You’ve Decided You Want a Baby—Now What?
By Cris Pearlstein
You’ve decided you want a baby—now what? Unfortunately deciding is only half the battle. Once that decision is made there’s a lot to consider when it comes to how to prepare your body (and mind!) for such an undertaking. We caught up with Dr. Mary Jane Minkin, an OB-GYN who has been practicing for over 40 years. Below she breaks down everything you need to know about what to do and what to expect while trying to conceive.
What is the first thing couples should do once they’ve made the decision to have a baby?
I would first say congratulations! And then I would say let’s make this the healthiest pregnancy we can. We always recommend that women who are trying to conceive (or getting ready to think about it) start taking folic acid supplementation. A woman who conceives while on extra folic acid significantly reduces her chances of having a baby with a neural tube defect, along with other defects.
I would encourage a good, healthy diet. A part of that would be avoiding a diet high in fish as there is too much mercury potential. Lastly, The American College of Obstetricians and Gynecologists recommends that couples speak with their OB-GYN healthcare provider in what we call a pre-conception visit. The purpose of that visit is to speak about some of these issues, to review medical conditions, and to go over the medications a woman may be on that may not be good for a pregnancy (particularly some blood pressure medications and some anti-seizure medications).
According to the CDC almost 65% of American women use contraception. What’s your recommendation when it comes to going off oral birth control or LARC as far as the timeline for pregnancy goes?
If it’s combined hormonal contraception, stopping a couple of months in advance is ideal. Use a barrier method (i.e. condom) until you’re ready to “go for it”. I have a similar recommendation for the removal of an IUD as well. The one thing you should do in advance is to stop Depo-Provera because it can hang around longer than hormonal contraception. Make a plan with your provider about what contraception method to switch to and when.
Do you have any health tips for women who are hoping to have a baby in the next 6 months to a year? Do you have any advice for maximizing their chances of getting pregnant?
I would start as soon as I knew I wanted a baby to lead the healthiest lifestyle possible—even if that means years in advance. Ideally I would want someone not smoking (and in practical terms, the less the better). I would avoid drinking, too. Now I think it’s OK to toast the bride at your cousin’s wedding, but once you are seriously trying to get pregnant, the least possible alcohol is ideal. And of course, no drugs. Cocaine is particularly very hazardous to a pregnancy. The American College of Obstetricians and Gynecologists suggest that marijuana shouldn’t be used either. For the record, fathers (or partners) should try to do these same things. These habits will lead to the healthiest sperm.
It’s good to try to help minimize stress leading up to and during pregnancy. Meditation, yoga, or any other relaxation technique that works for you I recommend. And of course, regular exercise which is good for the body and the mind.
What methods of ovulation tracking do you think are best?
I’d first just try to have a good time. Timing intercourse around mid-cycle is ideal. If you want to be more exact, ovulation predictor kits (sticks) are a good method. And since having sex on a timed schedule can be stressful, and you might need lubrication to help. I would recommend Pre-Seed, a lubricant which is sperm-friendly and designed for use during conception. Many lubricants are not, so avoid them.
Purchasing multiple pregnancy tests can get expensive. And with all the packaging that comes along with them, they can begin to feel wasteful, too. When do you recommend a woman take a pregnancy test?
I like the First Response home pregnancy test kits. They can detect pregnancy as early as six days before the first day of the missed period. If you want to wait a bit longer you can, but one advantage of finding out early is that a positive pregnancy test tends to reinforce good lifestyle behaviors. First Response makes multi-test packs, if women want them, which cuts down a little bit on the waste. With all pregnancy tests always read the instructions first.
How long should the average couple try on their own before seeking out additional intervention like a fertility specialist?
Women who are under 35 can wait a year before seeking out medical consultation. If a woman is over 35, we encourage her to seek medical evaluation if she has been trying for 6 months or more.
Mary Jane Minkin, MD is a practicing gynecologist in New Haven, CT with over 40 years of experience. She serves as Clinical Professor of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine, and is the founder of MadameOvary.com, Dr. Minkin is nationally known in the field of gynecology, and is often interviewed and quoted in the print and broadcast media, including the New York Times, Wall Street Journal, Time, along with People Magazine, and BuzzFeed.