Important facts for planning pregnancy

(Content revised 02/2025)

If you are planning for pregnancy…

you and your partner should prepare yourselves physically and mentally, improve your health and nutrition. It is hoped that the baby you are expecting can develop and grow in a desirable environment, and to minimise the risk of any pregnancy complications.

Advanced Maternal Age

  • Advanced maternal age has been defined as women who are 35 years or older at estimated date of delivery1.
  • Natural fertility decreases with increasing maternal age, in particularly after mid-thirties2.
  • As women age2,3:
    • The risks of early and late miscarriage increase;
    • Health of the foetus will be affected, also the risks of foetal chromosomal abnormality and other complications such as intrauterine growth restriction increase;
    • The risks of pregnancy-related complications such as gestational hypertension, pre-eclampsia, gestational diabetes, preterm delivery as well as the need for caesarean section and their associated complications increase.

When you and your partner have stable relationship and wish to become parents, you should start to plan and prepare your pregnancy early to avoid the possible complications associated with advanced maternal age.

References

1.The American College of Obstetricians and Gynecologists. Pregnancy at age 35 years or older. Obstetric Care Consensus No. 11. Obstetrics & Gynecology 2022;140:348-366.

2.Johns Hopkins Medicine. Advanced Maternal Age. Accessed 5 February 2024: https://www.hopkinsmedicine.org/health/conditions-and-diseases/advanced-maternal-age

3.Kahveci B, Melekoglu R, Evruke IC, et al. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth 2018;18:343

Have Good Psychological Preparation

Getting pregnant and meeting your newborn would be one of the most important and unforgettable moments in your life. You may feel excited but nervous when planning for pregnancy. From getting pregnant to after childbirth, both you and your partner may have different emotions, which include worry, anxiety, irritability, warmth, fondness, etc. Because of physical discomfort, hormonal changes, role change and challenges in baby care, women could have mood disturbances during pregnancy and after childbirth. To promote good mental health and get well-prepared in becoming parents, you and your partner can:

  • Get prepared financially by making a financial plan for the family before getting pregnant.
  • Get prepared for childcare arrangement, such as communicating with other family members about the need for their assistance in childcare if necessary.
  • Establish realistic expectations for pregnancy and parenthood by experience sharing from other new parents.
  • Share with each other about views and values on parenting issues and make adjustments if needed.
  • Build up an intimate and strong relationship with each other, so that your baby would grow up in a family full of love.

If you or your partner experiences persisting emotional disturbances, seeking professional help as early as possible is needed.

Stay Physically Active

Being physically active and having an active lifestyle are beneficial for your physical and mental health. Exercise regularly can help to reduce the chance of overweight during and after pregnancy.

Do aerobic exercise for 150 minutes every week. You can notice your heart rate increased during moderate intensity of physical activity. If you just start to do exercise, you may choose the simple and easy activities, such as jogging, riding a stationary bike, swimming, etc.

  • If you cannot find time to do exercise, you can do physical activity for at least 30 minutes daily. It can be accumulated from separate sessions to meet the daily requirement.
  • Use public transport when going out. Get off one station earlier and walk quickly to the destination. Besides, walk up or down the stairs instead of using the lift.
  • Do more housework to exercise your body.

Maintain a Healthy Weight

Either underweight or overweight will affect your chance of pregnancy. Woman at healthy weight increases her chance of getting pregnant, and has lower risk of complications during pregnancy.

Let's calculate your Body Mass Index (BMI)

BMI = Weight (kg) ÷ (Height (m) × Height (m))

BMI < 18.5, underweight

Even the pregnant woman will increase her weight during pregnancy, she may have higher chance of preterm birth or give birth to baby of lower birth weight.

BMI > 23, overweight / obesity

The pregnant woman will have higher risk of pre-eclampsia, gestational hypertension or diabetes, etc.

If you are overweight or obese, try to control your weight before pregnancy. It is better to reduce weight by maintaining a balanced diet and increasing your physical activity.

Control Your Diet. Have Regular Physical Activity.

Control Your Diet

Proper diet control is essential for maintaining healthy weight. Stay at healthy weight if you are normal right now. If you are overweight or obese, you should goal for a healthy weight. Do consult dietitian or doctor to regulate your diet and keep your weight within a normal range.

