Oct 28 2008

Pre-Conception

Posted in All Posts, Getting Information, Pre-Pregnancy, Pregnancy Life

This morning I went to the doctor for my “pre-conception” visit.  I don’t know exactly what I expected, but I came away feeling like there should have been more.  I mean this is a huge, life-altering thing we’re talking about doing, and the doctor just smiled and nodded and said, “Okay, so you want to get pregnant, did you have some questions for me?”  There was no bloodwork, no urinalysis, they didn’t even check my weight.  They did check my blood pressure so I should take some measure of comfort in that, but still…

Maybe I’m blowing this out-of-proportion as I sometimes tend to do, but from what I have been reading, I thought that a work-up was in order.  You know, just to make sure everything was okay before getting started.  But the doctor said I look healthy (and as we know, looks are everything) so apparently I’m good to go.

I did learn something useful when I asked whether I could continue my current medicines.  Now I don’t take a lot of medicine if I can help it, in fact, I only take aspirin about 5-10 times a year.  But I was relieved to receive the go-ahead with the things I do take.  The only confusion I still have is in regards to the vitamins.  I am currently taking a multi vitamin that covers most everything, including folic acid, but the doctor recommended that I up my dosage a bit.  She also gave me a pregnancy package that includes several prenatal samples.  Call me cynical, but I am nervous about pills that doctors push.  I can’t help it, I’ve watched too many documentaries on the evils of the pharmaceutical industry so I am wary.  The samples include the following:

Vitafol-OB +DHA – This vitamin states that it is sugar, lactose, gluten and iodine free.  It is also free of ocean boren contaminants (are they referring to mercury?) and it is a natural plant source.  Then to the right of the captions is a picture of a fish with a big x through it as the vitamin does not contain fish oil. 

Then we move to Prenate Elite, a vitamin that is “film coated” but dye free.  Apparently it is the “first and only Rx prenatal vitamin with metafolin.”  I’ve never even heard of meta-folin!  This particular brand is available by prescription only.

The Prenate with DHA is the one that frightens me the most with its claim to be a “gentle stool softener.”  I’m sorry, a what?  Since when did they start putting stool softeners in a prenatal pill?  I mean I know that there can be certain problems that would require a stool softener when someone is pregnant, what about before or after you’re pregnant?  What do you do with the stool softener then?

And last, we have the Citra Natal with DHA, an “Rx prenatal vitamin and omega-3 (DHA) derived from an all natural plant source.”  It, too, does not contain fish oil nor does it have mercury or PCB.  It is also a stool softener.

So what have I learned from this little visit?  Well, there are a plethora of prenatal vitamins from which to choose and I will have to do some research to decide which might be best.  I also learned that from the time we start trying to conceive (which is in January, by the way) until the time we do conceive, I’m on my own.  In fact, she said that I don’t need to come see her again unless one of two things happens: we haven’t conceived after seven or eight months of trying or I am eight weeks pregnant. 

And that is the official word from the doctor.  I guess all I have to do now is keep exercising, eating healthy, taking my vitamins, and having lots of sex.  Sounds like a good plan to me! 

Oh – and if you have any experience with prenatal vitamins or have any brands that you’d like to recommend, I’m all ears!!

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DeLynn - October 28, 2008 - 5:48 am

I think the reason for the stool softener is because the increased iron one would get via the vitamins may necessitate one. :) Personally I think I would avoid that vitamin. My dh is an Ob/Gyn…I think he has women just buy prenatal vitamins over the counter. That is what you could do now….especially make sure to get that folic acid.

Benita Lantz - October 28, 2008 - 5:57 am

And that is the official word from the doctor. I guess all I have to do now is keep exercising, eating healthy, taking my vitamins, and having lots of sex.

VERY IMPORTANT…..BUT

BE RELAXED AND IN A LOVE MAKING STATE OF MIND. MAKING LOVE WITH YOUR CPA, NOT SEX. PRAYING FOR YOUR YET TO BE CONCIEVED CHILD, THAT HE OR SHE WILL BE RAISED UP TO LOVE, SERVE AND HONOR GOD.

MAY YOU AND YOUR CPA BE BLESSED WITH A BLESSING FROM HEAVEN, THAT IS WHAT LITTLE ONES ARE.

Kristina - October 28, 2008 - 8:24 am

Very interesting. I didn’t know that people went in for a pre-conception appointment. I guess it makes sense though.

Lori - October 28, 2008 - 10:09 am

I saw your web page referenced on apartmenttherapy.com and I am amazed at how our lives are so parallel. My family even came into town over the past weekend for a wedding. Crazy.

