Preparing and planning pregnancy. Where to start planning a pregnancy for a woman and a man - stages, medications and recommendations What is needed to plan a pregnancy

Planning a pregnancy is no less important a stage than the period of bearing a child. A woman should be ready to conceive - this is much better than the sudden news that a baby will appear in 9 months.

Where to start in preparing to conceive a child

If you have no idea where to start, take a look at preparatory courses for expectant parents. Both men and women can visit them. If you are theoretically savvy in matters of conception and the course of pregnancy, it will be much easier for you to endure the process of bearing a child.

Preparing for conceiving a child is very important

A woman should prepare for conception at least a year in advance. During this period, it is important to strictly monitor your health, regularly undergo medical examinations and completely abandon bad habits. First, you should undergo a series of tests prescribed by your doctor to rule out the presence of chronic diseases, primarily hereditary ones.

Sports help control your health. Regular exercise in the pool, frequent walks in the fresh air and light jogging have a positive effect on the functioning of the body and, accordingly, help to conceive a healthy baby.

If necessary, lifestyle adjustments are made and special vitamins are prescribed.

Much attention should be paid to choosing a doctor who will help you get examined. He should become a true friend of the family, and for this it is important not only to pay attention to the physical condition of the future parents, but also to support them morally.

The essence of preparing for conceiving a child for men

For a man, preparation is no less important than for a woman. Many diseases can be equally transmitted to the baby from both parents, and bad habits can affect the quality of seminal fluid.

A man should visit a doctor together with a woman; it is advisable to make all decisions together; the doctor should talk equally carefully with both parents.

Only with the participation of both partners is there a high probability of successful conception and a comfortable pregnancy.

Many men like to visit baths and saunas, but in such places the temperature is critical for sperm, so it is better to limit your time in the steam room or completely eliminate it from your lifestyle.

The following advice can also be given to men:

• the optimal time for the maturation of healthy sperm is 2–3 days - this is the recommended break between sexual intercourse;
• In addition to the examinations that the future parents must undergo together, the man should visit a urologist: for the future father, his own examination program will be drawn up and his own course of taking vitamins will be prescribed.

Do not neglect each of these points - any little thing can affect the health of the unborn baby.

How to prepare for pregnancy psychologically

The psychological side of the issue is no less important than the physical one, but future parents often forget about this. Experiences associated with the birth of a baby can negatively affect the health of the mother and the development of the fetus. As a result, progression of various disorders is possible - both reversible and irreversible.

Both when planning pregnancy and during pregnancy, a woman’s calm state is important

First, figure out why you need a child at all. You must make informed and mature decisions because your comfort and the happiness of your family depend on how well your expectations match reality. To check this, answer yourself a few questions honestly.

Do you want a baby at this particular time in your life? Are external circumstances putting pressure on you, such as the wishes of your partner, parents or society? Do you have hidden problems that you are trying to solve with the help of having a child? Are you currently with a person with whom you really want to have a child? You must understand that this person will become a part of your life. Are you sure that your partner also wants children and sees you as a person with whom he would like to spend the rest of his life? Does your partner share your aspirations? Is there free space in your life for a child? Will you be able to allocate space in the apartment, time in your work schedule, energy for upbringing and money to ensure a decent standard of living for your child?

Of course, not every parent has everything necessary to raise a child. Complete financial stability may never come, and this is not a reason not to have offspring. However, this is a good reason to plan how you are going to deal with troubles in the event of unforeseen circumstances. Analyze which of your loved ones you can turn to for help.

A woman must understand how she will cope with the first difficulties after the birth of a child, what she will do when he screams or cries, at what stage he will begin to walk and say his first words. Find reliable sources of information that you can use if you have questions.

Sometimes, when preparing for conception, people concentrate on doctors and examinations, forgetting that every little thing plays a role in this matter. For example, it is important to remember the following habits.

1. Do not harm your body first. Remember that the health of parents is equal to the health of the child, albeit the future one. Everything that harms you (smoking, alcohol, stress) harms your baby.
2. Eat rationally. If your rhythm of life does not include time for proper nutrition, think about whether you have enough time to raise a child. Eat healthy foods rich in vitamins and minerals.
3. Movement is life, and in this case this expression has a direct meaning. Properly structured sports activities will help not only to conceive a healthy child, but also to carry him to term without any problems.
4. Adequate sleep is necessary for every person for complete restoration of strength, rest and relaxation. Good health is impossible without it, as is conceiving a healthy baby.
5. Stress is the biggest danger for modern women, the “scourge” of our days. They surround you everywhere - at school and work, in society and even in the family. Protect yourself from nervous tension as much as possible, otherwise it is fraught with negative consequences - even miscarriage in the early stages of pregnancy.
6. Future parents should not work in harmful conditions. Many industries contain harmful environmental factors - they need to be removed from your life.

Preparing for pregnancy is just as important as actually bearing a child, and future parents should make every effort to conceive a healthy baby.

Ovulation is the process of the release of the female reproductive cell from the ovary into the free abdominal cavity. This phenomenon is observed approximately in the middle of the menstrual cycle - on the 12-14th day from the last bleeding. Ovulation and 1-2 days after it are the time at which conception is possible.

For a quick pregnancy, the expectant mother should know the date of ovulation. A woman can use it, but it may be inaccurate.

To calculate ovulation, a woman planning a pregnancy can rely on subjective sensations - an increase in the volume and change in the consistency of vaginal discharge, pain in the lower abdomen, increased libido. However, more reliable results can be obtained by measuring and performing home tests.

Home ovulation tests are a strip test that measures the concentration of hormones in the urine. There are also special devices that diagnose the release of an egg into the abdominal cavity based on the composition of saliva. The most accurate method of calculating ovulation is to track the dynamics of follicle maturation using ultrasound equipment.

To give up smoking

Preconception preparation for pregnancy must necessarily include smoking cessation. Cigarettes contain many harmful substances that have a negative impact on the body of the expectant mother and child. Carbon monoxide reduces the amount of oxygen in the blood, nicotine depresses the central nervous system, and tars are strong toxins.

Smoking itself significantly reduces the likelihood of conception, since nicotine and other harmful substances have a depressing effect on the internal female organs. Tobacco abuse may be a cause of infertility.

Smoking during pregnancy increases the chance of intoxication of the baby and oxygen starvation. These factors cause retardation of intrauterine growth and development and pathologies of the nervous system of the unborn child. Using tobacco while pregnant can lead to premature birth.

Smoking abuse is the cause of premature placental abruption and intrauterine death of the baby. Nicotine and tar increase the likelihood of a child developing asthma and pathologies of the cardiovascular system. That is why a woman planning a pregnancy is advised to give up cigarettes in advance. Stopping smoking even at the earliest stages of pregnancy does not exclude the occurrence of pathologies in the fetus.

Alcohol exclusion

Like smoking, drinking alcoholic beverages affects the fertility of the female body. Long-term use of ethyl alcohol in large doses can cause ovarian atrophy- the main organ responsible for the onset of ovulation.

Alcohol consumption is a type of addiction, so a woman planning to conceive should give it up in advance. Taking ethyl alcohol has a negative effect on the body of the unborn child.

Even a small amount of beer or dry wine can have irreversible consequences. Ethyl alcohol increases the likelihood of placental abruption and miscarriage. Also, chronic alcohol consumption can cause developmental abnormalities in a child. The nervous system of the fetus suffers the most - children whose mothers took alcoholic beverages lag behind their peers in mental development.

Chronic alcoholism causes fetal hypoxia. It leads to retardation of intrauterine growth and development of the unborn child. Drinking alcohol also increases the likelihood of stillbirth.

The most important things about preparing for pregnancy:

Normalization of body weight

Increased or decreased body weight can cause problems with conception and pregnancy. To determine the normal weight of the expectant mother, you should calculate your BMI (body mass index). Its optimal values ​​lie between 18 and 25. To calculate BMI, divide your weight in kilograms by the square of your height in meters.

Excessive thinness causes female infertility. Fat cells are involved in the exchange of sex hormones; when they are severely deficient, menstrual irregularities and lack of ovulation are observed.

