Thursday, March 14, 2013

Preconception Checklist: 100 Things To Do Before Trying To Conceive (Part 1)

 If you have been considering trying to conceive (TTC) for any amount of time and are the kind of person who likes to look up tips and suggestions to be prepared, you are probably as disappointed as I have been with the resources that address what you can do in the year or more leading up to TTC.  Reading these publications and pages, it seems almost like there is nothing you can be doing now to start preparing for your future family.  But if you look closely, you'll see that many of the items on the checklist are things that take a lot of time!  If you are already thinking about starting a family, it's not too early to start preparing.  Below are 25 tips and suggestions I have gleaned from a variety of sources that ideally would be considered at least 12 months before TTC:

 1.     Focus on enjoying your non-parent time.  Of course, you are excited about possibilities for the future, but don't forget the present.  Try to fit in all of your favorite activities that would be more difficult to do with a tot.  If you are in a relationship, revel in having exclusive access to your partner and time for lazy days with him or her. 
2.     Start thinking about how you will strengthen your relationships in preparation for a baby.  Shore up your social support network while you can and use this clear-headed time to figure out how you will make time for the special people in your life after baby.  If you are married or in a relationship, look into books that will prepare your marriage for the ups and downs of parenthood (I particularly liked Babyproofing Your Marriage, written with practical tips by real moms).
3.      Tell someone you are thinking about trying.  Especially if you don’t have a significant other or he/she isn’t very excited to talk about all the planning this far in advance, this can be an isolating time.  You have babies on the brain but no one to talk to about it.  If there’s no one in your everyday life who can fill this purpose, try an online forum for other people in this same situation who also want someone to chat with (e.g.,

4.     If you are employed or in school, consider whether or not you want to work or continue your education after your child is born.  If yes, what steps should you take now to prepare for 6+ weeks of maternity leave?  If no, what do you want to get out of your current job or educational experience before you leave?  Make a plan to wrap things up so that the transition is smooth and you are ready when the time comes. 
5.     Look into flexible parent jobs.  If you aren’t planning to work for a while after your child is born, but you want to go back to work eventually, start thinking of ways you can earn a little income or continue to get experience while you are staying home.  Explore work-at-home options that use your skills or training or part-time jobs in your area of expertise.