My husband and I got married on May 18th. I’m 38 and my husband is 35. We’ve been trying to conceive for the past 3 months, to no avail, and I, too, have some weight to lose. Everything I’ve read, including my doctor, says not to be concerned until we hit 6-8 months, so I’m trying not to get too crazy. But, I got laid off 2 days after returning from my honeymoon, so the timing would be great if it happened now while I have the time.

My doctor prescribed “Primacare” soft gel vitamins months ago and, although I can’t tell if they’re working or not, I like them. I was taking GNC pre-natal vitamins for a few months prior to my wedding (to sort of ‘rev my body up’ for baby) and they made me horribly nauseous if I hadn’t immediately followed them with food.

Now, if I could only plan my pregnancy like my wedding…

Best of luck to you and husband!!!

admin - October 28, 2008 - 10:15 am

All great responses! Benita – thanks for your good wishes and your thoughtful reminder. DeLynn – that makes sense, I’ve heard that iron can do weird things to the body (fingers crossed that it won’t be a problem) :) Kristina – I didn’t know about going before getting pregnant either. Of course it could just be me, I’m admittedly a little anal when it comes to preparation. Lori – good to have you hear, I like hearing that there’s someone else in the same situation and your advice on the vitamins is very helpful! Definitely keep in touch as I’m curious to hear your progress. (and I know how stressful it can be wanting to plan everything just right!!)
Tabitha

Amanda - October 28, 2008 - 12:52 pm

Hi, I found your site thru PioneerWoman.com. I just wanted to say congratulations on your wedding and good luck with ttc. I have been married for 11 years now and have 2 wonderful baby boys (a 2 year old and a 7 month old). I have to say that the best advice that I can give is don’t get too worked up about it. I know that is hard to do, but just try to take it all in stride. It sounds like you have everything in order now just let nature take its course. It may take a while, I tried for 5 years before having my first. As far as the vitamins go I would probably stick with the OTC ones for now. The additional iron can wreak havoc on in that regard, but I wouldn’t use the ones with the stool softener until you know that you need it.

One more thing, if you haven’t already you should check into getting a basal thermometer and charting your cycle which can help speed up the process and will help you understand your cycle a little better. You can also get Ovulation Predictor Test Strips and Pregnancy Tests for much cheaper online than in the stores.

Again, good luck to you and your hubby.

admin - October 28, 2008 - 1:01 pm

Hi Amanda – what great advice, thank you!! And congrats to you on your little ones! Tabitha

erin - October 28, 2008 - 1:41 pm

wow! this isn’t something that i have had to think about much as i have kaiser (hmo) and just went to the pharmacy to pick up their version of the otc prenatal. however it is the same vitamin that my [not pregnant, not TTC] sister also takes on the advice of her dr, his theory being that pregnant women need to get the best nutrition of their lives, so if you want a good vitamin a prenatal is a good thing to look at. mine has a ton of folic acid but is not overboard on iron and i just munch on dried apricots all day long which help a LOT in the digestive area. before we got pregnant i just took a folic supplement that i picked up at the grocery store along with my regular centrum.

pre-pregnancy, my dr told me to just be sure i was getting enough folic acid (hence the otc supplement). not enough can cause neural tube defects like spina bifida or anencephaly, and the neural tube forms/closes usually before you even know you are pregnant.

good luck and have fun! i stood on my head – literally! i’m 30, dh is 33, and we wanted badly for this baby to happen (our first). he laughed when he saw me standing on my head (and i didn’t for very long – more as a stunt to make him laugh), but the joke is on him because now we’re pregnant. :)

i used the ovulation predictor at http://www.pregnancyguideonline.com to help predict when, too.

admin - October 28, 2008 - 1:49 pm

Hi Erin – what a great idea, the vitamins, not the standing on your head part – I’m afraid I’d hurt myself! :) And I like the idea of eating dried apricots which I have not actually tried yet. And congrats to you, when are you due?

Jess - October 28, 2008 - 7:01 pm

I didn’t take pre-natal vitamins, per say. I took Floradix, a non-animal iron supplement, which does not constipate. I also took Folic Acid and a Calcium-Magnesium supplement. My little boy turned out perfect, so I guess I did alright. : ) Good luck to you!