Obesity, like underweight, negatively affects the fertility of the female body. Increased body weight disrupts progesterone synthesis and is a producing factor for polycystic ovary syndrome. Also, extra pounds increase the load on the mother’s musculoskeletal, urinary and cardiovascular systems during pregnancy.

To normalize body weight, a woman planning a pregnancy is advised to maintain a calorie diet. It is also useful for the expectant mother to engage in sports during the period of preparation for pregnancy. Developed muscle tissue has a beneficial effect on the course of pregnancy.

Taking folic acid

Folic acid or vitamin B9 is a substance necessary for normal cell division. Its deficiency during pregnancy provokes defects in the neural tube of the embryo and other pathologies associated with abnormal tissue growth processes.

A woman planning to conceive a baby should start taking folic acid 3-6 months before her expected pregnancy. Lack of vitamin B9 causes pathologies on the mother's side - anemia and bone marrow dysfunction. Also, a deficiency of this substance can provoke female infertility.

Having a gynecological examination

A gynecological examination at the planning stage is the prevention of various complications of pregnancy. It includes a visual and instrumental examination in a chair, a vaginal smear for testing and a hormonal profile.

Preparation after a missed pregnancy or miscarriage should include searching for the reasons for the miscarriage. Quite common causes are genital infections and progesterone deficiency. Both conditions can be eliminated with the help of competent medical care.

Preparation for a second pregnancy after a cesarean section necessarily includes an ultrasound examination of the uterine scar. Its failure can cause organ rupture in the last weeks of gestation or during childbirth.

If a woman is planning to conceive after 40 years of age, she should have her ovaries checked. Quite often at this age, functional atrophy of the organ occurs. Ovarian failure is an indication for the use of a donor egg and IVF.

Genetic consultation

Preparing for pregnancy after 30 years of age should include genetic counseling. This procedure is recommended for women of any age. However, after 30-35 years, the likelihood of congenital anomalies in the unborn child increases significantly. This feature is due to the fact that with age, the mother’s eggs accumulate genetic mutations.

The specialist determines the genotype of a man and a woman, identifying the carriage of pathogenic mutations. The doctor can determine the likelihood of a child developing diseases such as thrombophilia, color blindness, achondroplasia, phenylketonuria, and cystic fibrosis.

Consultation with a geneticist is mandatory for a couple with a history of more than 2-3 miscarriages in a row. Quite often, spontaneous abortion is a consequence of congenital developmental anomalies that are incompatible with life.

Compensation for chronic diseases

Pregnancy is a kind of test of a woman’s body. During pregnancy, the load on all the mother's systems increases. That is why, in order to fully prepare for pregnancy, the expectant mother should compensate for chronic pathologies.

Diseases of the cardiovascular and urinary systems have the greatest impact on the course of pregnancy. Pathologies such as arterial hypertension, chronic renal failure, and coronary disease are especially dangerous.

Also, the expectant mother should compensate for her existing diabetes as much as possible. During pregnancy, increased or decreased blood glucose concentrations have a negative impact on fetal development.

Refusal of hormonal contraception

At this stage of medicine, the exact effect of oral contraceptives on the development of the unborn child is unknown. A woman planning a pregnancy should stop taking hormonal pills in advance - at least for one menstrual cycle.

After discontinuation of the drugs, the woman’s body returns to independent hormonal regulation. This process may take several months. When oral contraceptives are discontinued, several eggs may simultaneously mature in the first cycle. This may result in the conception of two or more children.

Financial questions

Raising a child is a very expensive process. That is why, before the intended conception, parents are advised to resolve all financial difficulties and pay off debts. Spouses should have a “safety cushion” in case of unexpected expenses.

Psychological preparation

Before conceiving, the expectant mother should be mentally prepared for the upcoming pregnancy. The pregnancy process can be complicated by various pathologies; a woman should be aware of them and be prepared for their occurrence.

Psychological preparation consists of a positive attitude and avoiding stress. Negative thoughts of the expectant mother increase the chance of unsuccessful attempts to conceive. Emotional stress and anxiety can cause disruptions in the menstrual cycle and lack of ovulation.

Taking a family history

A predisposition to many complications of pregnancy and childbirth can be inherited. When planning to conceive, a woman is advised to talk with her relatives about pregnancy.

Weakness of labor, gestational hypertension and diabetes mellitus are only a small part of the pathologies that have a genetic predisposition. The expectant mother should be aware of possible problems and be prepared for their development.

Diet is one of the factors for successful conception and easy pregnancy. A woman should get used to dietary restrictions in advance, since during pregnancy it will be difficult for her to give up her favorite and tasty food.

The daily diet of the expectant mother should include a sufficient amount of protein. Their best sources are lean meats, poultry and fish, as well as eggs and dairy products. A woman planning a pregnancy is recommended to eat cereals, cereals, fresh vegetables, fruits and berries, as well as nuts.

When preparing for conception, the expectant mother should limit the consumption of processed foods, smoked, fatty and canned foods. She is also advised to reduce the amount of chocolate and other sweets in her daily diet.

Taking vitamin E

Vitamin E or tocopherol is responsible for the maturation of the eggs of the expectant mother. Its deficiency in the diet can cause infertility. The largest amount of vitamin E is found in food of animal origin - chicken eggs, milk, meat, liver. However, tocopherol is also found in plant foods - sunflower oil, almonds, walnuts, rowan, and rose hips.

With a severe lack of vitamin E, a woman may experience various symptoms. These include dry skin, decreased visual acuity, brittle nails, absent-mindedness, spots on the skin. In this case, the expectant mother is recommended to take tocopherol preparations.

Going to the dentist

During pregnancy, the condition of teeth deteriorates. This feature is associated with an increase in the need for calcium and fluoride, which are spent on the growth and development of the baby. If the expectant mother has minor caries, it may progress sharply during pregnancy.

Also, caries and other oral diseases are a source of bacterial flora. There is a risk of pathogen migration to other organs, including the fetal membranes. The possibility of bacteria moving throughout the body is associated with a decrease in the expectant mother’s immunity.

During the period of bearing a baby, it is prohibited to use many types of painkillers. Analgesic drugs can cross the placenta and have a negative effect on the fetus. That is why it is preferable to cure existing diseases of the teeth and gums before conception.

Dr. Komarovsky about preparing for pregnancy:

Communication with your spouse

When preparing for pregnancy, expectant parents are encouraged to communicate with each other about planning a child. Such conversations strengthen the emotional connection between spouses and allow them to get to know each other better. Also, during communication, you can draw up a rough plan for raising your future baby, based on the preferences of both parents.

It is useful for the expectant mother to find out her partner’s attitude towards the baby before conception. Sometimes she will have to reconsider her views on certain things and come to compromises with her husband. Solving everyday problems after pregnancy can lead to quarrels and misunderstandings.

Studying specialized literature

Before the planned conception, the expectant mother is recommended to carefully study all the nuances of the process. A woman should become familiar with the mechanisms of fertilization, the course of pregnancy, and the upcoming birth. Knowledge helps you prepare for bearing a baby and not be afraid of various problems.

Also, a woman planning a pregnancy is recommended to study books and films on raising and caring for children. The expectant mother should know in advance the rules for feeding, washing and swaddling the baby.

Preparing for pregnancy for men

The processes of conception and gestation depend not only on the woman, but also on her partner. The quality of male seminal fluid is influenced by many factors - nutrition, smoking, alcohol intake, stress, physical activity. To identify pathologies of the reproductive sphere, the spouse is recommended to take a spermogram. This analysis will show the quality and quantity of male germ cells.

Sperm are renewed in 2-3 months, which is why a man should lead a healthy lifestyle before the expected conception. To improve the quality of seminal fluid, it is recommended to eat a balanced diet and avoid alcohol and smoking.

Also, men should not visit baths and saunas or take hot baths. High temperature provokes the death of sperm. To improve the quality of seminal fluid, a man is recommended to use the vitamin complexes Spematon or Pregnoton.

The expectant father should be tested for sexually transmitted infections. Some of them may have a secretive course and not be transmitted to a woman. However, during pregnancy, the mother's immunity decreases, which increases the likelihood of infection.

