may improve fertility in women and men who are vitamin D deficient.
    During pregnancy vitamin D is involved in transferring calcium to the growing baby. You can ask your doctor for advice about testing whether you need vitamin D supplements.

    You can buy these supplements at most pharmacies and supermarkets.

    If you haven’t taken extra folate or iodine before pregnancy, don’t worry. Make sure you’re getting enough as soon as you know you are pregnant and continue until you have finished breastfeeding

    It’s also a good idea to have your iron levels tested to see if supplements are needed. Low iron levels can reduce your chances of becoming pregnant.

  • Smoking

    People who smoke are more likely to have fertility problems and take longer to conceive than non-smokers.

    Second-hand smoke is almost as damaging as smoking, and women who are exposed to second-hand smoke take longer to conceive than women who are not.
    The chemicals in cigarettes damage eggs and sperm, and can affect a baby’s health.

    Smoking affects:

    • the DNA (genetic material) in eggs and sperm
    • people’s hormone production
    • the fertilised egg’s ability to reach the uterus
    • the environment inside the uterus, where the baby grows.

    Quitting at least three months before trying for a baby is important to make sure the sperm is healthy when the baby is conceived.

    The good news: A healthy baby starts with healthy sperm and healthy eggs. The good news is that the effects of smoking on eggs and sperm and fertility are reversible. Whether it’s the male or the female (or both) who smokes, quitting will increase the chance of conceiving and having a healthy baby.

    How can I quit smoking?

    Quitting can be difficult but the benefits for parents-to-be and for the baby are enormous. You can talk to your doctor about what’s available to help you stop smoking.
    We also have a Smoking Cessation Clinic here at South West Healthcare.

  • Alcohol

    Drinking alcohol can reduce a person’s fertility, regardless of their gender. Even drinking lightly can reduce the chance of pregnancy.

    Heavy drinking increases the time it takes to get pregnant and reduces the chances of having a healthy baby.

    Heavy drinking can reduce men’s sex drive, affect the quality of sperm and cause impotence.

    For women planning a pregnancy, not drinking alcohol is the safest option.

  • Recreational drugs

    Recreational drugs reduce the chance of pregnancy and having a healthy baby.

    For both men and women, taking cocaine, heroin, ecstasy, cannabis and other recreational drugs can reduce the chance of having a baby.

    Taken over a long period of time, recreational drugs can cause permanent problems with the reproductive system and infertility.

    Using cannabis can lower men’s sperm count.

    Recreational drugs can also cause serious problems in pregnancy. All drugs pass into the bloodstream. Some directly affect sperm or eggs and reduce fertility. Some pass directly into the baby’s bloodstream across the mother’s placenta, which can cause health problems for the baby.

  • Caffeine

    Tea, coffee, energy drinks and some soft drinks contain caffeine.

    As caffeine can affect fertility, to be on the safe side it is recommended that women limit their daily caffeine intake to 200 mg per day (approximately two cups of coffee) if they are pregnant or trying to conceive.

    Guarana is a caffeine substance used in some energy drinks such as Red Bull, V and Mother. These drinks are not recommended in pregnancy.

    It may take longer for women who drink large amounts of caffeine to become pregnant.

  • Chemicals in our environment (at home & work)

    In our everyday lives we come into contact with many different chemicals – through the products we use, the food we eat, and the air we breathe. It’s difficult to completely avoid chemicals in our environment, however there are some simple ways to reduce your exposure.

    • Wear masks and gloves when using chemicals like cleaning products or pesticides and when touching used cat litter and gardening soils.
    • Wash fruit and vegetables to remove pesticides, fungicides, herbicides and other chemicals that may have been sprayed on them.
    • For more information see chemicals in our environment.

     

  • Oral health

    During pregnancy, a woman’s oral health can affect her health and the health of the baby.

    If you are trying for a baby it’s a good idea to have a check-up with your dentist to make sure you don’t have signs of gum disease. If there are signs of gum disease, your dentist can advise you about the best way to treat it.

    Pregnancy hormones and morning sickness can increase the risk of having dental problems. The dentist can also talk with you about how to keep your teeth and gums healthy during pregnancy.

