When trying to conceive, it is important to be prepared at least three months before you even try to become pregnant. You need to be in top physical condition in order to have the best chance of ovulation and to help you have a successful pregnancy.
For Soon to be Mothers on Birth Control
If you are on birth control pills or have an IUD, you need to speak to your doctor about going off these forms of birth control. The IUD, of course, needs to be removed and it is a good idea to have at least one normal cycle without the IUD so you can see what your cycle is going to be like and to have a “fresh” and healthy uterine lining built up. The IUD can change the way the uterine lining builds up during the cycle. You should shed the lining you had with your IUD and should have one additional regular cycle so that the uterine lining can build and mature while you have no foreign body in the uterus.
For birth control users, it is optimal to wait a couple of cycles before trying to get pregnant. Because birth control pills can interfere with ovulation, it is a good idea to have a cycle in which you ovulate normally and can see how long your ovulatory cycle is. Two cycles are even better, because you will be able to really assess your ovulatory cycles and can allow time for the uterine lining to build up to full capacity. Birth control pill hormones (estrogen and progestin) will shrink the uterine lining, especially if you have taken them for many months or years. This shrinkage results in the lightening of periods because there is less uterine lining to build up.
Without hormones, your uterine lining will build during the first half of your cycle and will be more favorable for implantation, should you have a fertilized egg. If you accidentally get pregnant before you have had two normal cycles, don’t worry. As long as the fertilized egg implants successfully, it means your uterine lining was acceptable and your pregnancy should go on normally.
If you are taking an injectable form of birth control such as Depo-Provera®, you should wait until the effects of the shot has worn off for at least three months. Because the shot lasts three months, this means waiting up to six months before getting pregnant (three months while the shot is active and three additional months). In reality, even though the shot is out of your system, fertility can take up to two years to normalize again, especially if you have taken the shot for many cycles. The Depo-Provera® shot works partly by making the uterine lining very thin and unfavorable for implantation. It takes at least three cycles for ovulation to return to normal and the effects of the female hormones to build up the uterine lining to pre-shot levels.
The best chance of conception comes when the mother is of a normal weight. Women who are too thin may have problems ovulating as will women who are overweight. If you have the time to get yourself into that “golden” normal weight, see your doctor about reaching that goal.
You first must know whether you are underweight, normal weight, overweight or obese. This can be done by calculating your body mass index or BMI, which is a measure of how your height and weight come together to determine your status. The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is their height in meters squared.
The BMI can be calculated from any online BMI calculator. Normal BMI is 18.5 to 24.9
If your BMI is less than 19, you should try to gain some weight before conceiving. Your periods might become more regular as normal ovulation starts again. Being overweight can affect ovulation and fertility as well. A BMI of greater than 25 but less than 30 means that you are overweight. A BMI of 30 or more means that you are obese. Losing weight is naturally the way to remedy those numbers. There is some evidence to suggest that losing even 5-10 pounds can straighten out ovulatory difficulties so that you will ovulate at regular intervals and will have the best chance of being fertile at expected times.
This doesn’t mean you have to start on a drastic diet plan as this can affect your overall nutrition. Try to lessen the number of calories you eat and increase the exercise. A gradual weight loss is best if you have the time. It also doesn’t mean you won’t be able to get pregnant if you are underweight or overweight. It just makes things more challenging.
Habits to Consider Changing
Before you conceive, you might be in the best position to change some lifestyle behaviors that can influence the pregnancy. For example, if you smoke, this is the time to get through the occasionally arduous process of trying to quit smoking. Now, above all other times, you have the best motivation possible—that of trying to conceive and carry a healthy pregnancy. Talk to your doctor about tips to quit smoking or join a stop smoking program. When you have stopped smoking, this will be one less thing you have to worry about once you get pregnant.
The Smoking Habit
The dangers of smoking while pregnant are well established and, after the baby is born, you definitely don’t want to expose him or her to secondhand smoke. The time to stop smoking is before you conceive your child. In the woman, smoking can cause enhanced aging of the eggs in your ovaries, making it more difficult to fertilize the egg and making it more difficult for implantation to occur. Smokers run a greater risk of not being optimally fertile and having a miscarriage should they conceive while smoking. In order to have the best chance of a healthy conception and pregnancy, both partners should be smoke-free.