Liz - October 29, 2008 - 8:24 am

I alway consult my best friend on medicine since she’s a pharmacist. If you’re having doubts about what the dr is pushing, just talk with a pharmacist. They’re really knowledgable (sometimes more so than docs) and have no agenda…. aka pharmacy reps taking them out to lunch. :)

Congrats on this big step! So exciting!

admin - October 29, 2008 - 2:00 pm

Liz – that’s a fantastic idea, I didn’t even think about a pharmacist. I’ll definitely have to look into it!

admin - October 29, 2008 - 2:01 pm

Hi Jess – I’ll have to look into the Floradix too because I worry about the whole iron-causing-issues thing. Thanks for the suggestion! (and I’m glad your little boy turned out perfect!)

duvetgirl - October 30, 2008 - 4:15 am

Hubby and I are on the same starting to try after Christmas plan (I want one last big new year’s eve party!) so I’m really pleased I’ve found your blog. Good luck!

admin - October 30, 2008 - 4:19 am

Hi duvetgirl – that’s awesome! Keep me posted, I’d love to hear updates!

Rayne - October 31, 2008 - 12:07 pm

That’s about how it goes. Until you’ve tried unsuccessfully for a significant amount of time (and that can vary by OB and your age), the doc doesn’t really “interfere”. When we were trying (it took us 15 months), I started taking an over the counter prenatal just to get some extra vitamins in me. And once I got pregnant, my OB said those were just fine. I didn’t need any special prescription pills.

Good luck!!

admin - October 31, 2008 - 12:09 pm

Hi Rayne – thanks for the advice!! I’m going this weekend to get some vitamins and I think I will just get over-the-counter.

Laurie - October 31, 2008 - 7:20 pm

Hello, it’s Laurie again. I just wanted to throw my 2 cents on this one with things I’ve learned on my own fertility journey. These are things my doctor has told me for optimum environment. Your mileage may vary on the advice, as always consult your own doctor.

First, whatever prenatal you take should have at least 1000mg of folic acid. Some do, some don’t. If yours doesn’t, then research foods that are high in folic acid and eat them. Take your prenatals a minimum of 2-3 months prior to conceiving.

DHA is actually a big deal. You can get supplements in gel form alone or as part of a vitamin. I don’t remember if it is a bigger deal during pregnancy or during the first year. I just took it as soon as I found out I was pregnant with my daughter and for the first year both.

Also, begin to eat foods high in calcium. If you are pregnant, your child will generally get everything it needs to survive – even if it means sucking you dry of your own resources. It’s fascinating how it works.

I was told NOT to take ibuprofin or similar medicines while trying to get pregnant as it can interfere with the timing of your ovulation. The reason that is important is that your follicles need to grow to a certain size to be viable for implantation, and if you ovulate early they are obviously not going to be big enough. That was a rough one for me as I have chronic pain issues, but I did it.

Some prenatals do make you sick. My sister (who has 9 kids), always took them with some food at night right before bed. She was nauseated taking them any other way. I did the same thing with the same results, and slept through whatever mild nausea feelings I might have had. In the daytime was a different story.

I would definitely chart and do the whole basal temperature thing. There is a great book out there about fertility and charting, but I can not remember the name of it. The amount of information in that book will blow you away. The only thing I remember is the name “fertility” somewhere in the title and the cover of the book looked sort of like a romantic watercolor abstract figure of a woman.

The other surprise for me was how long sperm can live (up to 5 days), yet how short the window is to get pregnant when you ovulate. For example, when I was ovulating, I had a window of 36 hours total, and the dr. would “prescribe” sex at specific times based on when I got the last shot.

Male sperm are persistent, but slower. Female sperm are faster, but don’t live as long. So, if you want a boy, have sex BEFORE you ovulate, but if you want a girl, have sex WHEN you ovulate. It’s not 100%, and I’m not using technical terms, but that’s what my sister-in-law told me her Doc told her, and she’s a peds nurse also. (doesn’t it sound silly, like the game of gossip?)

Anyway, I’m just passing on some information. Use it for what it’s worth and do your own research also. Good luck!

admin - November 1, 2008 - 3:42 am

Laurie – this is so helpful, thank you! I had read about some of the information you mentioned but some of it I had not heard about before and I will definitely look into. Thanks again! Tabitha

AmbulanceMommy - November 1, 2008 - 12:07 pm

interesting….a pre-pregnancy appointment. i’ve never heard of those.

We worked with a fertility doc, but I have to tell you, the one I went to, their policy is that you must be TTC (trying to concieve) for a year before they even speak to you. At your first fertility doc’s appointment, they would do more than just check your BP.

But if you haven’t been trying before, your regular doc is going to say everything yours did. Because for many people, pregnancy is kind of easy to achieve. Unfortunatly, for some it’s not. But If you haven’t been trying, then you don’t know, right? :)

it might help if you could find out when you were ovulating, and without buying the expensive tests, its easist to just use your body as a clue.