  • Mental health and wellbeing

    Looking after your mental health and having the support of people you love and trust (partner, family or friends) are important when planning for pregnancy.

    If you have experienced mental health issues in the past or you are taking medication, talk with your doctor, mental health worker or psychiatrist about your plans to become pregnant. You can also contact Beyond Blue or COPE.

    Finding out that you or your partner is pregnant can bring a range of emotions. Some people are very happy while others feel nervous or anxious. You can even feel a range of different emotions in the same day.

The woman's monthly cycle

Some people think the ‘menstrual cycle’ and a ‘period’ are the same thing. A period is when you bleed (or menstruate). A menstrual cycle starts on the day when a period starts (day 1) and ends the day before the next period. A cycle’s length is considered normal if it’s between 21 and 35 days. They can vary between women and from one cycle to the next.

Working out your menstrual cycle length

If your menstrual cycles are different lengths (most women’s cycles are) you can work out your average cycle length.

The number of days in a woman’s menstrual cycle can vary month to month. Periods are not always regular. It can be useful to work out an ‘average’ cycle length, based on the length of three menstrual cycles, to estimate when you’re most likely to be ovulating.

If you add the number of days in three cycles and divide the total number by three, it gives you your average cycle length.

Example

Sarah tracked her last three menstrual cycles by counting the time from the first day of one period, to the day before the next period.
Cycle 1 was 28 days; Cycle 2 was 32 days; Cycle 3 was 27 days

28 + 32 + 27 = 87

87 divided by 3 = 29

So the average length of Sarah’s menstrual cycles is 29 days.

Your Menstrual Cycle

Understanding your cycle is the key to getting your timing right. Let’s break it down and look at what happens during each stage.

Menstruation: Days 1 – 5

Day 1 of your cycle is the first day of your period, meaning the first day of full flow (spotting doesn’t count). During this time, the uterus sheds its lining from the previous cycle. Between days 1 – 5 of your cycle, new follicles (sacs of fluid containing eggs) begin to develop within your ovaries.

Follicular phase: Days 5 – 12

The body selects a follicle to develop and the dominant follicle begins to secrete oestrogen which in turn increases the thickness of the uterine lining, preparing it for pregnancy.

Ovulation: Days 12 – 15

The pituitary gland releases a surge of luteinising hormone (LH), triggering the release of the mature egg from the ovary and into the fallopian tube. Sperm can survive for up to 2 – 3 days in the fallopian tubes waiting for the arrival of the egg for fertilisation, however the egg has a window of approximately 12-24 hours in which it can be fertilised after release. The dominant follicle that has released the egg then forms the corpus luteum. This important structure releases progesterone (and oestrogen) which assist in maintaining the uterine lining.

Luteal phase: Days 16 – 28

After ovulation, cells in the ovary (the corpus luteum), release progesterone and a small amount of oestrogen. This causes the lining of the uterus to thicken in preparation for pregnancy.

If the egg is fertilised, the embryo (fertilised egg) travels into the uterus and implants in the lining of the uterus. Once implanted, the embryo begins to produce Human Chorionic Gonadotrophin (hCG). The corpus luteum continues to produce progesterone, which maintains the thickened lining of the uterus.

If no fertilisation has occurred, the corpus luteum dies, progesterone levels drop, the uterus lining sheds and the period begins again.

Conceiving a baby

When are you most likely to conceive?

You are most likely to conceive during the ‘fertile window’ – the days in a woman’s menstrual cycle when pregnancy is possible. The ‘fertile window’ is the day an egg is released from the ovary (ovulation) and the five days beforehand. The timing of the ‘fertile window’ depends on the length of the menstrual cycle, which varies among women.

Having sex (intercourse) during this time gives you the best chance of getting pregnant.

Working out your most fertile days (when you are ovulating)

Knowing when you ovulate can help you plan for sex at the right time and improve your chance of getting pregnant. You can keep track of your menstrual cycles on a chart, in a diary, or on a free period-tracker app on your smartphone.

When you know your average menstrual cycle length, you can work out when you ovulate.

To work out the length of your menstrual cycle, record the first day you start bleeding (first day of your period). This is day 1. The last day of your cycle is the day before your next period begins.

