Wednesday, May 23, 2012

How to Prepare for Conception

I don't want this post to come off the wrong way. I'm going to share the things I did to get my body ready for conception, but the underlying message is NOT: "Do these things and you will get pregnant." Unfortunately, people could do all of these things and still not get pregnant, while other do none of these things and get pregnant right away. 

As someone who likes to plan and orchestrate things, I have to remind myself of this simple truth all the time: I can control the inputs, but not the outputs. 

But embracing that message doesn't stop me from working on the inputs. With Henry, there were about eight months between the time I picked up some free pregnancy and conception books at a public library sale to the time Matt and I decided we would start trying. I used that time to prepare my mind, body, and life for pregnancy. 

Here are some of the things I worked on:
  • Making sure my BMI was in the right range.
  • Scheduling a pre-conception physical with my general physician.
  • Eliminating harmful substances from my life: alcohol, medicine, caffeine, etc.
  • Eliminating toxic substances from my life: in cosmetics, cleaners, etc.
  • Learning how to track my cycle (by measuring temperature and monitoring cervical fluid) to ensure I was ovulating each month (I love this book and this book).
  • Meeting with midwives.
  • Increasing my exercise, water intake, and relaxation.
  • Eliminating unwanted commitments and stress from my life.
  • Taking prenatal vitamins religiously.
The left-hand sidebar includes a list of all the conception books I recommend.

In terms of preparing for Bambino #2, there were about two months between when I decided I was ready for a second and when we starting trying. I was in pretty good shape on my list above, except that I didn't feel physically strong. I did some running and exercising in those two months, but not as much as I would have liked. My plan is to walk for an hour every day during pregnancy and go to prenatal yoga once a week. I didn't start tracking my cycle again because I learned during my research that the best indicator of ovulation is cervical mucous. I pay attention to that indicator and can tell when I'm ovulating.

Definitely let me know if you have any questions!

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Anonymous said...

Hi I'd love to know which books you'd recommend - those links aren't working for me.

I've just ordered Taking Charge of Your Fertility. Looking forward to learning all about it!

Cécy said...

What do you consider the right BMI range?

Sara E. Cotner said...

Here's the calculator I used (it's from the U.S. government):

Anonymous said...

YES to the BMI thing (and the other things too)!
I know several women who don't realize that a healthy weight can be a factor in fertility.

Anonymous said...

The BMI is an extremely outdated, body shaming tool. Asking someone their weight + height is not an indicator of health at all. I am well over 'obese' but nowhere near being obese. A quick google search will pop up lots of criticism of using it because it's so outdated.

I would not encourage your readers to use that as a measure of health.

Alissa said...

Hi Sara,

I've been on birth control for well over 7 years. I'm interested in getting off the pill to start tracking and regulating my cycles before my husband and I start trying to conceive. Can I ask how you prevented getting pregnant when you were not wanting yet to conceive?


Anonymous said...

The BMI calculator is considered 'out-dated' because it doesn't take into account where the fat is located (eg, breasts), or muscle weight. What I meant in my earlier comment is that many women, who I have personally known, have failed to recognize that being excessively over/underweight can cause difficulties in regards to conception. A quick search on Google shows a 2010 study that states: 'For every BMI unit over 29, chance of pregnancy fell by 4%.', which is something to consider. This leads us to Sara's second piece of advice: 'Scheduling a pre-conception physical with my general physician.'

Sara E. Cotner said...

I'm well-aware of the criticism against the BMI measure, but I still find it to be a useful starting place. The "normal" range for my height spans 41 pounds. That takes into account a lot of different body types and factors.

Of course your physician will have more insight into your personal health. I absolutely respect anyone who does not find the BMI useful for their individual situation. I merely mention it in case it's helpful to some folks.

@ Alissa: Matt and I use a combination of condoms and family planning (via Taking Charge of Your Fertility).

Lynna said...

I'm pregnant! I just had to tell someone. We are trying to keep it a secret until July 24th, which seems like an eternity. I figured it was safe to shout it out into cyberspace! So, now I've told my favorite blogger. I feel so much better now... lol.

Anonymous said...

...or a condom can break when you are 17.

I only say that half-sarcastically (heck, it happened to me). I love this blog, but everytime there is a post in anyway connected to women and their bodies I cringe a little, because it is usually really unhealthy in some way. I am not one to go around cyberspace judging what are essentially personal blogs, but I really like you so I feel like I should say something.

Some people get pregnant super easy and some people don't. Like body shape, a lot of it is luck of the draw genetics. Sure, you can assist in small ways but at the end of the day ol' Mr. DNA is the prime mover here.

It is unhelpful to shame women (especially women having difficulty conceiving) about their weight, sleep patterns and reading list. It just is.

Sara E. Cotner said...

Hi, Lynna! Hooray! Thank you for telling me! Please keep me updated about your journey; I wish you the very best.

@ Anonymous: There's definitely a discrepancy between my intent and my impact. My intent is never to hurt or upset people. But, honestly, I'm still having trouble understanding how this post can be considered "unhealthy" or "body-shaming." I started the post by saying that one could do all of these things and still not get pregnant or one could do none of them and get pregnant right away. That's the nature of conception; we cannot control it. Then I simply listed the things I chose to do, none of which seem to me to indicate an unhealthy attitude toward my body or anyone else's. Most of them, in fact, came straight out of the multiple books I read about conception. Here are some excerpts about BMI:

"An individual whose BMI falls in the normal range will be at the lowest risk for many health problems. With regard to preconception readiness, women with pre-pregnancy BMIs anywhere in the normal range have the most favorable odds of conceiving and having a healthy full-term baby. Women with pre-pregnancy BMIs above or below the normal range, especially those who are obese (BMI above 29) or underweight and undernourished, increase their risk of problems associated with conception, pregnancy, and their offsprings' lifelong health...Pre-pregnancy weight within the normal BMI range is the healthiest recommendation we can advise..."

