Planning for your pregnancy.
If you are thinking about pregnancy, visit your doctor for a preconception consult. They will provide you with expert advice on planning your pregnancy.
The preconception period (three months prior to pregnancy) is the time to make life changes that can help boost fertility, reduce problems during pregnancy and assist in recovery from birth.
If you and your partner are planning to conceive, you should start taking folic acid before you get pregnant. Folic acid helps to provide the best health outcomes for your baby when it is growing. Taking folic acid daily before and during pregnancy also prevents the occurrence of neural tube defects, such as spina bifida, in your baby.
Watching what you eat
If you and your partner are preparing for pregnancy, you should look at your diet and see where you may be able to make healthier food choices. Eating more healthy foods will help with your chances of conceiving and having a healthy pregnancy.
There is no safe amount of alcohol to drink during pregnancy; therefore, for women who are pregnant or planning a pregnancy, not drinking is the safest option. Alcohol can affect the health and development of an unborn baby for life.
Quitting smoking before pregnancy is the single most effective means of protecting your baby and yourself from the development of serious complications during pregnancy. By quitting smoking you are more likely to conceive naturally and without delay, less likely to suffer a miscarriage or ectopic pregnancy and less likely to deliver your baby prematurely.
The best time to get pregnant
You’re most likely to get pregnant if you have sex within a day or so of ovulation (releasing an egg from the ovary). This is usually about 14 days after the first day of your last period. An egg lives for about 12 to 24 hours after it’s released. For pregnancy to happen, the egg must be fertilised by a sperm within this time. If you want to get pregnant, having sex every couple of days will mean there’s always sperm waiting in the fallopian tubes to meet the egg when it’s released. Sperm can live for up to seven days inside a woman’s body. So if you’ve had sex in the days before ovulation, the sperm will have had time to travel up the fallopian tubes to ‘wait’ for the egg to be released. It’s difficult to know exactly when ovulation happens, unless you are practising natural family planning, or fertility awareness. The menstrual cycle is counted from the first day of a woman’s period (day one). Some time after her period she will ovulate, and then around 12-14 days after this she’ll have her next period. The average cycle takes 28 days, but shorter or longer cycles are normal.
The woman’s monthly cycle
Ovulation occurs each month when an egg is released from one of the ovaries. Occasionally, more than one egg is released, usually within 24 hours of the first egg. At the same time, the lining of the womb begins to thicken and the mucus in the cervix becomes thinner so that sperm can swim through it more easily. The egg begins to travel slowly down the fallopian tube. If a man and a woman have recently had sex, the egg may be fertilised here by the man’s sperm. The lining of the womb is now thick enough for the egg to be implanted in it after it has been fertilised. If the egg is not fertilised, it passes out of the body during the woman’s monthly period, along with the lining of the womb, which is also shed. The egg is so small that it cannot be seen.
Folate and pregnancy
Folate and folic acid are important for pregnancy as it can help prevent birth defects known as neural tube defects, such as spina bifida. Folate is a B group vitamin needed for healthy growth and development.
This vitamin is known as ‘folate’ when it is found naturally in food, such as green leafy vegetables, and as ‘folic acid’ when it is added to food, such as bread and breakfast cereals, or used in dietary supplements.
Folate has been proven to be particularly important for the development of the nervous system and for preventing neural tube defects (NTDs) in babies.
Approximately one in 500 babies in Australia is born with a neural tube defect (NTD) such as spina bifida.
Spina bifida is one of the most common birth defects in the Western world. About 150 babies are born with spina bifida in Australia each year and it occur in the first weeks of pregnancy when the brain and spinal cord are forming.
You can increase your folate intake by eating folate rich foods, including folate fortified foods in your daily diet or by taking a folic acid supplement. A good sources of folate include green leafy vegetables, fruit (citrus, berries and bananas), legumes and some cereals (many breakfast cereals now have added folate).
The voluntary fortification of several foods with folate has been permitted in Australia since June 1995 and mandatory folic acid fortification of all flour used for making bread (except organic bread) came into effect in September 2009. Three slices of bread (100g) contains an average of 120 micrograms of folic acid.
