How to Plan a Pregnancy

Catrina Skepper: The decision to have a new baby is a huge decision for any family. Melanie Every is a midwife and she has joined the baby channel to give you some tips and advice on what preparations you should undertake as you plan your forthcoming pregnancy. Welcome Melanie. Melanie Every: Hello there. Catrina Skepper: Planning in pregnancy there is not huge amount you can do before hand but diet and exercise and general health must be the things that most women are concerned about. Melanie Every: Yes, that's right and I think one of the most important things about planning for pregnancy is actually to be quite relaxed about it. What you are aiming for is -- Catrina Skepper: It's opposite to what we find most of you -- Melanie Every: What you are looking for is good general health. You are not looking to be an athlete in the Olympics or in anything like that. You want a good diet, obviously give up smoking if you smoke and give up alcohol. Catrina Skepper: How long - people think about smoking but I mean if you are a heavy smoker, how long should you wait, say after you have given up smoking because that's days in -- Melanie Every: It does I mean ideally you would like to wait about six months but three would be better than not giving up at all and it is quite difficult and sometimes you do need a lot of help and advice to give up smoking and I would advice people to seek it. Catrina Skepper: Because they can become very unrelax once you have given up smoking and -- Melanie Every: You can, you do need a little bit of help and you probably need a bit of help and support from those around you. If you tend to get a bit grumpy -- Catrina Skepper: And is the main reason for giving up smoking and/or drinking for that matter because it can directly affect the health of the baby while it's even in the womb. Melanie Every: It can very much so and in fact, smoking is also linked with miscarriage. Catrina Skepper: And diet generally I mean people know what's healthy and what's bad but what would you advice, is it no-fat diet presumably? Melanie Every: No fat dieting, no efforts to reduce weight or gain weight very quickly, low fat, low sugar, but good healthy nutritious food, adequate protein, adequate vitamins, and vegetables, that kind of diet. The only thing that I would add to that is of course that we do recommend people take folic acid so trying to -- Catrina Skepper: Offering supplement form -- Melanie Every: In supplement form, yes. Catrina Skepper: Well I have never know what foods are strong in folic acid? Melanie Every: It tends to be things like dark green vegetables, and whole meal bread and that type of thing. Catrina Skepper: And folic acid, is there specific dosage, isn't there that you should take in pregnancy? Melanie Every: There is. I mean for most of the population, it's 44 micro grams a day. If you have a family history of babies being born of neural tube defects things like Spina Bifida, I would advice people to go and discuss with the GP because you may need a higher dose. Catrina Skepper: And how long leading up to planning of pregnancy should you be taking and --? Melanie Every: Well ideally, at least three months. Catrina Skepper: As well, yeah. Some reasons, perhaps being on the pills for certain amount of time, they come off the pill, how long again, often you hear people saying is it is dangerous to the baby who have been on the pill, are there sort of lingering on hormones around that you should wait before you actually trying that during pregnancy? Melanie Every: There is no real evidence that there is harm from becoming pregnant immediately after coming off the pill and indeed in case when you find women become pregnant while they are still on the pill for various reasons. The main area of - if you like controversies, is can you exactly date when your pregnancy was because it takes some women a little while t get their cycle back to normal, if they come off the pill. So again, ideally, three to six months before you become pregnant would be really good but if you stop taking the pill and become pregnant immediately, don't worry about it. Catrina Skepper: And in things like exercise, I mean you said already that you also don't want to suddenly increase your exercise regime but is there anything that deemed dangerous to conception for the baby in that terms of exercise? Melanie Every: There isn't really anything that's going to affect the conception. Obviously once you become pregnant, you want to avoid sort of things like hard contact sports. I would certainly wouldn't recommend sort of taking up gym corners or parachute jumping or anything like that but if you are used to taking moderate exercise, then that should continue. Catrina Skepper: Right once you become pregnant, preparing for the arrival of the baby, what are the things that you tell the moms, the pregnant mothers, what is sort of advice that you would give? Melanie Every: I think the first thing I say to young moms is to remember the pregnancy is normal. It's a normal physiological event. You are not sick, you are not I'll. Admittedly, a lot of women do feel pretty rough in the first few weeks. And it tends to be one of two things and if you get both, you are very unlucky. You either tend to feel quite sick, or you feel incredibly tired and that really, really tired and some women will tell you that they are going to sleep at 6 O'clock in the evening and they still can't get up at 7 O'clock the following morning. But that does past, usually around about 12 weeks, that does past. Catrina Skepper: I remember the - I have got three children but in my first pregnancy, I was genuinely afraid to - because there are so many changes happening to you body, it's not the weight gain or anything else but I was particularly sick with my first one and felt nauseas all day long. It didn't