A preconception health check can help you address medical conditions, medications, vaccinations, nutrition, lifestyle habits, and other factors before pregnancy begins.
Key Takeaways
- Schedule a preconception appointment with your OB/GYN or midwife, ideally about three months before trying to conceive.
- Take a daily prenatal vitamin containing at least 400 mcg of folic acid unless your healthcare provider recommends a different amount.
- Review every prescription, over-the-counter medication, vitamin, and supplement you take.
- Make sure chronic health conditions are well controlled before pregnancy.
- Check that your vaccinations are up to date.
- Avoid smoking, vaping, alcohol, recreational drugs, and unnecessary exposure to potentially harmful chemicals.
- Review your family health history and discuss whether genetic counseling or carrier screening may be appropriate.
- Take care of your dental and mental health as part of preparing for pregnancy.
- Remember that you do not have to make every change overnight. Your healthcare provider can help you create a plan that fits your health and circumstances.
When Should You Start Preparing for Pregnancy?
Ideally, preconception planning should begin about three months before you start trying to become pregnant, although some changes may need to begin earlier.
Preconception care gives you time to review your health, medications, vaccinations, lifestyle, family history, and other factors that could affect pregnancy. It also gives you an opportunity to address medical conditions or make medication changes before pregnancy rather than after you see a positive test.
Starting early also gives you time to begin taking folic acid, update vaccinations when needed, improve nutrition and activity habits, and address questions about fertility or previous pregnancy experiences.
The Office on Women’s Health offers additional information about preparing for pregnancy.
Schedule a Preconception Appointment
A preconception appointment is more than a routine physical. It gives you and your healthcare provider a chance to look at your overall health through the lens of a future pregnancy.
Your provider may review:
- Your personal medical history
- Previous pregnancies and deliveries
- Menstrual cycles and reproductive health
- Current medications and supplements
- Allergies
- Vaccination history
- Family medical and genetic history
- Mental health
- Nutrition, exercise, sleep, and other lifestyle factors
- Tobacco, alcohol, and recreational drug use
- Occupational or environmental exposures
- Any concerns about fertility
This is also a good time to ask questions. If you have had a previous miscarriage, preterm birth, complicated pregnancy, or pregnancy affected by a birth defect, be sure to mention it.
A preconception checkup from March of Dimes can also help you understand what may be discussed during this type of visit.
Review Your Medications and Supplements
Do not assume that a medication is safe simply because it is available over the counter or labeled as a supplement.
Bring a complete list of everything you take to your preconception appointment, including:
- Prescription medications
- Over-the-counter pain relievers
- Allergy medications
- Vitamins
- Herbal products
- Dietary supplements
- Acne medications
- Weight-loss medications
- Medications used for mental health
- Hormonal medications
Some medications may need to be changed before pregnancy, while others can be continued. In some cases, stopping a medication suddenly can be harmful, so do not stop a prescribed medication on your own.
Your healthcare provider can help determine what should be continued, changed, or discontinued before you begin trying to conceive.
If you have a chronic condition that requires medication, March of Dimes information about chronic health conditions and pregnancy can provide helpful background, but your own healthcare provider should guide decisions about your treatment.
Start Taking Folic Acid
Folic acid is one of the most important nutrients to address before pregnancy because the baby’s neural tube develops very early in pregnancy, sometimes before you know you are pregnant.
For most people who could become pregnant, 400 mcg of folic acid daily is recommended. Taking folic acid before pregnancy and during early pregnancy can help reduce the risk of neural tube defects, including spina bifida.
Many prenatal vitamins contain folic acid, but check the label to make sure you are getting the recommended amount.
Some people may need a higher dose based on their medical history or previous pregnancy history. Your healthcare provider can tell you whether you need more than the standard amount.
You can read more about folic acid from the CDC’s folic acid information, including why it is recommended
Check Your Vaccinations
Vaccinations are another important part of preconception planning.
Your provider can review your vaccination history and determine whether you need any vaccines before pregnancy. Some vaccines are recommended before pregnancy because certain vaccines are not given during pregnancy.
If you have vaccination records, bring them to your preconception appointment.
Your healthcare provider can also explain which vaccines are recommended based on your individual health history, travel plans, occupation, and pregnancy plans.
Get Chronic Health Conditions Under Control
If you have a chronic medical condition, getting it as well controlled as possible before pregnancy can be an important part of preparing for a healthy pregnancy.
Conditions that may require special attention include:
- Diabetes
- High blood pressure
- Thyroid disorders
- Asthma
- Epilepsy
- Heart disease
- Kidney disease
- Autoimmune conditions
- Mental health conditions
- Obesity or being significantly underweight
For example, blood sugar management is particularly important before and during pregnancy for people with diabetes.
Your healthcare provider may recommend changes to medications, additional testing, or consultation with another specialist before you start trying to conceive.
The goal is not to have a perfect medical history. The goal is to identify anything that can be addressed before pregnancy.
Review Your Family Health History
Family history can provide useful information when planning a pregnancy.
Think about health conditions that have occurred in your family or your partner’s family, including:
- Birth defects
- Genetic conditions
- Chromosomal conditions
- Developmental disorders
- Certain inherited diseases
- Multiple miscarriages
- Infertility
- Pregnancy complications
Depending on your history, your provider may recommend genetic counseling or carrier screening.
You do not need to know every detail of your family tree. Even knowing about major medical conditions affecting parents, siblings, children, or close relatives can be helpful.
March of Dimes information about getting ready for pregnancy also discusses the importance of understanding your health history before conception.
