Planning for a baby can be overwhelming, especially when it’s your first pregnancy.
However in Australia, we’re lucky there’s so much available health information on fertility, IVF, private vs public hospitals, obstetrics, birthing options, and genetic screening.
If you’re thinking about falling pregnant, the best advice I can give you is to first visit your GP.
Below are six reasons why.
ON THIS PAGE
- To get a pre-pregnancy health check
- Understand public vs private hospitals
- Have the proper medications prescribed
- Explore fertility factors
- Discuss options for singles and LGBTI families
- Learn about genetic carrier screening
- About Dr Achala Manchanda
Pre-Pregnancy Planning Health Checks for Peace of Mind
Getting a thorough pre-pregnancy health check is a must.
Since pregnant women are considered one of the high-risk groups for hepatitis B, I also recommend screening for this viral infection.
Any current medical conditions need to be carefully assessed and managed.
Women with epilepsy, diabetes, or asthma may need to update their treatment plans before trying to get pregnant.
Your GP can also refer you for prenatal genetic carrier screening. More on this below.
Public vs Private Pregnancy: Costs, Hospitals, and Benefits
Your GP can give you the low-down on having a baby through the public and private health 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.
In the public system, midwives will look after you throughout your pregnancy and when you give birth. You’ll also likely receive occasional obstetrician visits.
However, you can’t choose obstetricians, and you may see a different one each time. Some people prefer more consistency in their 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 and with some hospital visits.
There are often out-of-pocket expenses.
Private obstetric care is usually accessed through private health insurance. You’ll 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). Depending on where you live, these costs can add up to more than $10,000.
The good news is that you choose your obstetrician and the hospital to deliver your baby.
You’ll likely have a private room, be allowed to recover for longer in your room and possibly even enjoy postnatal care in a fancy hotel upon leaving the 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.
The public versus private decision can be a tricky one. A visit to your GP is golden in deciding which path best suits your circumstances.
Medication Before Conceiving
As part of your pregnancy care, your GP will let you know which medications to take and those to avoid.
I usually advise you to take both for around a month before becoming pregnant.
Some medicines, herbal remedies and creams 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.
Medications to Avoid When Pregnant
You can’t take many acne treatments when pregnant. You also must avoid particular antibiotics, cold and flu remedies, and over-the-counter medicines, such as ibuprofen.
Vitamin A and many other supplements aren’t generally considered safe in pregnancy either.
Fertility and Falling Pregnant
I often joke with patients about how we spend our youth trying to avoid falling pregnant, only to surprise our adult selves when it doesn’t happen the instant we’re ready.
In fact, conceiving can be quite hard for many people. According to Access Australia, one in six couples has difficulty conceiving.
For women, the likelihood of in-utero fertilisation decreases as we age. There’s a 20% chance of a 30 year old returning a positive pregnancy test during each cycle, and for a 40 year old, it drops to 5%.
Visiting your GP to help plan for pregnancy is essential.
They’ll look at your family history and complete a medical examination to see if you have any conditions requiring extra fertility care.
Your GP will advise on making good lifestyle choices to increase your chances — stopping smoking, cutting out alcohol and drugs, getting regular exercise and managing your weight.
We’ll also debunk myths about the best time to have sex. The same goes for other far-fetched theories on falling pregnant, such as whether you should hug your knees after sex and avoid exercise (the answers are no and no).
Every day I’m asked how long it takes to get pregnant. Some couples take one cycle; others take a decade.
I generally advise women to 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.
Depending on various factors, including age and pre-existing medical conditions, your GP may refer you to a fertility specialist.
Rest assured, not all referrals result in IVF. These specialists also offer other assistance, such as help with ovulation.
Singles and LGBTQI+ Family Options: IVF, IUI, and More
If you’re not in a position to fall pregnant naturally, your GP can outline your options. Medical science is racing ahead at mind-blowing speeds in this area.
Adoption and fostering are also great options.
Same-sex couples have many available options for having a baby. I recently met with two lovely ladies who were considering IVF egg sharing. Egg sharing is where doctors use the genetic mother’s eggs to create an embryo and then transfer the embryo to the birth mother’s uterus.
What a delightful way to start a little family!
It’s also important to understand the many legal, financial and societal considerations.
Again, your GP can point you in the right direction to gather more information on these topics.
Genetic Carrier Screening
Advancements in reproductive medicine continually amaze me. Genetic carrier screening is no exception.
Genetic screening is a test to determine if either parent has an increased chance of having a baby with certain genetic conditions. Such conditions can reduce a child’s quality of life and lifespan. Examples include:
- Cystic fibrosis: 1 in 25 people are carriers / 1 in 2,500 people have the condition.
- Fragile X syndrome: 1 in 250 people are carriers / 1 in 4,000 people have the condition.
- Spinal muscular atrophy: 1 in 40 people are carriers / 1 in 6,000-10,000 people have the condition.
Almost all children born with these genetic conditions show no family history. Being the case, I’ll provide you with all the necessary info and leave the screening decision in your capable hands. There’s no wrong or right choice.
Doctors conduct genetic screening by sending off blood or saliva swabs for testing. Ideally, we do this before you fall pregnant, and people who plan to have multiple children with the same fertile partner only need to be screened once.
In the event of a positive screening result, your options depend on whether you’re pregnant or not.
Your GP can walk you through your choices.
It’s important to note that we can’t pick up chromosomal conditions such as Down syndrome with genetic carrier screening. Instead, we can conduct blood tests and ultrasound scans during your first trimester as part of your prenatal care.
Dr Achala Manchanda is a local GP at Doctors of South Melbourne.