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Preparing for pregnancy

This factsheet is for women who are planning to have a baby, or for anyone who would like information on how to prepare for pregnancy. It also includes information for men who plan to become fathers.

Being fit and healthy maximises the chances of a healthy pregnancy. By the time you have missed your first period, you are two weeks pregnant. So, it's best to prepare for a pregnancy before trying to conceive and follow the advice that is given to pregnant women.

  • Stopping contraception
  • When is the best time to conceive?
  • Healthy weight
  • Healthy eating
  • What to stop before trying for a baby
  • Hazards at work
  • Issues to discuss with your GP
  • Advice for fathers
  • Further information
  • Sources
  • Related topics

Stopping contraception

You will regain your normal fertility as you:

stop using barrier methods of contraception, such as the condom and diaphragm

stop taking the contraceptive pill

have a contraceptive implant removed

have an intra-uterine device (coil) removed, including one that releases hormones

If you use contraceptive depot injections, your return to fertility may be delayed after you stop them. The time it takes to become fertile again varies between women, but it may be up to 12 months.

When is the best time to conceive?

According to the National Institute for Health and Clinical Excellence (NICE), more than eight in 10 couples who have regular sexual intercourse and don't use contraception will conceive in the first year of trying. Having sex every two to three days is the best way to conceive. Trying to time intercourse with ovulation (when an egg is released from your ovary each month) can put you both under stress and this is unlikely to improve the chance of successful conception.

Couples are usually advised to wait for a year before going to see their doctor, as a pregnancy might take time to happen. However, if you have infrequent or no periods, it's advisable to see your doctor sooner.

Healthy weight

Women who smoke and who are underweight or overweight (BMI less than 18.5 or over 25 - please see our BMI calculator) are also more likely to have trouble conceiving. If you need to lose weight, try to do this before you become pregnant because dieting to lose weight isn't recommended during pregnancy.

Healthy eating

Eating a healthy diet before pregnancy means that your body has adequate stores of vitamins and minerals. A nutritious, well-balanced diet includes:

  • plenty of fruit and vegetables (at least five portions per day), which provide vitamins and fibre
  • starchy foods such as potatoes and whole grain cereals, bread and pasta
  • protein such as lean meat, fish and pulses
  • dairy foods such as milk and yoghurt, which supply calcium

It's best to limit your intake of sugary, salty and fatty foods.

Pregnant women can become anaemic so make sure you eat plenty of iron-rich foods to build up your iron stores. These include red meat, pulses, fortified breakfast cereals, dried fruit, bread and green vegetables.

A well-balanced and varied vegetarian diet should provide all that you need, but you may find it harder to eat enough iron and vitamin B12. It's a good idea to speak to your GP about ways to increase your intake. Also ask for advice if you are on a vegan or any other restricted diet.

There are certain foods that you shouldn't eat pre-pregnancy because they may make you ill or may harm the baby if you do become pregnant. The Department of Health advises that you don't eat:

  • liver and large quantities of vitamin A in supplements such as fish liver oils
  • unpasteurised dairy products
  • raw or soft-cooked eggs
  • pâtés, including vegetable pâté
  • soft cheeses such as brie or camembert
  • blue cheeses such as stilton or roquefort
  • swordfish, marlin and shark
  • any more than two tuna steaks (170g raw) or four tins of tuna (140g drained) per week

Folic acid

Folic acid (one of the B vitamins) is the only pre-pregnancy vitamin supplement recommended for women who are eating a balanced diet.

You need folic acid for the development of healthy red blood cells. Adequate intake of folic acid also reduces the risk of your baby being born with a neural tube defect, such as spina bifida. The neural tube develops very early in pregnancy, during the first few weeks after fertilisation. At this point you may not have even realised you are pregnant.

It's important that you start taking folic acid supplements when you start trying for a baby or as soon as you realise you are pregnant. The recommended dose is 400 micrograms (0.4mg) daily, which you should take as well as meeting the recommended intake of 200 micrograms in your diet. Good sources of folic acid include fresh dark green vegetables such as broccoli, peas, brussels sprouts and chick peas. Many breakfast cereals are fortified with folic acid and it is also found in wholemeal bread.

