Weight and exercise

Check your weight: any woman who is very over- or under-weight may find her fertility levels are affected.

If you are overweight during pregnancy you are at higher risk of blood pressure problems, and will also find the extra weight of pregnancy puts more strain on your joints. If you are seriously underweight due to a poor diet, there is a risk your baby may be smaller than it should be during pregnancy.

Regular exercise is also important: aim for three 20 minute sessions each week. Walking, swimming and cycling are all good forms of exercise. Avoid high impact exercise regimes like vigorous aerobics or step exercises once you are pregnant. Pregnancy hormones soften the ligaments that hold some joints in place and strenuous exercise can lead to injury. Remember to tell your exercise teacher as soon as you are pregnant so the routines can be adjusted to suit you.

Stress and anxiety

High anxiety and stress levels are known to affect both fertility and the pregnancy, so if you’re working hard, staying up late or constantly meeting deadlines, make positive changes to reduce some of the stresses in your life. Think about new ways to relax, too, for example taking up a yoga class, or using a relaxation tape.

Find out more about relaxing mind-body workouts on icircle Health

Your diet

A good diet, providing you with all the necessary nutrients, is vital when you are planning to conceive. If you eat well, you should not need to take a general vitamin or mineral supplement, but if you do, make sure that you take one specifically designed for pregnant (or pre-pregnant) women, as these do not include Vitamin A. High levels of this fat-soluble vitamin may cause developmental abnormalities in the foetus.

Taking supplements

The one supplement all women planning for a baby should take is folic acid, one of the B vitamins. The Department of Health recommends taking a folic acid supplement as this has been shown to significantly reduce the risks of having a child with spina bifida. You can get the recommended dose of folic acid, 0.4mg a day (which may also be described at 400mcg or micrograms) at any chemist’s. If you are epileptic and take drugs to control your epilepsy, consult your doctor before taking folic acid.

As well as taking a supplement, try to eat more foods that contain folic acid. These include green leafy vegetables, especially sprouts and spinach, and some fortified breakfast cereals. If you are already pregnant, take the supplement as soon as you can and continue for the first 12 weeks of pregnancy.

Foods to avoid

Some foods carry tiny risks for pregnant women and therefore you may like to avoid them when you are trying to conceive. These include:

• Soft cheeses, especially those made with unpasteurised milk, which may carry listeria. There is a small risk that listeria can cause an infection which may lead to miscarriage
• Liver or foods containing liver, like pates, as these contain high levels of vitamin A
• Raw or undercooked meats which can carry listeria
• Pre-cooked chilled meals, which may carry food poisoning organisms if they are not thoroughly reheated until piping hot
• Ready-washed salads which have been shown to sometimes carry listeria. Wash all vegetables and salads before you eat them
• Lightly-cooked eggs. Hard boil eggs until the whites and yolk are solid to avoid possible risk of salmonella

Checking your immunity

Most women in the UK will have been vaccinated against the rubella virus in their teens, but this does not necessarily give lifelong immunity. If a developing foetus is exposed to the rubella virus, especially in the first 12 weeks of pregnancy, serious disabilities can result.

Ask your GP to check your immunity three months or so before you try to conceive. This involves a simple blood test to detect antibodies in your bloodstream. If you aren’t immune, you can have a vaccination, but it is important to then wait at least three months before trying to become pregnant.

Smoking

If you or your partner smokes this will significantly reduce your chances of conceiving. Women who smoke are also more likely to have an ectopic pregnancy or miscarriage. Medical research has also shown beyond doubt that smoking affects the development of babies in the womb: many are smaller than average because they are effectively starved of oxygen while they are growing.

Giving up smoking is one of the single most important things you can do for yourself and for your developing baby. If you cannot give up, at least try to cut down. Your doctor or midwife may be able to put you in touch with a local support group or you can contact Quitline, a national helpline for smokers, on 0800 002200.

Alcohol

There is no evidence to suggest that an occasional social drink or two does any harm, before or during pregnancy. So while some couples decide to abstain from alcohol completely while they are trying for a baby, others find that a glass of wine or beer helps them relax.

But alcohol is a problem if taken in excess: binge drinking and alcohol addiction have been shown to affect the health of the developing baby. If you know that you drink more than you should, consider how you can reduce your intake before conceiving. Ask your doctor for help, and think about joining a support group.

Drugs and medication

If you are trying to conceive, it’s best to avoid taking any drugs, prescribed or otherwise. Some medicines can decrease fertility, so tell your GP you are trying for a baby if you need a prescribed medicine when you are ill. This is just as important for men as for women, as some prescriptions can affect sperm production or development. Talk to your GP if you are on long-term medication; he or she may be able to prescribe an alternative if the original drug is known to have an effect on fertility.

Working environment

At one time many people worried about using computers or visual display units (VDUs) while pregnant, but research that has been carried out shows no links between VDUs and any specific health problems for babies.

However you should be particularly careful if you come into contact with the following at work:

• Industrial chemicals, such as lead and arsenic
• Many types of paints or varnishes
• Soldering or work involving rubber
• Anaesthetic gases (which may cause early miscarriage)
• Dry cleaning fluids.

If you work in a potentially hazardous environment, talk to your health and safety officer or union representative about the possibility of altering your job or using extra protection while trying for your baby or when you’re pregnant. This can be just as important a consideration for men as for women, as some chemicals can affect sperm production. If in doubt, ask your doctor for advice.

Toxoplasmosis

Toxoplasmosis is an infection which causes few symptoms in a healthy adult, who may not even be aware of having caught it. However, it can have serious effects on an unborn child, including brain damage and blindness, especially if it is caught during the first three months of pregnancy.

This potentially dangerous disease is caused by an organism found in raw meat, cat faeces and contaminated soil, so you need to take extra care when you are pregnant or trying to conceive. To minimise the risk of contracting the infection:

• Avoid eating raw or undercooked meat
• Take care when preparing meats not to mix raw and cooked meats. Use separate chopping boards for raw and cooked meats
• Store meats carefully in the fridge so that raw meat juices do not drip onto other foods
• Wash your hands if you have handled raw meat
• Wash all fruit and vegetables carefully
• Always wear gloves when gardening
• Get someone else to empty the cat-litter tray
• Always wash your hands after stroking your pet

When to stop the pill

Doctors vary in their views on this. Some doctors recommend allowing a month or two for your body to adjust itself to its natural cycle before conception. Others point out that the hormones are eliminated from your system as soon as you have your next menstrual period, and believe there’s no point in waiting. You may want to discuss this with your doctor.

Once you have stopped contraception and are trying to get pregnant, it is a good idea to keep a note of the dates of your menstrual periods. This will make calculating the fertile time of your cycle easier, and if infertility treatment is needed, knowing your typical cycle may help with diagnosis and treatment choices.