pregnancy

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Having a baby is an important and exciting time in your life. While pregnancy is a very natural process, there are a number of important things to consider before and during pregnancy which will be beneficial for both mother and baby.

Most couples achieve pregnancy within 12 months of trying. If the contraceptive pill has been taken, it may take up to 6 months to begin ovulating again. Women over 35, and those who smoke, take longer, on average, to conceive.

Before becoming pregnant there are several important things to consider and have checked by your doctor.

SMOKING should be ceased preferably at least 3 months before conception. Passive smoking should also be avoided. It is often much easier to quit smoking when there is a very good reason to do so - like the health of your baby.

FOLIC ACID is a vitamin found in green leafy vegetables. Folic acid supplements have been shown to dramatically reduce the risk of neural tube malformations such as spina bifida. All women planning pregnancy should have 0.5 mg of folic acid supplement each day for 3 months before pregnancy and during the first 3 months of the pregnancy.
Where there is a family history of spina bifida or anencephaly, you have diabetes or are taking certain epilepsy medications, the dose should be 5mg per day for the month before conception and during the first 3 months.

RUBELLA ( German Measles ) contracted during pregnancy can cause very serious damage to the developing baby. Most women have been vaccinated against rubella - however, you should have a blood test well before you plan to become pregnant to check that you are immune to rubella. If you are not immune, you should be vaccinated before becoming pregnant - however you must not become pregnant for at least 3 months after the rubella vaccination (MMR) as it is a live virus.

Rh BLOOD GROUP - women who are Rh Negative and have an Rh Positive baby (the father will be Rh Positive) are at risk of having "blue babies" in subsequent pregnancies - where the baby is born very anaemic or may be stillborn. All women should have their blood group checked to see if they are Rh negative. Rh Negative women who have an Rh Positive baby are given an "Anti D" injection after delivery to prevent this problem arising.
* Rh Negative women who have a miscarriage should also be given Anti D at the time.

GENETIC DISEASES. There are a number of inherited diseases which can be tested for and advised about - the more common include thalassaemia, cystic fibrosis, Huntington's chorea and haemophilia. If there are any inherited illnesses in either partners family, seek advice from your doctor.

ALCOHOL, even in modest amounts, can cause abnormalities in babies. Alcohol should not be consumed prior to or during pregnancy.

DRUGS. "Recreational" drugs should also not be used during pregnancy. Caffeine intake should be reduced and advice sought before taking "over the counter" or herbal medications.

MEDICATION. Some medications should not be taken before or during pregnancy. If you are required to take medication for an ongoing illness, discuss this with your doctor before conception.
Medications to avoid include :
- Ro-Accutane (and some acne creams including Retin-A and Airol ),
- hormones,
- some epilepsy medications (especially Phenytoin - Dilantin ),
- Warfarin ( Coumadin, Marevan )
- aspirin and anti-inflammatory medication ( e.g. Nurofen, Voltaren ) should not be taken in the 3 months prior to delivery.
- vitamin A supplements should be avoided

TOXOPLASMOSIS is an infection with a parasite carried by cats and present in some raw meat. If contracted in pregnancy it may cause serious abnormality in the baby. During pregnancy you should not handle cat litter trays and always cook meat well. Hands should be thoroughly washed after gardening or handling raw meat.

LISTERIA is also an infection which can contaminate food - if contracted it frequently causes the developing baby to die. Avoid unpasteurised milk and dairy products (e.g. soft cheeses), thoroughly wash raw vegetables and cook meat well. Make sure food utensils and work areas are thoroughly cleaned after preparing uncooked food.

DIET and EXERCISE. During pregnancy it is advisable to have a well balanced nutritional diet - this should be high in fibre and low in saturated fat. Regular non-contact exercise is encouraged - however it is best to avoid high level exercise and becoming overheated.
A supplement ("Elevit"), containing folic acid, iron, calcium, essential vitamins and minerals, specifically designed to provide the supplements required during pregnancy and lactation is available. Taking this balanced supplement for at least 1 month prior to conception and throughout pregnancy significantly reduces the risk of major birth defects and morning sickness and is more effective than folic acid alone.

Taking these simple measures is a positive step toward an uncomplicated pregnancy and a healthy baby.

SHARED ANTENATAL CARE - during and after pregnancy most women prefer to see the same doctor for their checkups. At St Agnes we offer "shared antenatal care" where women who do not have private health cover or are not seeing a private obstetrician can see one of our doctors for the majority of their check-ups. Three or four visits are scheduled with the antenatal clinic at the hospital where they will deliver. Modbury, Lyell McEwen and Women's and Children's Hospitals participate in shared antenatal care.
Our doctors who provide this service are Drs Karen Hand, John LePoidevin and Gail Laas.

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