Your time has come. Babies. You dream about them, talk about them and then talk about them some more. You’ve given your partner the nod, and together you’re just going to go for it; let nature take its course.
And why not? With the birds and bees doing a pretty good job to date getting humans pregnant, it’s little wonder most don’t bother with pre-pregnancy consults.
However, the best piece of advice you’ll get today is to spend half an hour with your GP to help plan the journey ahead. Better still, bring your partner along for the ride.
Here are five reasons why deciding to sit down with a doctor before getting up the duff is a good move.
1) Health checks = peace of mind
Having a thorough health check in preparation for pregnancy is a must. Your grandma’s rambling about ‘prevention being better than cure’ has never been more pertinent.
Besides giving you a good once-over, your GP will make sure your vaccinations are up to date. Contracting rubella and chickenpox while pregnant can cause serious problems with your baby. Hepatitis B immunisations should be considered for those in high-risk groups.
You can also discuss any travel arrangements and get advice on places to avoid. Countries such as South America, Indonesia and Malaysia should be reconsidered due to the prevalence of the Zika virus.
Any current medical conditions need to be carefully assessed. Women with epilepsy, diabetes or asthma may need to have treatment plans altered before conception.
Your GP can also refer you for optional pre-pregnancy genetic testing to see if you’re a carrier for cystic fibrosis, spinal muscular atrophy and fragile X syndrome.
2) Public vs private: the facts
Your GP will give you the low-down on having a baby through the public and private systems.
Public obstetric care is mostly covered by Medicare and is free or significantly cheaper than private care. The quality of public care in Australia is exceptional, especially in larger hospitals such as the Royal Women’s.
You’ll be looked after by midwives throughout pregnancy and at delivery – while seeing the occasional obstetrician. You can’t choose obstetricians and you’re likely to see a different one each time. Some people find this lacks consistency in antenatal care.
Shared care is also an option for healthy women and low-risk pregnancies. You get to see the same doctor or midwife throughout your pregnancy, along with some hospital visits. There are often out-of-pocket expenses.
Private obstetric care is usually accessed through costly health insurance. You need an obstetric level of cover for at least three months before falling pregnant.
There are out-of-pocket costs for an obstetrician and anaesthetist (if you use one). These can add up to more than $10,000, depending on where you live.
The good news is that you choose your obstetrician and the hospital at which to deliver your baby. You’ll likely have a private room, be allowed to recover longer in said private room and possibly even enjoy postnatal care in a fancy-pants hotel upon leaving hospital.
Your obstetrician will care for you from 10 weeks pregnant until your baby is six weeks old. Public care is from 17 weeks until you’re discharged from hospital, obstetrician unknown.
The public versus private decision can be tricky. A visit to your GP is golden in deciding which path bests suit your circumstances.
3) Medication ins & outs
Your GP will let you know exactly what medications to take and those to avoid.
Certain vitamins and supplements are recommended for pregnancy. In general, you’ll need folic acid, which reduces the risk of spina bifida, and iodine for brain and nervous system development. It’s advised you start both around a month before falling pregnant.
Depending on your levels, you may need a top-up of vitamin D and iron. Anaemia in pregnancy isn’t a good idea.
Some medicines, herbal remedies and creams also need to be stopped before falling pregnant. Obviously, the contraceptive pill is out. Less obvious is the fact that it can take 3-6 months for regular periods to return after stopping certain contraceptives.
You can’t take many acne treatments when pregnant. You also need to cut particular antibiotics, cold and flu remedies and over the counter medicines, such as ibuprofen.
Vitamin A and supplements including black cohosh aren’t considered safe in pregnancy either.
4) Falling pregnant is the easy part, right?
I often chuckle about how we spend our youth trying to avoid getting pregnant, only to be surprised when it doesn’t happen the instant we’re ready.
In fact, conceiving can be quite hard for many people. One in six couples has difficulty, according to Access Australia.
For women, the likelihood of in utero fertilisation decreases as we age. The chance of a 30 year old conceiving each cycle is around 20%. For a 4o year old, it drops to 5%.
Visiting your GP when trying for a baby is essential. They’ll conduct a full medical and family history examination to see if you have any conditions that may require extra fertility care.
Your GP will advise on making good lifestyle choices that increase your chances – stop smoking, cut out alcohol and drugs, get regular exercise and manage your weight.
Myths about the best time to have sex will also be debunked. As too will be other wild theories, such as whether to hug your knees after sex and refrain from trampolining (the answers are ‘no’ and ‘no’).
The time it takes to get pregnant is another question I’m asked every day. Some couples take one cycle, some take one decade. It’s generally advised women see a doctor for fertility advice following more than 12 months of regular unprotected sex – six months for women over 35 or if there’s a suspected fertility problem with either partner.
Your GP can refer you to a fertility specialist if the needed – dependant on a range of factors, including your age and pre-existing medical conditions. Rest assured that not all referrals to a fertility specialist mean in vitro fertilisation (IVF) – other assistance can be provided, such as help with ovulation.
5) Singles and LGBTI families
If you’re missing a requisite piece of biology to get pregnant naturally, your GP can outline your options. Medical science is racing ahead at mind-blowing speeds in this area.
Intrauterine insemination (IUI), in vitro fertilisation (IVF) and surrogacy are the three most sought after methods, yet adoption and fostering also have their merits.
Same-sex couples have an increasing number of possibilities open to them for having a baby. I recently met with a lesbian couple who were considering IVF ‘egg sharing’, where one partner’s eggs are used to create an embryo (genetic mother) which is then transferred to the other partner’s uterus (birth mother). What a lovely way to start a little family!
It’s also important to be aware of the many legal, financial and societal considerations. Again, your GP can point you the right direction to gain more information on such topics.
Dr Elaine Sung is the owner and principal GP at Doctors of South Melbourne. Her areas of special interest include women’s health and sexual health. Elaine has extra training in shared care (pregnancy care) and is the mother of two.
You can book an appointment with Elaine here.