Physical & Mental Health
6.     Begin to select a prenatal care provider.  It can take a long time to get in to see the more popular practitioners, and it helps if you aren’t already desperate when you start looking.  It’s not urgent that you make a final decision at this point, but it is good to start thinking about the kind of provider you want and maybe schedule informational meetings with potential candidates.
7.     Get a preconception checkup.  This preliminary examination and consultation can help to identify any changes that might need to be made or health concerns that should be addressed before TTC.  Since you are planning so far ahead, this checkup can be requested as an addition to an annual gynecological exam.
8.     Get healthy.  Figure out how you want to eat during pregnancy and work toward your goal.  Start or modify your exercise routine to maximize your fitness.  It takes a while to form new habits, and you want these behaviors to be ingrained already by the time you are trying to conceive. If you need help with these steps, find a free online community like SparkPeople that can provide advice, encouragement, and tools for tracking your progress.
9.     Decide if you want to try to lose weight before TTC. If the answer is yes, make a plan to drop the pounds gradually and healthily, hopefully with the last of the weight lost a few months before TTC.  Again, make use of online resources like SparkPeople to help you in your goals (I have used their site for over a year now and find it to be incredibly motivating and useful).  Look out for a future post on the pros and cons of dieting before TTC.
10.  Decide if you want any preconception genetic counseling.  Depending on your ethnicity and family history, there may be several genetic diseases that you could be screened as a carrier for.  Cystic fibrosis carriers, for instance, are common across most ethnic groups.  Be aware, however, that not all health insurance providers will cover preconception genetic tests (e.g., my insurance company paid a small amount, but it was far from fully covered).  
11.  If you decide to have any genetic screening, discuss what you would want to do if it turns out you and your significant other are both carriers of a harmful genetic mutation.  This is a very personal decision, but it may be better to discuss the options before you know the results of a genetic test.  
12.  Examine the pregnancy-friendliness of any medications you currently take.  If you take any medications for ongoing mental or physical health conditions, ask your doctor whether these are safe to take during pregnancy.  If not, it may take a while to find a pregnancy-safe alternative that works for your situation.  
13.  Consider the current status of your mental health—stress, depression, anxiety, etc.  Now could be a good time to get counseling or learn new strategies to improve your mental wellness, before adding a major stressor to your life.  
14. Begin taking a prenatal vitamin.  You want to be in optimal physical condition when TTC, so now is a good time to start building up your stores of important vitamins and minerals.  Plus, you will already be in the habit of taking it every day when the practice is most vital.
15.  If you are spiritual or religious, pray for the future of your family.  If you can, enlist others to spiritually support you during this time.  Consider meditating or journaling about your hopes and wishes for the children you envision having.
16.  Think about what you want to teach your child about spirituality and religion.  Talk to your spouse/partner about your spiritual background and what spiritual instruction you would like to offer to your child.
17. Consider how your moral convictions or religious beliefs might impact what you decide to do if you have difficulty conceiving.  What are your feelings about practices such as IVF, sperm or egg donation, surrogacy, and adoption?  Even if you never have any difficulties conceiving, this thought exercise can help you to empathize better with couples you encounter who are struggling with infertility. 
18.  Develop a financial plan.  Work toward debt reduction, create a budget, and build up enough savings to cover several months' income. 
19.  Consider a financial planning/management course.  One that I have personally found very helpful is Dave Ramsey’s Financial Peace University (it costs about $100 to attend a local classroom series).  The class is nice, but you can also get the basics with a freely available list of steps and online tools.  Note that Ramsey's course is primarily targeted to a Christian audience, with an emphasis on charitable giving/tithing, but there are many similar resources that have no religious focus. 
20.  Assess your health insurance coverage.  Do you want to switch to a more comprehensive plan?  Does a different plan have a waiting period before pregnancy coverage will begin?  If you are going to be leaving your job or finishing school, should you switch to your significant other’s health insurance now?  Note that the Affordable Care Act will be changing the coverage rules for pregnancy in 2014, so many of these concerns may not be an issue by the time you are ready to conceive.
21.  Decide whether you want to move before having a baby.  If so, now is probably the time to start looking, especially if you want to buy a house.  Think about when your current lease ends or when would be the most convenient time to change your living situation, then make it happen sometime before TTC if possible.  No one wants to move while pregnant, although it may be unavoidable depending on your circumstances. 
22.  Research life insurance policies and preferably finalize your coverage before trying to conceive.  You (and your partner) begin to have different life insurance concerns the day your little one is conceived and many unexpected things can happen during pregnancy.  If you or your partner already has a life insurance policy, think about how you want to update it.
23.  Look into the creation of a will.  It may be too early now to actually meet with a lawyer or draft up a document, but this is something you will want to have in place ASAP after your child is born, so considering its content now is a good idea.  This may also be the time to broach the topic of who might be a good guardian for your future children with your significant other.
Fertility & Alternate Plans
24.  Look into the options that are available to you if you have difficulty conceiving.  Figure out what your backup plan might entail and when you would want to start considering it (which might vary depending on your age and desired family size).  Fertility treatments may be an option and will vary depending on your specific situation, and you may also want to consider surrogacy or adoption. 
25.  Don't overlook the option of adopting through the U.S. foster care system.  Most people are somewhat familiar with traditional U.S. and international adoption, but adopting a healthy baby can take a long time and could be quite expensive.  If the cost or the wait seems prohibitive to you, consider how you feel about adopting an older child or fostering to adopt through the U.S. foster care system (

What other tips would you suggest for women who are thinking about trying to conceive but still have a while to go before beginning the process?  What preparations did you or do you plan to make a year or more before trying to get pregnant for the first time?

*For further reading, see Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception. Although the title references the popular 3-month timeline, the guide provides comprehensive coverage of most preconception topics and is not very fixated on the time aspect. 