The best book we ever bought was “Taking Charge of your Fertility” which is this ENOURMOUS book and is soooo helpful! I would reccomend it!!!

About the pre-natal vitamins:
try to find one that has the following:
4,000 and 5,000 IU (international units) of vitamin A
800 and 1,000 mcg (1 mg) of folic acid
400 IU of vitamin D
200 to 300 mg of calcium
70 mg of vitamin C
1.5 mg of thiamine
1.6 mg of riboflavin
2.6 mg of pyridoxine
17 mg of niacinamide
2.2 mcg of vitamin B-12
10 mg of vitamin E
15 mg of zinc
30 mg of iron

Theres lots of brands out there. I suggest printing the list, running into CVS or some other pharmacy, and standing in the alise debating :) That’s what I did….of course, now for the life of me, I can’t remember the name of the brand I took.

Good luck to you!!! Like some of the other comments said, remember to have fun!!!

AmbulanceMommy - November 1, 2008 - 12:09 pm

oooh, one more thing….the book Laurie was talking about is the one I mentioned in my comment. really great book, I really think you should go get it. Amazon carries it!

admin - November 1, 2008 - 9:06 pm

Hi AM – fantastic information, thanks for sending it! And funny you should mention that book… a friend just gave it to me so I will definitely have to sit and read it. very helpful!!

Sandy - November 2, 2008 - 9:02 am

You might also talk to your chosen father-to-be.
This is his big chance to make (ahem!) a healthy contribution.
We’re talking good nutrition, vitamins, low alcohol consumption etc. for him. Taking guanefesin helps mucus production and increases your chances of fertility. Natural family planning works! Have Dad-to-be pop a thermometer in your mouth 15 minutes before you get up every morning and then mark your temp on the charts. Save time for a quickie when your temp spikes. Voila!

admin - November 2, 2008 - 11:37 am

Hi Sandy – good point! It’s funny you mention the husband’s part. He eats pretty healthy already but this whole month he’s given up desserts which is a huge thing for him. I keep telling him it will get easier, but I don’t know if he’ll believe me. Vitamins is next on the list!! :)

Heads Carolina, Tails California - November 2, 2008 - 7:48 pm

Hi, I just found your site on Pioneer Woman and realized that like you, my husband and I are working on the family plan beginning in January. I also just had my pre-conception visit and only had my blood pressure checked. My doctor prescribed prenatal vitamins in a generic kind of way and just said to have the pharmacist make recommendations on a vitamin that would be easy on my irritable tummy. The pharmacist recommended PreNatal Plus. So far, so good, but I only take them at night just before bed. I recommend joining http://www.babycenter.com THey have very helpful articles, message boards, etc. on every aspect of pregnancy. I found the temperature/CM chart and have begun charting my basal temperature in the morning. I noticed that even though I am on the pill, I can still clearly see the patterns… Be sure to double check the info that people are posting in your comments. I noticed that a few of them are a little mixed up. That book you received should clear all those up. Good luck and I look forward to our journeys beginning in January.

admin - November 2, 2008 - 8:22 pm

hey – another pre-conception gal, so glad to hear from you! I know, there’s a bunch of information that I still need to weed through. Definitely keep me posted on your progress, I’ll be interested to hear how you’re doing!

erin - November 3, 2008 - 7:19 pm

we are 13 weeks along right now – due may 12. though i have been warned that a due date is a general idea, not a contractual obligation. :)

i second laurie who said to take your prenatals with food. my regular vitamins were really upsetting my stomach in the mornings. now i take my prenatals *as i eat* breakfast (literally between bites) to be sure there is something in my stomach cushioning the vitamins, and i haven’t had any problems anymore.

admin - November 4, 2008 - 5:36 am

Hi Erin – great suggestion about eating food with vitamins. I do the same thing – take them with meals and haven’t had problems so far. I’m hoping the prenatals will be the same! And congrats on being 13 weeks along – that’s fantastic!!

Robyn - November 15, 2008 - 6:43 pm

Just wanted to drop in and say that I had 2 friends that had fertility issues, one went the invetro route. They both conceved after having a massage with a Reiki Practitioner….something about the flow of energy. If nothing else you’ve had a great massage!

WJKIII - November 24, 2008 - 9:10 pm

The prenatals are way important – if you’re not afraid of your multi-vitamin, you’ll be fine on the prenates.

Melanie - November 26, 2008 - 1:31 pm

I’m 12 weeks myself, and for both of my pregnancies, I just used OTC vitamins and just ate healthy. As long as you are eating well, there isn’t any worries about less pharmacy-encouraged vitamins.

