Before I Get Pregnant

What should I do before getting pregnant? Is there a need for special preparation, or be spontaneous? When is the most effective time to get pregnant? … and many more questions that may make you anxious and you want an immediate response! Do not worry, more questions will arise, most will have an answer, and to those which you do not find any,  I  will try to answer for you. Do not worry, according to studies, everything we worry about in life:

87% – never happens

7% – really happens

6% – we can somehow influence the outcome

Which we can interpret that most of our fears will not happen, and the few that really will happen can not be controlled.

Be cheerful, positive and keep smiling. Laugh, ‘burst out’ laughing, so you create reactions in the body that lead to an increase in your tone, confidence and immune system. All this leads to a sense of health and happiness! And this is the most important thing to feel well during pregnancy, which in some or other form ‘stresses’ your body. Here too, it is very important to emphasize that pregnancy is a PHYSIOLOGICAL process and in no case should it be perceived as a burden or even worse, as a disease. Dear ladies, your body, physiology, and cycle of processes are created to be able to carry one or more pregnancies, accept it and enjoy this process. I’ve heard many women say this was one of the best moments in their lives! You become even more beautiful, charming and glamorous during your pregnancy!

The important moments and things to pay attention to before you become pregnant are many, but here I would pay attention to some of them:

  • Family history
  • Consultation with an obstetrician-gynecologist
  • Alcohol, smoking, medicament and drug abuse
  • Nutrition
  • Sports
  • Relationships in the family (only and exclusively between partners)

What does family history mean? Medical history/Anamnesis means interrogation. Well, of course you will not question your partner under a flashlight in a dark room. This means getting to know the relatives of the person next to you, asking if someone has any serious illness. There are diseases that are passed on to the generations. You may not be a health specialist and you do not know which are being transmitted and which are not, but it is good to be aware and in some doubt to consult with your general practitioner (GP), obstetrician-gynecologist, doctor of another specialty. In some cases, genetic counseling and analyses may need to be done. This information is not as stressful and frightening, as it seems to you now. It’s better to get the information you need early and to take the appropriate measures than to hear anything later and be far more stressed when you are already pregnant. Go back  to the lines above and read about fear and anxiety! If there are problems, it does not mean to dump your partner but to look for the solution together with the specialist.

Consultation with obstetrician-gynecologist. Before getting pregnant, its a good idea to meet with your Obstetrician-Gynecologist and share your plans. gynecological examination should then be carried out to reject any infectious diseases, tumor formations, deviations from normal statistics and genital location and, if necessary, make a microbiology specimen collection. It is lso advisable to do a pap-smear. I know that gynecological examination is always associated with an unpleasant experience, but dear ladies, in the hands of a careful physician, you will not experience pain. Most gynecologists would also perform an ultrasound that provides additional information about the layout, size, monthly cycle, readiness to get pregnant, and so on. Here I want to clarify that the gynecological examination is NOT dangerous even during pregnancy. It should be done because it provides additional valuable information that can not be obtained only through ultrasound. There are cases where a refusal of a gynecological examination would lead to an incorrect diagnosis and incorrect therapy.

If you wish, for pregnancy, I would recommend taking blood tests, namely the Blood Group and the Rhesus Factor of the Partners – there is a condition in which if the mother has a negative rhesus factor and the father has a positive one, in case of second pregnancy, there are fetus complications risks if during the first one prevention with anti-D gammaglobulin has not been done; CBC (complete blood count) – generally indicates the presence or absence of anemia and infection; glucose or blood sugar – increases in case of diabetes; AST and ALT – hepatic enzymes, indicate whether there is liver damage; bilirubin – two types, it is indicative of the hepatic function and the hemolytic anemias; urea and creatinine – show kidney function; toxoplasmosis IgM and IgG – parasitosis that damages the fetus; Hepatitis B and Hepatitis C – infectious diseases that can lead to severe liver disorders; AIDS – an infectious syndrome in which the immune system is suppressed and the body has reduced resistance to infections and neoplasms in the body; syphilis – an infectious disease leading to severe damage to the nervous system in the diseased, if not treated, and to severe damage to the whole fetus. All of these diseases are transmitted to the fetus in the womb or during labour. Urine is also tested for the presence of sugar, protein, sediment, increased bilirubin products, bacteria, and so on.

I would recommend you visit a dentist before you become pregnant, as well as between 20-30 week of gestation of pregnancy. There are studies that show that, in the presence of infections in the oral cavity, the likelihood of premature birth increases.

Getting pregnant is a complex biological process that requires optimal conditions, it happens after ovulation has taken place. Ovulation is a process of separation of the ovum from the mature follicle into the middle of the menstrual cycle. If the woman has a 28 day cycle ovulation occurs at 14 +/- 2 days. After ovulation occurs, it takes about 24 hours to fertilize a sperm in one of the uterine tubes. Ovulation tracking is done with tests available at pharmacies based on the LH (luteinizing hormone – female hormone) peak. For polycystic ovary syndrome, this test is not applicable due to the high level of LH throughout the cycle. Your gynecologist can also estimate approximately the day of ovulation by monitoring the ‘pupillary phenomenon’ of the cervical canal, the spinnbarkeit, density and colour of the cervical mucus as well as folliculometry. To optimize the probability of getting pregnant, it is best to have sex once every 24 hours, because the more ejaculation a man has, the more he reduces his fertility. It may sound fun, but to optimize the process, it is good for the woman to get an orgasm because the sperm is ‘sucked’ into the cervical canal, the uterus contracts, mobility of the uterine tubes increases, and these are processes that help the sperm and the ovum to move to each other.

