In preparation for the planning of a pregnancy, consideration needs to be given to the wellbeing of both parents.
There are many conditions which can have a significant impact on the wellbeing of both the mother and the baby requiring review in preparation for pregnancy. Conditions such as diabetes, hypertension, autoimmune conditions, and neurological conditions are the most commonly presented where modifications and optimisation of medications is necessary. Planning ahead to ensure these conditions are well managed prior to conception is ideal and is often done in conjunction with your GP and/or treating specialists.
There are some inherited conditions that may be more prevalent in families for which testing preconceptually is possible. Some families may be aware of such genetic diseases whilst other couples may present with infertility of recurrent miscarriage. Use of IVF and pre implantation genetic screening and diagnosis (PGD) of embryos prior to transfer can significantly reduce the inheritance of some conditions. Your doctor may recommend that you be reviewed by a genetic counsellor if they believe IVF and PGD may assist you.
More is being understood regarding the impact of environmental and lifestyle factors on the developing fetus. My goal is to ensure you are made aware of the potential harmful effects of substances such as smoking and alcohol on your fetus; to explain the impact of obesity on the developing fetus and complications that can arise in pregnancy as a result. I will endeavour to assist you with your challenges and refer to health professionals that can assist you further. Those good habits created prior to your pregnancy are then likely to endure after the birth of your child benefiting you and your children.
Folate & Iodine
The Australian recommendations for supplementation are with Folate 400mcg and 150mcg iodine daily to be commenced at least 4-6 weeks prior to conception and continued for the first trimester.
Higher dose supplementation of folate (up to 5mg daily) may be advised in some women:
- Neural tube defect in a previous pregnancy
- Personal history of neural tube defect
- First degree relative with a neural tube defect
- Type 1 or 2 Diabetes Mellitis
- Body mass index > 30kg/m2 (Obesity)
- Use of some neuroleptic medications
Deficiencies of vitamins and minerals in some population groups will mean recommendations for additional supplements may be advised.
Veiled women or women with darker skin are prone to vitamin D deficiency normally acquired from sunlight. Cholecalciferol (D3) ~1000IU daily is recommended.
Many women are iron deficient. During pregnancy iron stores fall dramatically and supplementation at some point is generally required. Ensuring stores are adequate prior to conception is encouraged.
Screening and Immunisation
Prior to conceiving it is important to ensure your vaccinations are up to date. Your GP can arrange to check your Hepatitis B & C, HIV, Rubella, Varicella, and syphilis antibodies. Some vaccinations cannot be performed whilst pregnant and therefore may be recommended prior such as for Rubella.
Vaccinations for influenza, provided yearly, are recommended for all pregnant women and those who intend to conceive. This is completely safe for use in pregnancy and highly encouraged.
Your doctor should also ensure that your cervical screening test is up to date.
Private Health cover
It is important that you are fully aware of your level of health cover. I deliver in Hurstville Private hospital which requires that your health fund cover you for delivery in a private hospital including accommodation, theatre cover and special care nursery if required.
The Medicare safety net will assist with some of your out of pocket expenses for your antenatal costs.
Maternity and Paternity Leave
Knowing your rights and your employers obligations is important in assisting with your financial planning during the time you will be away from work.