How do we prepare to be pregnant soon (maybe)?
December 24, 2016 10:41 AM   Subscribe

So my husband and I decided to start trying to conceive. I'm facing my first month in 14 years without birth control. Up to this point in life, I've pretty much ignored any pregnancy related info about what to do to prepare. I have questions.

We've known we would start trying now for the last few months but didn't think about it at all during that time. Now I feel like I should have been doing research for months already.

The few things I/we have done:
Put vitamins on the grocery list
Ordered some books that will arrive sometime in the next couple of weeks.
Found out from their website that my GYN is not an OB (or at least their office isn't, I think).
Decided on the hospital (Northside in Atlanta) because it's right down the street and I've read good things.

Regarding the doctor: Do I need to talk to my GYN if she's not an OB? I assume if she's not, she's got recommendations, but how do you even choose an OB? I guess I've been incredibly lucky in that I have never had to shop for a GYN because I've liked them all. Do I need to start looking into that now or after I get a positive test?

Do we need to tour the maternity ward of the hospital before we make a decision? What red flags should we be looking for (both doctors and hospitals)? Do I even need to worry about this yet or am I getting ahead of myself?

What can I do to prepare my body on such short notice? Do I need to start lotioning to prevent stretch marks (recommendations?) now or when I get a positive test or when I start showing? Can I just keep living my life like normal until a positive test or should I be preparing my body somehow?

What else should we be doing? What do we need to do now and what can wait until we get a positive test? I understand that people have babies all the time with alot less resources and preparation and I'm not freaking out about any possible thing that could cause harm, but I feel like we're in the dark.
posted by LizBoBiz to Health & Fitness (31 answers total) 18 users marked this as a favorite
The only two things I think you should be doing now are: 1) start taking a prenatal vitamin with folic acid and 2) talk to a doctor (your GYN is probably fine) to just get things started with figuring out what's next; probably the only thing they'd do now is to take you off any prescription drugs that are contraindicated for pregnancy.

I'd also stop drinking in excess and/or drug use and/or smoking if you're doing those things now.
posted by Betelgeuse at 10:48 AM on December 24, 2016 [7 favorites]

You'll want good quality prenatal vitamins. They're expensive. Some people can't tolerate them well. I liked the Rainbow Lite brand.

My understand is that the lotion won't make any difference with stretch marks. It doesn't get deep enough and I guess they are hereditary or congenital or whatever.

Generally cleaning up your diet and living healthy are the priorities to start with. Drinking a lot of water is good.
posted by vunder at 10:49 AM on December 24, 2016 [2 favorites]

Order a five-pound sack of salt so you'll have enough for all the skepticism you'll need for the flood if books, web sites, podcasts, magazines, and Friendly Advice you will be getting in the next year or ten.

Talk to the people who will hep you raise this kid (i.e., friends and family) because that's the community whose mores you will be working in, and whose help you will need.

Get your sleep!

And good luck. :7)
posted by wenestvedt at 10:50 AM on December 24, 2016 [10 favorites]

if you don't already have a regular work out routine you might want to develop that. I have heard that being in better shape can help make pregnancy and childbirth easier (YMMV of course) including prenatal yoga, which I am told is really awesome.*

*full disclosure I have never had a baby.
posted by supermedusa at 10:59 AM on December 24, 2016 [2 favorites]

I saw my regular doctor for the first three (maybe more) months before I went to the ob in her practice. Go for a check up first and your doc will tell you what to do.

Get a stack of cheap pregnancy tests at the dollar store. It may take awhile to get pregnant. I would test before doing anything on the forbidden list (drinking, hot tub) because with my first it took me 18 months to get pregnant and that is a loooooong time to go without a glass of wine. As long as you're taking folic acid and not binge drinking, smoking, etc you will be fine. Eat lots of fruits and veggies because you could be one of those people who can only tolerate red meat in the first trimester.

If you've been on bc for a long time you haven't been ovulating, so what you're really waiting for is that to kick back in. Once you figure out when you're ovulating, that's like most of the battle.

