Preconception Checklist: 100 Things To Do Before Trying To Conceive (Part 3)

At last it is time for part three in my 4-part series about preconception preparation.  As crazy as it seems to me, I have finally reached the 3-6 month mark before my own planned trying-to-conceive date!  Below are 25 tips and suggestions I have gleaned from a variety of sources that ideally would be considered at least 3-6 months before TTC.  Note that we are now getting into the time frame that most medical websites and other sources of preconception advice actually consider important for conception wellness and success, so you are likely to find additional research fruitful at this stage in your family planning.

Relationships

1.  Now might be the time to share with select friends or family members that you will be trying to TTC within the year.  This can be a good time to let people know you have conception in mind without them knowing exactly when you are trying.  This step is especially recommended if there are people in your life who would be hurt or offended not to be included in your plans but who you would rather not be stressing you out every month about whether you are pregnant yet.

Education/Career

2.  If you live in the United States, start learning about laws that protect pregnant women and provide certain rights for new parents.  This is a good exercise whether or not you currently work or plan to work after having your first child.  If you live outside of the U.S., begin to learn about your local laws and also take a few moments to be thankful that your country’s maternity policies are likely to be more generous and family-friendly (although of course not ALL are).
3.  If you are working, find out if you have been working long enough in your current job to be eligible for the benefits your employer offers.  Certain federal laws in the U.S. require employers to offer job security benefits for employees who have been working for at least one year, but these laws apply only to employers of a certain size and only require that a limited set of benefits be offered (specifically the ability to take off a total of 12 weeks unpaid leave during the year of the birth or adoption of a child without risk of losing a current position).  Many employers offer additional benefits, however, but these are determined by the employer and are subject to change.  Find out who is eligible where you work and for what.
4.  If you work and are not self-employed, determine what options your employer has for new parents.  How much time are you allowed to take off work?  Is any portion of maternity/paternity leave paid by your employer?  Are there policies for new dads too?  Is affordable childcare offered at your work facility?  Designated areas for expressing breast milk?
5.  You might also want to think about alternative approaches to your current work schedule while you have a newborn.  Would a more flexible work schedule, teleworking, job sharing, or coming back to work part time be an option?  If you work for a small company or don’t want to draw attention to your fertility plans, just look through the employee manual to find out what you can for now.  If there is a large HR department or you don’t think your inquiries will be looked upon negatively, go ahead and speak to someone in HR about the policies and benefits available.
6.  If you are a student, find out how much time you are permitted to take off for illness or other medical reasons without having to reapply for your program.

Physical & Mental Health

7.  Start taking an Omega-3 fatty acid supplement to support good fetal brain development (as well as maternal heart health—perhaps any prospective fathers might also want to join in on this good habit).  If you have any moral or digestive qualms about taking fish-based supplements, there are some high quality vegetarian/vegan options available on the market as well that don’t have a fishy aftertaste and might be more palatable during early pregnancy.
8.  Work on improved posture.  There are numerous exercises to help strengthen your back, core, and neck muscles to improve posture.  You could even invest in an inexpensive trainer that reminds you to keep you shoulders back, or a back support to improve your posture while sitting at a desk/computer.  Since lower back pain is epidemic during pregnancy and your body goes through a lot to try to support a growing fetus, establishing good posture now will help to prevent and minimize common posture-related pregnancy ailments.
9.  Begin drinking red raspberry leaf tea to strengthen and tone uterus and minimize menstrual pain when resuming regular ovulation.  Although the research on this herb is not entirely conclusive and its effects are likely to be small, it has been found in some studies to reduce the length of the pushing stage of labor.  It is also recommended as an all-around supplement for female reproductive health.  Stop taking this supplement before trying to conceive unless specifically advised by a health care provider, however, as its potential to stimulate the uterus could possibly be detrimental during early pregnancy.  Many naturally-oriented health care providers recommend resuming consumption of the tea in the second or third trimesters.  As always, be sure to consult with medical professionals you trust and to listen to your own body when making decisions about herbal supplements.
10.  Set targeted, personal goals for health, wellness, and preparation during the remaining months until TTC.  Perhaps make a list of specific goals and try starting to tackle one each week, or list 5-10 key outcomes you’d like to achieve before TTC and measure progress on each of them biweekly.  Sites like SparkPeople.com help you to track nutritional, fitness, and other wellness goals easily.
11.  Invest in good workout gear—quality tennis shoes, a supportive sports bra, etc.  You want to be safe and reduce injury during pre-pregnancy and early pregnancy workouts.  Plus, during this crucial preparation time you do not want to be incapacitated by sprains and strains.  Take extra care as you seek to tone and strengthen in preparation for your pregnancy.  You are aiming for sustainable, quality physical activity that will ready your body for carrying a baby and that you can continue well into pregnancy.
12.  Track daily caffeine consumption and begin to cut down to a level that is safe during trying to conceive and pregnancy.  Although ACOG has not issued an official recommendation, they have released a summary of research supporting the opinion that less than 200mg per day does not increase the risk of miscarriage or preterm birth.  This seems to have been adopted as the standard recommendation.
13.  Now is the time to start ditching alcohol altogether.  The substances in your body 3-4 months prior to conception have the most impact on fertility and early fetal development, so stocking up on good nutrients and eliminating toxins now is the best strategy.  That goes for prospective fathers as well, although total abstinence from alcohol may not be strictly required.
14.  Speaking of toxins, there are many everyday substances from cleaners to personal care products that can have an unhealthy impact on a developing fetus.  You may not be able to eliminate every possible source of pollutants and toxins from your life, but identifying your big risk factors and swapping for healthier/more natural products and environments when possible is a good idea.  See the Get Ready to Get Pregnant book for lots of specifics and a bit of a dire perspective about potential toxins, as well as some more open-minded and practical sources about what to worry most about (e.g., WebMD).
15.  Enjoy the last of your pregnancy no-no items.  Both potential parents may want to give some of these items up together out of solidarity and to keep temptation at bay.  Items to enjoy for a last hurrah include sushi, smoked meats, soft cheeses made with unpasteurized milk, and any other dietary items considered to be unsafe during pregnancy.  This could also include any hobbies that are unsafe for a fetus.  If you have a definite habit, start weaning yourself off of these treats or research some pregnancy-safe modifications.
16.  Work on reducing “wasted” calories in your diet (excessive sugar, fat, etc.).  You won’t need to increase your caloric intake much during early pregnancy, but you want all of your calories to be good ones.  Now is not the time to start a radical deprivation diet, but rather to make small changes toward a more balanced and healthy eating mindset.
17.  Instead, begin trying to view every consumption choice as an opportunity to meet both your body’s needs for nutrients and energy, as well as your needs for enjoyment and psychological satisfaction.  Consider:  Is what I’m about to eat going to leave me feeling satisfied?  If not, is there something else I could eat that I would still enjoy but might be more satisfying or do a better job of meeting my nutritional needs?

