By Shawna CohenUpdated May 10, 2019
For every woman who gets pregnant after a night of one too many drinks, there’s another who meticulously plans out every detail of impending motherhood—sometimes years in advance. The majority of us fall somewhere in between: Some might give up smoking but not their beloved coffee, while others will take up yoga as a form of stress relief but get only five hours of sleep each night. With so much information out there (Eat organic! Get acupuncture! Take your vitamins!), it’s easy to feel overwhelmed. The burning question, though, is how exactly do you get your body ready for pregnancy. Here’s how to get into optimal shape before bidding farewell to birth control.
What vitamins should I take before trying to get pregnant? Research shows that taking a daily multivitamin with folic acid dramatically lowers the risk of neural tube defect (NTD), a birth defect of the spine or brain, such as spina bifida and anencephaly, that affects between two and four of every 1,000 babies born in Canada, according to Motherisk, a clinical, research and teaching program. Run out of The Hospital for Sick Children, Motherisk promotes healthy development of the fetus and infants and is a helpful resource for everything from questions about prenatal vitamins to whether it’s safe to take cold medicine while pregnant.
Folic acid, also called folate, is a type of B vitamin that helps the body produce healthy new cells. It’s found in foods such as whole wheat grains and leafy greens, though it’s difficult to get enough folic acid from diet alone (for instance, ½ cup of cooked collard greens would only supply you with one-sixth of your daily recommended dose). Plus, this vitamin can’t be stored in your body. That’s why doctors recommend that all women of child-bearing age take a multivitamin fortified with folic acid (0.4 to one milligram daily), ideally three months before they conceive. In other words, if you’re off birth control or even thinking about getting pregnant, pop a multivitamin to ensure that you’re getting adequate amounts of folic acid—think of it as an insurance policy.
Do I need to change my medication before trying to get pregnant? When trying to conceive, many women assume that prescribed medications, such as antidepressants, or those required for high blood pressure could potentially harm the fetus and are, therefore, a no-no. That’s simply not the case. Yoel Abells, medical director of the Forest Hill Family Health Centre and a family physician practising obstetrics at Mount Sinai Hospital in Toronto, suggests that all women have a pre-pregnancy checkup with their doctor to discuss specifics, including which meds are safe and which to avoid.
For example, certain medications, such as the acne drug Accutane, can pose a risk of birth defects. But the benefits of taking certain drugs for long-term health problems, such as asthma, epilepsy and diabetes, as well as mental health issues like depression and anxiety, generally outweigh any risks. In some cases, doses may need to be altered, which is why speaking with your doctor is key. (Be sure to follow up with your doctor when you are pregnant to make sure that your dosage is still correct.)
While you’re there, be sure to check that your vaccines are up to date. Some diseases, such as rubella and German measles, can be devastating during pregnancy, increasing the risk of birth defects, as well as miscarriage, stillbirth and premature labour. Doctors also strongly recommend that women who are planning to get pregnant get the flu shot each fall, as there is an increased of developing serious complications during pregnancy.
Do I need to worry about my weight before I get pregnant? It’s tempting to think, I’m going to get fat anyway while pregnant, so do I really need to lay off the Lays? Sorry, but the answer is yes. When it comes to pregnancy, body mass index (BMI) matters. According to the American Society for Reproductive Medicine, 12 percent of all infertility cases are the result of “deviations in body weight from the established norm” (or weighing too much or too little).
“One of the most important things when trying to conceive is maintaining a healthy lifestyle,” says Christy-Lynn Cooke, a maternal medicine specialist at the Lois Hole Hospital for Women in Edmonton. “That includes achieving an optimal weight if you’re not already there, which means a BMI of 19 to 25.” (Not sure where you stand? Just Google “BMI calculator.”)
Anything over a BMI of 30 is considered obese, says Cooke, and may cause problems with ovulation, making it more difficult to conceive. The good news, though, is that even a little weight loss will help. Studies suggest that overweight or obese women who lose as little as five to 10 percent of their body weight can improve their chances of conceiving. Similarly, women with a BMI lower than the normal range (less than 19) can have problems conceiving, as they may experience skipped periods or menstruate without having ovulated. If you’re underweight, speak to your doctor about healthy ways to put on some pounds.
What kind of exercise is safe when I’m trying to conceive? There’s a common misconception that getting your body ready for pregnancy includes ditching your workout regimen. You certainly shouldn’t overdo it—now is not the time to start training for that half-marathon—as research shows that training to exhaustion can reduce fertility. However, moderate exercise is encouraged.
“Anecdotally, I find that women who exercise regularly seem to enjoy pregnancy more and lose more weight postpartum,” says Abells. The trick is to get into shape pre-pregnancy so that you can reap the benefits during and after.
For Raquel Cohen, 30, getting active was a priority. “I knew I wanted to get pregnant and I wanted to be healthy, so I found structured ways to make exercise part of my routine,” she says. To make sure she stuck with it, she signed up for a weekly Zumba class and joined a community-based running club, and she found that the added exercise was great for her energy levels. Now, seven months pregnant, she has had to modify her routine somewhat but is looking forward to getting more active again once the baby arrives.
