Are you thinking about getting pregnant, or are you ready to get pregnant?

If you are thinking about having a baby, there are several things that you can do to improve your health to give you the best chance of a healthy pregnancy. You won’t know that you are pregnant until a few weeks into the pregnancy, and those first few weeks area critical time for your unborn child, as this is when the baby’s organs develop. You need to aim to start improving your health before you become pregnant to give your baby the best start.

If you have any concerns about anything, please consult your GP before you start trying for pregnancy

 

Folic acid and pre-pregnancy vitamins

Taking 400 micrograms of folic acid from pre-conception (preferably at least 3 months before you get pregnant) until the baby reaches 12 weeks of pregnancy, reduces the chances of the baby developing neural tube defects. These are problems where the spine doesn’t fuse properly, such as spinabifida. Some women need to take a higher dose offolic acid(5mg) – consult your GP about taking higher dose folic acid if you have diabetes, if  your BMI is over 30, you take medications for  HIV or you have a diagnosis of thalassaemia or coeliac disease, if you are on epilepsy medication, or if you, your partner or someone in your oryour partner’s family has a neural tube defect.

Vitamin D is also important and women are advised to take 10 micrograms of vitamin D3 during pregnancy and breastfeeding to ensure the baby is not lacking in vitamin D. Low vitamin D levels can affect healthy bone development. Adequate levels of both folic acid and vitamin D for pregnancy are hard to achieve through healthy diet alone. They can be bought in over the counter supplements before you are pregnant (but avoid multivitamin supplements that are not specially designed for pregnancy, as these can contain too much vitamin A which can be harmful).

Once you are pregnant all women registered with a City or Hackney GP can obtain free ‘healthy start’ vitamins throughout their pregnancy and for the first year after the birth– ask your GP receptionist for
the form and take it to any City or Hackney pharmacy. These vitamins contain both folic acid and vitamin D.

 

Healthy weight and physical activity

Being a healthy weight will both help you to conceive (become pregnant) and reduce risks to your baby during pregnancy. A healthy weight depends on your height and is expressed as BMI (bodymass index). You can calculate your BMI using an online calculator – it is your weight in kg divided by the square of your height in cm. There is an online BMI calculator on the NHS choices website or you can ask you GP practice or pharmacy. The healthy range is 18- 25. Below 18, periods may stop and fertility be affected, above 25 (and especially above 30), fertility is also affected and there is a higher risk of pregnancy complications. If you would like help or advice about achieving a healthy weight, please talk to your practice nurse or healthcare assistant.

Physical exercise is important as well. You should aim for 5x30 minutes of moderate intensity exercise per week, and this should be maintained through pregnancy. Once pregnant, aim to maintain your current level offitness rather than pushing yourself to the point of exhaustion.

 

Smoking, alcohol and drugs

It is well known thatsmoking is bad for the unborn child, aswell as forthe baby after birth. Aim to stop before you become pregnant. Smoking can also affect fertility and reduce sperm count in
men. There is ahighly successful stop smoking service in City and Hackney. Ask your GP practice to refer you, or contact the team directly on 0800 046 9946 and give the name of your GP practice.

There is no safe level of alcohol in pregnancy. National guidance recommends that women planning to become pregnant,or currently pregnant, do not drink alcohol at all.

Similarly, recreational drugs are harmful in pregnancy. If you need help with stopping smoking, drinking alcohol or taking recreational drugs, please talk to your GP, practice nurse or healthcare assistant.

 

Medication

If you take any prescribed medication, please consult your GP about whether it is safe for you to take while trying to get pregnant or during pregnancy. You may need to change medication. It is best to do this before becoming pregnant. If you buy over the counter medicines, please consult the pharmacist about whether these are safe in pregnancy. Again, it’s best to do this before you become pregnant and make the changes in advance.

 

Mental health

Women with mental health problems, or who have had mental health problems in the past, are more likely to become mentally ill during pregnancy or in the first year after giving birth, than at other times of life.It’s a good idea to talk to your GP about planning a pregnancy to make sure that your mental health is stable and that any medications you take are suitable for pregnancy. Don’t stop medication without talking to your GP, as this could cause your health to become unstable. Pregnancy is also a time when mental health problems can present for the first time – your GP and midwife will ask you screening questions during pregnancy and after the birth to try to pick up problems like depression early on.

 

Chronic disease management

You may already have a health problem such as diabetes, epilepsy, asthma, high blood pressure, thyroid or other problems.If this is the case (or you take medication for any other health problem) please consult your GP about optimizing your health in preparation for pregnancy. This might include different targets for control of your condition than the ones you have currently, or a change of medication to one suitable for use in pregnancy.

 

Tell your GP as soon as you are pregnant!

Once you find out that you are pregnant, it’s best to let your GP know as early as possible. This will give them the chance to refer you for antenatal care early. Ideally, we would like all women to have their first midwife appointment by 10 weeks of pregnancy. This enables the first scan to be arranged at the correct time and any problems to be picked up early. Also, if you have had previous pregnancy complications these can be discussed early. Your midwife or GP can also give you further information on antenatal classes, preparation for parenthood and relationship counselling. You can also book yourself directly to the Homerton maternity team

Self-refer to Homerton Maternity Services

 

Useful information

NHS Choices informaton on Pregnancy