What to expect when you want to be expecting

If the idea of welcoming a bundle of joy is bringing on a bundle of worries, experts say, there are no fancy tricks that ensure a successful process. But some say, there are at least a few steps to take before beginning.

First of all, before getting anxious or over thinking it, keep in mind that the laws of nature dictate that it isn't that difficult to get pregnant, says Mairi Breen Rothman, from the American College of Nurse-Midwives, Silver Spring, Md.

"The most important part of preparing for pregnancy is probably psychological," she says. "Be a little patient with yourself. It's really not too hard to prepare for a baby. Usually you just get aroused, have sex and a little while later, a baby comes out."

But if you've decided that you're ready and you are one of those people for whom birth control has worked, the first thing to consider when trying to get pregnant is what type of birth control method you are currently using. If you are using condoms, a cervical cap or a diaphragm, all you have to do is stop using them. Similarly, an IUD should be removed.

When it comes to the birth control pill, says Andrew Satin, M.D., director of obstetrics and gynecology at Johns Hopkins Bayview Medical Center, Baltimore, the amount of time it takes for the hormones to leave a woman's system is relatively quick, although it varies depending on the person.

Satin generally recommends that a woman complete her current pill pack, then allow for a couple of regular menstrual cycles before seriously attempting to have a baby as it allows doctors to more accurately date the pregnancy. Doctors, however, can also use ultrasounds for this information so waiting isn't always necessary.

Conception is still possible, Rothman says, even if the plan is to wait out a couple cycles before really trying. "Both the great and the terrible thing about the birth control pill," she says, "is that it is out of your system after one day. If you typically take your pill at 8 a.m., by lunch time the next day, you are not on the pill. If you have sex at the right time, you could get pregnant."

In contrast, a Depo-Prevera shot can take a minimum of 12-13 weeks and up to six months or even longer to leave a woman's system. So consider that timeframe if you'd like to get pregnant sooner rather than later.

"It's a great first step if you're actually planning ahead for your pregnancy at all," Satin says. Both he and Rothman highly recommend that women who are planning to become pregnant set up a pre-conception visit with a health professional.

A meeting with a healthy professional allows the patient to review medical, genetic and reproductive history, address environmental concerns, discuss exercise, diet and weight gain and determine what current medications are acceptable or how to best transition away from ones that aren't.

You can also discuss vitamins and/or supplements you may want to begin taking. Satin points out, however, that you can easily get the recommended amount from a good, balanced and regular diet.

One exception, says both Rothman and Satin, is folic acid (at least 400 micrograms), which has been shown to lower the risk of neural tube defects if taken up to three months before pregnancy. Women who are anemic (when the

body doesn't have enough healthy red blood cells to carry adequate oxygen to tissues), may also benefit from iron supplementation.

In addition, Rothman says, "You really should be doing all the things that make us healthy when we're not pregnant: reduce stress, get enough sleep, stop smoking, drinking and recreational drugs."

Once you're prepared and you actually start trying, the time it takes to get pregnant depends on a woman's age and how "targeted" the couple is. Targeting, explains Rothman, is ovulation prediction. If a woman has a 28-day cycle, she is most fertile during the middle week, around day 14. A couple that is actively trying for a baby might have sex every 48 hours or so (it takes about 48-hours for a man's sperm count to return to normal), from day 10 to day 18. The average time it takes for a 30-year-old woman who isn't targeting to get pregnant, Rothman says, is one year.

If a couple fails to conceive after a year of unprotected sex, there are a variety of options including seeing a fertility specialist, incorporating herbal or homeopathic remedies or trying acupuncture which has been found to be quite helpful with fertility issues.

But even when it comes to less invasive fertility aids, rather than jumping the gun, Rothman says, "Let nature take its course first."