It all comes down to common sense: If you’re already fit, maintain your exercise routine. If you’re overweight or sedentary, build up your tolerance slowly (try cardio and strength training). Swimming can be a great form of exercise that you can continue throughout your pregnancy. This isn’t the time to shock your body with a brand new routine, but stay active and continue on with your usual exercise regimen. (Added bonus: Having a good level of fitness helps with labour, too.)
What is the ideal diet if I want to get pregnant? Whether you’re looking to lose or gain weight, a balanced diet can help. That means avoiding processed foods as much as possible and ensuring that you’re getting enough fruits, veggies, protein and healthy fats.
Neemez Kassam, a Toronto-based naturopathic doctor and an associate professor at the Canadian College of Naturopathic Medicine, says now is not the time to give up entire food groups (unless you consider french fries a food group). “You don’t want to make big, sweeping changes to your diet,” he explains. “A lot of people will go vegetarian or vegan when they never have been, thinking that will help them get pregnant, but there is no data to support that. In fact, most new vegetarians have improper nutrient balances, especially during the first five years. It’s all about nutrient density.”
You want to eat foods with lots of vitamin B12, folic acid and iron, says Kassam. Fortified cereal may combine all three nutrients. For vitamin B12, the best food sources are seafood, beef, lamb, dairy products and eggs. Folic acid can be found in foods such as leafy green vegetables, oranges, beans and lentils. And seafood, nuts, seeds, beef, lamb, beans and whole grains are all high in iron.
As part of her pregnancy prep, Cohen began eating a more plant-based, organic diet. She read up on the Dirty Dozen list, a guide to pesticides in produce by the Environmental Working Group, and prioritized which organic products were worth the splurge (such as strawberries, grapes, apples and spinach). She and her husband also took a closer look at the sources of the meat they ate. “We decided that it was more important to buy hormone-free, antibiotic-free meat products, which we’ll have once or twice a week,” she says. “We’ve also shifted to more of a plant-based diet to keep our budget more manageable and because it’s healthier in general.”
While there was no single piece of information that prompted Cohen to eat this way, it just felt right. “There’s so much about conception and pregnancy that’s completely out of our control,” she says. “Being able to make choices and do things that are within our control makes me feel like I’m doing something proactive and positive for the baby. Generally, I feel better when I eat better.”
Most doctors say there are no proven benefits to eating organic for fertility, but it certainly doesn’t hurt. “Does it make sense to eat products with fewer toxins?” says Abells. “Probably. But the reality is we’ve been doing it for years and kids seem to be OK. There’s no real evidence on that. Eat intelligently and eat healthy, and if you want to go on an organic diet, that’s fine, too.”
Can I still drink coffee when I’m trying to conceive? If you’re a coffee drinker, there is no need to give up your daily fix. However, limit your caffeine intake to 200 to 300 milligrams a day while trying to conceive and during pregnancy, says Amanda Selk, a staff obstetrician and gynaecologist at Women’s College Hospital in Toronto. Translation: one or two regular-size mugs of coffee—not the giant Starbucks ones (keep in mind that a Venti holds 415 milligrams).
While researchers have conducted numerous studies on the link between caffeine and fertility, outcomes vary (mostly because there are too many other factors to consider when looking at a woman’s overall health). However, most research, including a recent large-scale study published in the journal Human Reproduction, found that there is no evidence of a correlation between increased consumption of caffeine and higher miscarriage rates.
I better party now to get it all out of my system before I get pregnant, right? Until those positive lines appear on a pregnancy test, some women are inclined to drink, smoke and party while they still can (trust us, hangovers and babies do not mix). But it turns out, that’s not such a smart idea.
Numerous studies link smoking with reduced fertility. In fact, women who smoke are 60 percent more likely than non-smokers to be infertile. “Smoking can increase the risk of miscarriage,” says Selk. “It’s not good for you, period. It’s better to stop bad habits early.”
The same reasoning applies to alcohol. “We don’t really know what constitutes a safe amount of alcohol in pregnancy, which is why the safest thing is to not drink at all,” says Selk.
When it comes to smoking weed, one eye-opening study out of Australia, published in the journal PLOS ONE, suggests that using marijuana even before pregnancy more than doubles a woman’s risk of premature birth. The takeaway? Save the partying for when your kids finally leave for university (or at least sleep through the night).
Will stress affect my fertility? To prepare for pregnancy, Cohen got proactive about reducing her stress level. Before trying to conceive, she enrolled in a six-week-long, mindfulness-based stress-reduction course at Sunnybrook Hospital in Toronto. “They give you homework: You do regular meditation on your own, which I’ve kept up during my pregnancy,” she says, adding that she’ll devote anywhere from 10 to 45 minutes most days to the practice. “Mostly, it’s about breathing and being in the moment. That’s a life skill that can help you in all sorts of situations.”
Kassam encourages patients to reduce stress in whatever way works for them—there is no one-size-fits-all approach. “It could be walking, cycling, anything,” he says. “I have patients who have done axe throwing in a controlled environment as stress relief. Some were just socializing more with friends.”
While there is no definitive research on the relationship between stress and fertility, most healthcare experts believe that there’s a link. “Though there are no studies to prove it, I’m a firm believer that stress plays a huge role in infertility,” says Abells. “The interplay between mind and body is profound.”