last in the morning and all I wanted was someone to tell me when it was going to tend. I mean there are no rules about this. Melanie Every: There are no rules. But what happens is you see the ovaries continue producing hormones for the first 12 weeks and until the placenta takes over that function really and it's really during that period of time when the hormones are going to completely haywire, the people tend to feel the work usually, there is always an exception but usually after about 12 to 14 weeks you actually start to feel a little better -- Catrina Skepper: Why do they call it Morning Sickness because it can affect throughout the day? Melanie Every: It can indeed, it's a little bit than normally probably because most of the people have am empty stomach first thing in the morning and a lot of women will tell you that actually they feel sick when their stomach is empty and that's why the advice to eat a little often is quite good. Catrina Skepper: I know you talked about fat eating when you are pregnant but the urges can be theoretically quite disastrous. I mean I only wanted white bread and jam and just baked potatoes, anything that was white and sort of probably very refined. Those are the things that calm the sicknesses. Is there anything that you think is damaging, it could be potentially damaging to your unborn baby if you have a rather bad diet in first few months of --? Melanie Every: Well it's obviously not ideal but quite often when you feel sick, you do have that kind of desire for carbohydrate and if you concentrate yourself into good carbohydrate then that's fine. Catrina Skepper: Sugar from fruits and things like that obviously much beneficial -- Melanie Every: Yes, not ten pints a day or something like that, you know good fruit juice, fruit, wholemeal toast and honey, perhaps if you have got these desire for some things sweet. Catrina Skepper: That is what I went to eventually. And one of the things that I was being bit missed by is it can it help the brain development and the physical development of your child what you eat? Does diet affect the baby in the womb, for instance, if you eat at lot of fatty fish, everybody says now that's what's good for children. Is it actually good when you are pregnant to eat fatty fish and --? Melanie Every: Actually it is recommended that you only have one portion of oily fish a week when you are pregnant and that's because there is some evidence that a lot of from oily fish can might contain things like mercury and other minerals that are not too good. so one portion of oily fish a week is sufficient. Catrina Skepper: Okay, we have got some frequently asked questions here from our viewers. So I wanted if you minded answering them. One of them is about ovulation and it's a lady who has been trying to get pregnant sometime. The advice she has been given is rather conflicting. She says she knows when she is ovulating and the right time to have intercourse, she has been told is either every 24 hours or 48 hours, four days prior to ovulation and to continue throughout ovulation day. So this is a very scientific question. But what are the - what are the rights and wrongs of ovulation? Melanie Every: Well obviously the most fertile time is just when you ovulate. But you can remain fertile up to five days either side of that. I mean that's rare. It's usually sort of 48 hours that is the pick period for conception. But it is possible for conception to take place five days either side. Catrina Skepper: And so if you, you know, something that you are well aware of - you know that you are ovulating, should you start really the intercourse begin at least three of four days before -- Melanie Every: Oh yes it should really. Yes -- Catrina Skepper: -- to optimize your chance of getting pregnant. Melanie Every: Yes to increase your chances of pregnancy, yes. Catrina Skepper: And after ovulation, again for another possibly another five days -- Melanie Every: Yes. Catrina Skepper: Yeah and that goes, that leads to another question because lot of people then say, can you, is it a risk to your unborn baby to continue having sex, I mean it's one thing that women ask always. Melanie Every: No it's not. It's not. There is absolutely no evidence whatsoever that continuing to have sex has anything to do with them, miscarriage or anything of that nature unless, you have a specific condition and you are told about it but for normal women, it's not going to make any difference to go ahead and enjoy yourself I would say. Catrina Skepper: All the men are like feel no excuses, you see the headache excuse and work either but anyway, what about the things that you, the changes that you really need to make once you are pregnant? What would you consider those important ones are changes in your lifestyle? Melanie Every: Well obviously, there is the drinking and the smoking. Perhaps moderating your exercise. If you are feeling very, very tired, because if you are feeling very, very tired, you do need to rest. Catrina Skepper: So I am someone who likes to run, and minute I was pregnant, I thought help, if I run too fast, perhaps the pregnancy won't hold, I know this is totally psychologically probably wrong but is that the case of running might effect me, I mean athletes obviously continue running once they -- Melanie Every: No the baby is very, very well protected. It's inside the uterus, which is inside pelvis. So the baby is very, very well protected. What you might need to be a little bit cautious of though is that the hormones of pregnancy can make your joints softer and a bit more supple. So actually what you need to be careful about is the impact affect in your joints rather than what might happen to the baby, because the baby is quite safe. Catrina Skepper: Which is why Yoga and swimming and things like that are encouraged during the pregnancy. And as a matter