Navigating the reproductive journey: essential health milestones for women

Pregnancy is an exciting adventure with a lot to look forward to, but before you get the baby’s room painted and the crib built, the baby’s first dwelling needs to be in tip-top shape – your body. In this guide, a highly-regarded consultant gynaecologist explains the health milestones for prospective mothers to aim for before they’re prime for pregnancy.

From a purely physical standpoint, the best chances of conceiving happen in the ages of 18-24 years old, and the chances will steadily decrease until menopause sets in. But that is not to say that women older than 24 will never be able to conceive – the chances are still very likely provided that women are consistent with their planning and maintain good health. However, women over 35 years old should consider going to a fertility specialist for extra assistance.

The reproductive journey actually starts around three months before trying to conceive. This is because it can take 90 days for the ovarian follicles to mature into eggs that are prepared to fuse with sperm. Within this time, with due diligence and appropriate groundwork, an egg can be in the best possible condition for conception, which will have a long-lasting impact as that egg will eventually become your baby, and then one day a full-grown adult!

Thus, any of the recommended lifestyle, health, and dietary adjustments are best implemented at the start of this 3-month period.

Preconception checkups

The first thing to do is always have a preconception checkup with your doctor so they can assess your condition, and maybe even discover health issues that you may have not been aware of, both of which can affect your fertility. This includes:

• If you are at a healthy weight for your body; being under- or overweight will have a detrimental impact on fertility
• If you or your partner have any illnesses that run in your family or any genetic disposition for them
• Any previous cancer treatments, such as radiotherapy
• Any history of sexually transmitted diseases and infections
• Any pre-existing conditions

The health and condition of your partner are equally important to consider – after all, it takes two to tango and two to make a baby! If your partner has a low sperm count, is at an unhealthy weight, or has an unhealthy lifestyle, this too will make conception more difficult and unlikely.

Get familiar with your womb

Understanding your menstrual cycle and your gynaecological organs is vital, whether you’re trying to conceive or not.

Ideally, you are already seeing a gynaecologist semi-regularly for cervical exams, where they will be up-to-date with the status of your gynaecological health.

If you have notably heavy or light periods, very painful periods, periods that last longer than 7 days or shorter than 3, bleeding outside of your “regular” period time, or periods that come unpredictably, you may have a menstrual disorder. These can occur due to a variety of reasons – like endometriosis, polycystic ovary syndrome, fibroids, hormonal imbalances, gynaecological cancers, polyps, or fallopian tube damage – which can make conception very, very difficult, if not impossible.

This is because it indicates that the egg released during ovulation cannot attach properly to the uterine wall and be ready for sperm, or it can mean that the egg is not being released at all!

Knowing if and when you are struggling with any of these aforementioned ailments means that you are able to seek treatment sooner that may be able to preserve or even enhance your fertility.

The menstrual cycle is normally between 21 to 35 days, with the active bleeding of the period lasting around five days. As the period is the shedding of the uterine tissue and the unfertilised egg, then ovulation tends to occur on the direct opposite of the cycle, around 14 days before the period. Keeping track of your menstrual cycle will help you plan conception attempts in line with ovulation. An egg will live up to one day once released into the uterus, but sperm can live up to five days inside the reproductive tract, so planning intercourse for days 10 through 15 of the cycle will optimise your chances.

You are what you eat

It may be a childhood misconception that babies are grown in the stomach, but regardless, what goes on inside your belly will still influence conception and pregnancy.

How you eat is extremely pertinent to fertility and natal health. It is recommended to stay at a healthy weight (ideally, a BMI between 19 and 25) and to maintain it with an equally healthy diet – after all, you will soon be eating for two.

A balanced, nutritious diet is rich in fruits and vegetables and lean proteins – such as nuts and seeds, fibre and wholegrain foods, white meat and fish. Avoid trans and saturated fats that are found in fatty cuts of meat, excessive salt and sugar, and deep-fried foods, as these will put a strain on your blood vessels and heart. Stressing out your body will not be conducive to conception.

The big three nutrients you will want to prioritise are:

• omega-3 DHA. This can be found in eggs, cold-water fish, flaxseeds, and seaweed, for example. This is important because it aids in brain and eye development.
• Calcium. This can be found in leafy greens like kale and okra, soy, milk, cheese, and other dairy foods, for example. This is important for skeletal development.
• Folate. This can also be found in leafy greens, citrus fruits, fortified cereals, and dried beans. This is important for developing the nervous system and protecting a baby against certain birth defects.

These nutrients can also be taken in supplement form; folate is so important that it is recommended that women take more of it as a supplement called folic acid.

Don’t skimp on the folic acid

Folic acid, which is a type of vitamin B, is a huge advantage in the prevention of birth defects in the brain and spine (also called neural tube defects or NTDs), which can change the shape or how things function in the baby’s body and put them at risk of health issues or developmental setbacks.

It is recommended that soon-to-be-expecting mothers take 400mcg of folic acid daily, beginning at least one month before trying to conceive and continuing throughout the first 12 weeks of pregnancy.

Folic acid supplements can be in the form of multivitamins, prenatal vitamins, or just simply by itself.

Stop indulging vices

It is strongly recommended to cease drinking alcohol and smoking tobacco (or vaping) when pregnant, and that extends to prepregnancy as well – and this includes your partner. It is documented that smoking and drinking cause ovulatory issues (such as killing eggs) and disrupt the hormones, and furthermore can raise the risk of complications like miscarriages, stillbirths, and developmental problems. If you are actively trying for a baby, it is best to stop drinking alcohol and smoking as soon as possible.

Unfortunately, caffeine intake should also be limited, to at most two cups of coffee a day, as caffeine also changes hormone levels.

Stay active (but not too active)

Keep on top of your physical fitness with regular, moderate exercise like power walking, cycling, swimming, or resistance training to strengthen the body and regulate insulin and blood pressure. It will also help you reduce stress and improve sleep – you will miss those when the baby comes! Physical activity, when combined with a healthy diet.

Overexercising can disrupt or even halt the menstrual cycle, rendering you infertile.