Finances

18.  Develop a specific pregnancy savings plan.  If you’ve already looked into the cost of an uncomplicated pregnancy and childbirth under your health insurance plan, use that as a starting point for a savings goal.  Add an amount you’d like to be able to spend on maternity clothes and other pregnancy expenses and then figure out how much you’ll need to save in each of the weeks leading up to your TTC date to save the amount you figured.  Of course you can plan to continue saving during pregnancy, but you never know what circumstances or unexpected expenses may come up later.  This is just a start.

Practicalities

19.  Start Pinning/tracking your baby research and making Amazon wish-lists of products that stand out to you.  Perhaps start a secret Pinterest page to post discretely any findings that have associated images or media, plus a Word document or favorites list that allows you to save relevant links you might want to revisit.  You are getting to the stage where you might soon be making some very real decisions about how to begin trying to conceive, what to do during your pregnancy, and how to prepare for the birth of your child.  You don’t want to lose track of anything important you might learn during this time of preparation.
20.  Time to seriously read some preconception books.  There are many available out there that target prospective parents with different goals and interests.  For the scientifically-minded, books like Get Ready to Get Pregnant and Before Your Pregnancy are ideal.  For those who want a more friendly, personal voice the What to Expect series might be a better bet.  Of, for the impatient types who don’t really want to read a book about it but want key information fast, perhaps try The Impatient Woman’s Guide to Getting Pregnant.  Or take a selection of all of them.  You will find overlapping information in most, with more or less detail.
21.  Begin to explore community resources available to you during pregnancy and parenthood (especially free ones).  Are there active meet-up groups in your area for pregnant women or new moms (www.meetup.com)?  Does your local hospital provide free educational classes or yoga sessions for expecting parents?  What about your church community?
22.  Research the schools in your neighborhood (greatschools.com) and also the childcare options nearby.  Read parent reviews as well as looking at standardized test scores and other indicators for schools.  Are you happy with what you find?  If not, start working out a plan to make positive change in your local school system or to seek out alternative options as your kids age.  
23.  If you have a pet that isn’t used to being around small children, try to find opportunities for him or her to interact with little ones in controlled settings.  You might need to start with just being near kids and providing lots of positive reinforcement, or even using recordings of baby sounds.  Do not attempt any direct contact until your pet is ready and of course make sure parents give permission before you introduce your pet to any child.  If you suspect or know firsthand that your pet is not good with small children, consider working with an animal behavior specialist or trainer who can help you move toward a positive interaction pattern.

Fertility & Backup Plans

24.  Make final decisions about who you would like your prenatal care provider to be.  If there are several potential candidates, begin scheduling some appointments and dust off those interview questions you prepared a few months ago (or start a new list if needed).
25.  Spend some time thinking very specifically about the childbirth experiences of other women you know.  What did their care providers do or not do?  What do you think they wish they had asked before deciding on a provider?  If you don’t know anyone who has given birth recently, look online for stories or read reviews about your local hospital to get ideas.  This should provide you with additional questions to ask your potential care providers.