I was someone who wanted ALL THE RESEARCH but there's so much contradictory advice regarding pregnancy. Start with your doctor and if anything seems nuts, check askme. My dear mother went without chocolate all through pregnancy and breastfeeding because her doctor said to avoid it.
posted by TheLateGreatAbrahamLincoln at 11:02 AM on December 24, 2016 [4 favorites]

If you're on a well test your water now for nitrates as well as the normal things. Nitrates can make it hard or impossible to conceive. And if you eat a lot of fish and sushi like me and my friends do quite a few of them have had mercury tests and waited to get pregnant a couple fish-free months because of high levels (half my friends own boats and we eat a lot of fish, probably not an issue for average US-ian).

There is a ton of bullshit on the internet regarding folate, I know this because I had a b12 deficiency and had to supplement, I recommend reading some more authoritative resources than google or talking to your doctor on that one.

The other main thing is ask the female relatives on your mothers side for health history and tips. You are more like them than anyone else. If they all breezed through pregnancy 4 or 5 times a piece great, if they all gained 65lbs and spent the last 6 weeks in bed you might be doomed to a lot of netflix.

And don't worry, there's plenty of time to panic about everything else after you get pregnant ;)
posted by fshgrl at 11:03 AM on December 24, 2016 [3 favorites]

The recommendation is to take folic acid for two months BEFORE you try to conceive. I would actually start this today, even if you need to run to the market.

It's also recommended to see your doc asap. You can discuss your health and any genetic testing you may want to get done before or in the early stages of pregnancy.

You also should eliminate (or severely limit) your alcohol intake on days you may be pregnant. Also if your caffiene intake is over 200mg a day you want to get it down to 200mg or less. It's way easier to cut down before you're pregnant and exhausted from that.
posted by Kalmya at 11:06 AM on December 24, 2016 [2 favorites]

One (very minor) piece of advice I wish I'd heard before trying to conceive is to get tested for immunity to measles, mumps, & rubella. At my first prenatal appointment, I was tested (standard procedure at this office)--and it turns out the vaccines I got as a child aren't actually protecting me from rubella, which is very dangerous to the baby during pregnany. I can't have the MMR vaccine while pregnant, although I'd be advised to get it again once the baby's born.

Not a big deal unless maybe you work with kids in an area where a lot of people choose not to vaccinate. But it would have made more sense to me for my doctor to bring this up, say, when she took my IUD out, rather than when she confirmed I was pregnant.
posted by cogitron at 11:06 AM on December 24, 2016 [11 favorites]

Folic acid, at least 400 micrograms a day.

If you already have a hospital in mind, you will need an OB who has admitting privileges at that place. Their website may have a list. Keep in mind that due to call schedules and the somewhat unexpected nature of going into labor, the person you select as your OB may not be the one who actually delivers your child. My recently pregnant friends say their practices dealt with this by having you meet each of the practice docs at prenatal appointments.

If you have any chronic medical conditions/take medications on a regular basis, talk to your prescribing doc to see if you need to make any changes during pregnancy.
posted by basalganglia at 11:08 AM on December 24, 2016

you definitely want to talk to your doctor(s) about any prescription medications however do not be afraid to get a second opinion from a OB that has experience with the specific medication.

my wife changed some of the medication she was on before getting pregnant but did not change all of them. the first doctor we spoke to didn't know enough and tried to get her to stop to "play it safe" when in reality stopping would have been much more harmful to both my wife and the baby. our eventual OB understood the drugs in question and was able to say "it's much more important for you to get this medicine so that both you and the baby are healthy".
posted by noloveforned at 11:38 AM on December 24, 2016 [3 favorites]

Apart from the vitamin supplements, the main thing to do is just chill. Sleep loads! Sleep in! Have three-hour brunches!

Early prenatal care is pretty meaningless and a GP can deal with it easily. Decide what, if any, screening/testing you want -- would you abort if quality-of-life issues were uncovered? (Very little point to testing if the answer is no.)

Lotion won't do a damned thing. Okay, that's a lie. It will be a nice thing for your partner to rub you down with if you enjoy massages. But there's nothing that can prevent/minimise stretch marks.

Figure out the sorts of things that you feel will be important to you (do you want to avoid a c-section, or are you the sort of person who would thrill to the idea of scheduling one months in advance? do you want an unmedicated birth, or are you interested in access to ever good pain relief out there?), and when talking to an OB, find out where they stand on the things that you want to prioritise.

