Planning to have a baby is one of the most important decisions in a couple's life. Preconception care is a partnership between the couple and the doctor to help them attain their best health. The Father as the provider of sperm gamete and the mother as the chalice for this new life should provide the healthiest environment to their little one.
Your preconception care starts with a visit to the Gynaecologist. They will provide holistic management for your healthy and safe pregnancy journey. You will need to discuss this in detail.
About your periods: If your cycles are irregular, you may have hormonal issues that must be investigated.
About your previous pregnancies:
The best interval between two deliveries is twenty-four months. This time is needed for the mother's body to be replenished to accept the second pregnancy. Also, the first baby is old enough to be managed by others in the family.
If you have had a history of recurrent miscarriages, early births, tiny babies or any other complications during previous pregnancies, then this is the most crucial time to investigate and manage the condition.
Apart from that, it's very important to discuss with your doctor if you have had depression or psychosis during or after pregnancy.
About your medical issues:
Tell your doctor in detail about any medical condition you may have.
Any long course of medication you may have taken in the last 2 -3 years.
This is important as before you plan your pregnancy, your disease should be well controlled on medications that are relatively safe to take during this period as well as during pregnancy. Like if you have diabetes, your HbA1c should be less than 6 before you plan a baby.
Following certain medicines like isotretinoin for acne or tamoxifen for breast cancer, you will be asked to avoid pregnancy for some time. Medicines like Enalapril are very commonly used for controlling hypertension but may impact the growing fetus in the womb.
About your personal history:
Whether you smoke, drink or use certain drugs that may be harmful to the baby during pregnancy.
Your level of physical activity, exercise, sleep, job, etc.
Your mental health.
Your sexual history will also be discussed with you and your partner.
About your partner:
Their weight, general and mental health, medical issues, smoking, alcohol, substance abuse.
About your and your partner's family's history:
Any genetic conditions running in the families, like haemophilia, thalassemia
Any child suffering from congenital diseases like down's syndrome
Any family members who have medical conditions like diabetes, hypertension, etc.
About your age:
The most fertile years of a woman's life are between 18 to 30. After that, fertility may start declining, especially fast after 35.
For a man, the most fertile years are from puberty to 50 years.
About your body weight:
The most optimal Body Mass Index for planning conception is 18 to 25.
After assessing your health, the doctor may advice you on the following:
Start folic acid - 400 mcg for all & higher dose of 5 mg in some cases like if your BMI is more than 30, you are diabetic or you are on anti-epileptics.
Investigations - Certain routine blood tests and ultrasound pelvis may be done to know your general health as well as to rule out some genetic conditions like thalassemia. Sometimes the doctor may want to do investigations to assess your fertility too, especially if you are more than 35 years of age.
Specialistconsult - In case you have a medical condition like diabetes, hypertension, heart disease, epilepsy, asthma, psychiatric or renal diseases, you will be referred to a specialist to
Assess the present status of your disease
Whether it is advisable to get pregnant now or in future
To prescribe medications that are safe for pregnancy
To advise you about red flag signs, level of activity and other guidelines in terms of pregnancy
Till you are ready physically and mentally to have a baby, the doctor will prescribe safe and efficacious contraception for you
Fertile days
In most cases, ovulation occurs 14 days before your next expected period. Depending on your cycle length, the doctor will tell you the best days for planning a baby in case you are ready immediately.
Thus, managing and optimising your health before planning a pregnancy is the first step to giving your child the best and the healthiest future!
Want to consult the best gynecologists in India? Please find the links below.