Preconception Counseling

Good Fitness
Along with eating well and taking prenatal vitamins, being physically fit is also a plus during the pre-pregnant and pregnant stages. Studies have shown that good fitness during conception and pregnancy make for a much easier labor and delivery. Maintaining a body weight of no more than 15% above or below ideal body weight will provide an optimal environment for the fetal growth period. If a woman is less than 15% below ideal body weight, she is not just slight, she is skinny. In fact, many women this underweight won't ovulate normally, and this may make it hard to conceive. Finally, in the first trimester, many women have such extreme nausea and vomiting that they lose a significant amount of weight. For these reasons, I always encourage women to optimize their health before conceiving.

I recommend that women who exercise prior to becoming pregnant continue to exercise throughout much of pregnancy, however, some modifications may be necessary. Talk with your doctor once you become pregnant, and determine together the level of exercise that you both feel is safe. These guidelines should be applied to the time just prior to conception as well, as the fetus is nearly 2-3 weeks old before most women even know that they are pregnant.

Adequate nutrition and hydration must be maintained and overheating avoided. The core body temperature, and thus the uterine temperature, can exceed 102° during "spinning" or other vigorous exercise in a hot, crowded gym. Attempts to lose weight should occur before, not during pregnancy.

Controlling Habits and Environment During Pregnancy

It is also important for a couple to evaluate their daily surroundings and habits as they are trying to get pregnant.

Controlling your environmental exposure
Asbestos, lead, and radiation exposures should be avoided. If you have a cat, speak with your doctor about taking blood tests to see if you have antibodies to toxoplasma (parasite that can cause birth defects). If you do not have antibodies, you should use gloves and a mask to change litter boxes during pregnancy.

Controlling your habits
If you drink alcohol, smoke cigarettes or use illegal drugs, these habits need to be modified, preferably stopped, once you begin trying to conceive. They all can have terrible, lasting effects on your baby as its organs are developing, even before you know for sure if you are pregnant. For your own health as well as your future children, quitting, or at least cutting down on these habits, will help everyone. Your doctor can give you information about support groups, treatment centers and other sources of help.

What is the Best Time to Conceive?

Now that you have taken all of the proper steps to get ready for pregnancy, what is the best way to get pregnant? If you are a woman and have a twenty-eight day menstrual cycle, you should start having intercourse at least five days before you expect to ovulate. This is usually about nine days after you begin your period. You should continue to have sex at least every other day until day nineteen.

There does not appear to be any advantageous sexual position, but it is best for ejaculation to occur deep within the vagina. There also does not appear to be any benefit to bed rest following intercourse (most sperm swim up the reproductive tract rather quickly).

Many people believe that stress affects a couple's ability to conceive. This is a myth. It is important, however, to keep the romance alive in your marriage, and try not to let the process of trying to get pregnant create friction or stress. Trying to conceive should be enjoyable for both partners.

Conclusion

Remember, be patient when you are trying to get pregnant. Many patients tell me they want to get pregnant in a certain month so they can deliver at a time that fits in their schedule. One of the couples I visited with wanted to conceive on a certain day so that they could deliver before the end of the year and sneak in another tax deduction. The reality is that getting pregnant can sometimes take six months to a year because the chance of conception each month is only one in five or six. If success does not come within six months to a year of trying, it is reasonable for the couple to talk with their physician to find out whether any tests or treatments are indicated.