Welcome to POPSUGAR Uninhibited: The Fertility Edition, a space where anyone who ovulates can come for information, advice and support. Here, we’ll tackle topics like fertility in your 20s, conception and egg freezing. You can find all of the stories here.
Whether you’re actively planning to have a baby or simply considering it, many physical and psychological factors are involved in taking care of you and your baby’s mental and physical health during pregnancy. Understanding the steps you should be taking — including who you should be speaking to and what you can do to ensure a healthy pregnancy and baby — will make the process easier. We spoke to obstetrician and gynaecologist Dr Kristina King and Dr Elizabeth Maxwell, an obstetrician, gynaecologist and clinical director of IVF Australia Wollongong for an OB-Gyn-approved checklist of steps to take before trying for a baby.
Check-in With Your GP
Before heading to the specialist’s office, one of the best places to start your fertility journey is with your GP.
“Your GP can provide you with a general health check and make sure you’re up to date with all of your relevant vaccinations, as well as cervical screening tests,” Dr Maxwell tells POPSUGAR Australia. Some women and people who menstruate have naturally low reserves of folic acid, and a folic acid deficiency can lead to complications like neural tube defect in a foetus. This is a condition which affects the development of the foetus’ brain and spinal cord. To prevent this, health professionals recommend that people who are planning on becoming pregnant take 400mcg of folate per day for one month before and three months after falling pregnant.
Discuss Necessary Changes to Your Diet and Lifestyle
No matter your gender, your overall physical health impacts your reproductive health, so discussing diet and lifestyle factors which may undermine the production of healthy sperm and eggs with your doctor is an important step.
“Eating well, cutting back on alcohol and quitting smoking if necessary are all important steps,” Dr King tells POPSUGAR Australia. If any of these steps pose a problem for you and/or your partner, your GP may be able to work with you on a plan to cut down, get help, or see a specialist who can provide assistance.
Engage in Preconception Counselling With Your Ob-Gyn
Dr Kristina King says she spends a lot of time seeing couples for preconception counselling.
“This basically means sitting down with your specialist and examining your medical history, and seeing if there is anything we can do to optimise your chances of a healthy pregnancy and baby,” she explains.
While it may seem extreme to engage with a specialist before you’ve even started trying, it’s enormously beneficial.
Related: Cost of Living, Career and Climate: Why Young Women Are Delaying Motherhood
“It’s often better to address any issues early, as a healthy pregnancy starts around the time of conception,” Dr King says.
“At this visit, we can talk about diet and exercise while trying to conceive and during the pregnancy, go through your cervical screening results, as abnormalities are far more difficult to manage during pregnancy, and discuss any risk of genetic conditions.”
A specialist will be able to provide a detailed treatment plan, and then support throughout your pregnancy.
Consider Genetic Carrier Screening
While it’s not something everyone thinks of, The Royal Australian College of Obstetricians and Gynaecologists (RANZCOG) recommends genetic carrier screening for couples considering having children. Dr Maxwell explains that genetic carrier screening “identifies if you and your partner are carriers of a genetic variation or condition which might mean you are at risk of passing it on to your offspring.”
While it might seem intimidating, and distinctly… unsexy, conditions like phenylketonuria (PKU), cystic fibrosis (CF) and fragile X syndrome (FXS) can have a major impact on a child and their family’s life. Genetic carrier screening can help couples make informed decisions about conceiving naturally or via IVF, or taking alternative pathways like donor sperm or adoption.
After lobbying by the RANZCOG, the federal government has announced it will be making genetic carrier testing Medicare funded from 2023 (although they are also pushing for Medicare-funded IVF and post-screening counselling for couples faced with these tough decisions).
If You’re Conceiving With a Partner, Engage a Therapist
If you plan on having your baby with a partner, you’re starting a long journey with them. Many studies indicate pregnancy and child-rearing place significant strain on parents’ relationships, and in 2011, the American Psychological Association reported that 67 percent of couples found their relationship satisfaction experienced a steep decrease post-birth.
According to the International Journal of Environmental Research and Public Health, “partner-stress” increases the risk of pre-and post-natal depression, so it’s important to ensure both parties are prepared for the change in their relationship and lives. Dr Maxwell emphasises that “it’s important to discuss with your partner that you are both going to start trying to conceive and make sure you are both on the same page.” Natural conception requires both parties to take responsibility for their physical, emotional and financial health, as well as take care of each other.
“Your relationship is really important at this time,” says Dr Maxwell. “If it takes a bit longer to conceive, that can strain your relationship, so communication and looking out for each other is key.”
Understand Your Fertility Window
Having an idea of what your fertile window is and when it occurs each month is essential, and you can find more details on the specifics of establishing your fertility window here. However, there are simpler ways to do it.
“To reduce anxiety around this, I often tell my patients to simply have unprotected sex at least twice a week, from the end of their period,” says Dr Maxwell.
Related: Everything You Need to Know About Ovulation and Your Fertile Window
Check Out Alternative Pathways
Dr Maxwell notes that a lot of the advice commonly laid out is for cis male/female couples.
“However, if you’re a couple who are both females, or both have ovaries and a uterus, then you will need a donor sperm in order to conceive. It’s best to have a referral to an IVF clinic to talk about your individual circumstances and options for donor sperm early,” she says.
“Likewise, if you’re in a same-sex relationship and both produce sperm, then you will need to use an egg donor and surrogate, and again, your fertility specialist is best placed to guide you here.”
