Women know to see a GP for blood tests and antenatal care once they see that positive pregnancy test.  But did you know that there are things to do and important health tips to optimise the health of you and your baby before you even fall pregnant?

Preconception care involves optimising your health in preparation to start a family.  Here is a simple check list to do when you start planning.

•  Folic Acid supplement – The best time to start folate is 3 months before conception. Most of the pregnancy multivitamin contains the recommended folate of 0.5mg.  The dose should increase to 5mg per day for women with previous pregnancy affected by neural tube defect, women on anti-epileptic medications or women with diabetes.

 

• Ensure vaccination is up to date – Chicken pox and Rubella are infections that can cause serious effects to the baby or the mother if contracted during pregnancy. As both Chicken pox and Rubella are live vaccines, they can only be given before you fall pregnant.  If you are unsure of your vaccination status, see your doctor to do an immunity check and vaccinate before you fall pregnant.  Influenza and whooping cough immunisations are also recommended during pregnancy but these can be safely administered during pregnancy.

 

• Ensure your pap smear is up to date – while it is safe to do a pap smear during pregnancy, if there are any abnormalities picked up during the pap smear, it is more complicated to investigate and manage these when you are pregnant.

 

• Health insurance – Have you thought about whether you want to have your deliveries in a private or public hospital? Private health insurance is not essential for pregnancy and delivery but if would like to have your delivery in a private hospital, you need to get cover before you fall pregnant.  If you are not sure whether private or public is the best option for you, see your GP to discuss the benefits and costs involved so you can make an informed decision.

 

• Avoid smoking and alcohol – Smoking and alcohol have teratogenic effects on the baby. No amount is safe so quit before you conceive.

 

• Review health history – Do you have any medical history such as diabetes, heart disease, thyroid disorders, epilepsy or mental illness? Are you taking any medications?  It is important to optimise your health and ensure that any medical conditions are managed appropriately before pregnancy.  Previous obstetric and gynaecology history as well as genetic or chromosomal disorders are also important issues to discuss with your doctor.

 

• Ensure healthy diet and weight – A healthy balanced diet is important before and during pregnancy. Specific things to watch out for includes:
• Avoid raw or undercooked meat and unpasteurised milk to reduce the risk of toxoplasmosis
  • Avoid paté, soft cheese (feta, brie, blue vein), pre-packaged salads, deli meats and chilled/ smoked seafood to reduce the risk of listeriosis
  • Limit fish containing high levels of mercury

 

• Avoid exposure to toxins in the household and workplace – Child and health care workers can reduce the risk of cytomegalovirus and parvovirus B19 by using gloves with changing nappies and handwashing. Avoid handling cat litter and garden soil to reduce the risk of Toxoplasmosis.

 

• Dental check – ensure there is no dental or peridontal disease prior to pregnancy. These can be a source of infection.

 

• Iodine supplementation – The recommended amount is 150mcg per day. Not all pregnancy multivitamins contain iodine so check before you buy.

 

If you would like more reading or literature, here is a really good resource with unbiased information on pregnancy care.

We are happy to discuss with you any questions you have on preconception and pregnancy care.  It is such a special and exciting journey in your life and we are privileged to be a part of this.  Call 3257 0841 to make an appointment to see a doctor with special interest in women’s health.  For more information on our women’s health clinic visit: Doctors @ Teneriffe Women’s Health Clinic.

 

Dr. Dora Lee

FRACGP MBBS (UQ) B PHTY (UQ)

Dr. Dora has a Certificate in Sexual Health and Family Planning and is a part of the Doctors @ Teneriffe special interest group on Women’s Health

 

 

Reference – RACGP Red Book

http://www.racgp.org.au/your-practice/guidelines/redbook/preventive-activities-prior-to-pregnancy/