And here's from a different book:

"There's a strong connection between weight and fertility, but it's a complicated one, too--and it's much more than just a numbers game. Getting to the bottom of your bottom line is one of the most important steps you can take when you're getting your body ready for [conception]....If you have more than the normal amount of fat cells (because your BMI is high), those fat cells will be producing more estrogen than necessary. If you have far fewer fat cells than you should have (because your BMI is very low), your body will be estrogen starved. Because a delicate balance of hormones--which includes the perfect supply of estrogen--needs to be maintained for your reproductive cycle to work the way it's supposed to, too much or too little estrogen (from too many or too few fat cells) can throw your fertility off kilter. In fact, it's suspected that more than 10 percent of all fertility problems stem from weight issues."

And from another book:

"Just as being underweight can prevent ovulation altogether, being overweight can also alter your cycles by causing excessive production of estrogen, which interferes with the normal feedback system of the hormonal cycle. To eliminate hormonal imbalances due to being under or overweight, you should try to attain a normal weight through wholesome foods and exercise."

I read all of that and was compelled to ensure that my BMI was in the "normal" range. Although I couldn't control whether or not I got pregnant, I could control my BMI. I found that comforting and helpful.

Someone else could read the same information about BMI and decide that it doesn't resonate with them. That's totally fine! The best we can do is make decisions that align with who we are and who we want to be. We each have to find our own authentic paths.

When I share my path on this blog, I am not judging or condeming all other paths. I'm simply saying: Here's the path I chose for myself and here's why.

Alissa said...


Thank you for your feedback. I participated in your Purposeful Conception course late last year. I had a hard time actively participating, as I was travelling for work much of that time. I've been planning to purchase Taking Charge of Your Fertility. I went ahead and ordered it this evening. I'm looking forward to reading it.

I share many of your same values, and appreciate your blog so much. It takes a lot to put yourself out there. Congrats on Bambino #2.

Best Regards,

Justine said...

Many moms are surprised by their pregnancies due to various reasons and not all moms are healthy before the pregnancy, during, or after. They can have healthy babies too. But they have a higher risk of not having them born healthy. Why is this "shaming"? It's fact.

Ellen said...

I also don't feel that there was any shaming in your post. I can understand how these posts may sting for people who are having trouble conceiving or who don't agree with some of your health markers. But Sara, I just wanted to let you know that I think you're doing a good job keeping your language respectful here.

Anonymous said...

Don't forget to take folic acid. Even if you aren't trying to get pregnant right now.

All people need folic acid. But folic acid is very important for women who are able to get pregnant. When a woman has enough folic acid in her body before and during pregnancy, it can prevent major birth defects, including:

Spina bifida (SPEYE-nuh BIF-ih-duh), which occurs when an unborn baby’s spinal column does not close to protect the spinal cord. As a result, the nerves that control leg movements and other functions do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries.
Anencephaly (an-en-SEF-uh-lee), which is when most or all of the brain does not develop. Babies with this problem die before or shortly after birth.
The results of some studies suggest that folic acid might also help to prevent other types of birth defects.

Folic acid also helps keep your blood healthy. Not getting enough can cause anemia (uh-NEE-mee-uh).

Experts think that folic acid might also play a role in:

Heart health
Preventing cell changes that may lead to cancer
More research is needed to know this for certain.

Birth defects of the brain and spine happen in the very early stages of pregnancy, often before a woman knows she is pregnant. By the time she finds out she is pregnant, it might be too late to prevent those birth defects. Also, half of all pregnancies in the United States are not planned. For these reasons, all women who are able to get pregnant need 400 to 800 mcg of folic acid every day.

And if you have family history of heart disease/strokes/heart attack you need to be checked for MTHFR a blood clotting issue that can cause miscarriages. If you do have this you will need to take folic acid for the rest of your life. Don't wait until you've had three miscarriages (when they usually test for reasons you are losing pregnancies) demand it.

Carla (too lazy to log in)

kacey said...

Just thought I would add to the husband and I are on cycle #3 of trying (though I have long cycles, so it's seemed a lot longer). Tracking cervical fluid is amazing...i can't believe I wasn't aware of my body's amazing fluctuations before I went down the road of conception.

I started my first cycle cutting out all coffee and alcohol. When I got my period I was devestated, so decided to take more of a "live and let live" approach. I went back to my one cup of coffee in the morning, and have an occasional glass of wine with friends. I know it's not the sanctioned medical advice, but it's helped me stay sane through this process.

Thanks, Sara, for always putting it out there. Every woman has her own way of going about these things, but no one for criticize you for your's and Matt's methods. They seem to have worked so far! Best of luck with the new bambino.

Cécy said...

@Kacey: Ditto here. I have long cycles as well so I know the feeling. When we first tried getting pregnant I completely cut off alcohol. Got pregnant but it was ectopic and couldn't drink or have sex for several weeks. Now trying again and since I chart I allow myself the occasional drinks prior to ovulation. It's less stressful and not to mention more discreet when hanging out with friends.

Kristy said...

Hi Sara!

I really liked this post and agree with most of the others that you've done well at writing non-offensive content. DH and I are thinking about trying for #3 this Fall. My first son was unplanned so no conscious prep there and my second was planned with some effort in preparation. I really like all of your suggestions but think that financial planning is also important in the process. Does Matt do anything to prepare?

Sara E. Cotner said...

Yes, Kristy! I totally agree with the financial preparation piece (and it also looks like I forgot to mention preparing our partnerships).

As I was reading the preconception books, none of the male-specific suggestions really applied to Matt.

Best of luck to you!

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