Obstetrics & Gynaecology

Planning For Pregnancy

  • September 1, 2021
  • 3 minutes read

Most people think that when they are ready to have a baby, it be easy to conceive. However, this may not be the case for many couples. Pre pregnancy consultation and check-up is important to assess whether there are any medical issues that need to be addressed before conception.

Common problems faced by couples in our fast-paced stress filled world include medical issues like anovulatory cycles in women; low or abnormal sperm counts in the men; poor general health due to unbalanced diet and lack of exercise; or the couple just not having frequent enough intercourse.

Anovulatory cycles are so common that it is estimated to occur in about 20 percent of females. Regular menstrual cycle does note mean that ovulation has occurred, therefore a blood test is often done to check if ovulation has occurred spontaneously. If spontaneous ovulation does not occur, investigations are needed to identify the cause and to treat accordingly. They can also take ovulation medication to induce ovulation. Many people think that they ovulate 14 days from the first day of their menstruation, but actually it is 14 days before the first day of the next menstruation. This means if a woman is not pregnant, she will have her menstruation 14 days after she has ovulated. However as we have no way of knowing exactly when the next menstruation will occur, we can only make an estimation based on the previous 6 to 12 cycles.

As the ovum survives only for 24 hours and the sperms for 48 – 72 hours, couples who are trying to conceive need to have intercourse at two to three days interval. Many couples find that difficult as they are too tired after a hard day’s work, or if they work different shifts. Another phenomenon nowadays is that many people have to travel overseas due to work so the couple may be apart during the fertile period.

Due to many reasons, some couple may require the use of lubricant but if they are trying to conceive, they need to ensure that the lubricant they use do not destroy the sperms like most of the common lubricants available off the shelves.

For the guys, it is important to ensure that they avoid activities that will be harmful to their sperms like soaking in hot springs, relaxing in the sauna or steam bath. They should also avoid working with the laptop on their laps as there is a fair amount of heat generated by the computer. Smoking and consuming excessive alcohol are also detrimental to the function of sperms. Eating a proper diet high in vitamins and antioxidants is important, these would include berries, fruits, grains and nuts. Sometimes vitamin supplements may be necessary to treat certain dietary deficiencies.

Eating a healthy balanced diet consisting of grains, protein, fruits, vegetables and dairy products is important to ensure proper nutrients, vitamins and minerals necessary for proper functioning of body cells. Intake of two to four helpings of fruits and vegetables is important for healthy bowel habit and prevention of constipation, which unfortunately tend to be aggravated during pregnancy.

Supplement with folate is essential in preventing cleft lips and spinal bifida in the fetus, vitamin B6 is also found to reduce miscarriages. Not only are these vitamins important for the normal development of the fetus, they have also been found to be important for adult heart health. Women who are anaemic will require iron supplement to achieve a normal haemoglobin level. Untreated anaemia during pregnancy may lead to poor intra-uterine fetal growth, increased risk of preterm labour and low birth-weight babies.

Exercise is important to improve one’s stamina and muscle tone, leading to a well-conditioned body more able to cope with the strains of pregnancy, and reduce the risk of abnormal bleeding and preterm labour.

Achieving the ideal BMI (Body Mass Index) before pregnancy is advantageous as low BMI is associated with amenorrhoea (no menstruation), increased incidence of miscarriages, and low birthweight babies. High BMI women will have increased risk of pregnancy complications like gestational diabetes mellitus or impaired glucose tolerance; preeclampsia; hypertension in pregnancy; large babies, and need for operative deliveries.

Smokers should reduce and hopefully stop smoking as smoking has one of the greatest detrimental effect on fertility in both the male and female, and in pregnancy is associated with increased risk of miscarriages, hypertension, small for size babies and preterm delivery. The same applies to alcohol intake as there is no actual safe level in pregnancy but higher intake is associated with more serious complications and even fetal alcohol syndrome. People who work with chemicals should follow the strict safety procedure at the work place to minimize direct exposure to harmful agents. Infection of a pregnant woman with Rubella (German measles) is associated with a high incidence of miscarriages and fetal abnormalities. This is preventable as long as the woman has been previously immunized against Rubella, therefore it is important to ensure one has the antibodies to Rubella before pregnancy.

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