Folic acid supplements are available in Australia over the counter from pharmacies and through your doctor at varying doses. Look for supplements that contain at least 400 micrograms of folic acid; these will generally be supplements containing only folic acid or special pregnancy supplements. Multi-vitamin supplements generally contain less. The best way to guarantee you get enough folic acid, is to take a daily folic acid supplement at least one month before and three months after conception. You don’t need to take folic acid supplements after that.
Higher dose folic acid
Some women have an increased risk of having a pregnancy affected by a neural tube defect, and are advised to take a higher dose of 5 milligrams (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if they:
- or their partner have a neural tube defect
- have had a previous pregnancy affected by a neural tube defect
- or their partner have a family history of neural tube defects
- have diabetes
In addition, women who are taking anti-epileptic medication should consult their doctor for advice, as they may also need to take a higher dose of folic acid.
If any of the above applies to you, talk to your doctor as they can prescribe a higher dose of folic acid. Your doctor or midwife may also recommend additional screening tests during your pregnancy.
Folate in your diet
Many foods are naturally rich in folate. But note that folate is water-soluble and is easily destroyed by cooking. Vegetables are best lightly cooked or even eaten raw. Cooking by microwave or steaming is best.
The following are good sources of natural folate:
- vegetables (broccoli, brussels sprouts, cabbage, cauliflower, English spinach, green beans, lettuce, mushrooms, parsnip, sweet corn, zucchini)
- fruit (avocado, grapefruit, orange)
- legumes (chickpeas, soya beans, lima beans, red kidney beans, lentils, haricot beans)
- juices (many apple and orange juices).
Immunisation and pregnancy
During pregnancy, your immune system is naturally weaker than usual. This means you are more susceptible to certain infections and illnesses which can be harmful to you and your developing baby.
Following some simple precautions will help minimise the risk to you and your baby of developing these health issues.
Immunisation is a simple and effective way to protect yourself and your baby from certain infections. Before becoming pregnant, check that you have protection against diseases that can cause illness in you or your unborn baby.
As well as the routine immunisations such as tetanus and polio, pregnant women should have immunity against measles, mumps, rubella, chickenpox, whooping cough and influenza.
All women are encouraged to get vaccinated before pregnancy as not all of these vaccines are recommended during pregnancy.
However, if you were unable to receive these vaccines before your pregnancy, it is recommended you get them as soon as possible after your baby is born. All vaccines can be given to breastfeeding mothers, and having immunity will reduce the likelihood of passing on these illnesses to your baby.
Vaccinations before pregnancy
Measles, mumps and rubella
Rubella infection during pregnancy can cause serious birth defects. If you were born after 1966, you may need a booster vaccination for full protection. This should be done in consultation with your doctor. It is recommended that you wait four weeks after receiving this vaccine before trying to get pregnant.
Chickenpox infection during pregnancy can cause severe illness in you and your unborn baby. A simple blood test can determine if you have immunity to this infection. If you are not protected, speak to your doctor about receiving two doses of the vaccine for full immunity. It is recommended that you wait four weeks after receiving this vaccine before trying to get pregnant.
Protection against serious illness caused by pneumococcal disease is recommended for smokers and people with chronic heart, lung or kidney disease, or diabetes.
Vaccines that are required to travel to other countries are not always recommended during pregnancy. Find out more about travel and pregnancy.
Safe vaccinations during pregnancy
Whooping cough (pertussis)
Whooping cough can cause serious illness and even death in babies less than six months old. It is now recommended that all pregnant women receive a pertussis (whooping cough) vaccination during their third trimester (ideally at 28 weeks). A combination of antibodies being passed through the mother’s bloodstream and the reduced risk of the mother contracting the disease makes this an ideal time to administer the vaccine. Most states now offer the pertussis vaccination for free. Speak to your doctor or antenatal care provider to schedule an appointment.
Influenza can cause serious illness and being pregnant increases the risk of flu complications, especially with the H1N1 influenza virus. Because of this, the flu vaccine is recommended and funded for all pregnant women.
The influenza vaccine is safe and can be administered before, during or after pregnancy. Getting vaccinated every year protects you against new strains of the virus and also reduces the risk of spreading influenza to your baby. Getting the flu vaccine during your pregnancy will also provide ongoing protection to your newborn for the first 6 months after birth.