Ovulation happens about 14 days before your period starts.

  • If your average menstrual cycle is 28 days, you ovulate around day 14, and your most fertile days are days 12, 13 and 14.
  • If your average menstrual cycle is 35 days ovulation happens around day 21 and your most fertile days are days 19,20 and 21.
  • If you have shorter cycles, say 21 days, ovulation happens around day 7 and your most fertile days are days 5, 6 and 7.

Your most fertile days are the three days leading up to and including the day of ovulation.

Some women have very irregular cycles or find it difficult to work out an average cycle length. This can make it hard to work out when ovulation happens. If it’s all too hard, having sex every 2-3 days covers all bases and improves your chance of getting pregnant.

Timing and conception

Ovulation is when a mature egg is released from the ovary. The egg then moves down the fallopian tube where it can be fertilised. If sperm are in the fallopian tube when the egg is released, there is a good chance that the egg will be fertilised, creating an embryo, which can grow into a baby.

Pregnancy is technically only possible if you have sex during the five days before ovulation or on the day of ovulation. But the most fertile days are the three days leading up to and including ovulation. Having sex during this time gives you the best chance of getting pregnant.

By 12-24 hours after ovulation, a woman is no longer able to get pregnant during that menstrual cycle because the egg is no longer in the fallopian tube.

There’s almost no chance of getting pregnant if you have sex before or after the fertile window, but if you’re not trying to get pregnant, don’t rely on this. Contraception is your best option to avoid pregnancy.

You can use an ovulation calendar to help you work out your most fertile time. These are the days you are most likely to get pregnant. It can also estimate your due date if you do become pregnant during your next fertile days.

Signs you are ovulating

There are signs that can help you track and predict ovulation, including:

  • Changes in vaginal mucus: A few days before ovulation, you may notice your vaginal mucus becomes clear, slick and slippery, and feels a bit like egg white. This is a sign that ovulation is about to happen. It’s the best time to have sex, as sperm travel more easily in this kind of mucus.
  • Changes in body temperature: When you’ve just ovulated, your body temperature may increase very slightly, by about half a degree Celsius. If you’re using temperature to keep track of when you are most fertile, you need to use a special thermometer to take your temperature every morning before you get out of bed. If you record the readings every day using a graph or a spreadsheet, it’s possible to learn your pattern over time. The time when you are most fertile is 2 to 3 days before the rise in temperature

Ovulation predictor kits detect levels of luteinising hormone (LH) in your urine. You can use a predictor kit from a supermarket or pharmacy, to test your urine for signs of ovulation. If you start testing your urine a few days before the day you next expect to ovulate, a positive result means you are going to ovulate within the next 24 to 36 hours (one to two days).

Having sex in the days leading up to and the day of ovulation will increase your chance of conceiving.

What are the chances?

Having sex as close as possible to the time of ovulation increases the chance of pregnancy.

If a woman has sex six or more days before she ovulates, the chance she will get pregnant is virtually zero.

If she has sex five days before she ovulates, her probability of pregnancy is about 10 percent.

If she has sex on the day of ovulation, or the two days before, the chance of getting pregnant is around 30 percent.

How quickly can you expect to get pregnant?

  • After one month of trying, 38% chance of pregnancy
  • After three months of trying, 68% chance of pregnancy
  • After six months of trying, 81% chance of pregnancy
  • After 12 months of trying, 92% chance of pregnancy

Age and fertility

A woman’s age is the most important factor affecting her fertility and her chance of having a baby. The chance of having a child is much higher for women younger than 35 years and men younger than 40 years than for older women and men.

It’s a biological fact that as women and men age, their potential to have children decreases, although the exact time when this starts to happen can vary among individuals.

Across a population, women younger than 35 and men younger than 40 have a better chance of having a child than people who are older. This is true for natural pregnancies and for pregnancies conceived through assisted reproductive treatments such as IVF (in-vitro fertilisation).

A woman in her early to mid-20s has a 25–30% chance of getting pregnant every month. Fertility generally starts to slowly decline when a woman is in her early 30s, and after the age of 35 the decline speeds up. By age 40, the chance of getting pregnant in any monthly cycle is around 5%.

Page last updated: 5 March 2024

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