Once you have made the difficult decision of deciding if you are well enough to get pregnant and raise a child (or another child) you need to start preparing your body for pregnancy.

Medications

If you are taking any antidepressants, pain relieving drugs, or any other prescription medicines you are likely to need to stop these medications before you start conceiving. It is best to speak with your GP and he/ she will help you gradually wean yourself off these drugs, or perhaps advise other similar drugs that are proven to be safe during pregnancy. Advice is normally that you should have stopped your medications for a month before trying to conceive.

You may be able to start taking some of these drugs again once you are past the first three months of pregnancy, when the risks of abnormalities are smaller.

Even natural remedies need to be stopped as many herbs may affect your unborn child once you conceive. Don't think that because they are natural they can't do any harm.

You also need to stop using aromatherapy oils (whether in a bath oil, moisturiser or any other medium) as some of these oils can also be harmful. Some oils are still safe to use, but you need to check before you use them.

Rubella

It is worth having your immunity to Rubella (German measles) tested before you start trying to become pregnant. Even if you know you have been imunised against rubella in the past it is possible that your immunity has lessened over time. Your immunity is tested by taking a blood sample. If you are not immune to Rubella it is best to be immunised a month before you start trying.

If you are not immune and catch Rubella during your pregnancy it can lead to deafness and deformations in your unborn baby.

Supplements

It is quite likely that you already take a multi vitamin, or various vitamin complexes. It is best to change your normal multi vitamin tables for one which is designed for pregnancy. This is because you need to be careful not to have too much of vitamin A, which is often present in standard multivitamins.

At the very least it is important to take a folic acid supplement. This is especally important in people with ME/CFS as there has been research that shows sufferers are often deficient in it. Also if you have recently stopped the contraceptive pill your levels might be lower than normal, as the pill also can cause deficiency.

You need to take 04.mg (400mcg) of folic acid a day, this amount is found in most pregnancy multivitamins.

Nutrition

It is quite obvious that I am going to state here that you should eat a healthy diet, not always possible when you just don't have the energy to do anything more than throw some chips and pies in the oven. Aim to eat fruit everyday (remember that fruit juice counts as a portion of fruit), and try to chose healthier 'easy meals'. Things like tins or sachets of soup are relatively healthy.

You can also try cooking double the amount when you do have the energy to cook a meal from scratch. The rest of the food can be frozen or eaten the next day.

You should try and cut down on the amount of caffeine you drink too, this is found in chocolate, tea, coffee and coca cola.

Foods that you should not eat at all while you are trying are: unpasturised milk, cheeses made from unpasturised milk, cheeses with blue veins, pate, liver, soft eggs and fried eggs (unless the yolks are completely cooked). Ensure that all food, especially meat dishes, is thoroughly cooked. You should also avoid peanuts if you or your partner have any history of allergies or eczema.

Nutritional Guidelines:

Ideally you should be aiming to eat, every day:

Two to three calcium-rich foods, such as reduced fat milk, cheese and yogurt

At least five servings of fruits and vegetables. Of these, one should be rich in vitamin C – good sources include oranges, cantaloupe, kiwi, and papaya. And two servings should be rich in folate, a B vitamin that helps prevent defects such as spina bifida – lentils, orange juice, spinach, and broccoli are good.

Eat two servings of a lean, high-protein food, such as fish, white meat or a vegetarian alternative.

Base most of your meals on starchy foods, particularly whole grain foods, including brown rice, oatmeal, and wholewheat bread.

Drink plenty of fluid

Smoking and Alcohol

If you are are smoker you should try and stop smoking before you start trying to conceive. Smoking reduces the oxygen carrying capacity of your blood, meaning that less oxygen would reach your unborn child.

You should also cut down on the amount of alcohol you drink (not a problem for a lot of us with ME/CFS), again it is best to completely give it up but the occasional glass of wine should not be harmful.

Exercise

Another commonly recommended thing is do get yourself fit and healthy, but when you have ME/CFS even just keeping up with basic household chores can be a struggle. Here I would advise that you don't take up any new activities, unless you feel you are able to do so and do so sensibly, stopping if you become ill. You certainly don't need to be mega fit to be able to carry a baby, and if you try doing too much exercise your ME/CFS is likely to become worse, possibly making pregnancy harder to cope with.

Toxoplasmosis

Toxoplasmosis is caused by a parasite called toxoplasma gondii, it is found in raw meat, in cats who eat raw meat and in cat faeces. In only about 30-40% of people who catch toxoplasmosis during their pregnancy will the infection pass to the unborn baby. If the unborn baby becomes infected it can result in miscarriage, stillbirth, growth problems, blindness, water on the brain (hydrocephalus), brain damage, epilepsy, or deafness, sometimes the effects may not be seen until some time after the birth, so babies whose mothers caught toxoplasmosis during pregnancy will be under observation for quite some time.

There is not always any symptoms when you catch toxoplasmosis, but you may get swollen glands and feel as if you have a viral, glandular type illness.

To avoid catching toxoplasmosis you should ensure that all meat is thoroughly cooked before you eat it and that you use seperate cutlery and surfaces for raw meat and other food stuff. Also get someone else to empty out the cat litter tray, or wear gloves and thoroughly wash your hands afterwards. You should also wear gloves when you do any gardening. If you stick to these guidelines the chances of you catching toxoplasmosis is very small indeed.

Your Partner

The male side of the equation can also do things to help improve his sperm count and the healthiness of his sperm. He should cut down on drinking, reduce the amount he smokes (ideally giving it up altogether as passive smoking can be harmful to an unborn baby too), eat healthily and if he wears tight underwear he should try swapping it for looser boxershorts as lower temperatures in the testicles facilitates the production of sperm.