Finding out you are pregnant can be a very exciting and nervous time. There are lots of things to consider and plan and you’ll need to know some key things to help you do that. Read about your baby’s development and your pregnancy week by week, by clicking on the links below.
Weeks 0 - 3
Your weeks of pregnancy are dated from the first day of your last period. This means that in the first two weeks or so, you aren’t actually pregnant – your body will be preparing for ovulation as usual. You ovulate (release an egg) around two weeks after the first day of your period (depending on the length of your menstrual cycle).
During the third week after the first day of your last period, your fertilised egg moves along the fallopian tube towards the womb. The egg begins as a single cell, which divides again and again. By the time the egg reaches the womb, it has become a mass of more than 100 cells, called an embryo. Once in the womb, the embryo burrows into the lining of the womb. This is called implantation.
In weeks four to five of early pregnancy, the embryo grows and develops within the lining of the womb. The outer cells reach out to form links with the mother’s blood supply. The inner cells form into two, and then later, into three layers. Each of these layers will grow to be different parts of the baby’s body.
The inner layer, called the endoderm, becomes the breathing and digestive systems, including the lungs, stomach, gut, and bladder. The middle layer, called the mesoderm, becomes the heart, blood vessels, muscles, and bones. The outer layer, called the ectoderm, becomes the brain and nervous system, the eye lenses, tooth enamel, skin and nails.
In these early weeks of pregnancy the embryo is attached to a tiny yolk sac which provides nourishment. A few weeks later, the placenta will be fully formed and will take over the transfer of nutrients to the embryo.
The embryo is surrounded by fluid inside the amniotic sac. It’s the outer layer of this sac that develops into the placenta. Cells from the placenta grow deep into the lining of the womb, establishing a rich blood supply. This ensures the baby receives all the oxygen and nutrients it needs.
The fifth week of pregnancy is the time of the first missed period, when most women are only just beginning to think they may be pregnant. Yet already the baby’s nervous system is developing, and the foundations for its major organs are in place. At this stage embryo is around 2mm long.
As the ectoderm develops, a groove forms and the layer of cells folds to form a hollow tube called the neural tube. This will become the baby’s brain and spinal cord. Defects in the “tail end” of the neural tube lead to spina bifida, while defects in the “head end” lead to anencephaly (when the bones of the skull and the brain does not form properly).
At the same time, the heart is forming as a simple tube-like structure. The baby already has some of its own blood vessels and blood begins to circulate. A string of these blood vessels connects the baby and mother and will become the umbilical cord.
By the time you are six to seven weeks pregnant, there is a large bulge where the heart is and a bump at the head end of the neural tube. This bump will become the brain and head. The embryo is curved and has a tail – it looks a bit like a small tadpole. The heart can sometimes be seen beating on a vaginal ultrasound scan at this stage.
The developing arms and legs become visible as small swellings (limb buds). Little dimples on the side of the head will become the ears, and there are thickenings where the eyes will be. By now the embryo is covered with a thin layer of see-through skin.
By seven weeks, the embryo has grown to about 10mm long from head to bottom. This measurement is called the “crown-rump length”. The brain is growing rapidly and this results in the head growing faster than the rest of the body. The embryo has a large forehead, and the eyes and ears continue to develop. The inner ear starts to develop, but the outer ear on the side of the head won’t appear for a couple more weeks.
The limb buds start to form cartilage, which will develop into the bones of the legs and arms. The arm buds get longer and the ends flatten out – these will become the hands. Nerve cells continue to multiply and develop as the nervous system (the brain and spinal cord) starts to take shape.
By the time you’re eight weeks pregnant, the baby is called a foetus, which means ‘offspring’. The legs are lengthening and forming cartilage too. The different parts of the leg aren’t properly distinct yet – it will be a bit longer before the knees, ankles, thighs, and toes develop. The foetus is still inside its amniotic sac, and the placenta is continuing to develop, forming structures called chorionic villi that help attach the placenta to the wall of the womb. At this stage, the foetus still gets its nourishment from the yolk sac.
Conception usually takes place about two weeks after your last period, around the time that you ovulate (release an egg). In the first four weeks of pregnancy you probably won’t notice any symptoms. The first thing most women notice is that their period doesn’t arrive. Find out about the signs and symptoms of pregnancy.
