Preparing your body for pregnancy

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Preparing your body for pregnancy

• Dr Bianca Zondagh
• Obstetrician Gynaecologist
• Netcare Unitas Hospital

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Preparing for pregnancy

• Deciding to have a family is one of the most
  momentous decisions you are likely to make in
  your life
• The idea of becoming a parent can take some time
  getting used to
• Not everyone plan their pregnancy well in
  advance, and many women have a healthy pregnancy
  with no special precautions at all

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Preparing for pregnancy

• If you and your partner have the luxury of time
  to get in the peak of health and fitness before
  you conceive, you will improve your chances of
  conception and also have a greater chance of a
  healthy pregnancy and a healthy baby
• YOU WILL HAVE TO CHANGE YOUR LIFESTYLE

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Changing your lifestyle - time

• Many new parents think that their new baby will
  fit in somehow and life will go on as usual
• IT WONT!!!!
• Babies need a lot of time and attention, and new
  parents will have less time for
• Each other
• Friends / family
• Recreation
• Working overtime

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Changing your lifestyle - costs

• Whatever you earn, youll spend 15-25 of your
  income on baby things (clothes, nappies, food,
  equipment etc)
• Household costs like heating, new dishwasher,
  washing machine, nanny / domestic helper /
  au-pair
• A NEW CAR?!
• Start saving money right now!!

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Changing your lifestyle - smoking

• One of the most damaging things you can do as far
  as the health of your unborn baby is concerned,
  is smoking
• Major cause of avoidable health problems, like
  hypertension, heart disease and stroke
• Risks miscarriage, stillbirth, low birth weight
  baby with failure to thrive, foetal abnormalities
• Partner low sperm count, passive smoking causes
  as much damage

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Changing your lifestyle - alcohol

• A poison that can damage the sperm and egg before
  conception, as well as the developing embryo
• Risks mental retardation, restricted growth,
  damage to brain and nervous system, FAS,
  stillbirth
• How much? No alcohol is the only safe limit,
  although the UK DOH says 4 units a week are safe

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Changing your lifestyle - drugs

• Always check the label of medicines or ask your
  friendly pharmacist about what is safe to take.
• Some acne treatment should be stopped 3 months
  before conception Ro-accutane / tetracyclines
• Most OTC flu-medicine and pain killers are not
  safe
• Dont assume homeopathic medicine to have no
  harmful effects ginko biloba / St Johns wart /
  ginseng / green tea

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Changing your lifestyle - drugs

• Social drugs should definitely be cut out before
  trying to conceive
• Dagga interferes with production of sperm
  effect can take 9 months to wear off
• Cocaine / heroine / morphine can damage the
  chromosomes in the sperm and egg leading to
  abnormalities
• When syringes are shared, theres a risk of
  contracting HIV

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Changing your lifestyle - exercise

• Pregnancy puts a strain on your body, so the
  fitter beforehand, the better you cope
• Beware of excessive exercise or being underweight
  you will struggle to conceive due to hormone
  suppression
• Never raise your body temperature during exercise
  it can damage your eggs or the growing foetus
  nervous system

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Changing your lifestyle - weight

• BMI weight(kg) length(m) length(m)
• Eg. BMI 70 1.65 1.65 25
• If you are within the normal weight range for
  your height, you are less likely to suffer
  problems such as high blood pressure or diabetes
  during pregnancy
• A BMI of 20-25 is ideal for optimum health this
  weight range is associated with fewest problems

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Changing your lifestyle - weight

• BMI lt 17
• You may have difficulty to conceive If you are
  poorly nourished, you baby may lack essential
  nutrients for normal growth and development
• BMI 17-19
• A little underweight, but baby should be OK if
  you gain weight at a reasonable rate

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Changing your lifestyle - weight

• BMI 26-30
• A little heavy more likely to suffer discomforts
  such as heartburn, varicose veins, tiredness,
  constipation, skin irritation caused by friction
  and perspiration
• BMI gt 30
• You will tend to suffer from health problems that
  can complicate pregnancy, such as high blood
  pressure and diabetes
• Medical procedures such as foetal heart
  monitoring and epidurals can be more difficult
• Normal and caesarean deliveries are complicated

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Turning your womb into a greenhouse

• Making healthy babies is like gardening get the
  soil healthy, plant the seed, feed and water it
  regularly
• Nutritional status at the time of conception and
  the first few weeks that follow is the single
  most important determinant of a babys growth in
  those critical early stages

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Hatching healthy eggs

• Unlike men who produce a regular supply of fresh
  sperm, women are born with all their eggs and
  they gradually disintegrate
• Your fertility is dependent on the health of
  these eggs, plus your bodys ability to produce
  the right balance of hormones to mature your eggs
  ready for ovulation with each cycle
• There are specific vitamins, minerals and fats
  that will make you more fertile

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Tune up your hormones

• Vitamin B6 and zinc
• Ensures that that adequate levels of hormones are
  produced important for development of eggs and
  ovulation
• Adequate levels also increases your sex drive
  (hence the aphrodisiac effect of zinc-rich
  oysters!)
• Alleviates PMS, pregnancy sickness, and postnatal
  depression
• Omega 3 6 fats
• Essential for healthy hormone function

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Prevent spina bifida with folic acid

• SB the spinal column is imperfectly closed
  resulting in a permanently disabling neurological
  disorder
• Folic acid play a crucial role in cell division
  the neural tube forms in the first 28 days
  before you even know youre pregnant!
• Adequate supply of folic acid (5mg/d)
  pre-conceptual reduces the risk of birth defects,
  miscarriage, premature birth and low birth weight

