Preconceptual Advice

Things you should do

• Take folic acid tablets from before you become pregnant until 12 weeks of pregnancy. This helps to prevent spinal cord problems developing in the baby.
• For most women the dose is 400 micrograms (0.4 mg) a day. You can buy this dose of folic acid tablets from pharmacies. The dose is higher and needs a prescription (5 mg daily) if you have an increased risk of having a child with a spinal cord problem. That is: if you had a previously affected pregnancy; OR if your partner or a first-degree relative have a spinal cord defect; OR if you have coeliac disease (your intake of folate may be affected by this condition); OR if you take medication for epilepsy; OR if you have sickle cell or thalassaemia.
• Check if you are immune against rubella. See your practice nurse for a blood test if you are unsure. Get immunised if you are not immune.
• Eat a healthy diet. Include foods rich in iron, calcium and folic acid.
  Wash your hands after handling raw meat, or handling cats and kittens. To avoid certain germs which can be harmful to a developing baby. Wear gloves when you are gardening. Again, to avoid certain germs.

Things you should avoid

• Too much vitamin A. Don't eat liver, liver pâté, or take cod liver oil or vitamin A tablets.
• Listeriosis. Don't eat undercooked meats and eggs, soft cheeses such as brie or camembert, pâtés, shellfish, raw fish, or unpasteurised milk including goat's milk.
• Fish which may contain a lot of mercury. Don't eat shark, merlin, swordfish. Also, limit the amount of tuna to no more than the equivalent of six tuna sandwiches per week.
• Sheep, lambs, cat faeces, cat litters which may carry certain infections.
• Peanuts - if you have a personal or family history of eczema, hay fever, or asthma.

Things you should stop or cut down

• Caffeine - in tea, coffee, cola, etc. Have no more than 300 mg per day. This is in about three cups of brewed coffee, or four cups of instant coffee, or six cups of tea.
• Alcohol - have no more than 1-2 drinks, once or twice a week.
  Smoking - you are strongly advised to stop completely.
• Street drugs - you are strongly advised to stop completely.

Other things to consider

• Your medication - including herbal and 'over the counter' medicines. Is it safe to take when you are pregnant?
• Your work environment. Do you work with chemicals, etc, which may be harmful?
• Medical conditions. For example, if you have diabetes, epilepsy, or other medical conditions you may need special advice before becoming pregnant. Also, if certain conditions run in your family, you may benefit from genetic counselling.