Planning for Pregnancy

Timing sex to get pregnant

Your egg can live for 12–24 hours after leaving your ovary. Sperm can live inside your body for up to 7 days. This means your chance of getting pregnant is highest if you have sex in the two or three days leading up to ovulation and the day after ovulation.

Most women ovulate in the middle of their cycle (halfway between periods) but this can vary. Ovulation can be affected by illness, stress or change in routine.

Get to know your cycle so you can pinpoint ovulation and know when are your most fertile days. There are many online tools and apps to help you track your cycle.

Ways to tell when you are ovulating

• Checking your cervical mucus
• Measuring your body temperature
• Ovulation kits

Cervical mucus

At certain stages of your cycle you will notice some vaginal discharge (usually by finding it in your underpants or when you wipe). This discharge is mucus from your cervix. Changes in this mucus can indicate the days leading up to ovulation:

• Early in your cycle (before ovulation) there is no mucus.

• As you become fertile the mucus becomes moist or sticky, white or cream coloured, thick and slightly stretchy.

• When you are most fertile, the mucus is slippery, wet and watery and clear in colour.

• After ovulation the mucus dries up. There can be no mucus, or some sticky mucus that is thick, white or cream coloured.

Body temperature

Your basal body temperature is your temperature when you first wake up in the morning, or after at least three hours of uninterrupted sleep.

To measure your basal body temperature, you need to take your temperature using a special basal thermometer before you get out of bed and before you have anything to eat or drink. You should do this at the same time each morning if possible. When you ovulate, hormonal changes trigger a slight rise in your basal body temperature, which lasts at least until your next period.

Your temperature may spike on other days in your cycle, but unless it stays elevated at for least three days in a row, you are probably not ovulating. You are most fertile on the day of the temperature spike and on the few days before.

The first month or two of charting your temperature will help you to identify a pattern and predict your fertile days each month. Ask your pharmacist for more information on basal thermometers.

Ovulation kits

Many types of ovulation kits are available to help you chart your cycle and pinpoint your fertile days.

Ask your pharmacist for more information.

Alcohol

Excessive amounts of alcohol during pregnancy are very harmful to a developing baby. It is not currently clear what is a ‘safe’ level of alcohol use during pregnancy. Current national guidelines recommend that it is safest not to drink alcohol if you are planning a pregnancy, or if you are pregnant or breastfeeding.

For more information visit www.drinkwise.org.au.

Getting healthy for pregnancy

Your eggs mature about 100 days before ovulation. Sperm production can take about 120 days. Ideally, you and your partner should make changes for a healthier lifestyle at least 3–4 months before trying for a pregnancy.

Pregnancy planning health checklist

• Stop smoking, alcohol and other social drugs.
• Follow a healthy diet based on freshly cooked and prepared food.
• Reduce your caffeine intake.
• Be physically active.
• Aim to have a healthy body weight.
• Avoid contact with toxic substances at work and at home.
• Avoid toxoplasmosis (a parasite infestation).
• Avoid listeriosis (an infection caused by listeria bacteria).
• Try to reduce your stress.
• Book a preconception health check with your doctor.
• Book a preconception dental check with your dentist.
• Take daily folic acid supplements for at least a month before conception and during the pregnancy. Iodine supplements are also recommended before and during pregnancy.

Smoking

Cigarette smoking is not safe during pregnancy. One of the best things you can do if you are trying to get pregnant is to quit smoking. Smoking increases your risk of:

• ectopic pregnancy (a pregnancy outside the uterus) and miscarriage

• having a premature baby

• complications of pregnancy affecting the placenta

• your baby having a low birth weight.

• your baby dying at birth or soon after birth.

For information and help to quit, ask your pharmacist and/or call the Quitline on 13 QUIT (13 78 48).

Toxoplasmosis

Toxoplasmosis is a condition caused by a parasite (Toxoplasma gondii). You can pick up this parasite from contact with cat droppings, soil, or raw (or undercooked) meat.

Toxoplasmosis usually harmless and has no symptoms or only mild symptoms, but in pregnant women it can harm unborn babies and cause birth defects. If you are pregnant or planning to get pregnant, you should:

• avoid cat litter and cat droppings

• wear gloves while gardening or handling soil

• wash hands and surfaces thoroughly after handling raw meat

• avoid raw or rare meat; eat only well-cooked meat.

Listeria infection (listeriosis)

Listeriosis is a bacterial infection that is usually harmless in most people, but is dangerous to your unborn baby if you are pregnant. Listeria infection can cause miscarriage, premature labour, stillbirth or complications after birth. Listeria bacteria have been found in many types of food and can grow on food that is stored in the fridge. Listeria infection can cause symptoms of food poisoning.

