Pre-Pregnancy Checklist

by Craig L. Bissinger, MD, FACOG

Here's What You'll Find Below:The reality of pregnancy, (Shall I keep the coffee maker?)
All about cycles and baby making
Lifestyle changes for a healthy baby and mom
Vaccination concerns and genetic testing
Smoking, drugs and pregnancy

So you have decided to have a child. Congratulations. Welcome to a whole new world of choices. Never before have your decisions had such a profound impact on another person. Everything you eat, drink and smoke will affect your baby. But before you throw away your morning coffee or tea take a few minutes and read these common sense thoughts on pregnancy.

The Realities of Pregnancy

The first thing I do with my patients is remind them of the reality of pregnancy. Women have been having babies since pre-historic times. Somehow, the species survived without all the current hoopla surrounding pregnancy and childbirth.

I often ponder the reason we affix so many rules to this exciting time of our lives and I think I have an answer. We are used to being in control of our lives and bodies. We walk, run, jump and skip when we choose. During pregnancy, there is an alien being within our midst, taking control of many of our bodily functions. To compensate for this lack of power, we look for ways to fight back. Watching what we eat is a great example of control. Avoiding caffeine, cigarettes and NutraSweet are just a few of the controls we impose.

Getting Pregnant: Cycles and Baby Making

Getting pregnant can be the easiest or most frustrating event in your life. All these years you've tried to avoid pregnancy and now you are ready. The first thing to remember is that most couples will get pregnant (85% get pregnant within 12 months of unprotected intercourse). For the 15% who don't, there are a variety of tests to help decipher the cause and help them conceive. Second, it is helpful to understand the menstrual cycle and when a woman is most fertile.

Every woman has her own unique cycle. A cycle refers to the number of days between the beginning of two consecutive menstrual periods. We will use a standard twenty-eight day cycle as our example but the rules will apply to cycles of 21-40 (or more) days as well. The release of an egg (known as ovulation) occurs around fourteen days before the beginning of the next menstrual period. Ovulation is the period of maximum fertility. In the case of a twenty-eight day cycle, ovulation would occur 14 days after the first day of a menstrual period, regardless of the number of days of menstrual flow. To give another example, if a woman's cycle was 40 days, she would ovulate roughly 26 days after the first day of her period (because 40-14=26).

At ovulation, there are other signs that may be present. The cervical mucous becomes very thin and clear, resembling a raw egg white. Another sign is the onset of a sharp or dull aching in the right or left lower part of your abdomen, which can last from 12-36 hours. This is known as mittelschmerz and occurs when an egg is being released from the ovary. Another way to determine the time of ovulation is to do a home ovulation predictor test. This simple urine test, available at many drug stores, can predict ovulation 24-36 hours in advance.

In any case, it takes two to tango. Intercourse should occur on a regular basis around the time of ovulation. I have always suggested trying to have relations every 24-48 hours, starting two days before you expect ovulation. In order to account for the occasional irregular month, I recommend continuing this regimen for a few days past your expected ovulation.