Preparing for any big undertaking makes life a lot easier.- and pregnancy is no exception. Carrying a baby is inevitably stressful, but planning can help keep it to a minimum. However, not all women who are thinking about having a child have someone to look up to, and the first trip to the doctor can even be scary for some. Last week we already raised the issue during pregnancy. This time we asked obstetrician-gynecologist Natalya Ivanova, as well as the founders of the MedOC clinic network, Elya Logina and Lisa Maslova, about how, in principle, to approach such an important and difficult life stage as pregnancy and childbirth: why planning is needed, what you should prepare for and what prejudices you shouldn’t believe.

Dasha Tatarkova

Why plan a pregnancy
and how to do it

An unplanned pregnancy naturally becomes a cause for stress, since parents did not necessarily lead a lifestyle focused on the health of the unborn child. However, this can be avoided - this is exactly what pregnancy planning is for: it helps to conceive and bear a healthy child. Preliminary tests and treatment will not take much time and will not be so expensive compared to correcting various complications later, when the child is already conceived. Psychological determination is also important so that the future parents or parent is prepared. Planning has existed abroad for a long time, but our doctors have openly supported and promoted this approach in recent decades.

The most important thing is health prevention. Roughly speaking, you need to prepare for pregnancy throughout your adult life. This is not as scary as it sounds, you just need to undergo a minimum examination by a gynecologist at least once a year, donate blood for hormones, in order to be confident in the processes occurring in the body and treat diseases in a timely manner. Preparations for a specific pregnancy should begin at least three months before the expected conception - both from a psychological and physiological point of view. Everyone who will take part in the life of the unborn child must be aware of their responsibility. You should not put off going to a psychotherapist if you have doubts: the birth of a child is associated with a large psychological burden, and consultations with a specialist before pregnancy will help you make an informed decision.

Everyone who will take part in the life of the unborn child must be aware of responsibility.

Pregnancy is a difficult condition for the body, and before it you need to gain strength by gradually improving your lifestyle. You should not sit in a confined space and wait for pregnancy to occur. This is a good chance, in principle, to start living healthier: get enough sleep, walk in the fresh air, get regular physical activity, eat a balanced diet and give up bad habits, including alcohol and, of course, smoking. Most likely, you will need to take vitamins, but all prescriptions should be made by a doctor, since hypervitaminosis is no less dangerous than a lack of vitamins - the same is true for minerals. If you need help quitting smoking, you can always consult a psychologist.

Already at the planning stage, you need to choose a clinic and a gynecologist who will treat you as a patient and send you for a full general examination to other specialists: an ENT specialist, an ophthalmologist, a dentist, a neurologist. If you have been seeing a specialized doctor for a long time, you should also discuss your future pregnancy with him. It is important to pay attention to dentistry because tooth decay and dental disease mean the presence of a chronic infection that can affect the child's health.

Can diseases become
contraindication for pregnancy

Various diseases and conditions can affect pregnancy. For example, some medications are strictly prohibited for pregnant women, so when planning a child, a woman must tell about all the medications she is taking or has taken recently. There are many contraindications in the early stages, when the fetus is especially vulnerable. The easiest way to reduce the risk is to carefully read the labels and not take medications marked “As prescribed by a doctor,” even if they are seemingly safe herbal remedies.

Medicines prescribed to women with depression or other psychological disorders may not be compatible with pregnancy. Their use should be discussed in advance with the attending physician and, if necessary, the medication should be changed; the obstetrician-gynecologist should also know about them. In the event of an unexpected pregnancy, you should not stop taking medications on your own and should immediately consult a doctor.

HIV-positive women can conceive and give birth to a completely healthy child. There are a lot of discordant couples, when one of the parents is infected and the other is not. Such patients receive preventive treatment and successfully give birth under the supervision of doctors. They arrive for childbirth with special medications. If a woman has cervical cancer, she gives birth by cesarean section. HIV-infected women are also required by law to undergo surgery: it is believed that a caesarean section reduces the risk of infection of the child. At the same time, she can write a refusal and give birth naturally - the same applies to breastfeeding.

How to choose a doctor and clinic

When choosing a clinic, you need to understand that the relationship between the patient and the doctor should be a partnership, and nothing else. In no case should the patient feel like a begging party, and the doctor should not show condescension; the woman should have confidence in the doctor on a subconscious level. The doctor should always explain everything in simple language, telling in detail why and why examinations, medications and procedures are prescribed, and not just present a fact.

When choosing a doctor, you can focus on your psychotype. To those who are used to strictly conducting business, a cheerful doctor may seem unprofessional, and vice versa. Over the course of nine months, the patient will need to feel free to openly discuss everything with her doctor, sometimes call him at night and ask questions - so it is important that they both feel psychologically comfortable with each other. Ideally, you should first choose a clinic, and then choose a doctor based on your psychotype. This is also possible in a regular antenatal clinic: to do this, you need to write an application addressed to the head with a request to transfer you to another doctor.

What tests need to be taken?

According to the standard scheme, you need to pass all general tests: routine and biochemical blood tests, urine analysis. Be sure to be tested for sexually transmitted diseases and ToRCH infections. If the test results require treatment, it should be done before pregnancy. Under no circumstances should you conceal information about past STDs: there is nothing to be ashamed of - the doctor should be aware of all the details.

ToRCH is an acronym for the names of infections: toxoplasmosis, rubella, cytomegalovirus and herpes. Pregnancy reduces immunity, which in turn can lead to the activation of processes that are already running, but proceed in a sluggish form. ToRCH infections have the most detrimental effect on the development of the unborn child's systems. So, if during an unexpected pregnancy acute rubella is detected, then, unfortunately, it is recommended to terminate the pregnancy. Toxoplasmosis, which cats carry, is also dangerous. To avoid contracting it during pregnancy, it is best to have someone else clean up after your pets.

Cervical cancer and breast cancer are the fourth and first most common cancers in women, respectively, which is why it is so important to undergo regular screening. Before pregnancy, Schiller or more sensitive tests are required to see the presence of changes in the cervix; you also need to find out whether relatives have had cancer of any location. It is worth getting tested for human papillomavirus: it is not known for sure whether HPV causes cancer, but studies show that all women with cervical cancer have it. Modern techniques, including genetic tests, make it possible to accurately determine whether a woman has a predisposition to cancer.

When planning a child, not only the expectant mother, but also the father should pay attention to her health. Men must be tested for STDs, ToRCH infections, and be examined by a general practitioner and urologist. Male infertility is a common phenomenon, partly due to the fact that inflammatory diseases in men are not so acute, they can simply be overlooked or undertreated.

If there is such a possibility, then on the eve of pregnancy it would be good to do genetic tests to eliminate the danger of the most common hereditary diseases. Some people need to do this without fail. For example, women over 35 years of age, those who have frequent miscarriages, and those who have children with chromosomal abnormalities in their family need to be tested to exclude chromosomal diseases. If you have already had an interrupted pregnancy, you should also tell your doctor about this.

How does a woman's age affect
for pregnancy

The popular opinion that after 30 years a woman is considered “old-born” has long been outdated. Nowadays, women generally tend to give birth later. This is explained by a variety of factors, including the level of medicine. The achievements of modern science allow a woman of reproductive age to worry less that she will not have time to give birth to children if she does not start at some specific moment. If a woman is healthy, fully examined, and has financial and psychological readiness, then there is no reason not to conceive a child.

You need to understand that throughout our lives we pick up various infections and suffer diseases of varying severity; some diseases become chronic. The age of 35, which doctors define as women at higher risk of pregnancy complications, is an approximate age; nothing specific happens between 34 and 36. However, it has been statistically established that the majority of chromosomal abnormalities in the fetus and cases of miscarriage occur in women over 35 years of age.

What can cause infertility

Infertility is the inability to conceive a child during the first year of regular attempts. Until the age of one year, there is no need to worry, especially if sexual activity is not very frequent. After a year of fruitless attempts, you need to start getting tested: first of all, for men, because they are easier to examine - the female reproductive system is much more complex. A man must be tested for infections and have a spermogram.

Then the study of the woman's health begins. It includes everything mentioned above: analysis of the mammary glands, ultrasound, tests for flora, HPV, chlamydia, ureaplasmosis, leukoplasmosis, genital herpes - all this can affect the possibility of conception. Examination of the cervix is ​​done using a microscope, because changes are not always visible to the naked eye. A common cause of female infertility is previous inflammatory diseases. Blocked fallopian tubes or cervical inflammation caused by HPV infection also affect your ability to conceive.

