El Paso Perinatology November 05, 2018

How to get healthy, have a little fun and plan for a growing family.

If you and your significant other are thinking about starting a family, congratulations! The entire process can be exciting, scary and overwhelming all at once. Many pregnancies are unplanned (in fact, nearly 50 percent of pregnancies in the US are), but if you're already talking about it, good for you.

When you're trying to conceive, much of the focus is understandably on tracking when you're ovulating and when to have sex. While these things are important for a successful pregnancy, there are other factors that can optimize fertility while also preparing you and your partner for growing a family.

Many factors play a role in fertility, the ability to carry a child and parenting as a whole. So remember that no matter how prepared you are, there are some issues that just can't be worked out before the baby. You and your partner should discuss the factors that are within your control as well as make sure your own health is in check.

Discuss Your Parenting Styles and Values

Without having been a parent before, you're probably thinking "how would I know my parenting style?" And while you should have conversations about your discipline style prior to pregnancy (will you be authoritative or indulgent?), it's more about discussing values and the ways in which you want to raise your child.

Yes, you should research sleep schedules, discipline tips and breastfeeding basics, but you should also discuss whether or not you want to raise your child in a religious environment and how you're going to discuss values like honesty, responsibilities, obedience and independence.

And if you and your partner practice different faiths, you'll want to talk through how that's going to work as well. Once you determine your religious values and how you want to raise your baby, you'll also be able to plan for things like schooling, baptisms, namings, and circumcision.

Discuss Finances and Career

Having a child is expensive: The U.S. Department of Agriculture reported that for those children born in 2015, it will cost $233,610 from birth through age 17. Before you get pregnant, you and your partner will want to discuss your finances and how it relates to growing your family.

In addition to discussions about how much you've saved, how much you want to put away for your child's college tuition and the basic annual costs of having a child, you'll want to discuss childcare. Will one of you stay home with your child for the first few years or will you need to apply for a local daycare?

If there are any issues that need to be worked out, you'll have time to make arrangements or adjustments.

Discuss Some of the Difficult Issues

Most pregnancies go full term without any problems for mom or baby, but in some cases, there are health issues that may come up during pregnancy. And while you can never really prepare yourself for difficult news, you will want to discuss potential outcomes, just in case you have to make some important decisions.

Three percent of babies born in the U.S. will be born with a major malformation. Sometimes, there is something genetically or structurally wrong with a baby. There could be severe problems and you'll have to provide long-term care for this baby as they age because of minor or severe disabilities.

Maternal issues should also be discussed—miscarriage and late pregnancy loss, preterm delivery, preeclampsia and gestational diabetes are some of the other complications that can come up during pregnancy. Talk to your partner about how you'd handle treatment, how you might cope emotionally or whether or not you're prepared for these risks. Keep in mind that no matter how much you prep, you won't really know how to react unless you experience it.

It can be beneficial to have a serious discussion with your partner about what that would mean for both of you and where you stand.

"Nothing is right and nothing is wrong, it's just about what the two of you believe."

Quit Smoking

Optimizing existing health is a huge topic of conversation during preconception counseling, says Smith. Be ready to commit to improving your health in all areas. Both partners—but especially mom—should stop smoking, quit drinking and manage chronic conditions.

Smoking during pregnancy can lead to all sorts of problems for your child, like low-birth weight, preterm delivery, lung conditions, asthma, learning disabilities, physical development issues and even death. And still, 12 to 20 percent of pregnant women smoke, according to the American Pregnancy Association, and more than 1,000 babies die every year in the U.S. because their mothers smoked during pregnancy. And smoking can also cause problems for fertility, too. Women who smoke are more likely to be infertile, and some studies show that men who smoke have poorer sperm quality than men who don't.

In addition to the problems smoking can cause for baby, quitting smoking during pregnancy can also up your energy levels, and reduce your risk of serious health conditions like heart disease, cancer and lung issues in the long-term.

Your significant other will want to quit smoking, too. The American College of Obstetricians and Gynecologists reports that secondhand smoke exposure during pregnancy can increase your child's risk of having a low-birth weight by as much as 20 percent. Secondhand smoke as an infant can also increase your baby's risk of sudden infant death syndrome, asthma attacks and ear infections.

Cut Back On Alcohol

Drinking during pregnancy can cause all sorts of issues, like miscarriage, stillbirth, fetal alcohol syndrome and physical, intellectual, behavioral or learning disabilities, but should you cut back when you're trying to conceive? Definitely, says Smith.

The first few weeks of pregnancy (yes, even those four to six weeks you may not know you're pregnant) are crucial for a baby's development: the face, mouth, lower jaw and throat will start to form, and the "heart" tube will even start to beat at the end of the first month. With so much of the crucial development happening, it's no surprise that alcohol can interfere.

The relationship between alcohol and sperm health is still being studied, but it won't hurt for your partner to cut back, too. It may even make the transition easier for the hopeful mommy-to-be.

