Contemplating Pregnancy?

Dr Nikki Twomey

Have you considered booking in for a pre-pregnancy care appointment?

A prenatal check-up is an excellent opportunity to detect issues with maternal health and family history that might affect a pregnancy and take steps to manage potential problems, as well as gaining advice on maintaining a healthy pregnancy and minimising health risks.  This can increase the likelihood of a healthy and emotionally strong pregnancy. Some things worth discussing with your GP include:

Your past medical history:

Chronic health conditions, such as diabetes, high blood pressure, thyroid disease or mental health concerns can have implications for conception and pregnancy outcomes and are best stabilised prior to pregnancy

Your menstrual history, current method of contraception, past pregnancies, assessment for STIs and cervical screening if due should all be considered prior to pregnancy.

Medications and supplements:

Medications you are taking, both prescription and over the counter, including nutritional supplements and herbal products should be checked to make sure they are safe to take in pregnancy.

Prenatal supplements advised during pregnancy include folic acid and iodine, and in some cases iron or vitamin D. Iodine is essential for brain and nervous system development. Women with pre-existing thyroid conditions should ask their doctor before taking this supplement. Higher doses of folic acid are required for women with certain pre-existing medical conditions to reduce the chance of developmental abnormalities such as spina bifida.

Lifestyle considerations:

It is best to start a pregnancy with a healthy weight to optimise fertility as well as pregnancy outcomes. The best way to do this is a healthy balanced diet and regular exercise. If you have any concerns this may be an area that your GP can help you address before pregnancy.

Smoking, alcohol and other substance use can all have serious consequences to the unborn child and should ideally be ceased before conception.  There is no known safe level of alcohol consumptions in pregnancy.

Reproductive Carrier Screening

Most people who are carriers for a genetic condition (up to 1 in 20 people) are healthy and don’t have a family history.  A blood test can detect if you are a carrier for some common genetic conditions. This is recommended for consideration by all couples planning a pregnancy or in early pregnancy. 

Both parents of need to be carriers of the same gene to have an increased chance of having a child with the condition.  Reproductive carrier screening can be done for a small number of more common genetic inherited conditions  (cystic fibrosis, fragile X syndrome and spinal muscular atrophy), or a larger number of conditions. The test is not currently funded by Medicare and costs around $400 per person tested. If an abnormal gene is found or there is a family history of a genetic condition you can be referred for further advice and testing.

Vaccinations

Immunity against varicella (Chicken Pox), rubella and hepatitis B is advised prior to pregnancy as these viruses can have adverse effects on pregnancy and the developing baby.  Before you try to get pregnant is an ideal time to check immunity and update vaccinations if needed.

 The consulting GPs at Neighbourhood Medical can assist you with pregnancy planning. You can have a read about them here.