By Erin Wilkins
If you or someone you love is thinking about becoming pregnant, congratulations! Planning a pregnancy can be exciting, confusing, and fun all at once. Whether you’re a single person, or planning a pregnancy with a partner, there are tons of things to think about as you follow the path toward parenthood. Here’s some information that might be helpful along the way.
A good first step when you’re thinking about getting pregnant is to schedule a preconception checkup with your primary care or reproductive health provider. It’s never too early to talk about preconception health, even if you’re not sure when you’ll start trying to get pregnant. At the visit they’ll make sure your immunizations are up-to-date, assess your overall health, and give you some tips about optimizing your fertility and getting as healthy as you can be going into pregnancy. They will also be able to provide you with referrals to providers who do inseminations and prenatal care if you need those. If you haven’t started taking prenatal vitamins yet, now is a good time to start.
Understanding your menstrual cycle and figuring out how to pinpoint ovulation can seem really confusing at first, especially if it’s something you haven’t thought much about in the past. A lot of us were never really taught the details of how conception and pregnancy actually happen, so it can be overwhelming trying to figure it all out. Hopefully you already know that a pregnancy happens when a sperm cell fertilizes an egg, which then turns into an embryo and implants itself into the lining of the uterus where it grows for about 40 weeks and magically emerges as a full-grown baby. What you might not know is that there is an entire series of events that happen within your body each cycle, involving multiple hormones and organs, that allow an egg to be released about once per month from one of your ovaries. That egg then travels through one of your fallopian tubes and makes its way toward the uterus. In order for a pregnancy to happen, a sperm cell needs to meet up with the egg soon after it’s released. There’s a small-ish window of time for the sperm and egg to meet, which is why figuring out the timing of inseminations is so important.
Each person’s cycle is different, and understanding how your body works and the nuances of your individual cycle and fertility patterns is key to getting pregnant efficiently when the time comes. There are a lot of good fertility-tracking apps out there that can help you learn more about the ins and outs of your monthly cycle, or you can use a paper calendar to chart it the old-fashioned way. There are other tools you can use to track your fertility patterns, too, like ovulation predictor tests, basal body thermometers, fertile mucus microscopes, and even examining your own cervical mucus. Your health care provider can tell you more about using these tools to track your cycle.
There are two main options to choose from when it comes to sperm donors: known and anonymous. A known donor is someone you know, oftentimes a friend, who provides you with the sperm you need to get pregnant. Anonymous donor sperm comes from a person you don’t know at all, who has been paid to “donate” at a sperm bank. We have a great one here in Minnesota called Cryogenic Laboratory (www.cryolab.com) and there are many others throughout the country that will ship sperm directly to you or your health care provider.
There are pros and cons to each type of donor, and figuring out what works best for you and your family is a really individual decision. Some prospective parents like the idea of having a lifelong connection to their donor, while others appreciate the anonymity and relational ease of a sperm bank donor. If you’re using the sperm of a known donor, keep in mind that you’ll be at risk for potentially being exposed to sexually transmitted infections so you’ll want to talk with your donor and have them get tested.
Depending on what type of donor you’re working with, you have several insemination options. Inseminations can be done at home or at a clinic, and can be done with “fresh” sperm from a known donor or frozen sperm from a bank. A midwife, nurse practitioner, or doctor can help you figure out which method will work best for you. The MN LGBTQ Provider Directory (www.mnlgbtqdirectory.org), a collaborative project between Rainbow Health Initiative and the MN Trans Health Coalition, is a good place to start if you need help finding a queer-friendly provider.
It’s not the most fun thing to think about, but there are some legal considerations when you’re planning a queer pregnancy. Things like donor agreements and second parent adoptions are some things you’ll want to talk about with a lawyer. Contacting a queer-friendly lawyer who specializes in family law is a great first step.
Prenatal Care and Birth Options
It might seem like a long way off, but once you’re pregnant you’ll need to find a health care provider to care for you during your pregnancy, birth, and postpartum. Most people start having prenatal visits within the first couple of months of pregnancy, and as you get farther along in your pregnancy you’ll have visits more often. There are a lot of places you can give birth: at home, a birth center, or at the hospital. It’s up to you and your health care provider to figure out what the best option for you is.
Doulas can also be an amazing source of support and care for queer families during pregnancy, labor, birth, and the postpartum period. Doulas are trained professionals who will support you and your family in whatever ways you need it, whether it’s emotional, physical, or informational. Here in the Twin Cities, we have a great community of birth workers and luckily a lot of them are GLBTQ-friendly. Check out www.transbirth.com, www.radicaldoula.com, and The SPIRAL Collective www.spiralmn.com to find a great doula in your area.
Erin Wilkins is the Clinical Programs Director at Family Tree Clinic, a community reproductive health clinic and education center in St. Paul. She completed direct entry midwifery training at Birthingway College in Portland, Ore. and has worked with many queer families during the childbearing year as a doula, apprentice midwife, and preconception consultant. She currently lives in South Minneapolis with her 5-year-old daughter. You can contact her at [email protected].