    

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 3 to 6 months before trying to get pregnant for the first time?

*For further reading, see Get Ready to Get Pregnant: Your Complete Prepregnancy Guide to Making a Smart and Healthy Baby. Although the author can be a bit too negative at times and the information a bit overwhelming, this guide provides comprehensive coverage of most preconception topics and cites a wealth of scientific research. 

Countdown to TTC: Week 38

Calculate the Costs

As a result of the holidays and various other obligation, I am getting behind on writing up my "weekly" posts, but I have been working toward my goals and trying to remember everything I experience so I can eventually write up my backlog of activities.  A few weeks ago, I decided it was time to think seriously about medical expenses of a future pregnancy.  As we enter the new calendar year (the year in which I sincerely hope I will be able to conceive my first child), I intend to begin experimenting with prenatal vitamins and other supplements I want to take to have a healthy conception and pregnancy.  But diving into this more medical aspect of the process made me curious about the actual costs of pregnancy and childbirth.

Of course, there are perhaps more unknowns than knowns in this arena (Will I be able to have the vaginal birth I desire? Will I experience any pregnancy complications? Will my health insurance coverage change before I become pregnant?), but I decided the responsible thing to do would be to research what the costs might be for my current health insurance provider given some reasonable assumptions.  In addition, I was interested in figuring out what my maximum possible out-of-pocket expense would be given my current insurance situation.  Although I wouldn't be willing to place any bets on the accuracy of these calculations, they should give me an idea of what I should be aiming to save over the next several months.

Step 1:  I began my calculations by going onto my insurance provider's online member site and using their cost estimator tool (a nice service if you have access to it).  I asked for an estimate of the total medical costs associated with a pregnancy and vaginal hospital delivery in my geographic area (see below for the output).  The results I got were a bit confusing, but it seems to me that the numbers given for each expense category were total expected billings (not amount owed out of pocket, as I would have expected). 

Step 2:  Once I learned what the expected total billings would be for this type of pregnancy and birth, I had to consult my health plan's summary of benefits to determine what proportion I might be expected to pay of these total expenses.  My medical deductible and pharmacy deductibles are $250 and $100.  Once those are met, my plan expects me to pay the following for prenatal care and delivery costs:

Step 3:  Now that I had figured out the expected costs (assuming a vaginal delivery and a pregnancy that was not high risk) and what proportion I would probably have to pay, I could make some estimates.  I began by evaluating the maximum possible costs.  Knowing my deductibles and the additional out-of-pocket maximum for my plan, I determined that $2350 was the absolute most I would have to pay for a pregnancy that spanned only one policy year (I could of course be unlucky and accrue some high prenatal costs in one policy year and then some additional high costs for labor and delivery in the next policy year when new deductibles and out-of-pocket maximum would apply).  So, worst case scenario has me paying as much as $4700 for one pregnancy. 

Step 4:  Finally, I wanted to estimate the real expected out-of-pocket cost of the standard vaginal delivery pregnancy the cost estimator summarized for me.  Assuming a $200 copay for the delivery facility (even though the cost estimator predicted no charge for this actually), plus 20% coinsurance on all the medical tests and doctor's bills (although some portion of this would no doubt constitute no-charge prenatal care), and the full estimated amount for pharmacy, I came up with an expected total cost of $1836.  It would also be reasonable to predict an amount a few hundred less than this if much of my doctor's costs came from fully covered prenatal care and if my birth hospital did not charge a facility fee.  On the other hand, any sort of complications or need for additional tests or specialized care would quickly bring this up to the maximum possible cost. 

So, in summary, I learned that I should probably expect to spend a couple thousand dollars on my birth.  Even if I switch insurance plans (which I actually expect to do), I will most likely select one that has a similar deductible and out-of-pocket maximum.  I also realized that small changes in my assumptions can make a substantial difference in how much I would overall expect to pay for a single pregnancy and birth.  This could be a scary realization, but I think my response to the information is reasonable.  I will make tentative plans based on what is most likely to happen, but I will also be prepared for things not to go according to plan.  Probably a good approach to new parenthood as well, now that I think of it...

What about you?  Do you or did you know down to the dollar how much your pregnancy should cost?  Have you come by any useful information about paying for pregnancy and childbirth or tips for dealing with health insurance providers?  What are some top dos and don'ts when it comes to pregnancy-related medical expenses? 

For more in this countdown series, see last week's challenge about Eating right while eating out.

Countdown to TTC: Week 41

Strength Training

Last week it dawned on me that maybe my plan of eating less and exercising the same amount as I have been for the past year or so wasn't going to result in the kind of change in fitness that I am hoping to achieve.  I do want to weigh less, ideally, but I really want to be physically ready for the challenges of pregnancy.  Even during the times when I lost a substantial amount of weight, I never really felt that I had increased in strength, flexibility, or endurance.  Usually, I felt weaker but also thinner and lighter.  As I've mentioned before, that won't do for this year's goals.  