If father-to-be is overweight, the chance of his partner to get pregnant will also be reduced. He should control his weight too!

You can visit the following websites and contact a dietitian or relevant organisations for weight management:

No Smoking

  • Smoking is hazardous to the growth of foetus. Smoking will also damage eggs and sperms, which reduce the chance of pregnancy.
  • You and your partner should quit smoking as soon as possible.
  • Act immediately. Call the Integrated Smoking Cessation Hotline of the Department of Health: 1833 183.
  • Visit Tobacco and Alcohol Control Office of the Department of Health for more information on “Quitting Smoking”.

No Alcoholic Drinks

  • Alcohol will damage the eggs and sperms, and reduce the fertility of both male and female. Alcohol can be transferred to the foetus from mother and affect the development of organs, leading to low birth weight or even mental deficiency. Pregnant women should avoid all alcoholic drinks.
  • You and your partner should avoid all alcoholic drinks to increase the chance of pregnancy.
  • Visit Alcohol and Health to understand and to reduce the harm of alcohol.

Reduce Caffeine Intake

  • Too much caffeine may increase the risk of low birth weight and miscarriage.
  • You should avoid energy drinks which may contain too much caffeine and limit coffee and strong tea drinking. You can choose the decaffeinated options.

Maintain a Balanced Diet to Get Optimal Nutrition

Include all 5 food groups every day including Grains, Vegetables, Fruits, Meat, Fish, Eggs and alternatives, Milk and alternatives. Consume a variety of foods enable us to obtain different nutrients we need.

  • Fat/Oil, Salt and Sugar (Male, Female -Eat the least)
  • Milk and Alternatives (Male - 2 glasses per day, Female - 1 to 2 glasses per day)
  • Meat, Fish, Egg and Alternatives (Male - 5 to 8 taels per day, Female - 5 to 7 taels per day)
  • Vegetables (Male, Female - At least 3 servings per day)
  • Fruits (Male, Female - At least 2 servings per day)
  • Grains (Male - 4 to 8 bowls per day, Female - 3 to 6 bowls per day)
  • Drink 6 - 8 glasses of fluid every day including water, tea, milk, clear soup

One bowl of grains = 1 bowl of rice; or 1 bowl of rice noodle; or 1½ bowls of cooked macaroni or spaghetti; or 1¼ bowls of noodles; or 2 slices of bread (with crust; from a one-pound, eight-slice packet); or 10 tablespoons of oatmeal (dry)

One serving of vegetables = ½ bowl of cooked leafy vegetables

One serving of fruit = 1 piece of medium-sized orange or apple

One tael of meat = 1 egg or ¼ block of tofu

Eat a variety of nutritious foods for optimal nutrition. A balanced diet ensures we get the nutrients we needed. It helps the embryo to receive the best nutrition from the mother, once you are conceived.

Limit your intake of foods with low nutritional value, especially those have high fat and high sugar contents, such as potato crisps, fries, cream cakes, biscuits, candies, fast food, instant noodles, processed meats, sweetened drinks and soft drinks. They provide high calories yet very limited nutrients. Over-consumption can lead to overweight and obesity.

Cut Down on High Calorie Snacks:

  • To replace soft drinks and other sweetened beverages with water or soda water.
  • To take fresh fruits as dessert or snack which are refreshing and sweet.
  • To replace instant noodles with non-fried noodles such as rice noodle and plain Chinese noodles.
  • To take nuts as snack in moderation. Although nuts are high in calorie, they are rich in dietary fibre and nutrients.

Choose variety of foods:

  • Choose brown rice to replace white rice, or wholemeal bread to replace white bread. Whole grain foods contain more nutrients; they have dietary fibre which increases satiety.
  • Choose a range of vegetables and fruits with different colours. For example, carrot, pumpkin, bell pepper, spinach, cauliflower, eggplant, grape, apple, blueberries and cherries.
  • Choose variety in the group of meat, fish, eggs and alternatives. Include meat, fish, egg, beans and soy products such as tofu and fresh bean curd sheet.
  • Apart from milk, yoghurt and cheese, you can choose alternatives that have high calcium content, for example, calcium-added soy milk, dark green vegetables and tofu.

Local adults tend not to get adequate iron, calcium, iodine and vitamin D. Pay extra attention to these important nutrients.

