Ladies, if you are using hormonal contraceptives and want to start trying in the next year, come off of them now. More and more women are having problems regulating their hormones after taking the pill, delaying trying to conceive by months up to a year (and beyond in some cases).
The pregnancy pressure is applied the exact second you lock lips with your groom. Your mama is happily sobbing from the wedding sidelines, not just because her little girl is grown—but also because she’s instantly envisioning whether you’ll paint the nursery pink or blue. And at every family function moving forward, you can expect to get some version of, “When are the two lovebirds going to start trying?”
Well, even if all you’re “trying” to do is figure out where to put all the wedding gifts you registered for (panini maker, anyone?), today, I’m going ask that you step away from those rarely used appliances and pay attention to this startling statistic: Jennifer Ashton, MD, Ob-Gyn and Senior Medical Correspondent for ABC News (@DrJAshton), says that almost 50% of the pregnancies in this country are unplanned.
That doesn’t necessarily mean they’re undesired, but they are unplanned. Says Ashton, with “typical” use of the birth control pill (i.e., women who forget to take it or don’t always do so correctly), the failure rate is 8%.
So, even if you’re not planning for a baby just yet—getting yourself in pre-pregnancy shape isn’t a bad idea (and I’ll bet you my first born that quitting smoking, eating well, and exercising won’t hurt you). Ashton also recommends a prenatal vitamin (with at least 400 mcg of folic acid) for all women of childbearing age exactly for this reason.
And, for those of you who are in the market to make that blessed woman a grandma-to-be—there’s more. I’ve got the goods on what you should be doing long before you ditch your pill pack, draw the shades, and hop in bed with your honey.
Get All Your Ducks Row-Ready
Ashton says the first step is looking at that life of yours and deciding what activities should go. “Obviously, any [recreational] drug use, smoking, and alcohol use should be stopped once you’ve made the decision you’re going to try. The most crucial time for [the baby’s] organ formation is weeks 3-8,” says Manuela Vazquez-Whitledge, MD, an Ob-Gyn at Hoag Hospital in Newport Beach, California.
Also talk with a doc if you’re on prescription medication for a chronic condition, like epilepsy, diabetes, high blood pressure, depression, or asthma. “It might be to your advantage to speak with a specialist prior to getting pregnant so you can understand how these meds affect your pregnancy and if you need to change them ahead of time,” says Vazquez-Whitledge. “[Pregnancy is] much easier on you mentally and physically when you are healthy and you’ve planned ahead.”
On Your Mark and Get Set
Ashton likes to compare pregnancy to an Olympic event, in that “you want to train for it and you want to make sure you’re in good physical condition before you get pregnant. This is a great time for women who [struggle with] being overweight to say, ‘You know what—I’m going to get an aggressive nutrition plan and get into shape for this pregnancy.’”
In fact, Ashton feels obesity is the “most important issue facing today’s reproductive age population.” Risks for overweight women during pregnancy abound—including gestational diabetes (dangerously high blood sugars affecting both baby and mom), preeclampsia (a potentially life-threatening condition that can affect the mother’s blood pressure, kidneys, brain, liver, and placenta), a higher risk of C-sections, and an increased risk of potentially fatal deep vein thrombosis (blood clots often occurring in the deep veins of the legs).
Belly Up for a Few Blood Tests
Vazquez-Whitledge says another baby box to check off is genetic testing— imperative if you’ve got a family history of inherited conditions like Fragile X syndrome (which can cause developmental delays), spinal muscle atrophy (a disease that causes muscle deterioration and weakness in children), and for people of Eastern European Ashkenazi Jewish descent, fatal neurological diseases like Tay-Sachs and Canavan disease.
“This is really nice to do prior to pregnancy. It’s an anxiety-provoking time, and the last thing you need is to add more stress,” says Vazquez-Whitledge.
You’ll probably also get stuck to see if you’ve got all your shots—most importantly, if you’re protected against rubella. Rubella is a contagious childhood disease that causes a mild rash, fever, and swollen lymph nodes—but if a pregnant woman is exposed to the virus, it may cause severe birth defects or miscarriage. The vaccine is not given during pregnancy to avoid a theoretical risk of infection—which means you’ve got to get it before you’re holding a positive preggo test in your hand.
Vazquez-Whitledge says it’s disappointing to see pregnant women with lab results that show they are not immune to rubella. “If they would have come in six months [ahead of getting pregnant], we could have given them the vaccine and they would be completely safe throughout their pregnancy.”
When I was newly married at age 27, there was nothing more unnerving as my mom’s insistence I give her a grandchild before it was “too late.”
But at the time, I was routinely working 50+ hour weeks and skipping lunch, exercise, and sleep. I couldn’t imagine mothering anyone, much less myself—and late nights with Thai takeout on a cluttered coffee table in front of the TV are not exactly kid-friendly. But, to my chagrin, both mama (and medical science) know what they’re talking about.
According to Ashton, it’s an irrefutable fact that the ideal age for women to reproduce is in their 20s—although that often doesn’t happen today for social reasons like lack of a mate or concerns about career.
Your eggs are “the best that they are going to be [in your 20s],” says Vazquez-Whitledge, who adds that your risk of pregnancy complications goes up as you age and after 35, the quality of your eggs goes down exponentially every year. “You can get various hormone tests—and they can look fine at 39, and two months later they can not be fine,” says Ashton.
And unfortunately, you can’t just assume that you’ll be the exception to the rule and hope for the best. “All you can go by is the stats and the stats are not in a woman’s favor as she ages,” says Ashton, who experienced her own epiphany while in medical school after an ectopic pregnancy threatened her ability to have children.
“I thought, hold on. Maybe it’s not up to me. Maybe I can’t micromanage this like I micromanage everything else. Becoming a physician was a priority, but becoming a mother was at the top. All my life I thought, ‘Oh, I’ll be able to decide and say when… and sometimes life is not like that.’”
“Women need to know that time is not on their side. And if the social aspects of their life are in place and they want children, they should put it at the top of their to-do list,” says Ashton. Read: Even if you’re just slightly swayed in the baby direction—it would appear that it’s best to get the preconception homework started sooner rather than later.
I Want My Mommy
Now, for those of you who are trepidatious about throwing the proverbial (baby-shaped) wrench into your life and career plan, I asked Ashton, who successfully juggles two teenagers, a thriving medical practice, and a second career in television news, for some words of wisdom:
“Be unconflicted. When I’m at work, I’m 150% there and I’m not thinking about who is going to take my daughter to hockey practice. And when I’m with my kids, I’m not thinking about work. Being in the moment 150% is very liberating,” she explains.
But, at the end of the day, she and her kids both know what comes first.
“Someone asked me when I was a chief resident, ‘Jen, what would you do if you were doing a hysterectomy and one of your children was injured and in the ER?’ I said, ‘As soon as another surgeon could replace me, I would leave the OR to attend to my children. I’m the only mother my children have.’”