Planning Your Pregnancy

When you and your partner feel like the time is right to try to start a family book an appointment with your health care provider.

With your health care provider, talk about:

• Your general health
• Medications your take
• Vaccinations you might need
• Testing for sexually transmitted infections

It is also a good idea to see your dentist before pregnancy. Dental problems in pregnancy can affect parent and baby.

Once you have decided to try to get pregnant, you will need to stop using birth control. The chart below has information about how long you need to wait after you stop birth control to get pregnant.

An egg and a sperm must meet in order for pregnancy to occur. The best time for this to happen is during ovulation. Ovulation is when the egg leaves the ovary and waits in the fallopian tube to join with the sperm. Most individuals who ovulate release an egg 14 days before their period starts.

You can predict when you are ovulating by:

Keeping track of your periods:

The easiest way to find out when you are ovulating is by keeping track of your period. You should do this for at least 2 months. Put a "P" on the calendar the first day you start your period. Count the number of days in your cycle by counting from the first day of one period to the first day of your next period. Count back 14 days from the start of each period of each month you were keeping track. Put an X on these dates. The X's mark the days you most likely released an egg. Your egg could leave the ovary 2 days before or 2 days after where you place the X. The best time to fertilize the egg is around the time of ovulation. If the time between your periods is not regular speak to your health care provider.

Discharge from your vagina:

When you release an egg the discharge from the vagina is clear and sticky and there is lots of it.

Checking your temperature:

When you ovulate your body temperature rises a bit. Take your temperature every day before you get out of bed and write it down. Your temperature will be higher for a week to ten days after ovulation. You need to use a "basal body temperature thermometer".

It is not necessary to have sex every day around the time of ovulation. This can decrease sperm count. The recommendation is to have sex every other day during ovulation.

Fertilization

Fertilization is when the egg and sperm meet. This happens in the fallopian tube. The fertilized egg or embryo moves down the fallopian tube and into the uterus. Implantation is when the embryo gets to the uterus and attaches itself to the lining of the uterus. This is where the baby will grow until birth.

There is no way to guess how long it will take for you to get pregnant. It is different for everyone. For most people, pregnancy may occur within one year of trying. Talk to your health care provider if you are not pregnant after a year of trying. Your health care provider can make an appointment for you to see a doctor at the fertility clinic in your area.

Increased age can make it harder to get pregnant. Fertility, the ability to get pregnant, falls in a woman's mid-thirties. Women over 35 years old should see a fertility specialist after 6 months of trying to get pregnant. Individuals who are 38 years should see a fertility specialist without waiting.

Some early signs of pregnancy are:

• a missed period
• feeling tired
• breasts are tender
• you have to pee more often
• feeling bloated
• nausea
• unusual bleeding (different from your period)

If you think you are pregnant or have a positive home pregnancy test book an appointment with your health care provider. Early prenatal care is very important for you and your baby.

Adoption is another way to have a family. Families are about love, nurturing, and support for all members. To find out more, visit the Adoption Council of Ontario. They have resources, information, peer connections and support to assist in your decision making.

Cannabis can affect the quality of the sperm or egg. Cannabis use during pregnancy can result in a higher risk of babies being born too soon or too small. Children may also develop learning problems as they grow. It is safer to not use cannabis before planning a pregnancy. If you are planning to use, follow these lower-risk tips.

Early prenatal care is important in helping you have the healthiest pregnancy and baby possible.

How often are the health care provider visits?

• During most of the pregnancy, once every 4 weeks.
• Once every 2 to 3 weeks after 30 weeks.
• Every 1 to 2 weeks starting after 36 weeks until labour starts.
• There will be extra visits made if the pregnant person needs extra care. If the pregnant person has any concerns or questions, they can also make extra visits.

Book the first visit as soon as you know you are pregnant. It is important for a partner or support person to go to the visit too. The first visit is longer than the others. You will have a full check-up and talk about your health history. Your health care provider will calculate your baby's due date.

What will the health care provider ask about at the first prenatal visit?

• Any physical concerns and problems you are having.
• Your eating and exercise habits.
• Stress in your life.
• Your immunization record.
• Use of prescription and other drugs during pregnancy (including over the counter medicines).
• Tobacco or alcohol use.
• Prenatal testing and genetic counselling.

At the first visit or soon after, the health care provider may want to do a pap smear. A pap test checks for abnormal cells of the cervix. You may have tests done to check for sexually transmitted infections (STIs). You will also have blood tests done, especially if this is your first pregnancy. You may have blood tests done again later in the pregnancy.

What will happen at the prenatal visits?

• A urine test.
• Weight check.
• Blood pressure check.
• Stomach examined and measured.
• Checking of baby's heart rate.

Parents-to-be should have enough time with their health care provider to get all of their questions answered. Prepare for your appointment by writing out your questions ahead of time.

Over 50% of pregnant individuals will have nausea and vomiting in pregnancy (NVP). Another name for NVP is morning sickness. Morning sickness is more common in the morning but can happen any time of the day. The exact causes of NVP are not known but changes in your hormone levels could play a role. You can also feel nauseous if your blood sugar is low and if you are tense, worried or tired.

Morning sickness can last from about the 4th to 14th week of pregnancy. It can last longer; sometimes the entire pregnancy.

What can I do to feel better?

• Take your time getting out of bed in the morning.
• Eat dry toast or crackers before getting out of bed in the morning.
• Eat small meals and snacks often in the day so your stomach does not get empty.
• Open windows and turn on the stove fan when cooking.
• Drink small amounts of fluid often during the day.
• Don't drink fluids during, just before or right after a meal.
• Don't skip meals.
• Get enough sleep, and nap when you can.