But as obvious as it sounds that I need to add strength and flexibility training to my routine, I was really reluctant to do so.  I don't want to reduce the amount of cardio I've been doing substantially--partly because that might actually cause me to gain weight instead of maintaining the status quo and partly because it's the kind of exercise I find most tolerable (at least I can watch my shows).  And there are only so many hours in the day.  So, I have started to add strength and flexibility training in small, tolerable ways with minimal equipment.  My workout gear consists of (1) tennis shoes, (2) three and five pound weights (I like the kind with the non-slip coating that don't leave your hands smelling like metal), (3) a sturdy wall, (4) a sturdy chair, and (5) an inexpensive thigh workout device.  I think someone can make a perfectly good strength and flexibility routine out of these few items, but there are a couple of additional things on my wish list, such as a plush yoga mat, an exercise/stability ball, wrist weights for walking, and maybe some resistance bands.  As a person with very minimal upper body and core strength, here's what I have been trying so far:

1. Twenty wall pushups and a few squats any time I go into the restroom at work and there is no one else in the room.  The handicap stall has a fairly sturdy wall and enough room to do these moves while locked into the stall, so in case someone comes in they won't see my mini-workout.  If you have your own office instead of a cubicle or are at home most of the day, this would be even more doable.
2. A few minutes of stretching after my cardio workout.  This is the time when my muscles are most warmed up and I am at my most flexible.  I can even bend over and touch the floor sometimes if I stretch enough.  Eventually, I plan to build this up to a 15 or 20 minute yoga or Pilates video a couple times a week.
3. Brief but challenging core training.  My core strength is pretty weak, so I will feel the burn the next day if I do a few arms-up full situps and about 10 Pilates criss-cross exercises.  This is enough usually to wear me out, but if I have any strength left I will do some crunches or leg lifts.  Hopefully, my stamina will improve over time.  I am working up to the 12 minute seated core workout video that's available for free on SparkPeople.
4. Extra weight lifting and gravity-based leg workouts when I have time.  I will usually do 10 or 20 dumbbell curls, another 20 two-arm tricep extensions (where you hold the weight behind your head and lift up), and then just spend some time doing leg lifts and balancing my weight.  Unlike my cardio workout, I don't have a particular routine.  I just pull something from memory from the various strength training workouts I have done that targets an area I want to strengthen, and then I keep doing it until I feel the muscle getting tired.  Eventually, I would like to work up to a more specific, measurable plan.  

What about you?  Do you have a favorite strength or flexibility training routine that works for you?  Any suggestions on where to find a strength training plan that starts with the lowest level of ability and keeps you feeling motivated and continuing to see improvements?  How do you know when to increase the weight or try something different?  What has been the greatest fitness milestone you've passed?  I'd love to hear from you, so please share your thoughts below.

For more in this countdown series, see last week's challenge about Tracking My Eating.

Countdown to TTC: Week 45

Proper Posture

Again this week, I decided to begin working on something that's a bit more challenging for me than some of my early goals: posture.  Honestly, if I just make a little progress on this one it will be a big improvement, because I have been hunching for as long as I can remember.  Maybe it's because I'm taller than most women, or maybe it's a holdover from my awkward teenage posture, or possibly I'm just too lazy to stand up straight.  Certainly adopting a lifestyle that involves sitting at a computer most of the day hasn't helped.  Whatever the reason, I know it's probably bad for my neck and back in the long run and I especially want to improve my posture before I get pregnant.  I've read numerous times that posture during pregnancy is even more important than it usually is because your body is changing and working hard to support extra weight that's all concentrated in one spot.  Women are already understandably more prone to back pain during pregnancy, so I really don't want to make it even worse by slouching all the time.

Although the origin of my bad posture is somewhat unknown, the reason for its maintenance is fairly obvious--my core, back, and neck muscles are weak.  Plus, I am so used to having bad posture that I almost can't even tell if my posture is good or bad at any particular moment.  Thus, my first course of action was to buy an inexpensive posture corrector to remind me to sit and stand up straight.  The particular corrector I ordered is made of elastic material that stretches around your back and shoulders and wraps around under your chest to attach with velcro.  It could be worn by a man or woman, but I feel it is particularly designed to strap under a woman's bosom.  I opened it as soon as I saw that it had arrived and started wearing it.  As various reviewers had mentioned, the material and the velcro are not very comfortable, so I wore a t-shirt underneath and padded some of the spots that rubbed (under the armpits, probably because my arms aren't as slim as the models) with washcloths.  While it doesn't exactly force you into the correct posture, the elastic is strong and definitely pulls my shoulders back without me doing anything.  Because of the way the getup looks and the fact that I am wearing it over clothes, I have no intention of wearing it out of the house.  Instead, it is a way to practice a couple of hours at a time sitting with good posture and hopefully that will slowly train my muscles and also make me more conscious of what proper posture feels like.  Even after just a few days I do feel like it is a little more natural to rest with my shoulders back rather than hunched forward.  But I'm sure it will take a long time to break my bad habits for good.