Iron

  • Meat, fish, eggs, dried beans, dark green vegetables, nuts, seeds, iron-fortified cereals
  • Consume vitamin C-rich vegetables and fruits with meals
  • Reduce intake of tea or coffee with meals

Vitamin D

  • Sunlight exposure is of vital importance in helping you to produce and absorb vitamin D
  • Egg yolk, salmon, vitamin D-fortified milk and breakfast cereals

Calcium

  • Milk, yoghurt, cheese, calcium-added soy milk, dark green vegetables, tofu

Iodine

  • Seaweeds, seafood, marine fish, eggs, milk and milk products

Folic Acid and Other Nutrition Supplements

Folic acid

Choose foods which are rich in folic acid, such as dark green leafy vegetables, beans and dry beans, fruits and breakfast cereals fortified with folic acid.

You are advised to take at least 400 mcg folic acid supplements daily (should not be more than 1000 mcg) when you plan for pregnancy and during the first trimester of pregnancy. It reduces baby's risk of having neural tube defect (malformations of brain and spinal cord). Some patients with medical disease may require a higher dose of folic acid supplement. Please discuss with your doctor whenever necessary.

Iodine
  • An average adult needs 150 micrograms of iodine daily. Hong Kong people are not getting enough iodine in their daily diet.
  • You should ensure an adequate iodine intake. This allows the foetus and his brain to grow and develop in an environment with sufficient iodine once he is formed. Here are some ways to get adequate iodine:
    • Choose foods rich in iodine. When choosing iodine-rich snacks (e.g. seaweed snacks), avoid those which are high in salt or fat content
    • Use iodised salt instead of ordinary table salt. Limit total salt intake below 5g (1 teaspoon) per day
  • You should seek advice from your doctor or dietitian if you consider taking an iodine-containing supplement to meet the needs.
  • Take iodine-containing supplements containing at least 150 μg iodine per day during pregnancy and breastfeeding.

Learn more about ways to get adequate iodine

Vegetarians

If you are a vegan, you may not get enough vitamin B12, iron, omega-3 fatty acids (e.g. DHA) from your diet. You are advised to consult your doctor or dietitian for nutritional assessment, and to choose an appropriate supplementation with recommended amount.

Plan Wisely for Vegetarian Diet

Smart Tips

Never take the nutritional supplements in a wrong way. Overdose of vitamin A may cause foetal anomaly.

Pay Attention to Food Safety

Choose fish with low levels of methylmercury:

  • Mercury is found in fish, especially larger predatory types, which can harm the developing nervous systems of foetuses and infants, leading to decreased IQ.
  • Fish provides essential nutrients like omega-3 fatty acids and quality proteins. Eat from a variety of fish and consume in moderation can mitigate risks.
    Smaller fish (under 605 grams), farmed and freshwater fish have lower levels of mercury in general.
    Examples: bighead carp, pomfret, dace (minced), salmon, grey mullet, sole fillet, grass carp
  • Avoid large predatory fish
    Examples: shark, swordfish, marlin, king mackerel, bluefin tuna, bigeye tuna, albacore tuna, yellowfin tuna, splendid alfonsino, orange roughy, yellowback seabream and dash-and-dot goatfish

More info: Mercury in Fish
https://www.cfs.gov.hk/english/multimedia/multimedia_pub/files/Mercury_in_Fish.pdf

Consume thoroughly cooked foods:

Ensure meat juices are clear, egg yolks are firm, and soups boil for at least 1 minute.

Avoid chilled ready-to-eat foods to reduce listeria risk, including cold meats, soft cheeses (e.g. Feta, Brie, Camembert), blue cheese, and raw vegetables.

More info: Know Your High-risk Foods
https://www.cfs.gov.hk/english/food_leg/files/Pregnant_women_e.pdf

Beware Personal Hygiene

Some animals or soils may contain bacteria or parasites. You should be aware of personal hygiene and wash your hands thoroughly after touching the animals. When handling raw meat, the excrement of animals or placing a plant, wear gloves and wash hands thoroughly afterwards. Pets should not be allowed to go into the kitchen.

Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; individuals may consider putting on surgical masks while in such places. Avoid contact with persons with upper respiratory infection, chickenpox or herpes zoster.

