The decision to start a family can be one of the most exciting and nerve-racking moments in your life. It can be a huge undertaking and doing some planning can have its benefits. According to the CDC, around 45% of pregnancies are unplanned, meaning more than 50% are. The question that comes up is, why anyone would need to do any official planning, why not just let nature take its course? The short answer is that you want to have a positive outcome. Planning can range from not trying to prevent a pregnancy to in vitro fertilization.
I have had patients who have approached me unsure of what to do to plan for pregnancy so I came up with some basic things that would help them on their journey to parenthood.
The first thing to do is speak to your physicians; this includes your primary care physician, OB/GYN, and any medical specialists you see. Having everyone onboard will ensure better results. With your primary care physician, you may need a physical, medical history review, and labs to ensure you do not have any chronic diseases or at risk to develop any, such as diabetes, high blood pressure, or thyroid disease to name a few. If you do not have an OB/GYN now would be the time to get one because that is who will be managing your pregnancy; they will do examinations and testing as well. These physicians and specialists will also be able to determine medications/supplements and activities that are safe and unsafe in pregnancy. This can help you to prepare for any medication, therapy, or lifestyle changes, such as stop smoking or losing weight, that you may need to do before becoming pregnant.
If you are taking any pregnancy preventing medications such as a birth control pill, injection, or implanted device ( IUD), once these have been discontinued it can sometimes take 6 months for your body to learn to regulate its hormones. This means that you may not get pregnant within the first 6 months of stopping your birth control; even though some people are lucky enough for this to happen immediately. Once you stop these medications, the next step is to track your periods, how often they come (in days), how long they last, and how heavy they are. This is very useful information for your OB/GYN as it may determine things that can affect your ability to become pregnant, such as fibroids or Polycystic Ovarian Syndrome (PCOS).
Most women ovulate once a month, this translates to having a 3-4 day window to get pregnant every month. If your periods are irregular, ovulation timing may vary. This is why ovulation kits have become popular for people to track when and if they ovulate. There are many ovulation kits available on the market and they can be a good starting point for pregnancy planning.
These steps are fundamental to determine your fertility status. Infertility by definition is not being able to get pregnant after 1 year of unprotected sex and in some cases 6 months if you are 35 years and older. It is important to understand that there are varying factors for infertility as well as varying treatment options. If you now fall into this category, a more in-depth workup and conversation need to happen with your OB/GYN. There is also the option of seeking further care and assessment from fertility centers. Both you and your partner should get full evaluations to determine which method of treatment will be best for you.
A very important thing that people sometimes overlook when thinking about pregnancy, is healthcare and work coverage. It is always good to know your workplace’s maternity and paternity leave policies. You should know what your health insurance may or may not cover regarding OB/GYN appointments, fertility assessments, and treatments, and hospital coverages. Understand the Family and Medical Leave Act (FMLA) and short-term disability processes as part of your planning.
The final thing to say is to find a physician or practice that you are comfortable with. As a physician, I can say the doctor-patient relationship is an important one. You will be sharing some of the most personal parts of your life with this person. Like the relationship with your partner, it can be successful when built on trust, and open and authentic communication. The conversations that will be had must be honest, clear, and detailed. It is important to ensure your needs are being met and that things are explained to you. Your physician or medical team will be able to put all the information you get from internet searches and recommendations made by friends and family in context. The right medical professionals will be your best resource when planning your pregnancy.
I hope that this bit of information can allow you to better navigate the healthcare system and be successful in becoming pregnant. In all, planning a pregnancy is an exciting time. You learn more about yourself and your relationships. Enjoy the process!