In addition to my sessions with the corrector, I am beginning to try a few other strategies to make my posture improvement a speedier and less unpleasant process:

1. Work on back and core strength.  There are numerous online articles and video explaining and demonstrating exercises that promote good posture.  In general, it is easier to support your head and keep your shoulders back if you have good upper back strength and to support the weight of your body if you have strong abdominals.  My typical exercise routine doesn't focus much on strength, and when it does I focus mostly on my arms and legs, so these are definite weak spots for me.  
2. Stretch.  There are lots of good stretches that promote better posture and reduce back and neck fatigue/pain.  Stretches can even be done at a desk at work. 
3. Adjust my sitting position.  If you're going to sit all day, it's better to sit properly in an ergonomic chair with legs straight down and preferably feet slightly elevated.  Or even better to use an exercise ball or a kneeling chair rather than a traditional desk chair.  Since I share my office space and take whatever chairs are available, for now I'll settle for getting up frequently, setting my chair to the proper height for my computer monitor, and trying to to cross my legs or lean to one side for a long time while I work.  

What about you?  Have you done anything to improve your posture recently and, if so, what was your strategy?  Do you have any experience with the effects of good/bad posture during pregnancy or have any words of wisdom to share?

For more in this countdown series, see last week's challenge about Having an Active Lifestyle. 

Countdown to TTC: Week 46

Get Active, Have Fun

 Once I commit to a certain activity or behavior, I am pretty good at following through on it.  So taking the stairs more or drinking more water are doable as long as I am able to remember they are on my to-do list.  But something I don't really do well is add spontaneous healthy behaviors to my day.  Even if I have an opportunity, I won't spontaneously add extra walking or play outside with friends or go out dancing.  For me, health-related activities are a necessary chore that you have to plan for but that you wouldn't want to do for fun.  So my goal this week was to work on changing my perspective about being active and to move toward having a healthy lifestyle, rather than a set of specific healthy behaviors.    

Step one of this effort was to register for and participate in a Color Run.  These events are popping up all over the United States and are pitched as "The Happiest 5k on the Planet".  Participants register in advance to take part in a 5 kilometer walk/run and show up on race day with thousands of other people to travel on a single track.  People of all shapes, sizes, and ages come to take part (including many families with infants and small children).  Runners/walkers are released in small waves, and there are several stations set up along the track representing a single color.  At each station, participants are sprayed by enthusiastic volunteers with dyed corn starch that starts to cover their clothing and bodies in bursts of bright colors.  When you complete the race, you toss a final color packet that you received at the start of the race along with hundreds of other participants, creating a rainbow cloud (pictured above).  

I am usually the type of person who avoids such events when possible, but since I started counting down to trying to conceive I have been thinking about my goals a little differently.  Usually I pass because I don't like waking up early on the weekends, which is almost always mandatory for walks/runs, and also I worry that I will get too tired or sore by the end of the race and look foolish.  Now, though, I am thinking more long-term.  Why avoid something fun like the Color Run just in case I might get tired?  I should instead look at it as a challenge and a goal for self-improvement.  Plus, it could be fun and maybe I would even want to be one of those mommies out there in a future race pushing my baby in a stroller or one of the fit pregnant ladies strutting along with a prominent belly bump.  

The next step will be a bit more difficult, because there is no specific plan or list to follow.  I will just need to start saying yes more often to opportunities to get active. I don't want to make a rule to always say yes, because there are some things I don't like to do or that are beyond my current abilities.  But having a yes attitude will be a good start.  Also, keeping an eye open for opportunities I might otherwise miss is a good idea.  I see lots of information about free events in my community, but usually I skip right to the ones about food or theater/movies and don't even look at active ones.  Even though most of them might not be my thing (I loathe most organized sports, for example), I might find the occasional gem like the Color Run - within my ability level, active, fun.  

What about you?  Is routine exercise the only way you get active, or are you able to find ways to get moving that aren't part of your exercise schedule?  How do you have fun while staying or getting fit?  What are some calorie-burning activities that you actually enjoy?   

For more in this countdown series, see last week's challenge about Eating More Produce. 

Countdown to TTC: Week 49

Meet Some Families in Your Community

 As a fairly young prospective parent and a graduate student whose peers are still fairly unsettled in terms of career and family, I have found it somewhat difficult to get to know people who are parents.  I suspect that most people naturally meet other parents when they are expecting a first child and continue to develop those relationships as their kids grow, but I think it could also be helpful to begin incorporating parents and children into my social network before I have baby #1.  With that end in mind, I incorporated two challenges into this week of my countdown.  

