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Pre-Pregnancy Checklist

pre-pregnancy checklist

Stopping Contraception*

Barrier methods, such as the diaphragm and condom, can be dispensed with immediately. However, if you are on the pill or are using an IUD, a bit more forethought is required.

The Pill

It is probably advisable to stop taking the pill a month before trying to conceive, so that you have at least one normal menstrual period before coming pregnant. However, there is some evidence to suggest that women are more fertile immediately after stopping the pill, so this could be ideal time to try if you have previously suffered from low fertility or had a miscarriage.

If you think that you are pregnant while you are still taking the pill, consult your doctor immediately. Some forms of the pill contain a high dose of synthetic progesterone (called progestogen) that may interfere with development in the first weeks of life.

The Intrauterine Contraceptive Device (IUD)

The IUD, or coil, works by irritating the lining of the uterus so that the fertilised egg cannot implant. A very small number of women do become pregnant while using an IUD. In these cases, the IUD is removed if it can be done so easily. If not, it usually comes out with the placenta after the birth.

Testing for Rubella*

Before conceiving, check with your doctor to see if you have antibodies to the German measles (rubella) virus.

Don’t assume you are immune to the disease if you have been vaccinated in the past – the antibodies lose their efficiency after a period of time, so check. If you are not immune, you should be vaccinated. After a successful vaccination, you should wait at least three months before you try to conceive, as the vaccine is live.

If you come into contact with someone who has, or is suspected of having, German measles, tell your doctor immediately. He will arrange for a blood sample to be taken and sent to the laboratory for antibody testing.

Depending on the result, the test may be repeated 10 days later. Should this test result in a suggestion that you have German measles, you and your partner will have to face the decision of whether to abort the pregnancy. Some doctors may recommend administration of antibodies in the form of gamma globulin to help avoid any damage to the foetus.

Take care: German measles (rubella), particularly if caught in the first three months of pregnancy, can cause malformations in your baby. These may include deafness, blindness, and heart disease.

Folic Acid*

This vitamin is essential for the production of red blood cells and plays an important part in foetal growth especially during the first 12 weeks of pregnancy. Folic acid is particularly important to the development of the nervous system and research has shown that folic acid supplements taken up to three months before conception and for the first 12 weeks of pregnancy significantly reduce the incidence of neural tube defects such as spina bifida. If you have not started taking folic acid before conception, start as soon as you know you are pregnant. Folic acid is available in tablet form, and is also present in green leafy vegetables, cereals, and bread.

Is Your Health Insurance Adequate?

Most health insurance companies require you to be a member for 12 months in advance of your due date before you can begin making claims for obstetric related services. However, most funds will pay you benefits during this “Waiting Period” if you have a premature birth and/or you suffer complications arising from the pregnancy. Of course your Estimated Date for Delivery would have to be confirmed by your doctor.

This ensures that people do not register simply because they are expecting a baby.

When you select your insurance provider, and your level of insurance, make sure you ask questions about exactly what you are being covered for. Having a baby can be an expensive exercise and having adequate cover can make the world of difference.

Here are the main Health Insurance Providers for you to look through.

Alternatively contact the following companies who provide a service to help you select the level of cover, and health insurance fund, that best suits your needs.

Genetic Testing and Counselling*

Genetic counselling is aimed at determining the risk you run of passing on an inheritable disease to your child. The second goal is to help you to decide whether or not to go ahead to conceive in the light of that assessment. You may be concerned because you have a blood relative (including, perhaps, a previous child) who has suffered from an inheritable disorder.

Can you benefit?

It is important to seek expert advice if you fall into any of the following groups:

  • if a previous child was born with a genetic disorder such as cystic fibrosis, or a chromosomal disorder such as Down Syndrome
  • if a previous child was born with a congenital defect, for example, a club foot
  • if there is a history of mental handicap, or abnormal development
  • if there is a blood relationship between you and your partner
  • If you have a history of repeated miscarriages.

For more information and support visit:

Breast Health

A breast check by your Doctor before you fall pregnant is a wise precaution, especially if you have a family history of breast cancer. During pregnancy your oestrogen levels rise dramatically and while very uncommon, can create the environment for developing breast cancer. Do not be alarmed but be diligent in your self breast examination.

Pap Smear

If you are planning to fall pregnant it is advisable to have a pap smear done before you fall pregnant to rule out any problems in advance. It is difficult to treat cervical cell changes during pregnancy. Contact your family doctor or a Family Planning Association Centre.

Blood Pressure

It is a good idea to have your blood pressure tested before you fall pregnant. This result can then be used as a good control point to monitor any fluctuations in blood pressure you may have during your pregnancy and can help to identify early signs of pre-eclampsia.

Your Medical History

Before going to your doctor to discuss your pregnancy plans try to source some information about your medical history and your partners. Here are some ideas for information that might be useful.

  • What are the major illnesses you have had?
  • Have you had any surgery?
  • Have you had any STD’s in the past?
  • Do you have or are you predisposed to diabetes?
  • What medications do you take, prescription and over the counter, or herbal?
  • What is your family history, particularly regarding genetic disease?
  • What is your obstetric history? Have you been pregnant previously?

Mums and Dads are great for this background information. As you will find out, they remember all sorts of things that happen to their children.

* Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002

Further Reading