What to expect when you're expecting (8 page)

Thyroid function. Thyroid function can affect pregnancy. So if you have or ever had thyroid problems, or if you have a family history of thyroid disease, or if you have symptoms of a thyroid condition (see
pages 174
and
531
), this is an important test to have.

Sexually transmitted diseases (STDs). All pregnant women are routinely tested for all STDs, including syphilis, gonorrhea, chlamydia, herpes, human papilloma virus (HPV), and HIV. Having these tests before conception is even better (or in the case of HPV, getting the vaccine; see next page). Even if you’re sure you couldn’t have an STD, ask to be tested, just to be on the safe side.

Get treated.
If any test turns up a condition that requires treatment, make sure you take care of it before trying to conceive. Also consider attending to minor elective surgery and anything else medical—major or minor—that you’ve been putting off. Now is the time, too, to be treated for any gynecological conditions that might interfere with fertility or pregnancy, including:

Uterine polyps, fibroids, cysts, or benign tumors.

Endometriosis (when the cells that ordinarily line the uterus spread elsewhere in the body).

Pelvic inflammatory disease.

Recurrent urinary tract infections or other infections, such as bacterial vaginosis.

An STD.

Update your immunizations.
If you haven’t had a tetanus-diphtheria-pertussis booster in the past 10 years, have one now. If you know you’ve never had rubella or been immunized against it, or if testing showed you are not immune to it, get vaccinated now with the measles, mumps, and rubella (MMR) vaccine, and then wait one month before attempting to conceive (but don’t worry if you accidentally conceive earlier). If testing shows you’ve never had chicken pox or are at high risk for hepatitis B, immunization for these diseases is also recommended now, before conception.
If you’re under 26, also consider getting vaccinated against HPV, but you’d need to get the full series of three before trying to conceive, so plan accordingly.

Get chronic illnesses under control.
If you have diabetes, asthma, a heart condition, epilepsy, or any other chronic illness, be sure you have your doctor’s okay to become pregnant, your condition is under control before you conceive, and you start taking optimum care of yourself now (if you aren’t already). If you were born with phenylketonuria (PKU), begin a strict phenylalanine-free diet before conceiving and continue it through pregnancy. As unappealing as it is, it’s essential to your baby-to-be’s well-being.

If you need allergy shots, take care of them now. (If you start allergy desensitization now, you will probably be able to continue once you conceive.) Because depression can interfere with conception—and with a happy, healthy pregnancy—it should also be treated before you begin your big adventure.

Get ready to toss your birth control.
Ditch that last package of condoms and throw out your diaphragm (you’ll have to be refitted after pregnancy anyway). If you’re using birth control pills, the vaginal ring, or the patch, talk your game plan over with your practitioner. Some recommend holding off on baby-making efforts for several months after quitting hormonal birth control, if possible, to allow your reproductive system to go through at least two normal cycles (use condoms while you’re waiting). Others say it’s okay to start trying as soon as you want. Be aware, though, that it may take a few months or even longer for your cycles to become normal and for you to begin ovulating again.

If you use an IUD, have it removed before you begin trying. Wait three to six months after stopping Depo-Provera shots to try to conceive (many women aren’t fertile for an average of 10 months after stopping Depo, so time accordingly).

Improve your diet.
You may not be eating for two yet, but it’s never too early to start eating well for the baby you’re planning to make. Most important is to make sure you’re getting your folic acid. Not only does getting enough folic acid appear to boost fertility, but studies show that adequate intake of this vitamin in a woman’s diet before she conceives and early in her pregnancy can dramatically reduce the risk of neural tube defects (such as spina bifida) and preterm birth. sFolic acid is found naturally in whole grains and green leafy vegetables, and by law it is also added to most refined grains. But taking a prenatal supplement containing at least 400 mcg of folic acid is also recommended (see
page 103
).

It’s also a good idea to start cutting back on junk food and high-fat foods and begin increasing whole grains, fruits, vegetables, and low-fat dairy products (important for bone strength). You can use the Pregnancy Diet (
Chapter 5
) as a good basic, balanced food plan, but you’ll need only two protein servings, three calcium servings, and no more than six whole-grain servings daily until you conceive—plus you won’t have to start adding those extra calories (and if you need to lose some weight preconception, you might need to cut some calories out).

Start modifying your fish consumption according to the guidelines for expectant moms (see
page 114
). But don’t cut out fish, because it’s a great source of baby-growing nutrients.

If you have any dietary habits that wouldn’t be healthy during pregnancy (such as periodic fasting), suffer or have suffered from an eating disorder (such as anorexia nervosa or bulimia), or are on a special diet (vegan, macrobiotic, diabetic, or any other), tell your practitioner.

It Takes Two, Baby

Sure, you’re closer than ever physically now that you’re trying to make a baby (that’s something baby-making efforts just about guarantee)—but what about your love connection? As you strive to form that perfect union (of sperm and egg), are you neglecting the other significant union in your lives (the two of you)?

When expanding your twosome becomes your number one priority, when sex becomes functional instead of recreational, when it’s less about getting it on than getting it done (and when foreplay consists of running to the bathroom to check your cervical mucus), relationships can sometimes show the strain. But yours definitely doesn’t have to—in fact, you can keep it healthier than ever. To stay emotionally connected while you’re trying to conceive:

Get out.
Been-there, done-that moms will tell you that
now’s
the time for you and your spouse to get out of town—or at least out of the house. Once baby’s on board, your days (and nights) of picking up and taking off will be numbered. (Maternity leave? More like maternity
stay
!) So take that mini vacation you’ve been saving up for—or that second honeymoon (you can call it a baby-to-be-moon). No time for a vacation? Try something new on the weekends—preferably something that you won’t be able to do once conception cramps your lifestyle (horseback riding or white-water rafting, anyone?). Need something more tame as a twosome? Slip off to a museum on a weekend afternoon, catch a late-night movie (or two) at the multiplex, or just linger over dinner at your favorite restaurant (no babysitters necessary).