If you think you have food poisoning while pregnant, see your doctor.

How to avoid listeria

When reheating food, make sure you heat it all the way through until it is piping hot and eat it straight away. Avoid:

• foods that are lukewarm

• foods that are precooked then refrigerated without reheating (e.g. seafood, ham, pate, pre-cooked meat products)

• uncooked seafood (e.g. oysters, smoked salmon, sashimi or sushi)

• pre-prepared salads and coleslaws (especially from delicatessens or supermarkets) • unpasteurised milk or foods made from unpasteurised milk

• soft, semi-soft and surface-ripened cheeses (e.g. feta, camembert, brie, or blue-vein cheeses)

• soft-serve ice cream and any products containing this type of ice cream (e.g. some thick shakes).

Preconception medical check

It’s a good idea to ask your doctor for a preconception health check. This could include:

• a general health check

• checking your family medical history

• checking if your vaccinations are up to date (e.g. rubella, influenza and chicken pox)

• checking if your medicines can be continued in pregnancy

• Pap test (Pap smear)

• breast check

• blood tests (e.g. blood type, iron levels)

• tests for sexually transmitted infections (e.g. hepatitis B, chlamydia, syphilis and HIV).

Preconception dental check

It’s best to avoid X-rays and non-essential medical procedures during pregnancy, so it is a good idea to have any routine dental work done before you conceive. Some women develop gum disease and have a higher risk of tooth decay during pregnancy. Long-term gum infections can sometimes trigger premature birth. Keep up brushing and flossing before and during pregnancy. Switch to a soft toothbrush if you don’t already use one.

Stopping the pill

Some women are fertile as soon as they stop taking oral contraceptives (the pill). Others take a few months to start ovulating again. Once ovulation resumes, pregnancy is possible. The hormones in birth control pills don’t stay in your system after you stop taking, so your baby won’t be harmed if you get pregnant right away. Some doctors recommend waiting until you have one normal period after stopping the pill before trying to get pregnant, so that is will be easier to predict your due date accurately.

Rh factor

Rhesus (Rh) factor is a protein found on the surface of your red blood cells. If your blood has this protein, you are Rh positive; if your blood does not have this protein you are Rh negative. Most people (about 85%) are Rh positive. A simple blood test can determine your Rh factor. Rh factor doesn't affect your general health. If you are Rh negative, and your baby’s father is Rh positive, there is a possibility that your body could produce antibodies that could harm your baby. Your pregnancy needs special care. If you are Rh negative, and your baby’s father is Rh negative, no action is needed. If you are Rh positive, no action is needed.

Men's fertility

The more sperm you have to start with, and the healthier it is, the greater the chance you have that at least one will be in the right place at the right time to fertilise the egg.

If you are planning to become a father, you can increase your change of healthy sperm by:

• having healthy eating patterns

• getting regular physical activity

• keeping a healthy body weight

• quitting smoking

• limit alcohol

• avoid recreational drugs

• avoiding toxins at work and home

• avoiding lubricants during sex

• keeping your testicles cool.

• checking with your doctor or pharmacist about whether your medicines may affect fertility

How to avoid overheating your sperm

• Avoid tight underwear or athletic shorts.
• Don’t sit for too long.
• Don’t ride a bike for long periods without breaks.
• Don’t put your laptop computer directly on your lap.
• Avoid electric blankets.
• Avoid hot tubs.
• Avoid saunas.
• Avoid hot baths.

Pregnancy tests

Most pregnancy tests rely on testing for a hormone (human chorionic gonadotropin) that is produced by the placenta during pregnancy. During the first trimester of pregnancy, levels of human chorionic gonadotropin in blood and urine rise steeply, then fall to low levels for the rest of the pregnancy. For best results using a home pregnancy test:

• ask your pharmacist for advice

• follow the manufacturer’s instructions

• don’t test too soon after your missed period.

Always see your doctor for confirmation of your pregnancy.

When to get help with fertility

For a healthy couple it can take up to a year to get pregnant, even if there are no problems. As a general rule, if you’ve been trying to get pregnant for 12 months or more (or 6 months if you are over 35 years old), you should ask your doctor about seeing a fertility specialist.

If your cycle is irregular, tell your doctor and consider earlier referral.

Additional resources

www.yourfertility.org.au

www.healthdirect.gov.au/getting-pregnant

www.healthinsite.gov.au/pregnancy

www.pregnancybirthbaby.org.au

www.quit.org.au

www.quitnow.gov.au

www.drinkwise.org.au