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Risk factors for folic acid deficiency

• Allergy to key foods like cows milk and wheat
• Being generally run down, underweight, or eating
  a poor unbalanced diet
• A period of excessive dieting / anorexia
• A recent miscarriage / stillbirth
• Regular alcohol intake or smoking
• Working particularly hard or being subject to a
  lot of stress

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Reduce the risk of Downs syndrome

• DS chromosomal abnormality caused by
  fertilization with a defective sperm or egg,
  there is an extra chromosome 21
• Affects older parents more because they had more
  exposure to damaging pollutants and an unhealthy
  lifestyle (stress, poor diet, alcohol, smoking
  etc)
• The quality of eggs also decreases as you get
  older you ovulate your best eggs first
• Anti-oxidants slows down the effect of aging and
  pollution vitamins A, C E, selenium zinc

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You need a multivitamin-mineral supplement

• Vitamins and minerals are the keys that make
  enzymes kick into action in your body
• Enzymes do the work in your body, by turning one
  substance into another, e.g. digest protein into
  amino acids, and then turn the AAs into protein
  to build your baby
• Nutrients are involved in just about every
  function in your body. If deficient, your body
  simply wont work as efficiently as it could
• If your baby doesnt get enough, key organs wont
  develop properly, resulting in lifelong disability

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Fabulous fats facts

• Did you know that your intake of essential fats
  has a direct effect on your childs IQ?
• A babys brain and nervous system are composed
  primarily of fats and you need to provide baby
  with the right building blocks to develop
• Essential fats are needed to construct the
  membranes of all cells

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The fabulous omega 6 fat family

• Important to form certain prostaglandins (very
  active hormone-like substances)
• These keep the blood thin, relax blood vessels,
  lower blood pressure, maintain water balance in
  the body, decrease inflammation and pain, improve
  nerve and immune function, and help insulin to
  work
• Deficiency seriously impacts babys health
  after birth failure to thrive, suffer with
  diarrhoea, skin problems, poor hair growth and
  poor utilisation of food for energy

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Omega 6 deficiency signs (gt5)

• High blood pressure
• PMS or breast pain
• Eczema or dry skin
• Inflammation, like arthritis
• Struggle to loose weight
• Diabetes or glucose intolerance

• Dry eyes
• Multiple sclerosis
• Drink alcohol every day
• Any mental health problem
• Excessive thirst

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The fabulous omega 3 fat family

• Series 3 prostaglandins are made of these fats
• Essential for proper brain function, affects
  vision, learning ability, coordination and mood
• They also reduce the stickiness of blood, control
  cholesterol, improve immune function and
  metabolism
• Deficiency can lead to permanent learning
  disabilities in your child, premature birth and
  low birth weight, and maternal depression during
  and after pregnancy

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Omega 3 deficiency signs (gt5)

• Dry skin
• Inflammatory problems like asthma or eczema
• Water retention
• Tingling in the arms or legs
• High blood pressure

• Prone to infections
• Struggle to loose weight
• Decline in memory or learning ability
• Lack of coordination
• Impaired vision

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Now its time to try to conceive

• Once you are fit and ready for pregnancy, it is
  time to start trying to conceive
• The decision to abandon contraception may produce
  a mixture of emotions excitement, anxiety,
  happiness or apprehension
• Dont get too anxious about counting days and
  time-tabling intercourse studies show that you
  are more likely to conceive if you are relaxed
  and happy

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Some conception facts

• Each month, you have a 20 chance of conception
• Your fertility begins to decrease from the age of
  25
• 75 of couples trying for a baby conceive within
  9 months, and 90 do so within 18 months

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Your ovulation time

• Keep a calendar
• Note each 1st day of your cycle
• Calculate your average cycle length (x)
• You ovulate 14 days before the start of your next
  period (x 14 ovulation) allow 3 days before
  and after for normal variation of cycle
• Keep a temperature chart
• Your body temperature increase after ovulation
• Ovulation kits
• Very simple and accurate
• You urinate on a test stick around the middle of
  your cycle it detects an increase in LH that
  predicts when you are about to ovulate

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Boy or girl?

• Timing intercourse male sperm faster but live
  shorter
• Boy no sex 2-3 days before ovulation sex ASAP
  after ovulation
• Girl have sex 2-3 days before ovulation
• Acid vs. alkaline flush vagina 30min before sex
• Boy bicarbonate of soda (alkaline)
• Girl diluted lemon juice or vinegar (acid)
• Diet
• Boy sodium and potassium meat, fish, rice,
  pasta, potato, beans, banana, apricots, celery
• Girl magnesium and calcium dairy products,
  eggs, nuts, soya beans, green vegetables, fresh
  fruit juice

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Preparing for pregnancy

• Start at least 3 months ahead of trying for a
  baby
• Sufficient time to build up good nutritional
  reserves and eliminate traces of alcohol and
  smoking
• Most important pre-conceptual preparation is
  optimizing nutrition
• Folic acid
• Good multivitamin and mineral supplement
• Good omega 3 6 fatty acid supplement

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A last thought get a good check-up

• If you have specific health worries / conditions
  that might affect pregnancy, discuss it with your
  gynae before stopping contraception
• Mention any medication you are on
• Check your immunity against rubella
• Get a pap-test

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Thank you