of course, once your early three months are overs, should you stop taking the folic acid because I heard that that's also something you should necessary to take throughout the pregnancy, is that correct? Melanie Every: As long as you have a good diet, with plenty of fresh vegetables, you probably don't need it after that. Catrina Skepper: And America is very big on supplementation throughout the pregnancy, this is something which is I know again quite controversial. What will you take, what you can add to your diet in terms of supplements to make it -- Melanie Every: Well if you have got good healthy diet, you really don't need anything else. The little bit of caution though because there appears to be some evidence that taking extra Vitamin A or supplements that contain Vitamin A could be harmful. So I would certainly advice women to avoid and indeed avoid eating liver during pregnancy, it's the same reason. Catrina Skepper: Liver? Melanie Every: Yes. Catrina Skepper: Interesting, sailfish? Melanie Every: Sailfish again it's a bit controversial, it's got more to do with the fat, but perhaps the water that they come from maybe polluted. And that's why perhaps you need to be a cautious about things like sailfish and -- Catrina Skepper: And even mercury levels so I know in certain fish like that live on the bottom sea. Melanie Every: And also things like Tuna and that's the link with the oily fish and only having one portion a week. Catrina Skepper: Well for somebody who loves red meat, you know, you become suddenly paranoid when they say we must eat if it's undercooked. What again, what are the trues about red meat? Melanie Every: Strictly speaking, you should have your meat thoroughly cooked and the risk with undercooked meat is something called Toxoplasmosis -- Catrina Skepper: Which is? Melanie Every: Which is a parasite and if it does get in through the placenta, it can cause damage to the baby. In some countries, routinely test for this. I mean it tends to be in countries or continent where culturally they often eat a lot of undercooked meat. Catrina Skepper: And does that same thing apply to raw fish and raw eggs, for instance or --? Melanie Every: Well raw eggs are not advisable because of the risk of salmonella -- Catrina Skepper: You would be quite careful because for instance, if you went to health bar, you might actually be given a fruit drink which has got raw egg in it. Melanie Every: Yes, that's right. Catrina Skepper: If certain utensils that use that touch raw eggs and restaurants or whatever, is that something that you really need to be careful about when you eat out, when you are not at home, and you might -- Melanie Every: The human body is very good fighting off infection but if you are a little concerned, it's always a good idea to ask and of course, a good hygiene would not allow utensils that are being in contact with raw meat or raw eggs or anything to actually come in contact with cooked food anyways. So it shouldn't happen. But if you are concerned, you can always ask what exactly is in this drink and has there been any raw egg and obviously things like mayonnaise need to be avoided. Catrina Skepper: And unpasteurized milk, cheese -- Melanie Every: Unpasteurized milk, soft cheese, pâté, those kinds of things there -- Catrina Skepper: There are a lot of things I mean it's essentially quite hard work. Melanie Every: When you list it all, it sounds like a lot, when you look at it in the context of the complete diet, it's not so bad after all and -- Catrina Skepper: And it's good for you in the long term. Melanie Every: Yes. Catrina Skepper: Now let's go back to some of these frequently asked questions. One here about timing and having a baby. When is the right time to have a baby and we are obviously looking at age here. Melanie Every: Yes, the right time is what is the best time for you -- Catrina Skepper: Do you really believe in that? I mean is that just the kind of psychological thing or is that a medical piece of advice? Melanie Every: It's a bit of both. It's a bit of both. Obviously you want to feel confident and ready and able to cope with this change to your family. So the right time for you is best. Now having said that, there are reasons for having babies quite early which is ideal from a physical point of view, so your early 20s -- Catrina Skepper: When is the female peak? What is the --? Melanie Every: Well actually the female peak for fertility is between 20 and 25, it's quite young. So you are mostly likely to conceive at that age and you are most likely to have a straight forward pregnancy and easy child birth at that age. But having said that, women are much healthier now than they were 50 years ago. So a woman in her 30s or even 40s having her first baby is very different situation than it was all those years ago when people used to get really concerned. Obviously what does happen as you get older is it may take a bit longer to become pregnant. So if a woman in her 30s wants to say to me, well I think early starting family for another five years, I would be inclined to say, well you need to think about that a little bit because in five years time you might find you don't become pregnant very easily and then by that stage, you haven't got a great deal of time left if there are any problems. Catrina Skepper: One other thing, that's right because also a lot of women who conceive naturally and quite easily the first time around, then have subsequent problems conceive? Why is that? And why is it becoming similarly more common? Melanie Every: I don't think anybody really knows, obviously, age is a factor and we also know that women, who have caesarians, takes slightly longer to conceive again. So that's something to be taken in consideration too. Catrina Skepper: Thank you so much for joining us today. It was great pleasure meeting you. Thank you.