Reduce Your Caffeine Intake

Some caffeine during pregnancy is okay, but if you're a three cups of coffee kind of person, you'll want to start cutting back.

Experts recommend consuming less than 200 milligrams of caffeine per day when you're pregnant, which is a about a 12-ounce cup of coffee. If you're trying to conceive, it can't hurt to adhere to those recommendations.

A small study published in the American Society for Reproductive Medicine's Fertility and Sterility journal studied 344 couples, and concluded that women who had more than two caffeinated drinks per day while pregnant had a 74 percent higher risk of miscarriage than those who drank less caffeine. And, when their significant others had more than two caffeinated drinks per day, there was also an increased risk of miscarriage.

According to American Society for Reproductive Medicine, it's better to take precaution and limit your overall caffeine consumption to one or two beverages per day.

Maintain A Healthy Weight and Evaluate Your Exercise Plan

Keeping your weight and exercise regimen in check is good for your overall health—doing so can lower your risk of hypertension, obesity and diabetes—but it's especially important if you want to start a family.

While it's important to find a workout routine that works for you (it's recommended that most adults get at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week), experts caution against working out too hard. If your body mass index (BMI) is less than 25 kg/m2, that is, if you're not overweight, limit vigorous exercise to less than five hours per week. Reason being? There may be a relationship between strenuous exercise and ovulation issues.

On the flip side, too little exercise may be associated with obesity, which may cause anovulation, a menstrual cycle without ovulation and according to one study may double the time it takes to conceive.

When it comes to weight and activity levels of male partners and fertility, more research is needed to understand the relationship.

The bottom line? Exercise and weight recommendations vary from person to person. Talk with your doctor about what's best for you and your partner.

Start Taking A Prenatal Supplement

Taking prenatal vitamins is a must during pregnancy, but you'll want to consider getting a head start. Taking at least 400 mcg of folic acid, a main ingredient in all prenatal vitamins, daily can help lower the risk of neural tube defects in babies when women take them before conception. It's best to start taking them at least one month before trying to conceive.

There are many over-the-counter options, but you can also ask your OBGYN for prescription samples and recommendations. Some women have trouble digesting prenatal vitamins, so it's okay if you have to try a few options before you settle on the one that works for you and your body.

Bonus? The extra nutrients, like biotin, may improve your hair and nails, too.

Prepare For Your Body To Change

It's no surprise that pregnancy changes your body, and while you'll never be able to know exactly how your body will handle carrying a baby, you'll want to be mentally prepared for the changes.

"Pregnancy is one of the most beautiful things in the world but it does take a toll on the body—and it's not all a bed of roses," says Smith. "I call them the pregnancy taxes—you have to pay your taxes and some people have to pay more taxes than others." Here are some of the changes or "taxes" you might experience while pregnant:

  • Acid reflux or heartburn
  • Constipation
  • Sleeping problems
  • Vaginal or pelvic pressure
  • Ankle swelling
  • Nausea and vomiting
  • Pain with walking
  • Varicose veins
  • Hemorrhoids
  • Scarring
  • Moodiness

"I think a lot of people are surprised at the level of discomfort that you can have during pregnancy and that it's a normal part of the process," says Smith. "It's a beautiful discomfort but discomfort nonetheless." But Smith thinks "most women forget about the discomfort as soon as they see their beautiful baby."

Most changes and symptoms will only get better after delivery, but if you're experiencing extreme discomfort, talk to your OBGYN about treatment options.

Ensure You're Up To Date With All of Your Screeings and Vaccinations

You and your significant other should be up to date on health screenings and check-ups. You should also schedule a preconception exam with your OBGYN—they can evaluate test results and answer any questions you might have about conception.

Also be sure you're getting checked for infections, like toxoplasmosis and sexually transmitted infections like genital herpes and human immunodeficiency virus. You'll want to be up to date with vaccinations for diseases that can be very harmful to your baby. The measles, mumps and rubella (MMR) vaccinations should be done before pregnancy since these vaccinations should not be given during pregnancy or within a month of attempting to get pregnant. It's also important that your doctor check to see if you've had chicken pox in the past. And you should also receive both the flu and whooping cough vaccine, otherwise known as Tdap, during each pregnancy.

Smith says it's also important that your doctors check to see if you're a carrier for some of the genetic diseases like cystic fibrosis or sickle cell disease. These conditions can contribute to pregnancy complications and may even prevent you from getting pregnant to begin with.

Spend Time Together As A Couple

Having a child is one of the best parts of many peoples' lives, but newborns, and kids in general, will take up a lot of your time.

Use the time you have while you're trying to conceive to connect with your partner. Take a trip, be spontaneous and enjoy your life together while it's the two of you. Try all of those restaurants you've wanted to eat at, spend time with friends or try something adventurous—something that's not safe for you or the baby when you're pregnant, like riding a roller coaster or skydiving.

Remember that the road to conception may be long and sometimes rocky, but starting a family can be exciting and extremely rewarding. While easier said than done, try to be patient and savor the time with your significant other.