Thinking About the Next Baby

As you hold your new baby in your arms, it may be impossible to imagine that you will ever have the energy to go through it all again. But sooner or later, you may decide that you want another child. If you had a low birthweight baby or a baby with a disability or special needs, or a miscarriage or stillbirth, you may be particularly anxious to do everything you can to create the best possible circumstances for your next pregnancy. Below is some information on how you and your partner can prepare for your next pregnancy. It takes two You will increase your chances of getting pregnant if you – and your partner – are in good health. A bad diet, smoking, drinking and unhealthy working conditions can affect the quality of sperm and prevent pregnancy from happening. You should both make your lifestyle as healthy as possible before you try to conceive. This pregnancy guide has more information for people trying to get pregnant, including tips on diet, smoking, alcohol and exercise. There is also information for everyone, not specifically for people trying to get pregnant, in the healthy eating and fitness sections. It includes getting your , losing weight, getting fit for free, and a healthy vegetarian diet. Folic acid Women should take 400 micrograms of folic acid from the time you start trying to conceive, right up until you are 12 weeks pregnant. You can get these tablets from a supermarket or pharmacist. Also eat foods that contain this important vitamin. These include leafy green vegetables, and breakfast cereals and breads with added folic acid (it will say on the packaging). You'll need a bigger dose of folic acid if: you already have a baby with spina bifida you have coeliac disease you have diabetes you take anti-epileptic medication Ask your doctor for advice. Here are some things that are worth doing before getting pregnant with your next baby. Rubella (german measles) Rubella in early pregnancy can damage your developing baby. If you were not immune during your last pregnancy, you should have been offered an MMR (measles, mumps and rubella) immunisation immediately after your baby was born. Before trying for another baby, it is important to check that you are immune to rubella by having a blood test. The blood test will measure if you have enough protection (antibodies) against rubella. Women with low or uncertain levels of antibodies can be immunised again. Your weight Maintaining a healthy weight can improve your chances of getting pregnant. You may have put on weight during your past pregnancy and want to go back to your normal size. This is particularly important if you weigh more than 100kg (220lb). The best way to lose weight is by following a balanced low-fat diet and doing exercise. Before you get pregnant, you can find out whether you are a healthy weight and get tailored advice with the . This calculator is not designed for use if you are already pregnant. It might help to join a slimming class with a friend or your partner to encourage and support you. Speak to your doctor if you need help or advice. You and your partner can also find out how to lose weight, but again this is not intended for people who are already pregnant. Medicines and drugs Some medicines can harm a baby in pregnancy but others are safe. If either you or your partner has a long-term illness or disability and has to take long-term medication, talk to your doctor about any possible effects on fertility or pregnancy. Check with your doctor or pharmacist before you take any over-the-counter drugs. Illegal drugs will affect your ability to conceive, and they can damage your baby's health. Diabetes and epilepsy If you have diabetes or epilepsy, talk to your doctor before you try to get pregnant. Postnatal depression and puerperal psychosis If you have previously experienced postnatal depression or puerperal psychosis, talk to your doctor before you try to get pregnant. Sexually transmitted infections (STIs) STIs can affect your health and your ability to get pregnant. If there is any chance that either of you has an STI, it's important to get it diagnosed and treated before you get pregnant. STIs – including HIV, hepatitis B and hepatitis C – can be passed on through sex with an infected person, especially if you don't use a condom. Some STIs can be passed on from one person to another without penetration. HIV, hepatitis B and hepatitis C can also be passed on by sharing equipment (such as needles) for injecting drugs. If you are HIV positive, you can pass the virus on to your baby during pregnancy, at birth or when breastfeeding. See living with HIV to find out more about pregnancy and HIV. Work-related risks Your employer is required to take into account any work-related risks to new mothers and pregnant women. See stay healthy at work for more information. Once you have told your employer that you are pregnant, they should make sure that your job does not pose a risk to you or your baby. Some risks can be avoided, for example by changing your working conditions or your hours of work. If a risk cannot be avoided, your employer should offer you suitable alternative work with similar terms and conditions to your present job. If this is not possible, you should be suspended on full pay. This means that you will be given paid leave for as long as necessary. Vaginal birth after caesarean section (VBAC) Most women who have had a caesarean section can have a vaginal delivery with their next baby. This depends on why you had a caesarean section the first time. Women thought to have a small pelvis, for example, may be advised to have a planned (elective) caesarean section next time. Your doctor will be able to advise you. Most women who are advised to try for a vaginal delivery in subsequent pregnancies do have normal deliveries. Finding it hard to get pregnant? It can take several months to get pregnant, even if it happened very quickly the first time. Find out about the best . If you are still not pregnant after a few months, talk to your doctor or family planning clinic.