Planning a Pregnancy

We always invest a great deal of thought, preparations and elaborate planning- be it physical, emotional or financial, into each decision we take. Then why should pregnancy, which is one of the most important journeys in a couple’s life, be an exception? 

Women nowadays are at par with men in terms of education and career, and taking a break for pregnancy and childbirth can be a setback. The decision to have a child, and what follows, changes your life completely. Hence, it is the need of the hour to know what goes into planning a pregnancy. It is also equally important to know for how long one can afford to procrastinate before the biological clock ticks away irrevocably.

What is the right age to plan a pregnancy? What is ‘too early’ or ‘too late’?

Girls become reproductively able once they start getting their periods. However, it might be ‘too early’ to get pregnant before the body completes its growth. Teenage years are when there is a growth spurt, and that is when the body requires all the nutrition and energy that may be derived through the diet for its own growth. Pregnancy at this time would pose an additional burden, and cause deficiencies in the mother and growth restriction in the baby.

As age advances, both the number and quality of the eggs in the woman’s ovaries start to decline. Babies born to older women are at a higher risk of certain genetic disorders such as Down’s syndrome. Moreover, as age advances, the mother herself might be at a higher risk of certain diseases such as Diabetes, high BP which may tend to crop up during pregnancy and cause an adverse effect on the baby.

To sum up, 21- 35 years might be the best time to plan a pregnancy. However, women on either side of this range can conceive as well, with proper guidance from their doctors. In the present era, with the environmental and lifestyle impact, women are attaining menopause at a younger age, hence, it is important to seek help at an earlier stage if your age is on the higher side and you are unable to conceive.

What is a preconceptional check up? Why is it so important?

A preconceptional check up is a check up with your gynaecologist before you get pregnant. The doctor would elicit your medical and lifestyle history, examine you and order a few tests. These tests would mostly comprise investigations to determine your fitness to carry a pregnancy and rule out certain infections which may have a negative impact on the baby. A lot of women are diagnosed with certain conditions such as hypothyroidism, Diabetes, high BP, heart conditions for the first time during this check up, mainly because they have never sought medical help so far. These may be correctable conditions, and it is very important to take the necessary action to bring them under control before the lady conceives, in order to ensure the good health of the baby, and also to have an uneventful course during pregnancy and childbirth for the mother. In case either parent has a history of genetic disorders in the family, it would be important to undergo a genetic screening and counseling in order to determine the potential risk to the baby, and to know about the screening tests during pregnancy available for the same.

During the preconceptional check up, the doctor would also start you on Folic acid supplements. Folic acid is a vitamin of the B complex group, which plays an important role in formation of blood cells in the mother, as well as development of the neural tube in the baby (which grows into the brain, the spinal cord and the surrounding structures). Deficiency of Folic acid may cause neural tube defects in the baby. Hence, it is important to supplement a mother-to-be with folic acid even before she plans a pregnancy, in order to replenish deficiencies and prevent deformities in the child.

What are the lifestyle changes I would require to make before I get pregnant?

As a mother, you would require to be physically fit before you have another human being growing inside you. A healthy balanced diet is a good practice, as is moderate physical activity. Your body goes through a lot of physiological changes during pregnancy, and to handle them well, each of your systems needs to be in optimal condition. Cut down on your junk food and aerated beverages, food with preservatives and chemicals. Go green, go natural. Increase your intake of fresh fruits, vegetables. Stay well- hydrated. Drink plenty of liquids. Cut down on your alcohol intake, smoking, or any recreational drugs you might be taking, for these do affect the baby in various ways. If you have any medical condition and are on regular medications, it is essential to check with your doctor regarding the safety of these medications during pregnancy.

When do I need to time intercourse in order to conceive?

A pregnancy is the result of the union of the sperm from the man and the egg (ovum) from the woman. Women with regular periods of 28- 30 days usually ovulate (release the egg from the ovary) around the 14^th- 16^th day of their cycle. The egg can survive for upto 12- 24 hours in the female body, whereas the sperms can survive for upto 72 hours. Hence, the ‘fertile period’ is the time of 2-3 days on either side of the day of ovulation. Roughly, in women with regular cycles, the fertile period is from day 12- 18 of the cycle, when the chances of conception are optimal.

When do I need to seek help if I am having difficulty conceiving?

Traditionally, ‘infertility’ is defined as the inability of a couple to conceive despite one year of regular unprotected intercourse. To sum up, if you and your spouse have been regularly having intercourse during the fertile period and are still unable to get pregnant, you would need to seek help of an expert.

However, there are certain situations in which you may need help at an earlier stage. For instance,

•          Women above 35 years of age
•          Women with irregular periods
•          Women with a history of surgery on the ovaries.
•          Women with a known or suspected blockage in the fallopian tubes (history of tuberculosis, endometriosis etc)
•          Men with any known abnormality in the semen
•          Men/ women with adverse lifestyle factors such as addictions (smoking, drinking, drugs), diabetes etc

In the above mentioned conditions, investigation and treatment may be justified even at an earlier period. It is preferable that you visit the doctor on the second day of your periods in case you wish to seek help for fertility treatment.

The author is an Obstetrician, Gynaecologist and Infertility Specialist practicing in Pune, who has helped several couples fulfil their dream of parenthood.