Nausea and vomiting in pregnancy isn't usually harmful to you or your baby. You should talk to your health care provider if:

• You are so sick you are missing meals every day.
• You cannot drink enough liquids.
• You are not peeing often, or your urine is dark yellow.
• You are losing weight.

Keeping your teeth and gums healthy during pregnancy has many benefits for you and your baby.

Did you know…

• Morning sickness can leave stomach acids in your mouth that can damage the surfaces of your teeth and promote tooth decay
• Changes in hormone levels during pregnancy can cause swollen gums that bleed during brushing and flossing, often known as “pregnancy gingivitis”

• Pregnant individuals with poor oral health have a risk of developing periodontitis (infection of bone holding the teeth in place). This type of infection has been associated with poor pregnancy outcomes such as:

  • delivering a pre-term baby
  • delivering a baby with a low birth weight

Visiting the dentist and the hygienist

• Regular dental cleanings and check-ups are important before, during, and after pregnancy
• Be sure to tell them that you are pregnant
• You may want to postpone routine dental radiograph until after your baby is born
• Should your dentist recommend an emergency radiograph, the dental office will provide a leaded apron to shield you and your baby from this low dose

What can I do to help?

• Brush your teeth and your gums with a soft toothbrush twice a day, using a pea size amount of fluoride toothpaste. Also, gently brush your tongue
• Gently floss daily to remove plaque from between your teeth and gums. If your gums bleed, keep on flossing
• Eat healthy nutritious food and avoid sweets
• If you gag, use a small, child-size toothbrush and lean your head down and over the sink while brushing. It helps relax the throat and allows the saliva to flow out.

What is secure attachment?

A secure attachment is the deep and lasting connection that babies form with their caregiver(s). Babies need to feel safe, cared for and protected. They need their caregiver(s) to be physically and emotionally available. This helps meet their needs in a warm, sensitive, and consistent way. 

Connecting with your baby while you are pregnant will help you prepare for their arrival. Attachment is for life, but happens mostly in the first year of your baby's life. How caregivers respond to and behave towards their babies can affect this lifelong bond.

How to form a secure attachment with your baby:

Have you ever asked yourself things like:

• "I wonder what my baby is thinking or feeling."
• "How will I show my baby how much I care?" or
• "How will I meet my baby's attachment needs"?

There are many things that you and your partner can do to build a secure attachment while you are pregnant. You can:

• Think about your growing baby and talk, sing, and read to them.
• Make a note about your baby's movements. Rub your belly and talk to them at the same time.
• Keep a diary or journal of your thoughts and feelings.
• Take time for yourself. Find activities such as prenatal yoga to help you manage stress.
• Think of things you and your baby will do after they are born.

Why is secure attachment important?

When you respond to your baby's needs, your baby will respond to you. You will see that it gets easier to soothe them. They will want to be near you and react to you. This secure attachment is the first way that babies learn to sort out their feelings and their actions. This is the foundation. It lets your baby explore the world and have a safe place to come back to. Secure attachment also helps your baby learn how to trust other people. It is an important part of developing healthy relationships for later in life.

When your baby arrives, you may feel:

• drained
• worried
• proud and happy
• stressed

You may be wondering how to support your partner once your child is born.

• If your partner is breast/chestfeeding, you can help by bringing baby to them when baby is showing hunger cues. You may also support them by offering them something to drink or eat.
• Make time for skin-to-skin with your baby.
• Bring home supper or offer to prepare meals.
• Hold your baby to soothe and calm them when they cry. This will help you bond with your baby and promote attachment.
• Give your partner a chance to take a bath or shower.
• Throw in a load of laundry, vacuum, and do dishes.
• Take the children to get groceries with you.
• Change diapers and bathe your children.
• Burp your baby.
• Bring home flowers.
• Spend time together and talk to each other.
• Keep your sense of humour.

The postpartum period is a change for you all. Remember, you are learning what may be the hardest job that you will ever have to do. It is okay to tell someone that you are feeling tired and overwhelmed. Talk to other parents and/or visit:

The Parent Resource Centre has a Parent Education Calendar. This helps you to find parenting workshops and playgroups from birth to 6 years of age. Most programs are open to all parents.

24-Hour Cribside Assistance was made by dads, for dads. You can get answers to basic questions about babies and new parents.

Dad Central Ontario gives you information and offers free booklets and articles. You will also find links to fathering websites from around the world. 

Human milk is good for your baby because it:

• Is always fresh and ready.
• Helps lower the risk of overweight and obesity.
• May increase protection against illnesses such as childhood diabetes.
• Increases protection against ear, chest and stomach infections.
• May increase protection against Sudden Infant Death Syndrome (SIDS), also called crib death.
• Helps to prevent constipation.

Breast/chestfeeding is good for you because it:

• Promotes closeness and touching with baby.
• Helps the uterus to return to its' normal size after birth.
• Helps to control bleeding after birth.
• Helps to protect against cancer of the breast and ovary.

Feeding your baby human milk is good for families, communities and the environment as it:

• Saves money as formula can cost a lot
• Saves time as there is no need to prepare formula and bottles
• Does not produce any garbage. There are no formula and bottle packages to throw out.

 It is important to know that:

• There are safe birth control options to take while breast/chestfeeding
• Birthing parents have the right to have changes made at work so they can keep breast/chestfeeding when they go back to work
• When you stop breast/chestfeeding it is hard to reverse the decision

Before you make your decision about formula feeding, you should know:

• Formula feeding is associated with a higher risk of ear, chest and stomach infections
• Formula does not change to meet baby's growing needs
• Formula feeding is less convenient as extra time needed for sterilizing equipment and making formula
• It's possible to make mistakes when making the formula
• There is potential for contamination when the formula company is making it

For personal or medical reasons, some families make an informed decision to give their baby formula.

Have you decided to give formula to your baby? Ottawa Public Health has information for you on how to make the formula safely.