First, I agreed to babysit.  It can be difficult as a non-parent to mingle with families with kids because of the limited shared social opportunities that are available.  Since it doesn't seem like a great idea to be the creepy stranger who shows up at parks or kid's soccer games (for good reason), I realized the best way for me personally to meet parents around me is to serve them.  This can be especially easy if you are part of a church or a student--just put the word out there that you are available to help and you are likely to start getting requests.  This weekend, DH and I agreed to watch two kids for a family that we know from naptime to bedtime.  Admittedly, we have been babysitting for this family for a couple of years now so it wasn't a completely new item for my countdown, but lately I have started to look at these experiences as an opportunity to learn about and prepare for future parenting situations.  If you decide to try this too in your prep for TTC, bonus points if you can get your significant other to go with you.  It is always great for me to see DH interacting with children and imagine what a wonderful father he will be.  Babysitting can have the added benefit of reminding you to appreciate your current life stage.  The kids are adorable and fun, of course, but it's a good reminder of how much work it is to care for little ones full time. 

Of course, not everyone has opportunities to babysit and some people may worry that they aren't prepared to care for someone else's children because of their lack of experience.   If that describes you, it may be especially beneficial for you to seek out some parents for your social network and there are other ways to connect with them besides child care.  My second challenge for the week meets those criteria: in addition to babysitting, I decided to volunteer for the meals ministry at my church.  This group provides a service to new parents and others in our congregation who are currently in need of some extra help getting meals together for their family.  It's a new experience for me and the first informational meeting hasn't happened yet, but I'm sure I will feel good meeting others' immediate needs and may even have a chance to develop friendship with some of the families.  There will probably be plenty of opportunities to offer help and to listen in addition to just dropping off food.  Plus, I will be getting a chance to contribute to a service I plan to use in the future and will be inspired to start perfecting some healthy family recipes.

Here are the benefits (as I see them) of getting to know some families before you have kids:

1.  Becoming a first-time parent can be stressful and it is nice to know you have some experienced guides to support you.
2. Pregnancy and the early parenting days might be at least slightly less intimidating when you know what to expect and have some clue what you're doing.  You might never be totally prepared, but interacting with and observing other kids can definitely provide some perspective and confidence.
3. Helping out parents in whatever way you can is a good way to figure out what kinds of help might be available to you when you become a parent.  New parents can miss out on valuable community resources if they don't know about them or aren't sure how to request assistance.
4. Pregnancy isn't the best time to completely overhaul your social network.  You want to have support from people you know and have build lasting relationships with when you are starting a family.  Incorporating some parents into your group of friends before it's a practical necessity might not totally solve this problem, but could help you get used to balancing friendships with people at different life stages.  It might also help you figure out how to plan activities that friends with and without kids both enjoy, so you don't drift away from your non-parent friends after having a baby.  
5. It never hurts to help someone out!  Even if you don't become best buddies with any of the families you meet, you'll have made some new acquaintances, established some goodwill, and made a positive difference in your community. 

What about you?  Do you know a lot of parents, or did you before you had your first child?  Do you think there are any benefits?  Do you struggle with maintaining friendships with people who are in a different stage of life?  How can people maintain a thriving social network regardless of their current marital or parental status?     

For more in this countdown series, see last week's challenge about Saving.

Countdown to TTC: Week 50

Saving Up for the Baby Circus

Even the most frugal parents find that a new baby--especially a first child--comes with a lot of swag.  I refer to all the accoutrement that accompany each tiny bundle, as well as the hilarious show that is often put on by parents attempting to juggle all of these objects, as the Baby Circus.  Each little prince or princess requires a substantial up-front investment in terms of furnishings and supplies, as well as a lifetime of age-appropriate updates and upgrades.  Must-haves include a place to sleep (possibly 2 if you want to keep LO close to but not in the parental bed for some amount of time), a car seat, diapers (disposable or cloth), and clothes.  These are just the bare minimums and by themselves can add up to an investment in the hundreds (with good deal hunting) or considerably more.  Then there are some of those nice "luxury" items like a stroller, toys, breast pump, bottles, high chair, swing, etc., etc.  I don't feel that buying all of these items will make one's child happier or more well-adjusted, but they certainly seem like they would make life with an infant a bit more convenient and manageable (at least until you are so overwhelmed with objects that you have a hard time remember it's all about having a happy, well-loved child).  

Just thinking about all of the supplies needed for the great Baby Circus makes my cash hoarding instincts kick in.  Since I have the benefit of a full year to prepare for trying to conceive, I figured now was a good time to start preparing financially for having my own darling money pit, while researching sensible ways to save and cut back too.  Step one of my plan is modifying the monthly budget to incorporate a small savings each month for future conception, pregnancy, and baby expenses.  In addition to my various other savings stashes (#1 of which is saving monthly for a down payment for a future home purchase), I have now added to the monthly budget a $25 savings for pregnancy and baby.  When I have more left over each month, I save more and distribute it across my different savings categories.  It may not be a huge amount, but now I know that by the end of this year of waiting I will have at least $300 saved that is ready to be dedicated only to baby-related expenses.  If nothing else, that's at least a good amount to get started amassing a cloth diaper stash. 