Everything in our body is regulated by hormones, so infertility can also be caused by hormonal diseases that prevent the egg from maturing. In this case, you can stimulate ovulation - cause superovulation. It happens that a woman cannot become pregnant for psychological reasons, since high levels of stress also affect hormonal processes. For the same reason, women often become pregnant after adoption - the psychological block that was put up by constant unsuccessful attempts is removed.

Do's and don'ts
during pregnancy

Pregnancy is not a disease. You should not believe the superstitions that during pregnancy it is best to lie still for nine months. Nothing like that - play sports and live life to the fullest. If the pregnancy was planned, everything proceeds without pathologies and the woman feels well, then there is no need to change her usual lifestyle. If you have been involved in sports, then continue, the main thing is not to go to extremes. Ride a bike, eat your favorite food, have sex; many feel great while driving until the very last weeks.

From the first days of pregnancy, you should not steam your feet, apply mustard plasters and cupping, or go to the bathhouse - an increase in temperature can negatively affect the fetus. Running in the first and second trimester can even make pregnancy easier, but strength exercises can increase the tone of the abdominal muscles, so just in case, physical activity should be discussed with your doctor. Swimming is generally recommended because water significantly reduces the stress on muscles and joints. If there is no threat of termination of pregnancy and placental abruption, then you can fly on an airplane for the entire period. Another question is that airlines will not allow you on board after 7 months according to their rules.

The popular recommendation to be careful when coloring or perming your hair did not arise by chance: during most such procedures you have to breathe in the acrid smell of ammonia. If the procedure is gentle enough and the room is well ventilated, you can dye your hair.

Your body will certainly change during pregnancy. The standard weight gain is 10 kilograms, but everything is very individual, and the smaller the initial body weight, the greater the gain will be. Changes are not limited to weight: drowsiness, shortness of breath, frequent urination, swelling, age spots appear, which usually go away on their own after pregnancy; in the first months the perception of familiar tastes changes, and in the last months insomnia occurs. On the positive side, women often note how strong their hair and nails are and how quickly they grow; many have improved skin condition, but acne may also appear. However, hormonal changes manifest themselves differently in different women.

Doctors should not intimidate patients with all possible complications under the sun. Most likely, none of them will happen to a pregnant woman, but the psychological state will be compromised - the woman will be afraid all the time. The risk of absolutely all complications cannot be excluded. However, the doctor must explain the most likely risks depending on the medical history and characteristics of each specific pregnancy. If there is anything to be wary of, it is depression during and after childbirth. This is a very real problem that cannot be ignored and can be helped with. You need to monitor your mood, listen to yourself and not attribute your experiences to hormones alone.

What to do in each trimester

The first trimester is mainly about tests, the second is about highly specialized doctors, and the third is about constant communication with a gynecologist. The frequency of visits to the gynecologist is determined by the course of the pregnancy itself, but the standard is 12 visits. The further along the pregnancy, the more frequent the meetings become.

First, the pregnancy must be correctly diagnosed: check the growth of the hCG hormone, and also make sure that the pregnancy is intrauterine. At the eighth week, the fetal heartbeat should be heard. After this, you need to go through all the tests again: pregnancy affects all systems of the body. Before 12 weeks, Prisca is examined for chromosomal abnormalities, at which point it is possible to determine the possibility of abnormalities in the development of the fetus. In the first weeks, the health of the unborn child is laid down and he is especially sensitive to adverse effects.

After 12 weeks, in the second trimester, highly specialized doctors should identify possible problems that could affect the course of pregnancy. It is convenient to do this at this particular time, since the fetus is not so vulnerable. After 20 weeks, an exchange card is issued - the main document of the pregnant woman. You should always carry it with you so that in case of unexpected hospitalization, the doctor knows about all the tests and features of the course of pregnancy. If it is not present during childbirth, the woman will be placed in an observational department for unexamined women and women with pathologies.

Childbirth is a collaboration between woman and doctor

In the third trimester, people most often want to see a gynecologist. CTG is done - a study of the fetal heartbeat - and Doppler, showing how the fetus is supplied with oxygen. Nowadays you can easily buy a gadget that allows you to listen to your child’s heartbeat at home through headphones. This, of course, is not a professional examination, but for your own peace of mind it is quite suitable.

Managing a pregnancy and delivering a baby are like two different specialties: it rarely happens that one specialist does it. Most likely, the doctor leading the pregnancy will recommend a colleague whom he trusts. Many people enter into contracts for childbirth with a specific doctor or hospital, but this only guarantees services. Any doctor is interested in ensuring that the birth is successful both from a legal point of view and simply from the point of view of professional ethics - with or without a contract. Childbirth is a collaboration between two people: a woman and a doctor. As with pregnancy management, it is important to establish contact here - this also affects the success of childbirth.

Should you be afraid of epidural anesthesia?
and caesarean section

Many women are afraid of epidural anesthesia, but when they realize how painful it is without it, it is too late to administer the drug. There is no need to be afraid of anesthesia. No one in the maternity hospital is interested in harming the child or the woman. Now there are schemes for selecting anesthetic drugs in certain doses so that they do not cause any harm. Prejudices that with an easy birth the child will turn out to be purposeless do not stand up to criticism at all.

Nowadays there is a very high percentage of caesarean sections all over the world. Young doctors are afraid of legal consequences, and because of this fear they opt for a cesarean section, since obstetrics is the most “complicated” branch of medicine. For some doctors, it’s easier to stand at the operating table for half an hour than to conduct a birth for 24 hours. Obstetrics is the art of predicting childbirth and catching the subtle moment when vaginal birth is fraught with complications, and only then resorting to cesarean.

Strict indications for cesarean section are, firstly, a longitudinal scar on the uterus, that is, if the woman has already had a cesarean section once. In this case, it is simply impossible to give birth through the natural birth canal: uterine rupture can occur at any time, and it is almost impossible to determine the presence of a rupture - and not all maternity hospitals are provided with means of quick assistance in case of bleeding. Secondly, a cesarean section can be planned: for placenta previa, for HIV-positive mothers, for women who have had cervical cancer, for a particularly narrow pelvis or a large fetus, and so on. An emergency caesarean section is prescribed, in particular, if contractions have begun, but labor does not progress for a long time.

Childbirth through the birth canal, if there are no contraindications, is of course preferable for both mother and fetus. Firstly, the woman is not left with a scar on the uterus and she will not have the risk of much more severe postoperative and post-anesthesia complications. This is also good for the child, since he is gradually preparing for life outside the mother’s body, passing through the birth canal. There is also a danger that the child will have an excess of anesthesia during a cesarean section. It is somehow impossible to play it safe here - you can only rely on the competence and professionalism of the doctor.

Update: December 2018

Pregnancy is a wonderful and very exciting time for any woman. In order for all 9 months to bring joy and a feeling of pleasant anticipation, pregnancy needs to be planned. Preparing for an interesting situation will not require a lot of time and money, but will make a big contribution to the health of mother and child.

The term “family planning” and “pregnancy planning” is familiar to many. These concepts include several main points:

• adequate contraception before planned pregnancy
• maintaining a healthy lifestyle for expectant mothers and fathers
• necessary studies and tests before conception
• taking certain medications in preparation for and during pregnancy
• correct psychological attitude of future parents

The following algorithm will tell you where to start preparing for pregnancy:

Algorithm for preparing for pregnancy

Psychological preparation

An important factor in a successful pregnancy is its desirability. Moreover, both parents must have the desire to have a child. It has been proven that an unhealthy psychological situation in the family often prevents the arrival of the long-awaited moment. But excessive “obsession” with future offspring does not bring any benefit. When planning, you need to continue to live a fulfilling life, have a job, engage in hobbies and take your mind off thoughts about pregnancy.

Rejection of bad habits

Everyone knows that smoking and drinking alcohol during pregnancy are associated with high risks for the baby. Women with bad habits are more likely to experience miscarriages, stillbirths, miscarriages and the birth of low-birth-weight children (see).

