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:

Relationships 
 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., http://babyandbump.momtastic.com/waiting-to-try/).

Education/Career
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.
 
Spirituality/Religion
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. 
 
Finances
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. 
  
Practicalities
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 (http://www.adoptuskids.org/).

 
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. 

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