Planning a Baby

What you thought you knew, but didn’t

Planning a Baby

The story about making babies all seemed so simple when we were young, whether you learned the story about the stork or the cabbage patch—or you were lucky and heard a truer-to-life version. In reality, there’s so much more to know about the remarkable journey to conception.

Deciding to have a baby is an exciting moment in life’s journey. Like heading out on an adventurous trip, preparation can help smooth the way. This article will mark out some guideposts to follow. Not planning a baby anytime soon? You may still want to read on; there are more than 180,000 unplanned pregnancies per year in Canada.

Check on your health

A basic health checkup is a good place to start your journey toward childbirth. Your family doctor can review your vaccine status with you, check your iron levels, update your Pap test, and run a sexually transmitted infection panel.

In addition to these fairly standard checks, there are some emerging ones to consider as well.

Body mass index (BMI)

Both high and low BMI numbers are associated with negative outcomes for pregnancy, delivery, and infant health. Lower risks are associated with normal weight: BMI between 18.5 and 25 kg/m2.

Vitamin D

Adequate vitamin D levels may play a role in improving the chance of fertilization. Should you become pregnant, having a healthy vitamin D status may protect against miscarriage, gestational diabetes, and the need for Caesarean delivery. A simple blood test can tell you if your levels are adequate.

Cholesterol

Blood lipids are used to assess risk for heart disease, but they can tell us something about pregnancy outcomes too. Having levels of HDL (good) cholesterol less than or equal to 1.29 mmol/L is associated with an increased risk of preeclampsia (a potentially serious complication of pregnancy characterized by higher-than-normal blood pressure).

Diet

What you eat is essential for your health and for a healthy pregnancy. Research has found that a higher intake of vegetables and whole grains helps lower the risk of pregnancy loss, as does high folate consumption and minimal alcohol intake prior to conception.

Supplement before pregnancy

Before conception, the egg and sperm cells mature. This process takes about 100 days, so it’s best to start prenatal supplements at least three months before you start trying to conceive. Check with your health care practitioner for advice about which supplements best suit your individual needs.

Multivitamins

Beginning multivitamin supplementation increases the odds of becoming pregnant and reduces your risk of pregnancy loss. Your multi should include iron, calcium, folic acid, and potassium iodide.

Fish oil

Fish oil supplementation helps reduce the risk of preterm delivery and increases infant weight, height, and head circumference.

Help sperm meet egg

Once you’re ready to start trying to conceive, it helps to understand more about fertility and timing.

After ovulation, the egg cell lasts about 24 hours. Sperm can live in the vagina for around five days. If you combine those long-lasting sperm and the lifespan of the egg, you get what is called the biological fertile window of about six days.

There are many different ways to identify when to time sex to occur within the six-day window: monitoring cervical mucus, tracking temperature, and using ovulation predictor kits, for example. The definitive guidebook on the subject is Toni Weschler’s Taking Charge of Your Fertility (William Morrow, 2015).

You can, of course, choose not to track any fertility signs. Assuming there is no reason to question potential fertility, if you have sex every one to two days, you’ll definitely improve your likelihood of conceiving.

How long until baby?

Once birth control is discontinued, the number of menstrual cycles it will take to conceive is highly variable. Most couples will become pregnant in the first three menstrual cycles. Yet even if you have not conceived one year after discontinuing birth control, your odds of conceiving within the next year, without any assessment or treatment, are high.

After stopping the birth control pill, there may be a lower rate of conception for the first three cycles.

Delaying pregnancy

Celebrity pregnancies late in life paint a rosy picture of delaying the decision to have kids. Let’s explore the facts.

In population studies, the age at last birth for people not using assisted reproduction technologies is consistently eight to 10 years before menopause. The average age of menopause in Canada is 51.

Pregnancy through in vitro fertilization (IVF)

Pregnancies later in life are often achieved with IVF using a younger woman’s egg cells. Success of IVF with donated eggs is higher under age 40, but few births occur even with donated eggs in women older than 45 years.

These figures are averages, so you could have a very different experience. Although it would be wonderful if there were a test that could tell you how much time you have left for baby-making, there are no tests that can predict your likelihood of conceiving without reproductive technology.

Age and fertility

One of the theories explaining why age can determine fertility is that oxidative stress affects the quality of egg cells. Supplementing with different antioxidants may help offset the damage. In mice, n-acetyl-L-cysteine, coenzyme Q10, and melatonin have been found to improve egg cell quality and ovarian function. In humans, taking melatonin and inositol improves the number of good quality embryos in IVF.

Whether pregnancy is a planned destination or a surprise detour, a little bit of knowledge helps you know which way to turn.

When to seek help

  • If you’re 35 years old or younger, seek help if you haven’t conceived after 12 months of unprotected sex.
  • If you’re older than 35, you should seek help if you haven’t conceived after six months of unprotected sex.
  • Seek help sooner if you have infrequent menstrual periods; have very long or irregular cycles; have (or suspect you have) endometriosis; or have (or suspect you have) a disease affecting the uterus, Fallopian tubes, or abdominal cavity.

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