Pregnancy preconception care

This article explains about pregnancy preconception care and explains what you can do before conception to prepare and care for your baby.

So you’re planning a healthy pregnancy and a healthy baby – maybe your first, maybe a little brother or sister for your other children.

What can you do to ensure that you are at your optimal health before this new life begins to grow inside you? After all, your baby will have been developing for 2 weeks before you have even missed your period Рso if you are planning to get pregnant read on…

Nutrition as part of preconception care

Ever heard the old saying ‚ÄėYou are what you eat‚Äô? Well that‚Äôs true, and now you are considering growing a whole new little person inside you, it‚Äôs time to consider what you do – and don‚Äôt – eat.

The guidelines for eating well during the pre-conception phase are the same as post conception (i.e. when you are pregnant). The basics of a good diet hold true, as always:

  • Eat a diet which obtains energy from grains, cereals, rice and pasta, rather than fats and sugars
  • Eat 6 portions of fruit and vegetables a day – particularly green leafy vegetables, which are high in iron and folic acid
  • Obtain calcium and energy from dairy products
  • Obtain proteins from meat, fish and pulses
  • Have only a small amount of fats and refined sugars each day.

In addition to this women are advised to avoid:

  • Too much liver, as it contains potentially dangerously high amounts of vitamin A (limit to one portion per week)
  • Soft non pasteurized cheeses due to a risk of listeria
  • Raw eggs / pre-cooked chicken due to a risk of salmonella
  • Ready-prepared meats and salads which could contain harmful bacteria – be especially careful at those summer BBQs.

Smoking beforehand and during pregnancy

Almost every smoker is thinking of giving up! Well, you’ve never had a better reason than now.

Smoking is a risk to the unborn baby, reducing the baby’s chances of growing to their full potential in the womb and increasing the chances of complications such as premature birth.

Smoking increases baby‚Äôs chances of respiratory problems and ‚Äėcot death‚Äô.

Smoking increases the likelihood of baby developing asthma and other allergic conditions.

Actually it increases the health risks of nearly everything!

The good news is that there is a lot of support available in the community to help you to quit. Ring your GP’s surgery to see if they offer smoking cessation clinics and see web links below.

Exercise as preparation for pregnancy

At this stage carry on exercising as normal if you are in a good exercise routine. Again this is an ideal time to adopt new habits – so consider taking up regular exercise if you do not already do so. Swimming is ideal throughout pregnancy, so is walking and even more strenuous forms of exercise such as running and cycling are suitable pre and during pregnancy, until you feel too cumbersome to continue.

Folic acid in the preconception period

A balanced diet contains approximately 200 micrograms (mcg) of folic acid per day, from green leafy vegetables and citrus fruits. Prior to and during early pregnancy it is advisable to take 800mcg folic acid daily. Research has shown that this reduces the chances of your baby developing neural tube defects, such as spina bifida or anencephaly (where the brain, spinal cord or coverings of these vital organs have not developed as they should).

If you have a family history of spina bifida or any other neural tube defect, talk to your GP about taking a higher dose of folic acid at this time (5 grams).

Preventing toxoplasmosis in pregnancy

If you have a cat at home, ask someone else to handle the cat litter for you, to prevent catching toxoplasmosis. This infection is carried in cat faeces and can be harmful to your unborn child. If there is no one to help you, then wear gloves and wash your hands thoroughly. You should also be very careful whilst gardening, as this bug can lurk in the soil – use gloves and wash your hands thoroughly.

Toxic chemicals and your baby

Whether at home or at work, stay away from potentially harmful chemicals and fumes; for example, insecticides or solvents.

Rubella immunity prior to pregnancy

Women who are planning to have children should have their Rubella immunity checked by means of a blood test before becoming pregnant. If they have no antibodies to the virus they need to receive the vaccine and then wait at least three months before trying for a baby.

Rubella (German measles) can do serious damage to unborn children, causing congenital rubella syndrome. This can cause serious birth defects, such as deafness and heart defects, miscarriage or stillbirth, especially if it is caught by a woman during the first 3 months of pregnancy (some 90% of babies born to women who contract Rubella during the first 11 weeks of pregnancy will have congenital rubella syndrome). Rubella remains dangerous to the fetus throughout the whole pregnancy.

Pregnant women need to be checked for their Rubella immunity status during each pregnancy, as immunity can reduce over time. If they are found to be not immune they will be offered a rubella vaccine after the birth of their baby, to protect any future pregnancies.

Sexually Transmitted Infections

Some STIs can be dangerous to the baby in pregnancy and birth. If you are planning to become pregnant and there is a chance you could have an infection, it is worth attending a local clinic at your GP surgery or sexual health clinic for a health screen. This will usually involve vaginal and urethral (entrance to bladder) swabs and your partner will be encouraged to attend also.

Alcohol in pregnancy

Just a few years ago women were advised to reduce their alcohol intake during pregnancy – with the amount varying from country to country. Now the widespread message is to cut out alcohol altogether to prevent a worrying condition – Fetal Alcohol Spectrum Disorder (FASD), whereby the child has a level of intellectual impairment. This can happen due to excessive alcohol consumption in pregnancy, but what is “excessive” is hard to define and some babies have displayed symptoms after relatively small amounts of alcohol consumption by the mother in pregnancy.

Drugs in pregnancy

Consumption of illegal drugs in pregnancy can lead to irreversible harm to mother and baby – for example miscarriage, premature birth and placental abruption (see glossary).

Medical conditions

Many medical conditions, such as diabetes, epilepsy and hypertension (raised blood pressure) need to be carefully monitored in pregnancy. It is advisable to talk to your GP or your specialist before becoming pregnant, in order to receive their expert care and advice – right from the start.

Finally…

Many people worry about whether they are psychologically ready to start a family. There’s certainly no right answer to this! I believe that if we all got to thinking about in too much detail then there would be no planned pregnancies! But certainly do talk to your partner about your hopes and aspirations, your own upbringing, your thoughts on child rearing issues such as smacking and coping with crying babies. Make sure you are ready to settle down and put those travel plans on hold Рat least for a little while!

Saying all that – you are about to embark on the best thing you ever did!

Some useful articles and resources on nutrition in pregnancy

To read about iron and folate try our articles on Iron in Pregnancy and Folate, or Folic Acid, in Pregnancy. For information on which foods you need in pregnancy and which to avoid, read our article on Nutrition in Pregnancy. We also have some great nutritional tips on how to manage Nausea, Constipation & Heartburn.

Click on this link for more information on Rubella.

The NZFSA has information about safe food during pre-conception and pregnancy.

The Quit Group NZ offers free telephone support and low cost nicotine patches to all NZ residents.

You should also consider taking a pregnancy multivitamin to ensure you’re getting enough folic acid and iodine prior to, and right throughout, your pregnancy.

Paula Skelton

Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

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Please note that Kiwi Families is not intended to replace individualised, specialist advice that you receive from your doctor and other health professionals.

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