Drinking Alcoholic Beverages
If you enjoy cocktails, wine or beer, these are things you should no longer do while you are pregnant. Experts feel that any amount of drinking in pregnancy has the potential to be harmful to the growing fetus. Consider stopping alcohol consumption before you have to because you are pregnant. If you find you are having a difficult time stopping drinking, you may be at risk of being an alcoholic. The time to figure that out and get help is before you conceive. There is help for those who can’t just stop drinking on their own. If you have a serious drinking problem, you should not try to conceive until you have gone through treatment and have been sober for several months. This will give you time to stabilize and get used to being a non-drinker. You will also be a more effective parent if you continue alcohol abstinence after the baby is born.
If you like your coffee, your lattes, your tea or your cola beverages, you may have to cut back before you conceive. There have been some studies showing that high caffeine intake makes you jittery, which will affect your ability to relax and conceive, and may increase the rate of miscarriages. The good news is that you do not have to stop caffeine all at once and you don’t have to stop drinking or taking caffeine altogether.
About 200 mg per day of caffeine is considered safe at the time of conception and even during pregnancy. Two hundred milligrams of caffeine can be found in two small cups of coffee, 2-3 cups of brewed tea or four cola beverages (including diet sodas and sugar-containing sodas). If you like expresso or drink a lot of coffee, consider ordering small cups of coffee instead of big ones and think about adding warm milk to a half cup of coffee in order to dilute out the caffeine intake. Gradually decrease your caffeine intake so that you reach the magic 200 mg per day mark. If you can stay at that level or below, you can have the green light for conception.
If you happen to be a green tea drinker, consider switching to black tea instead. Green tea interferes with the function of folic acid, a necessary nutrient for conceiving and pregnant women. Herbal teas are a challenge to figure out as well. The FDA doesn’t regulate herbal preparations and not all herbal teas are conception-friendly. Ginger tea, citrus teas, and peppermint tea are generally considered to be completely safe, even in pregnancy, but many others have unknown or negative effects on a developing fetus. Unless you are aware of scientific studies showing the safety of an herbal tea you like drinking, it is best to abstain from drinking that type of herbal tea while trying to conceive or while pregnant. Unfortunately, there are virtually no well-controlled studies of herbs and pregnancy so all the information out there is simply folklore and shouldn’t be taken as fact.
If you partake of illicit drugs, it is generally expected that this will be something you will not continue to do during pregnancy. There is no illicit drug out there that has been shown to be safe in pregnancy. One of the most commonly used illicit drug in people who are of the age to be fertile is marijuana. Unfortunately, science tells us that smoking marijuana interferes with conception. It makes the sperm sluggish so that they have a harder time reaching the egg to fertilize it. Marijuana also tends to stay in your system for much longer than, say, tobacco smoke. Even if you commit to a nonsmoking plan when it comes to marijuana, it can take up to four weeks for marijuana to be found undetected in your bloodstream, especially if you are a regular smoker.
Because there is no evidence that marijuana is safe in pregnancy, the time to quit is before you get pregnant. You don’t have to stop cold-turkey as the stress of this can interfere with fertilization, too. The idea is to clean your system of marijuana (in both the male and the female) so that fertility can be maximized and the pregnancy free of unwanted marijuana chemicals. If you need help doing this, seek treatment before you attempt to conceive.
If you partake of other recreational drugs, these should be stopped as well. Things like cocaine, heroin, Ecstasy, and methamphetamine are very dangerous in pregnancy and can cause preterm births and other health problems in the fetus, including poor weight gain, withdrawal seizures etc.
Programs to detoxify your system and help you stop addictive drugs are available in nearly every community. Do what it takes to become drug-free before you put yourself through the stress of trying to have a baby.
Nutritional Habits to Keep or to Change
It is ideal to keep your weight at an appropriate level and get the proper nutrients before you actually conceive. That way you will already be in the habit of eating healthy by the time you get pregnant and will stock up on nutrients that you might already be lacking in.