Even before you get pregnant, start taking folic acid by 400 micrograms per day until 12-13 week of gestation. Now the logical question is when should we begin to take it? There are publications that write 4 or 12 weeks before the conception, but I would ask – when do we know that a woman will become pregnant – no one knows. That’s why I would advise you to start taking by 400 micrograms of folic acid a day from the moment you start trying to get pregnant or a month earlier. Folic acid is considered to prevent neural tube defects.

Alcohol, smoking, medicament and drug abuse – why they should not be used before and during pregnancy, and when we breastfeed.

Alcohol reduces reproductive capacity in both men and women. There are many studies showing how alcohol has a detrimental effect on organogenesis (the formation of individual organs) and on organ development.

Smoking also has a negative impact on both sexes. For men, both the increased consumption of alcohol and smoking leads to reduced spermatogenesis (sperm formation) as well as to their fertility capabilities.

In women, the harmful effects of smoking on reproductive functions are even more detrimental. Substances in cigarette smoke reduce the mobility of the uterine tubes, the place where the actual fertilization of the ovum occurs, cause spasms to small vessels in the lining of the uterus (endometrium), thus leading to poorly developed endometrium, inadequate to take up the fertilized egg. Smoking is more likely to lead to abortion, premature birth, placenta previa, placenta accrete, lower foetal weight compared to children of non-smokers, more frequent bleeding during pregnancy, increased morbidity and mortality of the fetus, and so on.

Alcohol abuse as well as smoking generally lead to very negative effects on the body as a whole, which is reflected in many aspects both on the possibility of conception and to carry out a pregnancy!

This is the time for all smokers to think not only about what they do to themselves, but also to the non-smokers around you who like your company, but obviously not your habits, and most of all, to think about how bad they are for the next generation!

Before pregnancy and during pregnancy, if you are taking medication in connection with any illness, it is imperative to consult your doctor (the one who has given you the medicine) and your gynecologist. Do not take any medicine during pregnancy without consulting a doctor.

Drug use is a very serious problem. It has many negative effects on the human body, it’s reproductive abilities and pregnancy; it has a social and criminal impact. Even if I went into details, I would hardly convince anyone to give up on drugs. Drug addicts need serious support and help from specialists. Here is a good idea to say that the percentage of people with AIDS, Hepatitis C, Hepatitis B here is very high, and these diseases can be passed on to a very large percentage of both the partner and the offspring!

Nutrition. You have probably read and know a lot more diets and methods of nutrition than me, but I will still say some sentences about this. I think that this question is essential.

During pregnancy, calorie intake increases, with about 30-35% more than a non-pregnant woman. Here, I’d like to point out the biggest misconception and say that a pregnant woman should not think she should eat as if for two. Dear ladies, pregnancy is not an excuse to eat in excess or gorge on unhealthy foods. It can only cause you health problems, and it is also not aesthetic. Of course you do not have to starve! There must be no extremes, there must be moderation in verything.

Daily food intake should be divided into several meals per day. In my opinion 3-4-5 meals a day is optimal. Yes, in the hectic everyday life, this is quite difficult, but if you are reasonable, you can put 2-3 fruits in your bag before work and eat them before noon and in the afternoon. So if you have breakfast before work, lunch and a light dinner with one or two snacks in, you will have 4-5 meals.

And what should we eat? Before and during pregnancy, your food should contain enough protein, carbohydrates, fats, vitamins and trace minerals, which is why it is important to eat a variety of foods. If you can have 40-50% of your food green, it would be great. Under green meals, I mean fruits, vegetables, nuts without thermal treatment or with a minimal one. These foods have a lower calorie intake, contain a great deal of water, fiber, which helps to improve our digestive system and keep us fuller for longer. Eat produce that are local and in season, because these fruits and vegetables have the highest content of vitamins which are vital to you and your baby. This way, you will not have to take multivitamins which may cause heartburn and naseua.

Protein intake is very important. It is not necessary to be meat proteins because there are many women who do not like to eat meat products. However, you must replace meat with sufficient and quality protein. Let’s not forget that there is a lot of iron in the meat, and during pregnancy hemoglobin drops and sometimes it is necessary to take an iron supplement. In a normal diet there should be healthy fats. Fats are present in animal products, avocados, nuts, and so on.