By the time you are eight weeks pregnant, you will probably have missed your second period. However, some women experience a little bleeding during the early weeks of pregnancy. Always mention any bleeding in pregnancy to your midwife or doctor, particularly if it continues and you get stomach pain.
Your womb has grown to the size of a lemon by the time you are around seven or eight weeks pregnant. You’re probably feeling tired. Your breasts might feel sore and enlarged, and you are probably needing to pass urine more often than usual.
Some pregnant women start to feel sick or tired, or have other minor physical problems for a few weeks around this time. Most women stop having morning sickness and start to feel better by the time they are around 14 weeks pregnant.
Things to think about
- Finding out you’re pregnant - the most reliable way of finding out whether you’re pregnant is to take a pregnancy test. Once you think you could be pregnant, it’s important to get in touch with a midwife or doctor to start your antenatal (pregnancy) care.
- You can also work out your due date.
- Help and advice for teenagers - discovering you’re pregnant can be tough, but there is help out there.
- Common pregnancy problems - from morning sickness to vaginal bleeding, find out how to cope with the minor and more serious symptoms that can occur in pregnancy.
- Your feelings and relationships - pregnancy is a time of physical and emotional changes that can affect your relationships, so get as much information and advice as you can to help you cope.
- Antenatal care - the best way to make sure both you and your baby stay healthy is to make sure you get all the care available to you during pregnancy. This includes scans, checks and screening.
Pregnancy - 9 to 12 weeks
The face is slowly forming. The eyes are bigger and more obvious, and have some colour (pigment) in them. There is a mouth and tongue, with tiny taste buds. The hands and feet are developing - ridges identify where the fingers and toes will be, although they haven’t separated out yet. The major internal organs (such as the heart, brain, lungs, kidneys and gut) continue developing.
At nine weeks of pregnancy, the baby has grown to about 22mm long from head to bottom.
The ears are starting to develop on the sides of your baby’s head, and inside the head its ear canals are forming. If you could look at your baby’s face you would be able to see its upper lip and two tiny nostrils in the nose. The jawbones are developing and already contain all the future milk teeth. The heart is now fully-formed. It beats 180 times a minute - that’s two to three times faster than your own heart. The baby is making small, jerky movements which can be seen on an ultrasound scan.
The foetus grows quickly and the placenta is rapidly developing (it will be fully formed at about 12 weeks). The bones of the face are formed now. The eyelids are closed, and won’t open for a few months yet. The ear buds look more like ears as they grow. Your baby’s head makes up one-third of it’s length, but the body is growing fast - it is straightening, and the fingers and toes are separating. There are fingernails.
Just 12 weeks after your last period, the foetus is fully formed. All its organs, muscles, limbs and bones are in place, and the sex organs are well developed. From now on, it has to grow and mature. It’s too early for you to be able to feel the baby’s movements yet, although it’s moving quite a bit. Your baby’s skeleton is made of tissue called cartilage and, around now, this starts to develop into hard bone.
During this time your breasts will have got bigger, so consider wearing a supportive bra. You may also find that your emotions vary: you feel happy one moment and sad the next. Don’t worry - these feelings are normal and should settle down. You can find out more about feelings and relationships in pregnancy.
If you haven’t seen your midwife yet, contact your doctor or maternity team for your booking appointment and to start your antenatal care. This appointment should take place by the time you are 12 weeks pregnant. You will be offered your first ultrasound scan when you’re between eight and 14 weeks pregnant: this can vary depending on where you live.
Things to think about
- Checks and tests you may be offered - you will be offered a range of checks and tests during your first antenatal visit to help monitor your health and spot any potential problems.
- Where to have your baby - choosing where to have your baby is a big decision. Your midwife and antenatal team can talk to you about all the options available to help you make an informed choice.
- Healthy pregnancy diet - eating a healthy, balanced diet is especially important for pregnant women. Find out about healthy eating and which foods to avoid.
- Stay active, start exercising - find out about exercise and keeping active.
By the second trimester of your pregnancy, your baby is fully formed and growth continues. If you’ve had morning sickness, you should find that it starts to ease off around this time. Read about your baby’s development and your pregnancy week by week, by clicking on the links below.
