Folic acid (also called folate) is a vitamin important for the proper development of baby’s brain and spinal cord. Taking extra folic acid in early pregnancy can reduce the risk of brain malformations and spina bifida. Ideally, you should start taking folic acid from at least two months before you conceive and up to the 12th week of pregnancy. The correct dose is 800 micrograms per day. This is available over the counter at any chemist. Some pregnancy vitamins available over the counter do not contain enough folic acid so check with your chemist when buying a pregnancy vitamin supplement. Ellevit does contain the correct dose of folic acid.
Iodine is an essential nutrient for normal brain development and fetal growth. Iodine requirements increase during pregnancy and it is sometime difficult to get enough iodine from diet alone. The New Zealand Ministry of Health recommend that all women take additional iodine supplementation during pregnancy and while breastfeeding. The recommended supplement dose is 150 micrograms daily. Iodine supplements suitable for pregnancy can be purchased over the counter at any pharmacy.
Seaweed and kelp based “natural” supplements contain very variable concentrations of iodine and are not recommended for pregnant women. You can download a copy of the Ministry of Health’s leaflet on folic acid and iodine here. A more detailed leaflet from the Australian Ministry of Health is available here.
A Rubella infection in pregnancy can severely damage a developing baby affecting brain and eye development. Most women will have been vaccinated against rubella at age 11 to 12 and should still have immunity in adulthood. A few women will have not gained immunity following vaccination and others may have been missed by the vaccination programme. If you are planning to conceive ask your doctor to check you rubella immunity.
The New Zealand cervical screening programme recommends that women should have a cervical smear every three years from the age of 20. Cervical screening is a very effective intervention to reduce your risk of developing cervical cancer in later life. Cervical smears can be taken in pregnancy but if you are planning a pregnancy we would suggest that you make sure your smears are up to date or arrange to have one a little earlier than usual so any possible abnormal smear can be investigated before you conceive.
Nearly a third of women in Auckland are overweight when they conceive. Being overweight in pregnancy increases your risk of developing diabetes, having a baby with a congenital abnormality, having a caesarean section, developing a blood clot in the leg or lung or experiencing an infection after delivery. You can reduce your risk of all these complications by trying to get as close as possible to your ideal body weight before you conceive.
You can check if you are within a healthy weight range by calculating your body mass index (BMI). Ideally, you should have a body mass index of 20 to 25 and certainly less than 30. This is calculated from your weight and height. Click on the link here to check your BMI.
Weight loss should always be a gradual process combining dietary changes, exercise and support. Lucille Wilkinson our obstetric physician is very happy to see women with weight issues before they conceive to look at ways they can maximize their chances of a straightforward pregnancy and healthy baby.
The safest level of alcohol intake in pregnancy is no alcohol at all. Alcohol crosses the placenta and into both the baby and its surrounding amniotic fluid. In the first trimester alcohol can affect the development of baby’s heart, brain and face. In later pregnancy it can impair baby’s growth and further brain development. The risk for any individual woman with occasional alcohol use is probably low but no safe lower limit has been established. Because alcohol use is so widespread many babies are born each year suffering from the effects of alcohol exposure. While you are trying to conceive moderate your intake and ideally avoid alcohol completely. Complete abstinence for many months is probably an impossible target for most women but do avoid episodes of heavy drinking if you think you are have just conceived or are about to conceive.
Am I too Old?
One thing you cannot change is your age (but don’t worry). Many women have straight forward pregnancies and healthy babies well into their forties. There are some important risks associated with pregnancy in older women. These include an increased risk of having a baby with a chromosomal abnormality, particularly Down Syndrome. Older women are also more likely to develop problems with high blood pressure, diabetes and be delivered by caesarean section. However, many of these problems occur because older women are more likely to be overweight, or have developed medical problems so these risks may not necessarily apply to you.
It may also be harder coping with a new baby as there may not be young grandparents and an extended family to help. Having a baby can also present you with many new challenges (almost all very rewarding!) that professional life may not have thrown at you yet.
Do make an appointment to see us if you are planning to conceive and are worried about you age - we can usually be very reassuring.
Problems Getting Pregnant
About one in six couples have problems starting a family and this proportion rises to one in three in older couples. After six months of trying about seven out of ten women should be pregnant. If you haven’t conceived after this time then ask your GP to arrange some tests to check all is well. If you have very irregular periods, a history of past pelvic infections such as Chlamydia or a partner who has had infertility problems in a previous relationship you may wish to seek help sooner. For information look at the fertility websites on our Useful Websites and Information page.
Preparing for your Pregnancy