Feed your body those things you’d feed a child. This means cutting back on sweets and salty snacks. Think about replacing those things with fresh, whole fruits, berries, nuts, legumes, and dairy snacks. These will provide you with complex carbohydrates and protein to build healthy babies. Vegetables should be a part of your daily eating routine because, like fruit, they offer you complex carbohydrates you need for cellular fuel. Ideally, you should have 40-60 percent of your diet made from complex carbohydrates, 30 percent of your diet as lean proteins, and only 20 percent of your diet from fats. The fats you choose should come from plant sources like cottonseed oil, olive oil and other vegetable oils. Saturated fats come mainly from meats and are not healthy for your heart or blood vessels.
Extremes of dieting should be avoided while you are pregnant. When you finally conceive, you don’t need to begin eating for two until you are well into your second and third trimesters when the fetus is putting on weight and uses significant calories of its own. In reality, you only need to eat 200 calories more than what is recommended for your weight toward the end of the pregnancy. Before you conceive, stick to eating between 2000 and 2500 calories and take a multivitamin if you don’t think your overall nutrition is up to par. Some women take prenatal vitamins before getting pregnant and this is perfectly acceptable.
Exercise and Sports
Most OB/GYN doctors will encourage you to continue in any physical activity you did before you conceived your child as long as it isn’t a risky sport like skydiving or bullfighting. If you are already exercising for 30 minutes per day on most days of the week, you can keep this up during the pre-pregnancy period without altering your fertility. If you are a strenuous exerciser with little body fat, you might have to cut back so you can gain a few pounds. The amount you exercise before getting pregnant in part depends on how much exercise you are used to. If you are a couch potato, try walking before you run and if you are already a great walker, stepping it up to jogging won’t hurt, especially if you have weight to lose.
Avoid any exercise that will raise your body temperature above 102 degrees. This means avoiding Bikram yoga or “hot yoga”. Regular, restful yoga will help you with flexibility and will be relaxing. As you may already have determined, being relaxed and relatively stress-free can do a lot to improve your fertility.
While some stress is unavoidable, your pre-pregnancy months should be as free of unnecessary stress as much as possible. This includes work, financial, and relationship stress. If you are in a high stress position at work, see what you can do to lower your work expectations and decrease your stress level. Plenty of women conceive while in high stress job situations but, if your fertility is already marginal, a change in jobs can tip the scales toward conception. The same is true of relationships and financial stress. If you are dealing with meddlesome family members or a spouse that you can’t stop fighting with, maybe this isn’t the time to conceive. Counseling or therapy can help you learn ways to reduce stress through cognitive-behavioral changes, meditation, tai chi or yoga. The more stress you are under, the less are your chances of conceiving.
If you are burning the midnight oil or even staying up to watch movies, you are probably not getting enough sleep for maximal conception. The recommended amount of sleep is 7-9 hours of sleep per night, preferably in one sleeping episode. This doesn’t mean you can’t take naps but long stretches of sleep are best.
If you suffer from insomnia, you need to do what you can to combat this. It means developing good sleep habits, such as going to bed at the same time every night and waking up every morning at the same time. Other things that can positively impact sleep include:
- Sleeping in a comfortable bed with comfortable pillows
- Sleeping in a room that is neither too hot nor too cold
- Avoiding extraneous noise (you can use a white noise machine to block out excess noise from traffic or the activities of others in the home while you are trying to get to sleep)
- Using aromatherapy with lavender
- Drinking chamomile tea before bedtime
- Avoiding heavy meals before bedtime
- Avoiding exercise within 4 hours of bedtime
- Sleeping at night instead of during the day (try to be a daytime worker if at all possible as shift work and night shifts can affect your stress level, sleep level, and fertility)
Physicians and Midwives is a unique collaborative practice you won’t find anywhere else. We have 5 offices for your convenience all across Northern Virginia, including Alexandria, North Arlington, Mt. Vernon, Kingstowne, and Woodbridge. If you would like to be listened to, as well as cared for, then look no further.