A higher dose of 5,000 micrograms (5mg) of folic acid is recommended for women who have previously had a baby with a neural tube defect, or are taking medicine for epilepsy. If you have a family history of neural tube defects then you should also take the higher dose. Speak to your GP about folic acid before trying for a baby if any of these apply to you.

What to stop before trying for a baby

Smoking

It's a good idea to stop smoking before trying to become pregnant. Smoking reduces fertility by affecting ovulation in women and reducing sperm count and sperm motility in men.

Smoking during pregnancy is also linked with risks for the baby including premature birth, low birth weight and cot death.

Alcohol

Too much alcohol may decrease fertility in men. For women, heavy drinking, especially binge drinking, can cause problems for a developing baby, leading to poor growth, intellectual impairment or birth defects (fetal alcohol syndrome). The effects of small amounts of alcohol in pregnancy are not clear, but doctors know that it does cross the placenta and may affect the baby's developing brain.

It's best not to drink alcohol if you are trying to conceive, or at any stage during pregnancy. This is particularly important during the first three months of pregnancy, when important organs such as the brain are forming. If you do decide to drink alcohol, have no more than one or two units of alcohol, once or twice a week, and don't get drunk.

Medicines

Some medicines can affect fertility and may be harmful to the baby if you become pregnant. You should speak to your GP if you take prescribed medicines and ask your pharmacist or GP for advice about any other medicines. If you take regular medication, it's best to talk to your doctor before you stop taking it.

Hazards at work

Some working environments can have an impact on fertility. You may be risking your health or the health of your baby if you work with X-rays, chemicals or lead. Speak to your GP, midwife, or the occupational health or personnel department at work if you are routinely exposed any of to these. Your employer is legally bound to provide a safe working environment for you.

Issues to discuss with your GP

Existing medical conditions

You should speak to your GP before trying to conceive if you have any medical conditions. Get personal advice from your GP about chronic (longstanding) conditions such as asthma, diabetes or epilepsy, or past conditions such as a deep vein thrombosis (DVT). Pregnancy affects some conditions, and others can affect the developing baby. You may need to change or stop taking your usual prescription medicines.


Rubella

Rubella (german measles) used to be a common childhood illness but most children are now immunised against it. If you are infected with rubella during pregnancy, especially in the first three months, there is a high risk of the baby being deaf, blind or having heart or other abnormalities.

You can have your immunity checked with a blood test if you aren't sure whether you have been immunised or had the infection in the past. Your GP can give you an immunisation if you need it. You will be advised not to become pregnant for three months after the immunisation.

Genetic counselling

Your GP may refer you for specialist genetic counselling if you or your partner has a family history of genetic or chromosomal disorders, such as cystic fibrosis or Down's syndrome.

Advice for fathers

Smoking and drinking alcohol can affect the quality of sperm, so men should stop smoking and drink no more than three to four units of alcohol per day. Men should also try to maintain a BMI of less than 29 because being overweight can reduce fertility. There is a link between increased scrotal temperature and reduced sperm quality, so it might be a good idea to wear loose-fitting underwear, although it's uncertain whether this will improve fertility.

Further information

Family Planning Association

Sources

  • Simon C, Everitt H, Birtwistle J, Kendrick T. Oxford Handbook of General Practice. 2nd edition. Oxford University Press: 2006: 749, 766-767
  • Fertility: assessment and treatment for people with fertility problems. Clinical Guideline 11, National Collaborating Centre for Women's and Children's Health. February 2004
  • Eat well, be well: When you're pregnant. Food Standards Agency www.eatwell.gov.uk, accessed 8 January 2007
  • The pregnancy book. Department of Health, 2007. www.dh.gov.uk, accessed 8 January 2007
  • New and expectant mothers: a guide for health professionals. Health and Safety Executive. www.hse.gov.uk, accessed 8 January 2007

Related topics

  • Giving up smoking
  • Healthy eating
  • Healthy weight for adults
  • Routine care during your pregnancy
  • Sensible drinking