Like I said, I’m 12 weeks and I keep forgetting to call and schedule an appt with my OB. In fact, I don’t even have an OB. I better go…

EJ - November 26, 2008 - 2:05 pm

I have 3 kids and didn’t take vitamins during any of my pregnancies. They all made me puke. I tried to eat healthy and not give in (too much!) to unhealthy food cravings (like bacon!) but all I can say is… take all this advice with a grain of salt. When I was pregnant with my first baby, my mother-in-law gave me a battered copy of the book she had when she was pregnant in the seventies. “No more than 8 or 9 cigarettes a day” was my favourite piece of advice. Sheesh! Anyway, just try to do your best and know that some days you’ll want nothing to eat but Taco Bell, and that’s just fine. Just try to relax about all that stuff.

reagan - December 10, 2008 - 9:26 am

I read through all the comments and didn’t see the name of that book so I thought I would leave it in case you don’t already know aobut it. It’s called “taking charge of your fertility” it’s an amazing book and I learned SO much about my cycle. I highly reccomend it as it worked for us in the last couple months ;) There is also a way to track your temperature online at Ovusoft.com or .org that costs about $40 for a one time download to your computer and it’s very helpful (this is cheaper than other ones out there that you pay yearly) as it tells you when you’re fertile and not. I’ve heard that older women also have more of a possiblity of having twins. Wouldn’t that be fun?!

Since there is only a 24 hour window where your eggs are alive, it’s harder to time especially when you’re older I think. You’re usually fertile in a window of about 5 days before ovulation depending on the type of fertile quality fluid your body has. I was surprised to find that the fertile quality fluid is really key to getting that sperm up to the area that it can meet the egg!

I noticed that your last pregnany life post was Oct 28th and that made me wonder if you were pregnant and didn’t want to post about it yet. Good luck!

admin - December 10, 2008 - 10:49 am

Hi Robyn – thanks for the news about the massage, definitely sometime to keep in mind and you’re right, a massage never hurts! (well, depends on the masseur… ha ha)

Melanie – did you find an OB?

EJ – wow, it’s hard to believe there were books like that! We watch the show MadMen (about the 60s) and it’s amazing to see women drinking and smoking while pregnant!

Reagan – good info, I’ll definitely have to check it out. And no, not pregnant yet, but we’re really, really soon to trying. Getting very excited (and nervous)!

Heather - December 17, 2008 - 2:13 pm

I’m 19 weeks pregnant with my first and I’m taking the Rainbow Lite Prenatals (the six-a-day, not the one-a-day). My midwife said those are some of the best (the vitamins are food-based), and she encouraged me to continue taking the six-a-day if I could manage it.

You can get them for pretty cheap on Amazon — if you go with these, don’t make the mistake I did and buy some at Whole Foods; you’ll pay double the price!

Brad - February 1, 2009 - 11:17 pm

There is obviously a lot to know about stool softner. I think you made some good points in

Brad - February 3, 2009 - 3:17 pm

You are a very smart person!

Brad - February 4, 2009 - 3:17 pm

Hello webmaster. Great job.

mille - February 4, 2009 - 9:28 pm

I had problems with all of the prenatals I tried, until I found the Rainbow Light that Heather mentioned. I also took “Omega Mom” for DHA and a bit more calcium.

Look up green smoothies, too. I really enjoyed them for breakfast. It is a good tasting way to get all your kale/chard/whatever greens every day. An apple a day, by the way, is one of those old wives tales that science has backed up. So I had one every day in my smoothie. That is the best way to get vitamins…from food. Look up parsley, though. I was surprised to find that on the “avoid” list.

And finally, swim. It is relaxing mentally, and it will help get your body in shape. You want to be at your best for all of this. Good luck to you!

pregnancy - May 27, 2009 - 9:19 pm

Yeah! Really Wonderful Job! I gain a lot of nice and useful things from this site, thanks a lot! :)

Lynne - June 8, 2009 - 1:44 pm

You think that’s bad. My doctor never even heard of a preconception appointment and asked me “what’s that?” For the next couple minutes I had to explain to her what she was supposed to do. Sometimes, I just think they grab a random person off the street and say, “Here put this coat on, you’re a doctor now, congrats!”

Infertility Treatments - Fertility Clinic Wirral - September 28, 2010 - 4:54 am

Teaching couples to work together to keep stress and anxiety to an absolute minimum before, during and after medical treatment.

DHA and Pregnancy - November 7, 2010 - 1:27 pm

DHA is such an important fatty acid to make sure you get enough of during pregnancy. It is very important for the baby as it develops.

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