I want to mention here that if DH and I didn't already have a monthly budget, I would have put that as step number one and would instead have spent this week taking action to get a financial plan in place for us (or at least to buy some books about it).  After going through Dave Ramsey's Financial Peace University a few years ago and then taking a class at the local university on financial management (many community colleges and schools of continuing education offer such courses for $100-$200 dollars), I began tracking our monthly expenses and also deliberately saving for specific purposes.  We don't follow a strict system or cut off our expenses in a certain category each month because we are over budget, but I do like to stay aware of our money and feel like it is working for me and not the other way around.  At the start of the year I make a tentative budget outline (in Excel) and then after a couple months of expenses I download all our banking activity and fill in a monthly spreadsheet of our income and costs (lately I have been using the free trial version of Microsoft Money, but there are many fancier options if you are willing to pay an up-front cost for the software).

My second step for this week's theme has been to establish a designated cash envelope for future baby expenses.  This is a more opportunistic savings vehicle.  Whenever someone pays me back for something in cash or I get paid for babysitting (another activity I highly recommend as part of your preconception prep), I will stash it away in this envelope.  I'm sure some money will inevitably flow out of this fund when it turns out we actually needed some of the cash we stashed in it, but I think over the course of a year there will be a definite net gain.  Then this on-hand cash will be great for all those baby bargains I can't wait to buy--good-condition used baby supplies and clothes at consignment shops, Goodwill, and on Craigslist.

What about you?  How much do you think is a good idea to save before getting pregnant?  Are there any important expenses I'm forgetting about?  Do you have any tips for saving money on pregnancy and baby stuff?

Update:  After a great discussion on Baby Center about saving up for baby, I thought I had better mention an alternative baby savings plan that could be great for some people.  It's called the 52 Week Money Challenge and it involves putting away a different dollar amount each week that corresponds to the current week number in your countdown.  That is, week one you save one dollar, week two you save two dollars, etc. up until week 52 when you put away 52 dollars.  It sounds really manageable because the amounts aren't individually large, but by the end you save almost $1400 dollars!  This especially sounds like a good plan for reluctant savers who benefit from seeing their stash growing over time, which motivates additional saving.  Given my preference for having a set budget, though, I think saving a set dollar amount each month is personally more my style.  

For more in this countdown series, see last week's challenge about Hydration.

Countdown to TTC: Week 51

Hydrate Like a Pregnant Lady

Last week I prepared for conception (now in the not-so-distant future) by getting ready spiritually.  While I am continuing to read and pray, I also wanted to start doing something to get my body ready for the process.  I'm always hearing that the most physically demanding thing most women ever do is go through pregnancy and childbirth, and I definitely wouldn't say I'm in the best shape for such a marathon right now.  I have been on a journey for some time to eat healthier and get fit, but the actual weight loss and muscle gain associated with those changes have been minimal.  Now that I have a target date and a specific fitness challenge to prepare for, I am hoping to make some slow but positive change in the next 51 weeks.  When I go to the doctor for a preconception checkup, I want to be able to report that I've been doing everything I can to prepare for a healthy pregnancy.  

However, overhauling my life all at once seems like a stressful way to approach the situation.  I am starting early, so why not take things a step at a time, starting with something easy?  

The first "easy" task that came to mind was hydration.  It's simple, it's easily measurable, and it's important.  Plus, fluid intake needs increase significantly during pregnancy and low amniotic fluid is a common reason for term inductions.  I recently saw several episodes of A Baby Story and Baby's First Day on TLC in which women were induced at term for low amniotic fluid--a situation I'd like to avoid.  Admittedly, these inductions may not be necessary (see this great article on Science & Sensibility on the topic for more info), but it's also possible to reduce the risk of getting a diagnosis of low amniotic fluid in the first place by staying well-hydrated.  But apparently staying well-hydrated at term means drinking 2.5 liters (that's nearly 11 cups) of water per day!  So getting used to drinking plenty of water before getting pregnant seemed like a good idea.

Following that thought process, I set a goal for this week of drinking 8 glasses (64 oz) of water a day.  I am already a SparkPeople member, so tracking my water intake is as simple as clicking on an arrow each time I finish another cup.  Unfortunately, it turns out actually drinking that much water isn't as easy as I thought it would be.

