Baby or No Baby? Plan Ahead

Dr. WAN Hei Lok, Tiffany

Specialist in Obstetrics & Gynaecology

The later the pregnancy, the higher the risks to both mother and baby. As the risks of premature birth, high blood pressure, hyperglycemia and Down’s syndrome increase at the age of 35 and beyond, women are advised to start family planning before 35 years old.    

Planning for a Baby? Don’t Delay in Check-up before Pregnancy

If you are planning for parenthood, both of you and your partner should have a pre-pregnancy check-up. Routine blood tests are usually conducted to test for hepatitis B antigen and antibody, rubella antibody, syphilis, HIV antibody, varicella antibody, etc. Women with inadequate antibodies should receive the necessary vaccinations before pregnancy. The same tests can also find out if either or both are carriers of thalassaemia: if both parents carry the same type of defective genes, their offspring has a 25% chance of developing major thalassemia.

To determine the risk of transmitting genetic conditions to offspring, nowadays most couples choose to test for pathogenic mutations with genetic carrier screening.  With a single blood sample, the screening can detect the genetic make-up of a series of specific genetic diseases. The most common ones are spinal muscular atrophy, fragile X syndrome, cystic fibrosis, etc.

Other examinations are also required before pregnancy. Male partners are advised to test for sperm quality, motility and morphology, while women should undergo pelvic ultrasound and cervical screening (Pap smear) to ensure no cervical abnormality.

Pregnancy should occur within a year if all results are normal. Those who still fail to conceive are advised to seek professional opinion from a Specialist in Obstetrics and Gynaecology.  

A healthy lifestyle can increase the chance of pregnancy, such as regular exercises and rest, no smoking and alcohol consumption. As vitamins containing folic acid can promote fetal brain development and prevent severe congenital malformations, women are advised to take supplements 3 months before pregnancy. Male partners can also take multivitamins to enhance sperm quality.

Want to Avoid Pregnancy? Use Contraceptive Measures

Contraception should be considered if you choose not to have babies. Condoms are the most common methods, and the male partners should check if the condom is expired or damaged before use, and make sure that it is used correctly.

Oral contraceptives are now widely accepted, and the new generations are of lower dose and have fewer side effects. Oral contraceptives are only effective if they are taken consistently.

Injectable contraceptives are no different from the oral ones in terms of content. They are administered at clinic each month, or every 3 months for those considered not suitable for combined hormonal contraceptives.   

Intra-uterine contraceptive device (IUCD) is a long-lasting contraceptive measure. There are different types of IUCD, including copper and hormonal IUCDs. Far more effective than oral contraceptives, IUCDs can prevent embryo implantation and kill sperms, with side effects such as heavy menstrual flow and increased vaginal discharge. Other measures such as contraceptive patch and contraceptive vaginal ring are both effective with mild side effects.

For permanent contraception, couples may consider sterilisation. And it should be carried out only after consultation with a Specialist in Obstetrics & Gynaecology.