My understanding is that boozing before you know you have conceived makes no difference -- I cannot remember the explanation; something about a period where it is too early to affect the embryo -- consider the disaster it would be if alcohol at the very very start of pregnancy was harmful given the huge % of the population conceived while mom and dad were drunk! However, more a thing to ask a (research-loving, non-judgy) OB about.

I cannot say enough good things about Kate Figes' Life After Birth and Dr Jack Newman's book, and I cannot say enough terrible things about What to Expect. I enjoyed reading pregnancy/baby books to the point where I built up a collection of antiquated ones. Rima Apple has a couple of terrific books about the history of advice "experts" have given to mothers -- these are excellent reads; they will give you the confidence to ignore all the terrible, doesn't-feel-right-to-me, not-going-to-work-for-our-family advice you will be deluged with. (My vague understanding is that if you are in the States, US paediatricians dispense a great deal of parenting advice, which seems quite bizarre from here. Some of the worst infant feeding advice out there comes from maternity ward nurses and paediatricians, and some of the cruddiest parenting advice I've heard came from doctors and was presented in a "you MUST do this" fashion. Amazing! There IS good advice out there, but you can discard tonnes and tonnes of it.)

If you get a bad gut feeling about a health care provider, it is totally kosher to: ask for a different nurse while one is in labour (I had one who had no understanding of how pain control worked -- she had some very bizarre ideas there -- and unnecessarily went through hell until I just asked for somebody else to treat me), or 'fire' your OB, even very late on. My water broke and my OB turned into a weirdo and did not listen to my "No; that will raise the risk of infection," and I said fine, I was off to get a second opinion. He was absolutely furious and said I couldn't be his patient anymore if I didn't trust him -- yeah, dude, I don't, and I was trying to tell you that politely. Maybe five years later he was in the newspaper, losing his license to practice medicine. So, yeah, pretty glad I went with my gut there.

Finally, one thing I did that I was really happy with myself for was to start digging through thrift stores and grabbing the good clothing -- up to, like, size 4T, while still pregnant, if it was nice enough; I had the space, and the time just flies and it is a lot easier to shop without the 4yo kid in question in tow, and, started amassing a library of classic children's literature. I had some volumes saved from my childhood, and between that and the 2nd-hand kiddie lit buying frenzy, I had quite the library when the kid arrived. (If you are not sure about a book -- read it out loud. That is the best quick test of a book for wee tots: is it pleasant to read out loud? If not, forget it. Neither of you will ever really thrill to it.) I can't stress how pleasant this made the early years, having so much quality lit to choose from.
posted by kmennie at 11:41 AM on December 24, 2016 [9 favorites]

You don't smoke or hang around people smoking indoors do you? I'd quit that if you do.

Also, I'd go ahead and quit drinking. Quitting during the two-week wait was maddening. My advice would be to just go ahead and set that aside.

Learn what you can and can't eat while pregnant, and see if you can institute that as a daily diet for awhile. I spent my first trimester going into restaurants and walking around the grocery store googling "can I eat mayo pregnant?" "do mussels have mercury pregnant?" "cantaloupe listeria pregnant" "is the cheese in pesto pasteurized" "is marscapone cheese in tiramisu pasteurized" and so on. Sometimes I was hungry af but couldn't figure out what I could eat; sometimes I bought something only to realize I couldn't eat it; sometimes I got my heart set on something but discovered it had been the subject of a Listeria recall recently. After a couple months, I was a pro. It would've been nice if I'd figured all that out ahead of time, before a slip up would stress me out, and before the nausea and intense food preferences kicked in.

I became somewhat focused on environmental and household sources of unhealthy chemicals. Do you want to replace your toiletries? Do you want to test your water, or buy a water filter or an air filter (if you're near a freeway or port)? Do you have any concerns about the flame retardants in your couch or mattress? What about your shower curtain -- is it the kind that gives off a plastic smell? Would you want to replace your Teflon pan with cast iron?

