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.

Preconception

Ideally, at least 3 months before you start trying to conceive, both you and your partner need to consider your health and wellbeing. This includes:

• Optimising your weight to ensure you are a healthy weight for your height; being under- or overweight can have an impact on fertility, pregnancy and delivery.
• If you or your partner have any illnesses that run in your family or any genetic disposition for them you may wish to seek further medical advice
• Any previous cancer treatments, such as surgery, chemotherapy or radiotherapy
• Any history of sexually transmitted diseases and infections
• Any pre-existing medical conditions – again important to discuss these with a healthcare professional before trying to conceive.

Get familiar with your body

Understanding your own body is important, whether you’re trying to conceive or not.

Ideally, you are already having regular cervical screening, contraception and infection screening.  

Understanding your own menstrual cycle, the length of time from Day 1 of one period to Day 1 of the next should be regular and between 21-35 days. The duration of the bleeding is usually around 5 days but can be up to 7 days. 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 harder.

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 period is when conception does not occur and the lining of the womb breaks down and sheds with the unfertilised egg. Ovulation tends to occur 14 days before this. 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 a 28 day cycle will optimise your chances of conception. Around ovulation, there are a number of changes in your body such as a change in the cervical mucus and basal body temperature that can also assist in tracking ovulation timing.

You are what you eat

Nutrition in pregnancy will 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.

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:

• 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.
• 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.

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. For some women with health conditions such as epilepsy or diabetes require a higher dose of Folic acid– 5mg daily

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 stop drinking alcohol and smoking tobacco (or vaping) when pregnant, and that extends to pre-pregnancy as well – and this includes your partner. It is documented that smoking and drinking can cause ovulatory issues, disrupt the hormones, and can increase the risk of complications like miscarriages, stillbirth, low birth weight, pre-term birth and growth restriction. If you are actively trying for a baby, it is best to stop drinking alcohol and smoking as soon as possible.

It is also recommended to limit caffeine intake to at most two cups of coffee a day, as caffeine can also increase the risk of pregnancy complications.

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!

However, excessively exercising can disrupt or even stop the menstrual cycle, resulting in difficulty in conceiving.

Keep calm to carry on

Fertility can actually be improved with stress management and relaxation, high amounts of the stress hormone cortisol can repress other hormones necessary for ovarian function and can even degrade egg quality. Stress impacts the whole body and its organs. Try to meditate, practice mindfulness, or simply unwind daily. Make sure that you are getting a good amount and quality of sleep at night.

Studies have shown that women with fertility issues often experience stress levels comparable to those who are dealing with life-threatening illnesses, so it is pivotal to look after your physical and emotional well-being when trying to conceive.

If you are struggling to conceive, consult with Ms Bruce via her Top Doctors profile.