In addition, maternal smoking is not only associated with an increased risk of bronchial asthma in the child, smoking causes significant harm to the baby’s immune system by changing the structure of DNA. Drinking alcohol leads to fetal alcohol syndrome (a combination of special facial features, low birth weight and mental retardation).

Therefore, it is better to end bad habits before the planned conception. In addition, alcohol and nicotine can lead to changes in the egg and sperm, which in itself is associated with and.

Correction of chronic diseases

Many chronic illnesses common in our society are successfully controlled and do not interfere with pregnancy. Diabetes mellitus, hypertension, epilepsy, kidney disease - all this is a reason for a thorough examination before pregnancy. Some drugs needed for such diseases need to be replaced with ones that are safer for the fetus. Sometimes it is necessary to adjust the dose or frequency of taking the tablets. If for some reason the disease is not currently compensated (glucose levels are off the charts, blood pressure is jumping, epiactivity persists, etc.), it is better to postpone pregnancy until the causes of decompensation are clarified.

Elimination of harmful household and industrial factors

Working in hazardous industries (paint and varnish industries involving heavy metals and pesticides) can lead to complications during pregnancy and deterioration in a woman’s health. Therefore, when planning a conception, it is important to change work to less harmful and difficult work. The same applies to household hazards. Pregnant women often have a desire to renovate their nursery. Therefore, it is better to carry out all the finishing work in advance, before conception, while avoiding severe physical stress.

Reduce the use of household chemicals to a minimum, avoid the excessive use of chlorine-containing cleaning and detergents in everyday life, switch to using products you make yourself from baking soda, laundry soap, vinegar and other safe and forgotten products (see).

Weight correction

Obesity is the scourge of all modern society and the cause of many serious diseases (hypertension, diabetes, atherosclerosis and even cancer). But another important consequence of excess weight is problems with pregnancy and pregnancy. Excess kilograms change, increase blood pressure, strain the kidneys, and weaken a woman. In such conditions, pregnancy is difficult.

If the attempts are still successful, then the fetus suffers from chronic hypoxia, and the expectant mother risks getting a hypertensive crisis or ending the pregnancy with preeclampsia. That is why all obstetricians advise normalizing weight before pregnancy. Usually, this requires a correction of diet and rational physical activity. In rare cases, special medications prescribed by a specialist are required.

By the way, pathologically low weight also does not contribute to the onset of a normal pregnancy. To determine the norm, you can use the body mass index: BMI = weight (kg) / height 2 (meters). The normal index ranges from 18.5 to 24.9.

Proper nutrition

For pregnancy, pregnancy, and long-term lactation, it is very important to eat a nutritious and balanced diet. The diet of a woman planning to become a mother should include cereals, vegetables and fruits, meat (red is a must), eggs, fish, and a sufficient amount of liquid. But it's even more important to avoid foods that could potentially harm your unborn baby. After all, during the planning process it is impossible to say exactly when pregnancy will occur. Therefore, you need to behave as if an interesting situation has already arrived.

A pregnant woman (and therefore one who is planning to become pregnant) should exclude the following foods from her diet:

• Poorly cooked meat and fish
• Unpasteurized milk
• Dishes with raw eggs
• Unwashed vegetables
• Soft cheeses made from unpasteurized milk (brie, feta)
• Hot dogs and processed foods
• Sweet carbonated drinks
• Large amounts of coffee (more than 6 cups per day)

These simple rules will help protect against infections and improve the health of the body before planned conception.

Analyzes on TORCH

Before pregnancy, you should definitely get tested for a group of infections that are especially dangerous for pregnant women, grouped under the acronym TORCH:

• Some other infections (viral hepatitis B and C, syphilis, HIV infection)

Tests for toxoplasmosis, rubella, CMV and herpes are carried out for all pregnant women in the form of antibody determination. But it will be much easier to interpret the results, assess the risks, and determine the need for treatment if the levels of these antibodies before pregnancy are known.

To determine the activity of immunity in relation to TORCH infections, it is necessary to donate blood for immunoglobulins M and G. The former increase during primary infection, persist during the acute period of the disease and then gradually disappear completely. The second means the formation of an immune response to the invasion of infection; they arise some time after infection, then decrease to a certain level and persist for a long time, sometimes throughout life.

On the test results form you can see the following symbols:

• IgM - negative (less than reference values), IgG - negative

In such a situation, the woman has never encountered this infection; she has no immunity. In the case of rubella, it may be recommended to get vaccinated against the disease six months before pregnancy. Negative immunity to toxoplasma is a reason for careful heat treatment of food and reducing contact with cats. Similar results for CMV and herpes require examination of the partner and careful attention to the prevention of sexually transmitted infections, as well as limiting communication with children attending preschool institutions.

• IgM – negative, IgG – positive

The analysis data indicate immunity to infection. Perhaps the woman was ill in the past, or immunoglobulins were developed as a result of vaccination (against rubella, for example). In any case, the fetus will be protected by the mother's antibodies from a dangerous infection. Do not forget that there is an extremely low probability of a baby becoming infected during an exacerbation of a chronic asymptomatic infection (CMV, for example). But the risks of this are negligible.

• IgM – positive (at any IgG values)

Typically, these results indicate a current acute infection. During pregnancy, this conclusion is made after additional examination and special tests. When preparing to conceive a child, the presence of IgM is to postpone pregnancy until the disease subsides and stable immunity is formed (confirm this with a repeat test).

Ultrasound of the pelvic organs

Ultrasound examination is an informative, safe and inexpensive way to diagnose serious and not very serious diseases. With its help, you can detect large fibroids, endometrial and cervical polyps, cancer of the genital organs, and large ovarian cysts. Before pregnancy, all these conditions must either be treated, removed, or ensure that they are safe for the baby. In addition, ultrasound can often detect ovulation. This is especially helpful for women with irregular or long menstrual cycles. By finding out the approximate day of ovulation, a woman’s preparation for conceiving a child will be better.

Determination of TSH level

Thyroid-stimulating hormone is a substance that regulates the functioning of the thyroid gland. If there are disturbances in its functioning, TSH rises or falls. It is known that (reduced thyroid function) has a detrimental effect on the development of the baby, leading to mental development disorders. Therefore, it is important to identify this condition before pregnancy. An elevated TSH level (more than 2.5 mU/l in a non-pregnant woman) is often an indication for taking Thyroxine. The dose of the drug is prescribed by the attending physician, adjusting it when pregnancy occurs. In some cases, additional tests may be necessary. TSH is the only hormone needed to be tested when planning a pregnancy for every woman.

Taking folic acid

Numerous studies have proven that even in its first months it reduces the likelihood of fetal malformations (neural tube defects). Until recently, these defects were widespread, leading to the death of the fetus and newborn, as well as to severe disability of survivors.

Some such defects are visible even before birth (anencephaly - the absence of most brain structures), and some are closed and reveal themselves many years later with back pain, shortened limbs, scoliosis and headaches. The main means of preventing neural tube closure defects is to take folic acid several months before conception and during the first 12 weeks of pregnancy.

Required dosage:

• all healthy women: 400 mcg per day
• women with epilepsy: 1 mg per day
• women with children with similar defects: 4 mg per day

Some medications interfere with the metabolism of folic acid in the body, and therefore sometimes require adjustment of the dose of this vitamin (many anticonvulsants, calcium channel blockers, triamterene, bactrim, phenobarbitals).

When choosing a folic acid supplement, it is important to consider not only the dosage. Recently, this vitamin is often produced in the form of dietary supplements. It is better not to make such purchases. Dietary supplements are not tested for safety, so taking them before and during pregnancy is associated with a great health risk. It is better to purchase a regular medicine - folic acid.

Detection and treatment of iron deficiency

A decrease in the amount of iron in the body, and as a result, hemoglobin, has a detrimental effect on the health of any person. Weakness, brittle nails and hair, increased bleeding of blood vessels, low-grade fever, changes in appetite and many other unpleasant consequences occur. But for a woman in an interesting position, anemia is especially dangerous. It can lead to a more severe course of pregnancy, fetoplacental insufficiency and a decrease in the level of fetal health.

All women planning pregnancy, without exception, are recommended to take 50-80 mg of iron until the end of breastfeeding (see). If symptoms of anemia appear or hemoglobin drops below 110, the dose of the drug can be doubled. To assess iron storage in the body, ferritin levels are used (ideally it should be above 40).

