Planning a pregnancy is an exciting time in your life, but it can also be overwhelming. Your doctor can guide you on what to do before getting pregnant to help you feel prepared and confident as you embark on your journey. From preconception counseling to lifestyle modifications, there is a variety of ways you can reduce risks for you and your baby.

Preconception Counseling

When you’re ready to start or grow your family, set up a preconception counseling appointment with your health care provider or midwife. Even if you’ve had previous pregnancies, your provider can review your health and evaluate any new risks that need to be addressed. It’s a good idea to schedule preconception counseling about three months before you start trying to conceive.

Your health care provider will review many aspects of your and your partner’s health during preconception counseling, including:

• Personal medical history: Tell your provider about any chronic health conditions that could affect your pregnancy, such as epilepsy, diabetes, high blood pressure, anemia or allergies. It’s important to get these medical conditions under control before trying to conceive. You should also inform your provider about your current medications, previous surgeries and past pregnancies, especially if you’ve had pregnancy complications such as a miscarriage.
• Family medical history: An assessment of the maternal and paternal medical history will help determine if either parent has had medical conditions that might be passed to your child. Let your doctor know if anyone in your family has high blood pressure, diabetes, birth defects, an intellectual disability or other health concerns.
• Genetics: Several genetic disorders may be inherited (passed from parents to their children). Examples include sickle cell anemia, Tay-Sachs disease and cystic fibrosis. Genes that cause some genetic disorders can be identified by blood tests before pregnancy. Talk to your doctor about genetic screening before you try to conceive.
• Vaccine status: Your health care provider will make sure you’re up to date on current vaccines, including rubella (German measles) and varicella (chickenpox). It’s not safe to get these vaccines during pregnancy, and getting the diseases during pregnancy can cause miscarriage or birth defects. If you don’t have immunity, you should get the vaccines at least a month before trying to conceive. You should also stay up to date on your annual flu vaccine, which is safe during all trimesters of pregnancy.
• Virus exposure: Report any potential exposures to the Zika or COVID-19 viruses to your provider. Having either virus during pregnancy poses serious health risks to both the mother and baby.
• Intimate partner violence (IPV) screening: Intimate partner violence (IPV) is physical, sexual or emotional abuse caused by a current or former spouse or partner. It can also include reproductive coercion and pregnancy coercion. The American College of Obstetricians and Gynecologists recommends that all people who are planning a pregnancy be screened for IPV.

Pre-pregnancy checkup

As part of preconception counseling, your health care provider may recommend tests to check your health. A pre-pregnancy checkup may include:

• Blood tests to check your blood type and make sure you don’t have any sexually transmitted infections.
• Pelvic exam to check the health of your pelvic organs (vagina, cervix, uterus and ovaries).
• Pap smear to check for cancer by taking a sample of cells from your cervix.
• Physical exam to evaluate your weight, blood pressure, pulse rate, body temperature and breathing rate.

How to Prepare Your Body for Pregnancy

There are a variety of ways you can prepare your body for pregnancy and make sure you’re in the best possible health before conceiving:

• Avoid alcohol: Drinking alcohol may affect your fertility when trying to conceive. It can affect your hormone levels, menstruation and ovulation. Drinking during pregnancy can lead to serious problems for the baby, including premature birth and developmental disorders.
• Eat a healthy diet: Eating a balanced diet before and during pregnancy isn’t only good for your overall health, it’s essential for nourishing a fetus. Choose plenty of fruits, vegetables, whole grains, low-fat dairy and lean proteins. Avoid highly processed, fatty foods. Limit your caffeine intake to no more than one to two cups of coffee per day.
• Eliminate exposure to harmful substances: Pregnant women should avoid exposure to toxic and chemical substances (such as lead and pesticides) and radiation (such as X-rays). Exposure to high levels of some types of radiation and some chemical and toxic substances may negatively affect the developing fetus.
• Get regular exercise and manage your body weight: It’s important to exercise regularly and maintain a proper weight before and during pregnancy. Women who are overweight may experience medical problems, such as high blood pressure and diabetes. Women who are underweight may have babies with low birth weight.
• Identify domestic violence: Women who are abused before pregnancy may be at risk for increased abuse during pregnancy. Your health care provider or a midwife can help you find community, social and legal support to help you deal with domestic violence.
• Quit smoking: Studies have shown that babies born to mothers who smoke tend to be born prematurely, be lower in birth weight and are more likely to die of sudden infant death syndrome (SIDS). In addition, women with exposure to secondhand smoke are more likely to have low birth weight babies. There may also be dangers from thirdhand smoke — the chemicals, particles and gases of tobacco that are left on hair, clothing and furnishings.
• Reduce risk of infection: Avoid eating undercooked meat and raw eggs. In addition, avoid all contact and exposure to animal feces and cat litter, which may contain harmful parasites or viruses. Wash your hands frequently and avoid contact with people who are sick.
• Take vitamins: Start taking a prenatal vitamin or a daily vitamin with 400 micrograms of folic acid. Folic acid can help reduce the risk of birth defects of the brain and spinal cord (also called neural tube defects).