Carbohydrates are also very important. As you know, they can conditionally be divided into simple and complex. Simple carbohydrates include but are not limited to, chocolate, sugar, honey and sweetners. Complex carbohydrates are those found in potatoes, beans, bread, rice and other grain products. Carbohydrates should take up at least 30% or yout total daily calories, and should be made up primarily through the complex ones. You should know that in the sweet fruits there are many simple carbohydrates, be aware of your intake of simple carbohydrates because they add up very quickly. Consumers of carbonated beverages and natural juices should also be aware that a 250ml glass can be burned with 20 minutes of high-intensity cross trainer rotation because of the high sugar content. You will hardly go to your cross trainer every time you drink a glass of carbonated drink/juice, so think about swapping it out with water or tea. I do not mean that you should give up your favourite foods and beverages, but just limit them to 1-2 glasses of juice a day and a small piece of dark chocolate as is it the healthiest choice.

Enjoy the food you eat, but do not turn it into your main source of entertainment.

It is important to mention that at the end of pregnancy, women should put on no more than 10-12 kg of her original weight! Actually, the pregnant woman has gained about 4-5kg, when we take out the fetus, the placenta, the increased uterus, the increased amount of fluids, etc.!

Sports. Sports is important for both women and men. When we exercise, we are fit, have better blood circulation, vitality, vigor, self-esteem, a more reactive immune system, less stress, and the benfits range on. Sports lead to a reduction in weight, at the expense of fat to the fullest. This is important in some conditions such as polycystic ovary syndrome, as it increases reproductive capacity. In the initial state of reduced glucose tolerance or initial diabetes, diet and sport can be beneficial.

Where and which sports? This is a matter of your choice, I would personally advise you to avoid static sports such as in the gym. Another tip is to find a place for sports with a coach or a person to help guide your workouts. It is not my chance that they have the best bodies know what they are doing. Self-training, is not advisable if you have not previously been involved in sports. This is because you may not know your abilities and may underestimate or overestimate youelf. In either case, it will have a weak effect or even injury. The trainer will monitor you, test you and set the load according to your abilities. It’s a bit more expensive, but you’ll love the end result. Whether you are attending group or individual activities is a matter of preference, time, and last but not least money. Choose a sport that entertains you and allows you to ‘let off steam’. Try different sports and different places to practice. During pregnancy, you can practice various sports unless it is contraindicated in certain conditions, but in no case strength sport. Try yoga, calanetics, tae-bo or zumba. It is important to move before and during pregnancy. The more you exercise, the easier it will be to carry the extra kilos, the more red blood cells you will have, the easier it will be during delivery, the tougher you will be, with higher a pain threshold, and you will recover more quickly after childbirth.

Sports is healthly if practiced only within reasonable limits, do not forget that there are risks of injuries and trauma. These are mainly due to distraction, overstraining, inappropriate warm-up or intensity during practice, as well as by other participants in the sport. When you are working out, never stay in one place motionless in the center of events without watching others. I could give you plenty of examples, but if you do tae-bo and you get tired and stop moving in the rhythm of the group or even sit down, a participant can kick you or strike inadvertently. After all, it is not important who is to blame, but that you are injured!

Pay attention to the equipment. Workout gear that is good and good and comfortable not be felt. Poorly selected clothing, shoes, and other accessories may end your routine prematurely.

I personally train at WoW Sport – more information can be found at

Relationships in the family (only and exclusively between partners).

Creating a new life must be dictated by LOVE!

Before you create a family and children, you have to realize that this is forever. You need to be confident that you want it at this point in time with your particular partner! Creating a child will not solve unsolved problems. Do not use it as a vent! In the relationship between two  – there are only two! Do not let other people interfere, no matter how close they are to you. ‘Too many cooks spoil the broth.’

Since men and women differ in some ways – communication is key! Talk, share, meditate, and make decisions together. Try to create a hobby or obligations to do together. This will allow you to spend more time together, solve tasks and achieve compatability with each other.

When it comes to talking, I must mention some differences between men and women as a whole and in terms of talking.

Women are created to do several tasks at once – talking on the phone while ironing, watching the children, watching their favourite TV series, cooking and thinking about what tasks to give to her husband. The men on their part perform only one task in which they are engaged – he can watch the match and recognize each player in one movement, mentioning at least the last 3 teams he played in, he can fix the wall-plug in the bedroom, or repair the car, but he does not hear what the woman is telling him at the time. He nods his head and you think he understands you, but he has not even heard you. This is because men do their tasks one by one. You should not be angry, but understand and know when to talk to him – for example, you have 15 minutes to talk in the half-time.

Why do women talk so much? Women deal with stress by talking. They love sharing, telling and getting excited. Men, do not try to advise women – they do not want this, they want you to listen to them, to be empathetic and compassionate about their problems. Instead, listen, comfort, and support them so that they can always rely on you. She will love you and be forever yours!

Why are men silent? Men deal with stress by watching a match, searching on the Internet or fixing the car. When a man comes back from work, he needs a little time to shake off the stress. This is why, ladies, do not attack your men right out of the door with your problems or the tasks you will assign. Give him 20-30 minutes to recover by telling him that dinner will be ready soon, ask him if he wants a beer or to take a shower and tell him that you need him and you want to talk about something that worries you. He will enjoy your attention and feel happy!


Center for Fetal Medicine

Get informed about the world of Fetal Medicine with Dr. Boris Stoilov.

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