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Preparing for pregnancy

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SWEET TOOTH: Coffee, cinnamon scrolls and don't even get me started on caramel slices. I have an inherent sweet tooth, but I also know not managing my sugar levels will not help my PCOS.

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This week I received my textbooks for my part-time Graduate Diploma in Psychology and while paging through the course work for Brain and Behaviour (and wondering what I have gotten myself in for) it occurred to me how incredible it is that two people can make another human being.

When you really think about how we are able to produce a whole other person from two microscopic little cells in the conception process - a walking, talking, thinking, breathing, independent being, made up of complex systems, organs and the miraculous computer system that is the brain - it's almost unfathomable.

Interestingly before the brain starts to form in week five of pregnancy, a myriad of miraculous constructions are already taking place.

The formation of the zygote- when the sperm and egg unite in the fallopian tubes- the 46 chromosomes, 23 from you and 23 from your partner, already set the baby's traits like eye and hair colour, sex and to some extent, personality and intelligence.

It was at this point in my ponderings that I realised how important it is that I get my body 100 per cent right (or as close as possible) before I fall pregnant.

If - from the moment of conception - the outcomes of my child's brain and body development can be positively influenced by my actions now - well then my type A personality needs to make a list of what needs to be done and I need to get to doing it.

In my quest to find out what we wannabe-mums need to do to get preggy fit and healthy, I chatted to a dietician, a midwife and a fitness trainer - here is what they had to say:

Nutrition:

Rene Schliebs, an Auckland-based registered clinical nutritionist with 13 years experience says health should be a woman's main focus pre-conception, not your BMI range.

"The best approach in terms of preconception healthcare is to look at your fertility health over a period of four to six months to really get that phase right before you actually start trying," she explains.

This doesn't only apply to the woman, but to your partner as well (which means he needs to cut back on the Saturday beers with mates and get on board here too).

"I often see females at the clinic and they think it is all their fault that it's not happening and often it can be male factor problems as well," says Schliebs.

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While pre-conception diet is important for any couple trying to get pregnant, for ladies like me who have the added complications that Poly Cystic Ovarian Syndrome can bring, diet is even more important in dealing with insulin resistance, getting your sugar levels under control and aiding ovulation.

"With PCOS, cycles can become irregular and the inability to ovulate happens as well, which is made worse by insulin resistance," Schliebs explains.

While for women who are battling with PCOS and weight loss it may seem hopeless to lose all that weight before falling pregnant, even a 10 per cent loss of body weight and lowering body fat can kick start ovulation again.

For example, I managed to lose 10kgs- going from 77kgs to 67kgs over a year of increased exercise and working with a dietician and it does seem to have kick-started my ovulation. A 10 per cent loss of say 80kgs would be 8kgs- which is far more realistic than trying to drop 20kgs.

"I have seen so many polycystic women who think that there is no hope for them and we get their diet right, we get them losing a little bit of weight, eating the right types of low GI (glycaemic index) foods, less sugar and so many pregnancies happen," says Schliebs.

With PCOS as well as with endometriosis, an imbalance between progesterone and oestrogen can also play havoc with your fertility.

"Often the progesterone levels are far too low to hold a pregnancy and their oestrogen levels are too high, which can inhibit the initial stages of the cycle for ovulation as well," says Schliebs.

Schliebs helps women get these hormonal imbalances right by changing their diets.

The liver is one of the most important organs in regulating oestrogen, so even in the preconception phase, drinking alcohol is one of the worst things you can do.

"You should avoid alcohol from at least four months to six months before conception. Alcohol, even just a couple of glasses over the course of the week can increase oestrogen levels in women and men and that can decrease sperm count."

So - in the simplest, easiest way to understand- what you eat before you get pregnant can not only impact on the DNA of your unborn baby, but it could also be hindering your chances of getting pregnant.

All these changes can seem a bit overwhelming, but I saw a motivational quote on a friend's Facebook wall that I have decided to use as my mantra on my self-health journey: "Don't start a diet that has an expiration date, focus on a lifestyle that will last forever".

Fitness:

Lesley Dixon, midwifery advisor at the New Zealand College of Midwives says that the state of a mother's health is directly linked to the health outcomes of her baby.

"If you are overweight or obese, then that obviously is going to have long term health consequences to you individually as well as on your pregnancy and the birth as well," she explains.

"If you can keep yourself healthy pre-conceptually you are also making sure that the DNA you are providing for your baby as such is good DNA. It really is about optimising your health before pregnancy, so you can maintain this through pregnancy and the birth."

Auckland- based personal trainer Simone Rank who runs Yummy Mummy Fitness knows all too well how important fitness pre-pregnancy is for coping with pregnancy and recovering afterwards.

With 10 years experience helping mums with their fitness during pregnancy and getting back into shape after pregnancy and the mum of a three-year old boy, she is an advocate for preconception fitness.

"I always say to my girls if you want to exercise while you are pregnant you need to be fit beforehand" she explains.

"It's really hard to start if you haven't done anything because most doctors will tell you not to start when you are pregnant."

So - if you are like me and do your mandatory three days a week at the gym- it might be a good idea to really focus on getting yourself fitter.

If you aren't a fan of gym that is ok too, Rank says even just increasing your activity, going for a walk on the beach, swimming, biking- anything that helps you get your heart rate up will make a big difference to your health and fitness levels.

The added advantage is the healthy habits you pickup pre-pregnancy are a great help during pregnancy and child birth.

"So many of the ladies who do some body strengthening during pregnancy receive comments from their midwives and obstetricians about how strong their pelvic floor was. It makes such a huge difference," she says.

Mental preparation:

Schliebs says that a positive mindset towards your conception journey also plays a big role in the success of falling pregnant.

"It's so important to have a positive mindset and not have any of those negative thought patterns influencing your fertility health. The body does have a memory for that sort of stuff and the stress response can just hold onto that and shut down the reproductive system."

A lot of people leave pre-conception health until it is too late, it is not just about having a baby, it is about having a healthy baby, says Schliebs.

In terms of childbirth, your mental focus of getting through the pain of labour doesn't seem far off from the pain of getting your body fitter and healthier.

"Labour is call labour because it is hard work, so there is a level of stamina that is needed as such, a lot of that has a lot to do with how you go into the birth, your expectations," she says.

"For some women it is similar like running a marathon, mentally it's going through it saying I know this is going to be difficult but I am going to deal with that and get through it."

I figure the same can apply to making the decision to put down the chippies and get to the gym after work instead of vegging on the couch. So come on ladies - who is with me?

Need some motivation? So we need to eat better, get fitter, stress less and get mentally prepared for this. How can we all help each other? What are your thoughts and how can the Essential Mums community help? Any questions? Issues you would like me to cover? email me melody.mccabe@essentialmums.co.nz

- Essential Mums

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