Ferretab is convenient to use for those wishing to become pregnant, as it also contains folic acid. But as prescribed by a specialist, you can take many other drugs of 2-valent iron. It is important to remember that low ferritin without symptoms of anemia is not a contraindication to pregnancy. At any level, iron intake will be recommended for prevention. In addition to this, it is worth including a sufficient amount of red meat, eggs and fish in your diet (see).

Useless actions before pregnancy

Taking multivitamins to prepare for pregnancy

Multivitamin supplements that are fashionable nowadays are usually completely unnecessary (see). After all, among all the vitamins, pregnant women need to take folic acid, as well as two microelements (iron and, in some cases, iodine). The remaining vitamins and elements are prescribed only in cases of laboratory-confirmed deficiency, and in the form of individual medications, not complexes.

Moreover, actively consuming multivitamins and vitamin-containing dietary supplements before and during pregnancy can greatly harm the health of the future offspring. For example, when the concentration of vitamin A is more than 10,000 IU/l, deformities and damage to the fetus occur, and there is some cumulative effect. Therefore, vitamin A intake should be stopped in advance. You must be careful when taking vitamin D, as well as iodine-containing medications.

Complete “preventative” sanitation of the vagina

A routine and banal visit to a gynecologist is a frequent reason to prescribe unnecessary treatment. Some doctors, seeing positive results on the form for gardnerella, thrush, E. coli and other opportunistic pathogens, immediately rush to prescribe antibiotics or antifungals (see).

Undoubtedly, all of these pathogens at high concentrations and obvious symptoms in a woman can complicate the course of pregnancy. But if the same gardnerella does not exceed 10 5 CFU, and there are no less than 10 5 CFU of beneficial lactobacilli, and there are no symptoms at all, no treatment is required! Thoughtless sanitation destroys normal flora, promoting the proliferation of dangerous microbes (see,).

Testing for hormones

Another common way to make a woman worry is to conduct an analysis of all hormones in preparation for pregnancy. The dubious list usually includes androgens. All of them increase or decrease during a woman’s life, and even within one menstrual cycle, within individual boundaries. Therefore, even with a diagnosis of infertility, when there were signs of ovulation on ultrasound, examination for these hormones is not necessary.

Basal temperature measurement

The method, widely used in the past, was used to detect the day of ovulation. It is based on increasing the woman’s rectal temperature depending on the ovulatory process. This method is extremely inaccurate and uninformative for several reasons: errors in measurement techniques, individual characteristics of the female body, and the presence of ovulation not in every cycle. Usually, low basal temperature is just a source of worry for a woman. Therefore, to determine the fact and time of ovulation, it is better to use ultrasound or special tests (see).

Complete examination for unsuccessful pregnancy attempts for 11 months or less

A marriage is considered infertile after a year of planning without effect. Therefore, 3-4 months without pregnancy is not a reason to panic. In women after 30 years of age, ovulation occurs less and less often, so conception occurs more often after 6-12 months of attempts (see).

How can a man prepare for conception?

The appearance of offspring is always a decision of two people: mom and dad. The woman bears the responsible stage of bearing a child and giving birth to it. But this does not mean that the future dad should not prepare for this. When planning a child, a man should:

• Avoid drinking alcohol (including beer).
• Stop going to the bathhouse and sauna (preferably 3 months before the planned conception). Heat exposure can affect sperm quality and DNA, leading to difficulty conceiving.
• Avoid prolonged sexual abstinence. The sperm depot must be constantly updated to reduce the risk of mutations to a minimum.
• Get tested for viral hepatitis, HIV, syphilis and sexually transmitted infections.
• Support a woman in maintaining a healthy lifestyle and proper nutrition.
• Provide a favorable psychological atmosphere in the family.

It is important to remember that the contribution of paternal chromosomes to the development of the child is very large: the size and quality of the placenta depend on them. Therefore, a man’s preparation for conception should be no less thorough than that of a woman.

Preparing couples with infertility and failures in previous pregnancies

If pregnancy does not occur within 1 year, then the couple can be examined. The first stage of preparation is for men (see), then - determination of female ovulation by ultrasound and patency of the fallopian tubes (see). Depending on the results, the list of tests and prescribed treatment may expand. This issue can only be decided by the attending physician. If you plan to enter into pregnancy using IVF protocols, the list of hormones that require research is often expanded, and the man’s spermogram is also carefully studied.

When preparing a woman for pregnancy after a miscarriage and embryo freezing, it is important to understand that every 2-3 conceptions end unsuccessfully. More often this happens in extremely early stages, when a woman may not even know about her situation. The reason for this is genetic damage. It is believed that a comprehensive examination of couples is necessary only after 2 or more missed pregnancies in a row. If there are fewer failures, no additional measures need to be taken.

Direct preparation for conception

Ideal day to conceive

For pregnancy to occur, the fusion of male and female cells: sperm and egg is necessary. This process is not always possible, but only on certain days of the menstrual cycle.

Approximately 12-14 days before the start of the next menstruation, a mature egg is released from the ovary. This process is called ovulation. That is, with a classic cycle of 28 days long, this event occurs in its middle. The day of ovulation can be more accurately determined using ultrasound. After leaving the fallopian tube, the egg is capable of fertilization in about 12 hours. That is, half a day remains for sexual intercourse to occur and sperm to reach their goal. Sperm after entering the vagina remain viable for about 72 hours. Thus, the most suitable day for conception is the day of ovulation and two more days before it.

Abstinence before conception: benefit or harm?

There is an opinion that 2-3 days before the expected conception it is better to refuse sexual intercourse in order to increase the chances of pregnancy. There is part of the truth in this: with daily sexual intercourse, the number of sperm in the ejaculate decreases, since the body does not have time to produce them. But not every woman knows the exact day of ovulation, so there is no need to specifically maintain a three-day pause between contacts. It is much more important that both partners are committed to intimacy, because the benefits of mutual orgasm in the success of conception have been proven by scientists.

How many days in advance does a man need to prepare for conception?

The life cycle of sperm is about 72 days. That is, their composition is updated every three months. Therefore, it is advisable for a man to refrain from bad habits and exposure to high temperatures three months before planning a pregnancy.

The influence of posture on successful conception

The position of both partners during intercourse does not play a role in the occurrence of pregnancy. There is a version that after intimacy ends, a woman should become a “birch tree,” that is, raising her straight legs up. This is far from necessary, since sperm move towards the egg not under the force of gravity, but due to vibrations of the fluid, the villi of the fallopian tubes and contractions of the uterus.

How to plan the gender of the child?

On the Internet and women's forums there are many methods that supposedly help program the gender of the unborn baby. This includes conception according to the lunar calendar, and eating special food on the day of intimacy, and various special poses, and many other incredible ideas. All these methods are completely unscientific and useless.

There is evidence that sperm carrying the X chromosome (that is, responsible for the birth of a girl) are slower and more resilient. And sperm with a Y chromosome are faster and live shorter. Therefore, intercourse a day or two before ovulation will allow the X-sperm to reach the egg and increase the chance of having a girl. Accordingly, if sexual intercourse is performed on the day of ovulation, there is a high chance of conceiving a boy, because sperm with a Y chromosome will reach the egg faster. This method has some scientific element, it has a right to exist. But this method has no statistical evidence.

Having a child is a responsible mission. Many couples try to carefully plan their pregnancy and prepare for it in advance.

Undoubtedly, the birth of a child is one of the most important events in the life of any person. In order for this event to pass without problems, for a happy and healthy child to be born, women and men need to take a responsible approach to planning a child.

Preparing for pregnancy is perhaps no less important stage in the birth of a future child than pregnancy itself. Therefore, future parents need to undergo a series of tests and consultations at a family planning center six months before the planned conception of a child. More and more families in the modern world are using the services of these medical centers to plan pregnancy.

According to statistics, on average 3 out of 10 couples are planning the birth of a future child. Although this figure is still relatively small, thanks to modern information capabilities, couples know what is needed for proper pregnancy and family planning. Moreover, participation in this equally belongs to the future mother and father.

The process of pregnancy planning begins with the completion of the necessary laboratory tests by the woman and the man.

