So, you have successfully delivered and weaned your baby – perhaps it was your first child. You may already be considering another baby and wondering what the optimum timing is to undertake a further pregnancy. Here are some areas to consider when planning your next pregnancy.
First and foremost, every pregnancy should ideally be planned, to ensure the best possible outcome for the whole family – including the affect it may have on your last child as well as that on the unborn child. Assuming the family is prepared for another pregnancy, we should start with a physical assessment of the mother, to determine whether the time is right to plan a further pregnancy. A consultation with your physician will help in this process but here are some areas to consider.
Special care and consideration has to be made if a mother has had problems in previous pregnancies or childbirth. If your last delivery was by Caesarean section, then you need to wait for at least one year before embarking on another pregnancy. If you have a history of repeated pregnancy loss, then a thorough medical investigation (including hormonal assays and blood investigations) should be undertaken to exclude autoimmune disease and blood clotting defects. If you had a miscarriage in your previous pregnancy, it is recommended that you wait for regular menstrual cycles to be established for at least three months.
Of course, if you have previously delivered an abnormal baby, then genetic counselling should be undertaken before becoming pregnant again. Likewise, if you have experienced any thyroid hormone abnormality during pregnancy, you should consult an endocrinologist before trying to conceive.
If the mother suffers from high blood pressure, then the hypertension needs to be managed and blood pressure brought down to near normal levels - certain hypertensive tablets should also be avoided during pregnancy and your physician will be able to advise you on this. If the mother is diabetic, then blood sugar control has to be very strict and this would necessitate a switch from insulin injections to medicine in the form of tablets.
If none of the above applies, then there is still a requirement for preconception screening, which should include a cervical smear test and infection screening for hepatitis, rubella and toxoplasmosis.
Of course, the objective is to achieve your optimum state of health before becoming pregnant and this means looking at your nutritional preparation, exercise levels and also your working situation.
This brings us back to the beginning of the planning cycle - before becoming pregnant, you should aim to hit your ideal body mass index. Exercise is an important part of the preparation process and should be light and balanced, with the focus on non weight bearing activity, such as swimming. If you are a working mother, there should be no major concerns as most regular jobs do not adversely impact pregnancy but if you feel there are possible risks, then you should consult your physician.
After all this, you should now be ready and prepared for your next pregnancy.