Thursday, March 7, 2013

All evidence is good, but not all evidence is created equal

As I mentioned in my initial post Mind Over Motherhood, Deductive Parenting is concerned with gathering evidence and making informed decisions about all aspects of parenthood and family life.  I mentioned also that I have a background in psychology.  Taken together, I'm sure it sounds like I am primarily interested in the academic literature on the subject.  Although I do think published, scientific research is a crucial source of knowledge about a wide variety of topics, it is not the only thing I have in mind when I use the word "evidence".

When it comes to decisions about health, family, and kids, there is a lot more to it than just average results published in a journal.  Even though something may work for the "average" person, there is really no such thing as an average family.  And there is a lot more to these choices than just an academic analysis of what one ought to do.  Having been on the other side of the research process, I know just how much published findings often depend on specific contexts and specific circumstances.  Just because a technique worked for a particular sample doesn't mean it would apply well in a different culture or a different time period.  Plus, a child or a parent's unique temperament is likely to play a significant role in the success or failure of various applications.  It is important not to underestimate the impact of individual differences and normal variance within a group.

At the same time, it is rarely good to reject outright the expert evidence that is available to us.  In many cases, we can learn something valuable and practical from looking through the published findings.  Plus, when studies randomly assign individuals or families to experience different situations, we can be more confident that the results don't depend solely on idiosyncratic differences between some families that behave one way and other families that behave a different way.  Anecdotal stories from other parents, on the other hand, do not offer that same guarantee.  Sure, maybe your sister-in-law's foolproof tantrum solution is really a great strategy, but maybe it just works for reasons that are unique to her family's dynamic.

In my opinion, something useful can be learned from all kinds of sources.  At Deductive Parenting, I intend to cite evidence, when relevant, from family, friends, religious leaders, doctors and pediatricians, blogs and parenting sites, professional organizations, and also academic journals and other quality-controlled publications.  But as I sort through the variety of information available and figure out how to apply it to my life, I will try to consider the following questions:

(1) How likely is the information provided by this source likely to generalize to my situation?  Are the people or families used as evidence similar to myself or my family?  Are there any obvious reasons why this information is not useful for me?

(2) How much expertise does the source have in this topic?  For example, a pediatrician is an excellent source of information about children's physical health and may be up-to-date on all the latest research, but she or he may have less knowledge about effective parenting strategies. 

(3) Is there some way to find out more detail about the specific situations and factors that contribute to the evidence?  Can I read the published article myself or can I ask for clarification about why a family member or friend holds their current opinion on an issue?

(4) How difficult or harmful would it be for me to experiment with the suggestions or solutions that arise from this evidence?  Do I have to make a firm decision in advance, or would it be okay to experiment and see what works best for me?  Do the potential risks of changing my mind or wavering outweigh the possible benefits of discovering a better way? 

As you read through future posts and comments on Deductive Parenting, ask yourself these questions as well.  The better you understand your answers, the more confident you can be about your own decisions and the more prepared you will be to take the leap from thinking to doing.

What do you think?  Post comments below about your own experiences with different sources of information about preconception, pregnancy, and parenting. 

Mind Over Motherhood

I am not a parent...yet.  By training, I am a research psychologist.*  Either because of my nature or my educational background, I like to start anything that's important in life with thoughtfulness, careful consideration, and most importantly some thorough research.  That is why you find yourself reading the initial blog post of a woman who in all probability is at least a year away (probably longer) from even attempting to conceive her first child.  But for me that is exactly the time to start watching, waiting, learning, and planning.  It's hard to gather and weigh all the evidence when you're in the drugstore buying ovulation kits, or 1 week from your due date, or neck deep in toddler toys. 

Deductive Parenting is not an advice column or a definitive guide to anything.  Parenting decisions ideally involve a combination of brains and instinct, and my conclusions will not be the right conclusions for everyone.  Instead, this blog is a chronicle of my thoughts and discoveries along the journey of fertility and family.  I hope to inspire critical evaluation of things we may take for granted, balanced conversations about the big issues, and ideas for how to apply the results in practical ways.  As the psychologist Susan Fiske likes to phrase it: "Thinking is for doing".  Deductive Parenting applies that motto to anything and everything about becoming a parent, raising children, and managing family life, starting from day one of my own parental timeline. 

*Note: My background is not in childhood development or clinical practice.