Laboratory tests for women when planning pregnancy

The first priority is to donate blood to detect antibodies to pathogens of a group of infectious diseases that can harm the developing fetus during pregnancy. This group of infections is called TORCH infection. The presence of antibodies to the following infectious agents is determined:

• Toxoplasmosis is a chronic infectious disease caused by the protozoan microorganism Toxoplasma. The peculiarity of this infection is that it can be asymptomatic in a woman, its confirmation is possible only in the laboratory - determination of antibodies to Toxoplasma in the woman’s blood. If antibodies are detected, the conception of a child in such a couple is postponed until the woman is completely cured of toxoplasmosis.

If the pregnancy was not planned and laboratory testing was not carried out, then during the development of the fetus, toxoplasma enters it and leads to the development of severe defects that are incompatible with life. Then a miscarriage occurs in early pregnancy.

Toxoplasmosis can cause miscarriage

• Rubella is a viral disease that usually occurs in childhood. Today, to prevent the occurrence of rubella in a woman during pregnancy, vaccination against this infection has been introduced into the vaccination calendar.

If it is known for sure that a woman has had rubella in the past, then determining antibodies in the blood is not necessary. Rubella in a woman during pregnancy can lead to the development of malformations of the cardiovascular and nervous systems.

• Cytomegalovirus infection and herpes - these viruses are in an inactive state in the body of 90% of people. The purpose of the analysis is to determine the degree of activity of this virus when IgG antibodies are detected in the blood.

When these antibodies appear in the blood, the woman undergoes a course of antiviral treatment until a stable remission is formed (disappearance of IgG antibodies). Like other infectious diseases of the TORCH group of infections, cytomegalovirus and herpes during pregnancy lead to severe defects in the fetus.

• Chlamydia and ureoplasmosis are chronic asymptomatic infections of the female genitourinary system, which can infect the fetus during birth and lead to severe illness in the child after birth.

Also, a woman must have a smear from the cervix examined for the presence of an infectious process in the genital organs and the presence of atypical cells indicating a tumor process.

To predict the course of labor already during pregnancy planning, it is necessary to measure the size of the pelvis. This will make it possible to judge the presentation of the fetus to the exit from the uterus during childbirth and, accordingly, how labor will proceed. If significant changes occur in a woman, pregnancy is not contraindicated; however, for delivery, the gynecologist recommends a cesarean section.

Measuring the size of the pelvis will help predict the difficulty of childbirth

After performing these tests, the woman is consulted by a gynecologist who carefully collects analysis about previous diseases and the presence of other infectious diseases. The doctor also finds out what the course of the previous pregnancy was and whether the woman has had an artificial termination of pregnancy or miscarriages in the past. Depending on the result of the consultation, the woman undergoes a number of additional studies. Indications for their passage may be:

Regular menstrual irregularities - a laboratory determination of the level of a woman’s sex hormones (estrogen and progesterone) is carried out.

Previous history of spontaneous miscarriage.

Excess body weight is an indication for determining the level of glucose in the blood to exclude the presence of diabetes mellitus in a woman. The level of cholesterol and lipoproteins is also determined in parallel.

Frozen pregnancy with fetal resorption in the past - the woman’s hormonal background must be examined.

Inability for a woman to become pregnant for a period of time greater than 1 year - a diagnostic set of studies is performed to diagnose possible female infertility and its causes.

Laboratory tests that are performed on a man when planning a child

Examination of a man is an equally important factor in pregnancy planning, although this has not previously been given due attention. The list of tests for studying a man’s health includes:

• Determination of antibodies in the blood to sexually transmitted infections - first of all, the presence of chlamydia and ureaplasmosis is determined. These infections in men are asymptomatic, but affect the quality of sperm, motility and the ability of sperm to fertilize an egg.

If antibodies to these infections are detected, the man undergoes a course of antibacterial therapy, after which he is tested again. During an unplanned pregnancy, a man can infect a woman with chlamydia or ureaplasmosis, which will cause illness in the child.

Mumps (mumps) is a viral disease related to childhood infections. This infection is characterized by damage to the testicles of a man with their inflammation and the development of the inability of sperm to fertilize the egg. Nowadays, in childhood, boys are given a preventive vaccination against mumps.

Spermogram is a comprehensive study of sperm, which includes determining its quantity, viscosity, number of sperm, their motility, and pattern of movement. All these indicators are diagnostic regarding the ability of sperm to fertilize an egg.

A spermogram will tell you about the chances of fertilization

Also, after passing all laboratory tests, the man is consulted by an andrologist or urologist, who finds out what diseases of the genitourinary system the man suffered in the past. If necessary, additional laboratory and instrumental tests are prescribed - detection of antisperm antibodies in the blood, ultrasound examination of the prostate and testicles, computed tomography.

Laboratory tests for women and men

In addition to a certain range of laboratory tests separately for men and women, joint tests are also carried out:

Determining the blood type and Rh factor of the future parents is necessary in order to determine the development of hemolytic disease of the newborn in the child, which develops in the presence of a negative Rh factor of the fetus and a positive Rh factor of the mother's blood.

Clinical blood test - allows you to identify the presence of an inflammatory process in the body, in which there is an increase in the erythrocyte sedimentation rate and an increase in the number of leukocytes. These indicators serve as the basis for further in-depth examination.

Getting tested is an important step in preparing for conception.

Clinical urine analysis - includes indicators such as relative density, quantity, color of urine, and the presence of protein in it. The number of leukocytes, salts and bacteria in the urine sediment is determined microscopically. Changing these indicators makes it possible to diagnose infectious and inflammatory diseases of the urinary system.

Biochemical blood test - during this analysis, functional indicators of normal functioning of the liver (cholesterol, total bilirubin) and kidneys (creatinine, urea) are determined.

According to indications, an ultrasound examination of the organs of the urinary and reproductive system is performed. The positive aspect of this study is its high informativeness in the absence of harmful effects on the body of the subject. Therefore, ultrasound examinations are also performed on pregnant women without any harm to the developing fetus.

Consultation of related specialists

After laboratory testing, both women and men need to consult doctors of related specialties to exclude diseases of the internal organs. I routinely consult with the following doctors:

Therapist - consultation with a doctor of this specialty is necessary to identify or exclude diseases of the cardiovascular system (hypertension, coronary heart disease, latent heart failure), the respiratory system (chronic obstructive bronchitis, bronchial asthma) and the digestive system (gastritis, enteritis, hepatitis).

Endocrinologist - performs a consultation to determine the hormonal background of the body of future parents, since the process of fertilization and pregnancy is affected by the level in the blood of not only sex hormones, but also other hormones that regulate metabolism in the body. The endocrinologist also conducts a consultation to identify diabetes mellitus.

Geneticist - finds out the presence of hereditary diseases in the family of a woman and a man, determines the likelihood of developing a particular disease in a child.

Consultations with specialists will help eliminate problems in fetal development

At least six months, and preferably a year before the planned pregnancy, to improve the functional state of the organs of the reproductive system, hormonal levels and general condition of the body, future parents follow a number of recommendations, which include:

eliminating bad habits;

taking vitamins;

taking medications as indicated.

• Diet– balance is required regarding the energy value of products. Preference is given to plant foods that are rich in natural vitamins and fiber.

It is also recommended to consume lean meats, fish and poultry. Beef, rabbit, and chicken are suitable for this. Dishes should best be cooked boiled or steamed. It is advisable to limit the consumption of pork, sweets, and smoked meats.

• Diet– the daily amount of food is distributed in such a way that most of the food taken should be for breakfast and lunch, a smaller part for dinner. The last meal should be no later than 2 hours before bedtime, which will also allow for functional rest of the digestive system during sleep.

When planning a pregnancy, you need to follow a diet

Elimination of bad habits

• Tobacco smoking– as a result of this habit, nicotine addiction develops. Nicotine, entering the systemic circulation and blood through the lungs, has a negative effect on blood vessels and nutrition of internal organs. In men, it can cause a decrease in sperm motility and their genetic defects, which affect the development of the unborn child.

In women, nicotine disrupts the process of ovulation and the release of eggs from the ovaries. Therefore, if this bad habit exists, men need to give it up no less than six months before (the time for complete sperm renewal). It is better for women not to smoke not only when planning a pregnancy, but also while carrying a child and breastfeeding it.