I'm currently only on day 3 of this challenge, and so far I haven't met my goal.  Turns out I like to drink 5-6 glasses a day and anything more than that feels unpleasant.  It's not my ideal to have to pee every 30 minutes for half of the evening either (because I am trying to make up for not drinking during the day).  I'm sure I used to drink a lot more without issue at one time, but I have gotten into bad habits in the years since I went off to college and no longer had a ready supply of cool, filtered water and ice.  But I think by the end of the week I'll have achieved my 8 glasses a day and figured out some strategies to make it less challenging.  And I guess eventually one's body must become used to the better hydration and keep some of it in longer!  Here's what I've tried so far:

1. Buy a water bottle that keeps liquid cold for a long time and doesn't sweat.  I decided to go with the Trudeau Cool Off 24-Ounce Hydration Bottle because it is fairly affordable, has air insulation that prevents sweating, includes a straw so it doesn't spill all over you when you drink out of it but can still be closed, and comes in a cute pink color.  I drink a lot more using this than I do with smaller bottles, even though it is a bit large for carrying around.  And the fact that the water stays cold really helps. 
2. Figure out a good way to track your intake.  You think you will know how much you are drinking, but I found that method leads to extreme overestimation on my part.  The water bottle I got holds exactly 3 cups of liquid, so that way I know if I drink all of it and fill it 3 times during the day, I have exceeded my goal.  I also recommend using a ticker or counter throughout the day so you don't start fudging the numbers come evening.  As I said earlier, I like the one on the SparkPeople nutrition tracker.
3. Distribute your consumption throughout the day!  This is my main problem--I think I am drinking at work but I get distracted and then realize I have only had one cup of water in 5 hours.  If you are then determined to make up for it the rest of the day, you will find yourself in the same bladder-busting situation I did.  

What about you?  Do you have any suggestions on how to drink more water?  Any pregnancy stories about hydration?   What do you think I should do in the next 50 weeks to prepare for conception?

Countdown to TTC: 52 Weeks of Preparation

Week 52:  Pray Like a Mom

I am still planning to post the remainder of my Countdown to TTC Checklists, but a more pressing issue has inspired me to start writing another series.  DH and I are finally ready to start trying to conceive...one year from now!  Although we've always wanted a family and just celebrated our 3-year wedding anniversary, the timing just hasn't been right.  We are both graduate students on an uncertain completion timeline.  But it looks almost definite that DH will be finished within the next 2 years (maybe in only a year) and I am confident I can wrap up by then as well if I have a sufficient incentive (like a massive baby belly and a fierce desire to stay home with my newborn). That means a TTC start date one year from now would allow us to get pregnant no sooner than both of us should be wrapping up our studies--and because of the academic job market we would already know about DH's job by then too.  On the other hand, we are well aware that things don't always work out like we plan and we want to trust God for His timing, so we are approaching this decision prayerfully.

By now it is probably clear that I like to approach challenges with organization and thoughtful preparation, and this one is no different.  I downloaded my countdown clock which is ticking away in the corner of my computer right now (check out TimeLeft if you want to start your own -- the first countdown is free)  and now I am ready to start preparing for whatever God and my body have in store.

At first I struggled with what to do my first week, since it would set the tone for the rest of the year.  Should I do something easy, to smooth the way and make me feel capable of seeing through the other 51 weeks?  Should I go with something health-related since one of my biggest goals is preparing for a healthy pregnancy with minimal complications?  Then I realized that of course the first thing I should do, really any time I am preparing for such a big life change, is pray!  I want these habits I take on each week to extend throughout TTC and pregnancy, and being prayerful and connected with God should be first and foremost among those.  Everything about becoming a parent can be scary and stressful, but if I am getting my strength from my Creator, the one who formed me in the womb, I know I will have peace and assurance throughout the process.

So, this week I combed the Old and New Testaments for verses about conception, birth, parenthood, children, and God's sovereignty over them all.  I am planning to read at least one verse every day for the next year and meditate on it, as well as praying for God's guidance.  Below are some of the verses I found that most spoke to me: 

God, the Creator:  As you do not know the path of the wind, or how the body is formed in a mother's womb, so you cannot understand the work of God, the Maker of all things.  --Ecclesiastes 11:5 

God's Timing:  Commit everything you do to the Lord. Trust Him, and He will help you. Be still in the presence of the Lord, and wait patiently for Him to act.  --Psalms 37:5,7 

Infertility:   He settles the barren woman in her home as a happy mother of children. Praise the Lord.  --Psalms 113:9 

Preconception Health:  And the angel of the Lord appeared to the woman and said to her, “Behold, you are barren and have not borne children, but you shall conceive and bear a son. Therefore be careful and drink no wine or strong drink, and eat nothing unclean, for behold, you shall conceive and bear a son. No razor shall come upon his head, for the child shall be a Nazirite to God from the womb, and he shall begin to save Israel from the hand of the Philistines.”  --Judges 13: 3-7 

In the Womb:  For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth. Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.  --Psalms 139:13-16 

Childbirth:  A woman, when she is in labor, has sorrow because her hour has come; But as soon as she has given birth, she no longer remembers the anguish, For joy that a child has been born into the world.  --John 16:21 

Parental Instruction: Fix these words of mine in your hearts and minds; tie them as symbols on your hands and bind them on your foreheads. Teach them to your children, talking about them when you sit at home and when you walk along the road, when you lie down and when you get up.  --Deuteronomy 11:18-19

 
What about you?  Do you have any favorite inspirational words for prospective mommies and daddies?  What are you or did you do as you counted down to trying to conceive?  What do you think I should do in the next 51 weeks?  

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.