Pregnancy - 13 to 16 weeks
Your baby weighs around 25g.
Your baby’s ovaries or testes are fully developed inside their body, and the genitals are forming outside their body. Where there was a swelling between the legs, there will now be a penis or clitoris growing, although you usually won’t be able to find out the sex of your baby at an ultrasound scan at this stage.
At 14 weeks, the baby is about 85mm long from head to bottom.
Around now, the baby begins to swallow little bits of amniotic fluid, which pass into the stomach. The kidneys start to work and the swallowed fluid passes back into the amniotic fluid as urine.
Around this time, your baby will start to hear - it may hear muted sounds from the outside world, and any noises your digestive system makes, as well as the sound of your voice and heart.
The eyes also start to become sensitive to light. Even though your baby’s eyes are closed, they may register a bright light outside your tummy.
The muscles of the baby’s face can now move and the beginnings of facial expressions appear. Your baby can’t control these yet.
The nervous system continues to develop, allowing the muscles in your baby’s limbs to flex. Around this time, your baby’s hands can reach each other - they can form a fist, and hold each other when they touch.
If you’ve been feeling sick and tired with morning sickness, you’ll probably start to feel better when you’re around 13 or 14 weeks pregnant.
Some women start to experience an increased sex drive around this time, possibly due to pregnancy hormones or increased blood flow to the pelvic area. Some women don’t, and this is perfectly normal. You can find out more about sex in pregnancy.
You’ll notice a small bump developing as your womb grows and moves upwards. If you’ve been feeling the urge to pass urine more often over the last few months, it’s because your womb was pressing on your bladder. This should ease off now. See your doctor if you notice any pain when you urinate. Urinary infections can happen in pregnancy and it’s important to treat them quickly to reduce the risk of kidney infections.
Things to think about
- Headaches - getting headaches during pregnancy is common, but if they’re severe they could be a sign of something serious.
- Teeth and gums - your teeth and gums need a little extra care in pregnancy.
Pregnancy - 17 to 20 weeks
By the time you’re 17 weeks pregnant, your baby is growing quickly, and now weighs around 150g. The body grows bigger so that the head and body are more in proportion.
The face begins to look much more human, and eyebrows and eyelashes are beginning to grow. Your baby’s eyes can move now, although the eyelids are still shut, and the mouth can open and close.
The lines on the skin of the fingers are now formed, so the baby already has his or her own individual fingerprints. Fingernails and toenails are growing and the baby has a firm hand grip.
The baby moves around quite a bit, and may respond to loud noises from the outside world, such as music. You may not feel these movements yet, especially if this is your first pregnancy. If you do, they’ll probably feel like a soft fluttering or rolling sensation.
Your baby is putting on a bit of weight but still doesn’t have much fat so if you could see your baby now it would look a bit wrinkled, although it will continue to put on weight for the rest of the pregnancy and will ‘fill out’ by the last few weeks before birth.
By 20 weeks your baby’s skin is covered in a white, greasy substance called vernix. It’s thought that this helps to protect the skin during the many weeks in the amniotic fluid.
At 20 weeks pregnant, you’re halfway through your pregnancy. You will probably feel your baby move for the first time when you’re around 17 or 18 weeks pregnant. Most first-time mums notice the first movements when they are between 18 and 20 weeks pregnant.
At first, you feel a fluttering or bubbling, or a very slight shifting movement, maybe a bit like indigestion. Later on, you can’t mistake the movements and you can even see the baby kicking about. Often you can guess which bump is a hand or a foot.
You may develop a dark line down the middle of your tummy and chest. This is normal skin pigmentation as your tummy expands to accommodate your growing bump. Normal hair loss slows down, so your hair may look thicker and shinier.
You’ll be offered an ultrasound scan when you are 18 to 20 weeks pregnant - this is to check for abnormalities in the baby. Your midwife or doctor can give you information about this and answer any questions.
Common minor problems can include tiredness and lack of sleep. Sleeplessness is common, but there is plenty you can do to help yourself sleep, including using pillows to support your growing bump. Some women also get headaches. Headaches in pregnancy are common, but if they’re severe they could be a sign of something serious.
Things to think about