Preconception Preparation

Are you in the “Waiting to Try to  Conceive” time period of your life? Many women who are thinking about trying to get pregnant will make significant lifestyle changes towards this goal. Some common first steps include:

• Quitting smoking, drinking, and any drug or substance use.
• Beginning an exercise program.
• Taking prenatal vitamins daily.
• Eating a nutritious diet.
• Scheduling a preconception visit with your midwife or OB/GYN.

These are wonderful first steps to take. However, I would go a few steps further to address two issues that aren’t as commonly recommended toward your TTC/preconception time period.

1) Familiarize yourself with the Fertility Awareness Method (FAM).

FAM is a great way to get to know your body, whether you are trying to conceive a child, trying to avoid pregnancy, or just wanting to get a better understanding of your gynecological health. It teaches you to recognize and interpret your body’s natural fertility signs. If you are in the preconception time period, FAM will help you to know 1) if you are ovulating regularly, 2) how to predict when you will ovulate so you can  properly time intercourse, and 3) if you are having any potential fertility problems. The last reason is a big one, because it can give you information to take to your fertility doctor, and it can potentially save you lots of time, money, and extensive testing by helping you to identify or rule out certain issues more easily. While FAM can’t guarantee a quick conception, it does give a lot of information that can make your odds of conception more likely.

Want to find some great places to start learning about FAM? Try Fertility Flower (FF), which I recommend for its holistic focus and its personal feel. It offers a blog, forums, and the ability to chart your cycle online to observe your patterns of fertility. However, I have found that Taking Charge of Your Fertility(TCOYF), which is not as holistically minded, is stronger in its extremely active community and streamlined online charting. I use both sites for different reasons- FF for keeping me on track with eating real, nourishing food and paying attention to how I am feeling in all aspects throughout my cycle, and TCOYF for the visual layout of charting and interacting with other users. Both sites offer free and paid “premium” member accounts.

2) Consider what you’re putting in your body.

I never really knew what “nutrient dense nutrition” meant until about the past year, when I began to explore our nation’s food systems and eating habits. I was alarmed to realize the lack of variety, nutrients, and real food that we actually consume. Much of America’s “food” is more a product of nutritional science than of nature- and we are more deeply entrenched in this problem than you might think. Also, we consume a large amount of toxins through our food, skincare products, and various household items. How does this relate to preconception, you ask?

Well, we need good nutrition for our bodies to function well, correct? And one of our bodies’ natural functions is to ovulate each month. Also, it stands to reason that putting harmful chemicals into our body on a daily basis can adversely affect our body’s performance in the long run. What we put into our bodies can, and often does, affect both our abilities to function as well the quality of the eggs we release. It may not be necessary for every woman to significantly change what she consumes in order to conceive, and conversely, an intense dedication to eating real, nourishing food and throwing out every chemical source may not solve fertility issues for every woman. However, it is most definitely an aspect to consider in the preconception period- and it certainly can’t hurt!

Some of my favorite blogs and websites that address good health to prepare for pregnancy (and just in general!) are Naturally Knocked Up, Modern Alternative Mama’s page on natural pregnancy, and Environmental Working Group. I am still learning about this area, and if you ever come to my home you will see that we are definitely not “crunchy snobs” in these areas. We still have some chemical cleaners, we don’t buy organic all the time, and I’m not above Domino’s pizza. However, we are, as a rule, trying to make small changes bit by bit (that are in line with our budget) that will help our overall health- and hopefully will help us when we’re ready to try to conceive #2!

What about you? Are any of you in the “waiting to try” period? What changes are you making in your lifestyle to prepare for pregnancy? Share your stories!

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Saturday Morning Quote: Join the Minority

“Examine your own views toward the medical caregivers you have dealt with in your life- not just OBs. Korte and Scaer [authors of A Good Birth, A Safe Birth] classify medical consumers by the amount of control they hand over to their caregivers.

