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EDUCATION CORNER
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    Planning for Pregnancy

    Pregnancy planning is a huge responsibility and there are many things that need consideration while doing so. Here we discuss all the things that should be kept in mind while planning for pregnancy. 


    Factors affecting pregnancy


    There are certain factors that affect the fertility of a couple like: 



    • Body weight: Being overweight and underweight can reduce fertility and chances of pregnancy. So before planning pregnancy, get into the right weight. 
    • Smoking: Smoking affects the chances of a couple to get pregnant. It has a similar effect on fertility in both men and women. In women, smoking decreases the egg maturation and the functioning of the ovaries. While in males it declines the quantity and quality of sperm.
    • Stress and anxiety: Excessive burdens, anxiety, and stress can confuse the hormones and make pregnancy difficult. 
    • Diet: A healthy diet with plenty of fresh fruit and vegetables and enough fluids is a must to ensure pregnancy. 


    Things to ensure while planning for pregnancy:

    • Health and Diet
    • Stop using birth control
    • Immunization 
    • Past pregnancy complication/miscarriage/abortion
    • Genetic counselling

    Health and Diet: Before getting pregnant, a good supply of nutrients is required by the body to prepare for the coming days and to be able to hold the baby in the womb. The nutrients you will need during this phase will come from the diet you take. But as many micronutrients also play a vital role in conception as well as growth and development of the baby, so supplements are also required. Following are the nutrients most important during pre-pregnancy planning and during pregnancy: 


    • FOLIC ACID: Before pregnancy, makes sure your diet is rich in folic acid or you take a folic acid supplement. This can be done by intake of fortified whole grains, fortified cereals, vegetables, and citrus fruits. It is recommended to take 0.4 mg of folic acid before pregnancy for minimizing the risk of birth defects.
    • HIGH-QUALITY PROTEINS: High-quality proteins in your diet are important for your fertility. You need to include whole egg or egg white, fish (especially salmon), and white meat. In case you are vegetarian take beans, legumes, nuts, and pulses.
    • OMEGA-3 FATTY ACIDS: It is very important for the development of baby’s brain. For this, you need to take chia seeds, flax seeds, and fish which will maintain the functioning of hormones.
    • IRON: Iron is required to make RBCs for mother as well as a baby. It is also useful in carrying oxygen to all the organs as well as to the baby. Food items which include iron are wholegrain, nuts, green leafy vegetables, dried fruits, eggs, pulses, oily fish, red and white meat.
    • VITAMINS: Vitamins like folate, vitamin D, and Vitamin C are particularly important during pregnancy. So, it is highly recommended to take vitamin supplement throughout the pregnancy. 


    Stop Using Birth control 

    • Birth control involves various ways to prevent pregnancy like contraceptive pills, condoms, Intra Uterine Devices, etc. But if you trying to conceive, the following ways can help you in birth control reversal: 
    • In the case of a barrier method like a condom, you just need to stop using it to reverse the contraceptive effect. 
    • Contraceptive pills or injections need to be stopped when planning for pregnancy. It may take some time to become pregnant after stopping the pills or injections as these exogenous hormones may take some time to leave your body. 
    • IUDs need to be taken out of the body during pregnancy planning. You should visit a doctor for this purpose and get the IUD removed. 
    • Reversal of permanent contraceptive procedures like vasectomy and tubectomy is a complicated procedure that isn't always guaranteed to work. It depends upon the time passed since surgery and the type of procedure done. 


    Vaccination before pregnancy

    • Rubella vaccine before pregnancy: Measles, mumps, rubella (MMR) vaccine, should be given a month or more before pregnancy.
    • Flu shot: It can be given before or during pregnancy


    Past pregnancy complication/ miscarriage /abortion: Any complication in the past pregnancy or loss of past pregnancy increases the risk of complications in future pregnancies. This may cause increased chances of induced labor, C-sections, vaginal bleeding, pre-term birth, low birth weight, and retained placenta, etc. So, it is important to take the following preventive measures before planning for pregnancy: 

    • Treat the underlying condition, if any
    • Let your body recover before planning the next pregnancy
    • Consult your doctor
    • Start prenatal folic acid and other supplements
    • Take well-balanced diet
    • Make healthy lifestyle choices
    • Quit smoking and alcohol
    • Exercise regularly
    • Stay stress-free


    Genetic counselling: Genetic counselling program is a process where the mother is advised about the likelihood of an inheritable disorder to be passed on to the unborn child. Besides this, the consequences and nature of the disorder are also discussed when the mother is potentially carrying a child at risk. It is not usually necessary unless the mother or father or their families have an inherited condition and there is a potential chance of it being passed onto the child. Most common inherited disorders are: 

    • Cystic fibrosis
    • Down syndrome
    • Fragile X syndrome 
    • Hemochromatosis
    • Haemophilia 
    • Huntington’s disease
    • Muscular dystrophy
    • Neural tube defects


    Psychological preparation: While planning to conceive, only physical preparation is not important. A couple should also prepare psychologically and be ready for the pregnancy. Follow the guidelines and be mentally prepared: 

    • Read or discuss everything about pregnancy
    • Be stress-free 
    • Stay relaxed
    • Understand your risk factors
    • Know the complications 
    • Be prepared and have a plan
    • Seek Out Social Support
    • Communicate with your partner
    • Join a group of expecting parents


    References:

    https://www.cdc.gov/ncbddd/folicacid/recommendations.html “Folic acid recommendation”

    https://www.who.int/nutrition/publications/pregnant/en/ “Health and diet”

    https://www.cdc.gov/vaccines/pregnancy/downloads/pregnancy-vaccination.pdf “Vaccination before pregnancy”

    Frequently Asked Questions

    • Go off the pill
    • Talk with your partner
    • Quit smoking and drinking
    • Limit caffeine
    • Get in shape
    • Take prenatal supplement
    • Enjoy sleep
    • Be stress-free
    • Go to a gynecologist for pre-natal consultation
    • Make a plan
    • Stay healthy


    It depends upon the kind of birth control. In case of birth control pills, conception may occur between one to six cycles or more while implants or a hormonal IUD may take even longer. 

    • What supplements can I take to ensure a healthy pregnancy?
    • Folic acid tablets before pregnancy: It is needed to prevent neural tube defects (defects associated with the brain and spine) and for cellular division in the fetus and red blood cell formation in the mother. 
    • Iron and calcium supplement: Iron for the increased blood demand, and calcium for the bone growth of the baby as well as for milk production. 
    • B12 supplementation: It may be needed in vegetarians.
    • Other: Any other supplements may be required if a pregnant woman is not consuming a well-balanced diet. 


    Genetic counselling during pregnancy planning is done to: 

    • Evaluate genetic disease risk for you and your family
    • Explain the problem and recommend genetic testing if needed
    • For the correct interpretation of test results 
    • To understand and choose the best health options in case of risk of a genetic disorder


    • Announce pregnancy together
    • Go for pregnancy check-ups together
    • Make him enjoy baby’s kicks and movements
    • Let Him Make Decorating Decisions
    • Go together for parenting classes