To prevent mosquito-borne infections such as dengue fever, malaria and Zika virus infection, wear loose, light-coloured, long-sleeved tops and trousers in outdoor areas, and use DEET-containing insect repellent on exposed parts of the body and clothing to prevent mosquito bites; prevent accumulation of stagnant water at home, store food and dispose of garbage properly in order to control vectors and reservoir of the diseases.

If you plan for travel, please seek medical advice about prevention of infectious disease before the trip.

Maintain Oral Health

Go to dental check-up before pregnancy. Maintain good oral care in daily life to prevent any oral or teeth problems during pregnancy

Talk to Your Family Doctor

Gynaecological diseases, chronic disease, or family history of inherited diseases

If you have chronic illness such as thyroid disorder, diabetes, hypertension or depression, please seek advice from your doctor to use appropriate medications for pregnancy.

If you have any family history of inherited diseases, such as Down's syndrome, Thalassemia, Haemophilia, you should receive proper check-up to understand the chance of inheritance of the diseases.

If you suspect any sexually transmitted illness, please consult the doctor as soon as possible to avoid any transmission to the foetus.

Medicines and drug use

Some medicines may affect the development and health of foetus. If you are taking long-term medications, please consult your doctor for advice.

Vaccination

If a pregnant woman is infected with rubella or other infections, it may lead to congenital anomalies of foetus. Pregnant woman who has hepatitis B surface antigen positive may transfer the virus to baby during delivery. If you are uncertain about your vaccination record, please consult your doctor for advice.

Cervical screening

Cervical screening is a quick and simple test for detecting early abnormal changes in the cervix. Some treatment for abnormal changes may not be suitable during pregnancy. You are recommended to have screening before getting pregnant and receive proper advice on necessary investigations and follow-up in advance.

Expecting the baby

How to Increase the Chance of Pregnancy?

Have sex regularly every two or three days to increase the chance of pregnancy.

If you cannot have sex with your partner frequently for certain reasons, you may try to be familiar with your menstrual cycle and have sexual intercourse with your partner during ovulation to increase the chance of pregnancy. For instance, a woman who has a 28-day menstrual cycle, usually ovulates on 10 to 16 days before the next period. It is about the 12th to 18th days of each menstrual cycle (from the first day of menstruation).

Change in Your Biological Cycle

  • Change in body temperature
    Body temperature will be higher for 0.2 degrees Celsius than before ovulation. The fertile time ends when your temperatures are higher for three days than the previous six days.
  • An increase in mucus
    Around the day of ovulation, vaginal discharge will increase. The discharge is slippery and clear, and looks like raw egg-white. It can hold a stretch (‘spinnbarkeit').
    Ovulation test can also help you predict ovulation.
  • Lifestyle changes, stress, medications may affect these biological changes in your cycle.

If you cannot get pregnant …

About 80% to 90% of normal couples can conceive within one year without any birth control. If the couple is unable to conceive, medical advice should be sought. The chance of pregnancy will be higher if you tackle the problem earlier.

For details about subfertility, please refer to the Family Health Service website.https://s.fhs.gov.hk/un6g1

It is recommended to maintain a healthy lifestyle, so that you can get well prepared for your pregnancy and baby care.

Find more information and related resources https://s.fhs.gov.hk/asweb

Advice on preparing for pregnancy

  • Plan and prepare your pregnancy early.
  • Be prepared mentally before pregnancy, and let your baby to be grown up in a family full of love.
  • Have physical activity for at least 150 minutes per week.
  • Maintain a healthy weight. Women at healthy weight can get pregnant more easily.
  • Quit smoking and alcoholic drinks. Alcohol and cigarette damage eggs and sperms, and reduce the chance of pregnancy.
  • Choose nutritious foods, especially those rich in folate, iron, calcium, iodine, vitamin D.
  • Take 400 mcg of folic acid supplements daily (no more than 1000 mcg). To prevent iodine deficiency, you can consider taking iodine-containing supplement. Please consult your doctor or dietitian.
  • Avoid eating fish with high levels of methylmercury.
  • Avoid eating uncooked food.
  • Aware of personal hygiene and wash hands frequently.
  • Maintain good oral health. This helps prevent oral problems during pregnancy.
  • Talk to your family doctor about any medical history and inherited family diseases of you and your partner, and prevention of infectious disease.