• On one end of the spectrum are patients who totally relinquish responsibility for decisions about their bodies to the medical authority. A group of consumers closely related to the relinquishers are those who want to know what’s going on but still don’t want to make the decisions. Most consumers of medical care in North America lean towards these two views.
• On the opposite end of the spectrum, a very few consumers opt out of the current sytem altogether, using self-perscribed regimens for healing, without ever consulting a mainstream medical practitioner.
• A small minority of consumers are somewhere in the middle. They enter into a partnership with their caregiver or view the relationship as one of professional and client, as opposed to patient. These people want to have an active voice in their health care, They view their physician as an advisor who has expertise they can integrate into a plan for health. Join this minority.”

– Natural Childbirth After Cesarean, Karis Crawford, PhD, & Johanne C. Walters, BSN, RN.

Does it Matter How Well You Know Your Maternity Caregiver?

Yes, yes yes!!! I’m sure there are far too many of us who go in and out of our doctors’ appontments without knowing a thing about their personal lives or their general practice philosophy. I would like to argue that it is very important to get to know your maternity caregiver. When I discuss getting to know your provider, note that it is equally important to strive to get to know any doctors in a group practice who might be on call when you go into labor. If you only get to know your own doctor or midwife but he or she isn’t the one there for the big day, then all of this is null.

 Here are some reasons why it does matter how well you know your providers:

1.) How well you know your caregiver is an indication of how familiar you are with his or her philosophy and practices.

If your appointments consist of 10 minutes- blood pressure, pee in the cup, listen to the baby, get your belly measured, head on out- then you don’t know too much about who your doctor or midwife is. An initial interview with your provider can be helpful to get an idea of where he or she is coming from. However, I think it’s even more important to talk and ask questions about her birth philosophy and practices at each appointment. Over time, you will begin to see patterns emerging: active management vs. hands-off watchfulness, natural-birth friendly vs. natural-childbirth-makes-as-much-sense-as-natural-dentistry-minded, or pushy for his own agenda vs. the mom’s preferences taking the lead.

It is imperative that you try to talk to your caregiver about birth issues that concern you as much as you can well before the birth. Make sure you get his or her personal rates of c-sections, episiotomies, epidurals, IVs, etc. If you’re planning a homebirth, get your midwife’s transfer rates. Ask your provider a thousand questions about every circumstance you can think of. If you wait until you are in labor, it will be too late to know what to expect and you will not likely be in a good position to consider your options in the middle of strong contractions.

2.) How well you know your caregiver helps you know how you will work together.

The more you get to know your caregiver and discuss options with him or her ahead of time, the better idea you’ll have of how the two of you work together. If your personalities are always butting heads, then this is a hint that clashes could occur during labor. If your doctor always explains the pros and cons of each procedure and then asks you to make the decision, you have a pretty good chance of him being the same way on labor day. Of course, if you don’t know your caregiver very well, then you have no idea how you will work together for your birth. This adds one more variable of uncertainty to the process of labor and delivery- something that no laboring mother needs. This leads us to our last point.

3.) How well you know your caregiver helps you know how comfortable you will be at your birth.

The better you know your provider, the better you’ll know whether this particular doctor or midwife will make you feel comfortable or uncomfortable at your birth. Perhaps you discover that your caregiver is arrogant and inconsiderate of your desires for birth, or perhaps she is polite but you have differing birth philosophies. If these situations are the case, you may want to consider switching to a different doctor or midwife. You do not want to have to fight for the birth you hope for- you should be entirely supported towards acheiving your goals.

Perhaps, on the other hand, you discover that you and your caregiver are very much on the same page. Wonderful! Ideally, there should be a balance between your caregiver respecting your desires for birth and you trusting your caregiver’s professional training if something goes awry. If you have found this careful balence, then you know that you can be comfortable with your provider during labor and delivery.

Of course, you wouldn’t know any of this if you didn’t get to know your midwife or doctor during pregnancy. You wouldn’t have an understanding of her philosophy, you wouldn’t know what your interaction would be like during labor, and you wouldn’t know whether you would feel supported or be made to feel stupid and incompetent. You would go into labor feeling nervous and unsure of how things would go, and your caregiver might not neccessarily be a symbol of security to you.

If you do know your caregiver well, you will know much better what to expect, and you have the freedom to change who you’re seeing if you decide you aren’t comfortable with what you’re expecting. So, ladies- let’s get better acquainted with our maternity care providers!