PREPARING FOR PREGNANCY

Summary: In most cases we recommend daily supplementation of Folate, 500 micrograms for at least one month before pregnancy and for the first twelve weeks of pregnancy.

Folate is necessary for the healthy development of babies, particularly in the first few weeks of pregnancy when a baby's growth is most rapid. Unfortunately, often women are not even aware that they are pregnant at such an early stage. Since 2009 the Australian Government has mandated that all bread making flour (excluding organic flour) is supplemented with folate as a safety net. This is because insufficient folate (folic acid) has shown to be associated with neural tube defects like spina bifida. Research undertaken by the Australian Institute of Health and Welfare suggests that the incidence of neural tube defects has decreased by about 14% since folate was mandated in bread making flour. Food Standards Australia & New Zealand has prepared some information on folic acid / folate and pregnancy.

Summary: We recommend eliminating exposure to smoking (direct and 'second hand') both before and during pregnancy.

Smoking in particular can have many serious negative impacts on pregnancy and development. While there are many 'bad' chemicals in cigarettes, nicotine and carbon monoxide in particular can reduce the supply of oxygen to the developing baby. We strongly recommend that pregnant mothers do not smoke and that family members and friends abstain from smoking around pregnant women. The Royal College of Obstetricians and Gynaecologists has produced this leaflet on Smoking and Pregnancy. There are also resources like Quitline to help with strategies to reduce or quit smoking.

Summary: We recommend eliminating exposure to alcohol both before and during pregnancy.

Alcohol consumption in pregnancy can be a little controversial and over the last 20 years the official stance on whether low levels of alcohol consumption is safe in pregnancy has shifted a couple of times. However the official recommendation since around 2009 and our recommendation is that pregnant women should not consume alcohol. The reason for the controversy was, in part, because the linkage between very low levels of alcohol intake and harm was inconclusive. However what has been conclusively shown is that the threshold level at which harm can occur is small and, given such a small threshold before harm occurs, the most responsible recommendation is to recommend abstinence. The Royal College of Obstetricians and Gynaecologist has produced this leaflet on Alcohol and Pregnancy.

Summary: Please seek advice from your doctor or your obstetrician before pregnancy if you routinely take medications or drugs.

It is not possible to effectively cover prescription medications without taking into account your personal circumstances. However, in nearly all cases your prescription medication requirements can be accommodated through effective consultation with your doctor and your obstetrician. If you are considering pregnancy and are on prescription medications or other drugs, we recommend you Contact Us to arrange a consultation so that your personal circumstances can be properly assessed.

Summary: We recommend restricting caffeine to the equivalent of two instant coffees per day while pregnant.

There is currently no fixed, official, guideline on the amount of caffeine that can safely be consumed. Large amounts of caffeine may increase the risk of miscarriage or may make it more difficult to fall pregnant. Our advice is to restrict caffeine to around no more than 200mg per day. Due to the numerous sources of caffeine (coffee, some soft drinks, some teas or even chocolate) it can be difficult to estimate but as a general guide no more than two instant coffees or alternatively one brewed coffee per day.

Summary: There are many benefits to be gained from regular exercise during pregnancy. These include physical benefits and the prevention of excessive weight gain, as well as benefits for psychological wellbeing.

The benefits of regular exercise have been well established and these benefits in general apply equally while pregnant. Benefits include feeling more energetic, improved posture and circulation, stress relief and reduced anxiety, improved sleep as well as an increased ability to handle the increased demands on your body throughout the pregnancy, during labour and with a newborn.

Before commencing a new exercise routine, please consult with your health care professional to ensure that there are no medical reasons that would prevent you from exercising. If you have an existing routine your health care professional can advise if any modifications are required to your routine to accommodate the pregnancy.

RANZCOG have produced a Patient Information Resource on Exercise during Pregnancy with additional information.

Summary: We recommend that you achieve a healthy Body Mass Index (BMI) before becoming pregnant. A healthy BMI is above 18.5 and below 25.

Weight can be a delicate subject, however it is important to reach and maintain a healthy weight before becoming pregnant. Women who are outside of the healthy BMI range of 18.5 - 25 have an increased chance of pregnancy complications. BMI (Body Mass Index) is a comparison of your weight to your height. It can be calculated by dividing your weight in kilograms (kg) by your height in metres (m), then divide the resulting answer by your height in metres again to get your BMI.

During pregnancy there is no need to "eat for two". The following table is a guide to the range of weight gain expected during pregnancy. We have also included a simple BMI calculator below to easily find your BMI if you know your height and weight.

BMI 50+ will not be able to birth at Ashford Hospital

RANZCOG have produced a Patient Information Resource on Why Your Weight Matters with additional information.

Summary: Your health before and during pregnancy can have a lifelong impact on your baby’s health. For this reason, antenatal care should begin before you become pregnant (for example folate supplementation, see above).

The purpose of antenatal care is to improve the health and wellbeing of both you and your baby before birth. Your booking appointment will ideally occur around 6 - 8 weeks. During your first appointment we will take a detailed history (medical and family), undertake a health assessment and start to better understand your personal circumstances and your needs for the pregnancy. We will also answer any questions you may have and discuss your concerns.

For an uncomplicated or low risk pregnancy you will usually have somewhere between 8 - 10 antenatal visits with us. However, for a complicated or high-risk pregnancy we may require more.

RANZCOG have produced a Patient Information Resource on Antenatal Care during Pregnancy with additional information.

Summary: During your antenatal or postnatal care it may be appropriate to undertake cervical screening. Since around 2017 there have been significant changes to the way cervical screening / pap smear is undertaken resulting in an improved test.

Cervical screening saves lives by preventing cervical cancer which is the growth of abnormal cells in the lining of the cervix. Cervical cancer may develop following persistent infection with the human papillomavirus (HPV) that causes changes in cervical cells which may lead to cervical cancer, usually after 10–20 years. HPV is acquired by genital skin-to-skin contact most commonly through sexual intercourse, but any genital contact may be sufficient. HPV infection is extremely common in men and women who have had sex and four out of five people will have HPV infection at some time in their lives and usually won’t know about it.

RANZCOG have produced a Patient Information Resource on Cervical Screening in Australia with additional information.

Summary: We recommend reducing sources of stress where possible, seek professional advice regarding finances to reduce uncertainty.

Many prospective parents stress about their finances. And there are lot of financial aspects and personal circumstances to consider whether it is time off work or additional costs for baby furniture. The Raising Children Network has a section on Pregnancy And Work. The Australian Securities and Investments Commission also has a section on Budgeting For You And Your Child.