Is there any house repair that needs done that involves chemicals that you wouldn't want to expose a fetus to? Do you need to caulk up any openings? I found myself wanting to do home repair projects to prepare our house, but oh wait, I shouldn't be exposing myself to those chemicals. Sometimes you can buy safer alternatives, but they often need to be special ordered and cost a lot.

Dental work. Do you have any mercury filings that might need replaced in the near term? (Ideally, this would've happened awhile ago; see the comment above about mercury.) Have you had dental X-rays done lately?

Hair and nails. Do you dye your hair? ACOG says "most" dyes are "probably" safe, just avoid ones with ammonia, blah blah -- far easier just to go ahead and dye your hair back to a natural color that you can let grow out. Same with nail care. I'd go ahead and remove gel nails. Again, this is a "most are probably" safe situation, but given e.g., the advice here to minimize the time with your nails soaking in acetone, why not just minimize it right down to zero by switching to a more natural nail care regime?

What's the deal with maternity leave at your work? If US-based, are you like, one month away from being covered by FMLA? Or from being eligible to receive paid leave from your employer? If so, you might want to delay. If CA-based, would there be a big change in what SDI / Paid Family Leave would consider your salary (and hence pay you) if you waited a month?

There are things I wouldn't worry too much about. You probably have tons of time to switch doctors and hospitals, unless you want someone who's really in demand. Hospitals don't really "fill up" and can't be "reserved" anyway. On the other hand, the best doula / midwifes might, so that's something to research and lock in on the early end of your pregnancy. Similarly, I'm sorry to even bring this up, but something to do during pregnancy (though not yet) is to start doing research to figure out which daycares accept babies, so you can get on their waiting list right away, if that's something you'll want. I encountered a few places with six month waiting lists or more. You don't need to do that yet, but if you're going to use a daycare in say, the first six or eight months of the baby's life, I would definitely do the tours while you are pregnant and not while toting around a baby.
posted by slidell at 11:49 AM on December 24, 2016 [3 favorites]

^ By the way, my approach to pregnancy is on the more neurotic end, so ignore some of my advice if you'll be able to be one of those people who is chill about things.
posted by slidell at 11:54 AM on December 24, 2016 [2 favorites]

I'm a mom and a grandma. My daughters-in-law say this: if you're not doing some kind of flexibility-promoting exercise start now. Yoga, Pilates, dance, whatever.

If you have never spent much time with babies now is a good time to do so. Be straight with your friends who have babies and ask them to help you learn what you need to know; ditto for your husband.

Also, genetic testing. Not just because you're probably in your thirties, but also because you never know. My oldest son- who is adopted- and his wife turned out to both carry genes for Cystic Fibrosis, which they didn't find out until a couple of months into the pregnancy. The baby is fine, is a carrier too. If they decide to have another baby they will do selective in vitro.
posted by mareli at 12:25 PM on December 24, 2016 [2 favorites]

My doctors recommended starting prenatales 6 months before trying to conceive, so I would start those ASAP.
posted by avocado_of_merriment at 12:57 PM on December 24, 2016

I would talk to your GYN, who is almost certainly trained in OB. A lot of OB/GYNs only do GYN stuff for lifestyle reasons. But if you like her, she can probably give you recommendations for someone for the OB end. She can also walk you through the process of pre-conception care. Stuff to think about:
-get any vaccines you need, especially the flu, Tdap, etc. Your immune system goes to pot when you are pregnant.
-start taking a prenatal vitamin now so you're topped up on your folic acid. (You can get both of those when you're pregnant, but it might be easier to do ahead of time).
-you have PLENTY of time to decide about a hospital, but you'll want to make sure whatever OB you work with has admitting privileges at hospitals you're thinking about.
-stop smoking if you smoke.
posted by The Elusive Architeuthis at 1:05 PM on December 24, 2016 [1 favorite]

This might be the answer to a slightly different question 'how do I get pregnant', but I'd say start charting your cycle straight away. I had no idea how little I knew about my own body before I started this whole thing.
Do you know how long your cycle lasts, how long your period lasts and what the days are when you can get pregnant? I had no clue on this whole thing till like 5 months ago. I don't know why we're not all taught about it in school!
posted by stevedawg at 2:24 PM on December 24, 2016 [4 favorites]

if you decide to get tested for immunity to measles, mumps, rubella and chickenpox, be aware that those are live vaccines and it is recommended to avoid pregnancy for 6 months after receiving them.
posted by The Elusive Architeuthis at 2:31 PM on December 24, 2016 [5 favorites]

Prenatal vitamins aren't necessary but folic acid is. Start that asap, ideally you should be on it before you get pregnant.