• Alcohol abuse– in small quantities, alcohol has a beneficial effect on the liver, nervous system and cardiovascular system. However, when large doses of alcohol enter the body, its effect becomes opposite. This harmful effect also affects the genitals of women and men. The harmful effects of alcohol in large quantities are the same when consuming any alcoholic beverage, be it vodka, cognac, wine or beer.

Overeating can also be considered bad habits, so you should not forget about the dietary recommendations outlined above.

A healthy lifestyle includes a set of measures that help strengthen the functional state of all organs and systems of the body. These include:

Nutrition– includes all dietary recommendations and nutrition regimen outlined above.

Physical activity– practicing dynamic sports allows you to strengthen blood vessels, the heart, ensure good blood flow and nutrition of all organs, including the organs of the reproductive system. These sports include running, volleyball, football, and swimming.

It is better to exercise in the morning or at lunchtime. Exercising in the evening can even be harmful, since the body is physiologically tuned to rest. It is also important not to overdo it in this matter, so as not to lead to muscle or ligament strain. Overwork after physical activity also leads to the accumulation of lactic acid in the muscles, which causes pain and has an adverse effect on the liver.

Rational organization of work and rest regimes– any process of work activity must be interspersed with breaks for rest. So, if you are doing mental work, you can take 10-minute breaks every hour, switching your attention away from work. During physical work, depending on its intensity, the time between breaks is reduced. If the work involves a static load, then breaks need to be taken even more often; at the moment of rest, it is better to warm up a little and restore blood flow in the stiff muscles.

Dream– a very important factor in maintaining health in the body. A favorable sleep time is about 8 hours for an adult. Taking into account the biological rhythm in the human body and nervous system, the time conducive to proper rest is the period from 22.00 pm to 6.00 am. That is, 8-hour sleep at another time of day will not be complete and optimal.

Emotional activity– stress, prolonged negative emotions, mental fatigue lead to depletion of the body’s energy reserves, deterioration in the functioning of all organs and systems of the body, including the organs of the reproductive system. Therefore, during the period of pregnancy planning, it is better for future parents to avoid negative emotions, nervous exhaustion and stress. It is also advisable to avoid quarrels with relatives and friends, as they are much more difficult to bear than other types of stressful conditions.

A separate recommendation for men when planning pregnancy is to wear comfortable underwear without elastic bands, which allows free circulation of blood in the testicles and prevents sperm maturation disorders. Also, at least six months before the expected pregnancy, a man should refrain from visiting baths and saunas, since high ambient temperatures disrupt spermatogenesis - the process of formation and maturation of sperm in the testicles.

In general, it is necessary to remember that the testicles are located in a man’s scrotum precisely because for normal spermatogenesis the temperature in them should be 1-2ºC lower than body temperature, that is, 33-34.5ºC. In this case, spermatogenesis will proceed normally, and the sperm will have high activity in fertilizing the egg.

Vitamins when planning pregnancy

All groups of vitamins are very important for the normal course of pregnancy. The main ones are:

Vitamin C is a powerful antioxidant that improves the maturation of sperm in men and eggs in women. Its deficiency in the body can lead to the impossibility of fertilization. The daily requirement is about 100-150 mg. Foods rich in this vitamin include citrus fruits, rose hips, and onions. In the winter-spring period, when there are few fresh fruits and vegetables, the vitamin can be taken in the form of multivitamin tablets.

Vitamin E is a fat-soluble vitamin and is the primary vitamin that affects the maturation of germ cells. Contained in lettuce leaves, spinach, vegetable oil.

B vitamins - include a number of vitamins (B 1, B 6, B 12), which are involved in the metabolic processes of all cells of the body. These vitamins are contained in plant fiber - bread (made from wholemeal flour), porridge (buckwheat, rice).

Folic acid is also a B vitamin; its supply in a woman’s body is very important for the normal maturation of the fetal nervous system during pregnancy. It is also recommended to take folic acid in the form of tablets for normal pregnancy and the prevention of miscarriages.

Vitamin A belongs to the group of fat-soluble vitamins, is a powerful antioxidant, prevents the destruction of body cells. In relation to the organs of the reproductive system, this vitamin promotes the proper division and maturation of sperm and eggs. Contained in vegetable fats, carrots.

Vitamins are necessary for a favorable pregnancy

Taking medications when planning pregnancy

Medicines are prescribed by the attending physician or consultant physician, depending on the indications. These are drugs from various groups of drugs, these include:

Metipred– is a drug that inhibits the synthesis of male sex hormones. It is prescribed by a gynecologist or endocrinologist when there is an increased content of male sex hormones in a woman’s body, which affects the process of fertilization and pregnancy. It is also prescribed when a woman has had miscarriages in the past that are not associated with infectious diseases.

Progesterone– female sex hormone responsible for the menstrual cycle, fertilization of the egg by sperm and pregnancy. Progesterone is prescribed for appropriate conditions in women associated with its deficiency.

Commercial drugs in this group include Urozhestan, Duphaston, their molecule exactly repeats the structure of the natural progesterone molecule. This drug is also prescribed for other diseases not related to pregnancy planning - malignant tumors, menstrual irregularities, ovarian cysts, mastopathy, etc.

Dexamethasone– also a hormonal drug that is prescribed for hyperandrogenism (increased levels of male sex hormones) in women. Since this drug simultaneously affects metabolism, blood glucose levels (increases), and increases systemic blood pressure, it is used only under the supervision of a physician. When used, the drug stabilizes the level of hormones in a woman’s body, which promotes fertilization of the egg and normal pregnancy.

Rovamycin– macrolides, a special group of antibiotic drugs that destroy toxoplasma in a woman’s body. Treatment is carried out in case of detection and increased titer of Toxoplasma antibodies in the woman’s blood. The course of treatment averages 7-10 days, then a repeat laboratory examination is carried out to determine the presence of antibodies to Toxoplasma.

Josamycin– an antibiotic from the macrolide group, effective in the treatment of acute and chronic forms of chlamydia, mycoplasmosis, ureaplasmosis of the genital organs in women and men. A course of treatment of at least 10 days, then a re-examination, if the results are positive, treatment is continued or another antibiotic is selected.

Isoprinosine– an antiviral drug that can destroy rubella and herpes viruses in the replication (division) stage. This drug is used for a course of at least 7 days, then after a short break in treatment, antibodies to these viruses are re-determined.

Interferon- a drug that also has antiviral activity. The mechanism of action is to potentiate (strengthen) the antiviral immunity of the woman’s body. In addition, interferon also enhances general immunity.

If desired, family planning centers have a specialist psychologist who will help in solving psychological issues and problems that may arise for young future parents. Already at this time, consultations are carried out regarding feeding and caring for the infant. The psychologist talks about the possibility of pain during pregnancy and childbirth.

It is also advisable for the expectant father to attend counseling sessions with a psychologist, who will tell him how to behave if his wife has signs of labor and how to help reduce pain.

Contraindications for pregnancy

Unfortunately, there are a number of pathological conditions in women that can have a very adverse effect on pregnancy and fetal development. These conditions are identified at the stage of pregnancy planning and are medical contraindications to pregnancy. These include:

• type 1 diabetes mellitus (insulin-dependent) – a constant increase in blood sugar levels, disruption of the hormonal profile of a woman’s body, disruption of all types of metabolism during pregnancy lead to miscarriage or severe fetal malformations;

  chronic cardiovascular pathology in the stage of decompensation - heart defects in a woman, coronary heart disease with chronic heart failure can lead to the risk of death of a woman during pregnancy;

  chronic renal failure - diseases such as chronic glomerulonephritis and pyelonephritis lead to permanent failure of kidney function, and during pregnancy to a constant increase in blood pressure and toxicosis of the pregnant woman, which lead to placental abruption and fetal death;

  chronic liver failure - this condition occurs when liver function is impaired due to cirrhosis of the liver, chronic hepatitis of viral or alcoholic etiology, which leads to disruption of the hormonal levels of the woman’s body.

Therefore, identifying any pathology or deviation at the pregnancy planning stage will allow them to be corrected and the woman to bear the unborn child without any complications, avoid problems during childbirth and improve the health of the already born child.