Taking Charge of Your Fertility is a great book to get started with understanding your cycle with the goal to get pregnant (or not!) and I highly recommend it. You might get pregnant like that *snaps fingers* or you might need to time things accurately, but this is a low stress way to go about figuring it out.

Good luck!!!
posted by lydhre at 3:09 PM on December 24, 2016

You should make sure your hospital has a NICU (Neonatal Intensive Care Unit).

It is of course unlikely you'll need it, but you never know. (I speak from experience. For our youngest child -- now a healthy 24-year-old -- I was having a very normal and uneventful pregnancy until week 30, when I had to have an emergency c-section due to a ruptured appendix.) It's so much more reassuring to have your newborn (and premature or otherwise compromised) baby whisked up to the NICU on another floor in the same hospital, rather than having him or her transferred by ambulance to some other hospital!
posted by merejane at 4:21 PM on December 24, 2016 [1 favorite]

The one thing I wish I'd thought about before getting pregnant was whether my apartment was baby/kid-friendly. It wasn't; it had lead paint and kind of a sucky layout for a family, and we ended up moving when our baby was three months old, which I really do not recommend.
posted by Metroid Baby at 5:14 PM on December 24, 2016 [2 favorites]

You can get a whole bunch of ovulation predictor strips and pregnancy strips on Amazon for super cheap. Start using the ov strips, once a day, a week after your period starts. The best time to have sex is right before or during ovulation. For us, timing was key - we went without birth control for a long time, but I didn't get pregnant until I started really paying attention to ovulation and focusing on those days.
posted by beandip at 6:47 PM on December 24, 2016

My best advice is be prepared to be uncomfortable when you get pregnant. You may or may not get morning sickness (I did, the first 3 months, then it went away). Your body will change, yes, you might get stretch marks, and you can use lotions and/or cocoa butter, to ease that transition.

There is nothing like experiencing the first flutter of life.

As it goes on, you might want it to be done already. I know I did. It seems like it takes forever.

It never meets your expectations, and then you have a baby, and then it's great. Until you are walking up and down, at 2:00 a.m., jiggling, and singing the Elephant song. But that's okay, because it's your own little baby that you carried inside you for 9 months, and you love him or her and you will love and protect them forever.
posted by Marie Mon Dieu at 7:21 PM on December 24, 2016 [1 favorite]

Regarding Tdap, your ob will send you for a booster in your third trimester, when the baby will carry at least some pertussis immunity until they can get the first shot at two months. You don't have to worry about it now, and you'll pretty much have to do it then no matter when your last booster was. MMR is the one to check on now!

There are perfectly fine inexpensive prenatal. You can ask your doctor for a rec or do some research. There are a lot of choices and the category is well-monitored by anxious parents and their advocacy groups. It's really a combo of whether you have any special needs according to your doc, and what sits well in your stomach. (I took a generic Walgreens prenatal which was like $20 for 90 pills or something.)
posted by Eyebrows McGee at 7:52 PM on December 24, 2016

Oh and a really fun thing I did was I started paying attention to the songs I love and figured out which ones would be good to sing (over and over and over) to a baby.
posted by TheLateGreatAbrahamLincoln at 8:19 PM on December 24, 2016 [2 favorites]

Seconding Taking Charge of Your Fertility--even if you aren't a data-driven nerd like I am who tracks her cycle for fun and information, it's very helpful when actually trying to get pregnant to know when your most fertile days are. You can use ovulation predictor strips or chart your temperature and cervical mucus; TCOYF goes into great detail about how to do this. For some people, having lots of sex all the time is fun/average; for other people, knowing that having sex every other day in the week before you ovulate is all that's strictly necessary (maybe daily in the two-three days before) is a huge relief.

One commenter above mentioned that drinking before you test pregnant is often considered ok; the reason for this is that the embryo/placenta has not implanted into your uterine lining yet, so your blood supplies are not yet in contact. Some people are comfortable doing "drink til it's pink (the pregnancy test)", some aren't, this is up to you and your husband and possibly doctor.

I'd also recommend Expecting Better, a book written by Emily Oster distilling the exhaustive research she did into all the things you are/aren't supposed to do during pregnancy.

Seconding the advice to figure out what your birth preferences are before getting too far along in your pregnancy. I've never heard of anyone regretting hiring a good doula, if that's something you want to pursue. Having a knowledgable person with your throughout your labor and birth can be incredibly helpful; an OB or midwife or even L and D nurse is not going to be with you the entire time.

That's all I have for now, hope that's helpful! Full disclosure, I'm trained as a birth doula, so I have lots of thoughts and opinions about this. Please feel free to MeMail me if you'd like further advice or discussion.
posted by Illuminated Clocks at 8:31 PM on December 24, 2016 [2 favorites]

Yeah, there's no reason to quit drinking during TTC or the two-week wait. A book I'd recommend on this issue, and others, is The Panic-Free pregnancy.
posted by PhoBWanKenobi at 11:55 AM on December 25, 2016 [4 favorites]

Get your teeth cleaned now if you are due for the dentist. I had a very, very strong gag reflex during both of my pregnancies; I vomited every time I brushed my teeth from week 6 to the day I gave birth. No way could I have made it through a professional cleaning.
posted by gatorae at 6:41 PM on December 25, 2016

Everyone has mentioned prenatal vitamins, I wanted to add two things on this:

1. In theory, if you eat healthy you don't need them. I'm not the healthiest eater by a long stretch and I had my folic acid tested before pregnancy (for other reasons) and asked my doc if it was high enough for TTC. She said "Yes, but we encourage you to take a supplement anyway.". So I was taking a folic acid (only) supplement for the first few months TTC. Then I would read all this stuff online about vitamins and minerals I had never heard of that could help conception, or maybe implantation, and look up the daily dose and what foods had them etc. etc. And basically I felt like I would have to eat truckloads of food to get my daily dose of every stupid vitamin and I was stressing myself out trying to do that, so I switched to a prenatal multivitamin so I could relax and not try to guess if I was getting enough freaking selenium. So I recommend: don't just take folic acid, take a multivitamin. Not because it's likely to make much of a difference health-wise, just because it can let you relax a little if you're otherwise inclined.

2) In terms of which, I asked the OB (actually the resident who saw me before the OB) at my first appointment which one was the best, and she said they're all basically the same. She was visibly pregnant and told me she takes the costco store brand because they're cheapest. There are not "good ones" they're all the same thing. Get whichever one is cheapest or has the nicest packaging, or whatever. I switched to one with DHA because the baby doesn't like salmon.

Finally, everyone has mentioned drinking, but are you a fish eater? If so, be sure to look up the mercury risk of different fish. You need to cut out high-mercury fish yesterday because this takes a long time to clear out of your body.
posted by If only I had a penguin... at 7:55 PM on December 25, 2016 [1 favorite]

My only additional piece of advice is to save everything related to childbirth specifically until after you are pregnant. I can't imagine how it would change anything you would do up until that point, even if you're the type of person who would move to a new location because you don't like the obstetric offerings in your current neighborhood, you still have time to do that once you're pregnant. 9 months is a hell of a long time, really, even though from some perspectives it goes by in a flash. If you get ahead of yourself and start touring delivery wards and interviewing doulas and whatnot, and you're having trouble trying to conceive, you may find being knee deep in baby production factories/workers and so forth to be emotionally upsetting. I know I would have.
posted by treehorn+bunny at 6:47 PM on December 26, 2016

Thanks all of you for your very helpful suggestions!

I got the vitamins and have been taking them for a few days now.
I don't take any medications, so I'm good there.
Don't really drink alcohol that much so that's not a big deal either.
I'm already familiar with my company's maternity leave.
Childcare is taken care of (my husband will be a stay at home parent).

What about marijuana though? If I go visit friends in Colorado and partake, is that ok?
Are there common household chemicals that I should be avoiding at this point?
posted by LizBoBiz at 10:18 AM on December 27, 2016

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