Consider Genetic Carrier Screening
Carrier screening can identify whether you or your partner carry certain genetic conditions that could potentially be passed to a child.
Some carrier screening is offered routinely, while other testing may be recommended based on personal or family history, ancestry, or other factors.
Preconception is often a convenient time to discuss this because it gives you more time to understand your options and, when appropriate, complete testing before pregnancy.
Your OB/GYN or midwife can explain which screening options may be appropriate for you.
The American College of Obstetricians and Gynecologists explains carrier screening, including who may benefit from testing and what the results can mean.
Stop Smoking and Avoid Nicotine
If you smoke cigarettes, vape, or use other nicotine products, quitting before pregnancy is an important health goal.
Smoking during pregnancy is associated with problems including preterm birth, low birth weight, and other pregnancy complications. Quitting before pregnancy gives your body time to recover from the effects of tobacco exposure.
If quitting is difficult, ask your healthcare provider for help rather than trying to manage it alone.
The Office on Women’s Health offers resources for quitting smoking before and during pregnancy.
Avoid Alcohol and Recreational Drugs When Trying to Conceive
If you are planning a pregnancy, talk with your healthcare provider about alcohol and recreational drug use.
Alcohol exposure during pregnancy can affect fetal development, and some recreational drugs can also create serious risks during pregnancy.
If stopping alcohol or drug use is difficult, let your healthcare provider know. Getting support before pregnancy is a positive step toward protecting your health and your future pregnancy.
March of Dimes information about healthy habits before pregnancy includes recommendations for reducing behaviors and exposures that may affect pregnancy.
Take a Look at Your Nutrition and Weight
Preconception health is a good time to look at your overall eating habits rather than focusing on a restrictive diet.
Aim for balanced meals that include a variety of:
- Fruits and vegetables
- Whole grains
- Protein sources
- Healthy fats
- Folate-rich foods
- Calcium-rich foods
Your healthcare provider can also discuss whether your current weight could affect pregnancy and whether gradual weight changes would be beneficial before conception.
You do not need to follow a complicated “fertility diet.” Consistent, balanced nutrition is more useful than chasing a long list of supposedly fertility-boosting foods.
Stay Physically Active
Regular physical activity can support overall health before pregnancy.
For many people, walking, swimming, cycling, strength training, or other moderate activities can be part of a healthy routine.
If you already exercise regularly, ask your provider whether there are any changes you should make based on your health history or plans for pregnancy.
If you are not currently active, starting gradually is usually more realistic than suddenly beginning an intense workout program.
Make an Appointment With Your Dentist
Dental health is part of overall health, including during the years when you are planning a pregnancy.
If you are overdue for a dental cleaning or have concerns such as gum disease, tooth pain, or untreated dental problems, consider addressing them before pregnancy when possible.
Tell your dental provider if you are planning to become pregnant so they can take your pregnancy plans into account when recommending medications, imaging, or treatment.
The American Dental Association’s information about oral health during pregnancy provides additional information about dental care during pregnancy.
Review Your Mental Health
Mental health deserves a place on your preconception checklist.
If you have anxiety, depression, a history of postpartum depression, or another mental health condition, talk with your healthcare provider before pregnancy.
This does not necessarily mean stopping medication. Some medications can be continued during pregnancy, while others may need to be adjusted. The safest approach is to discuss your treatment plan before conception rather than making medication changes on your own.
It can also be helpful to think about your support system, stress level, sleep, work demands, and other factors that may affect your well-being during pregnancy and after delivery.
The Office on Women’s Health provides information about mental health and ways to get support.
Reduce Exposure to Potentially Harmful Substances
Certain chemicals and environmental exposures can be harmful during pregnancy.
Before becoming pregnant, consider whether you regularly work with or are exposed to:
- Pesticides
- Solvents
- Certain cleaning chemicals
- Heavy metals
- Industrial chemicals
- Cat or rodent feces
- Other potentially hazardous substances
If you work around chemicals or other environmental hazards, talk with your healthcare provider about the specific exposure and ways to reduce risk.
Your provider can also help you determine whether changes are needed at work or at home before pregnancy.
Review Your Reproductive and Sexual Health
A preconception appointment is also a good time to discuss your menstrual cycle, fertility, contraception history, and sexual health.
Depending on your circumstances, your provider may discuss:
- Menstrual cycle regularity
- Previous pelvic infections
- Sexually transmitted infections
- Cervical cancer screening
- Fertility concerns
- Previous pregnancy complications
- When to seek help if pregnancy does not occur
If you have irregular or absent periods, significant pelvic pain, a history of certain reproductive conditions, or concerns about fertility, bring those concerns up before you start trying.
Talk With Your Partner About Health, Too
Preconception health is not only about the person who will carry the pregnancy.
A partner’s health can also be relevant to conception and pregnancy planning. Smoking, alcohol and drug use, certain medications, medical conditions, and genetic history may be worth discussing.
If there are concerns about fertility, family history, or inherited conditions, your healthcare provider can explain whether your partner should also be evaluated.
Think About Your Pregnancy and Birth Care Options
You do not have to have every decision made before becoming pregnant, but preconception is a good time to learn about your options.
Depending on your health and preferences, you may receive pregnancy care from an OB/GYN, certified nurse-midwife, or a practice where midwives and physicians work together.
If you are considering midwifery care, ask how the practice handles routine pregnancy care, high-risk conditions, hospital care, pain relief, complications, and consultation with physicians when needed.
Understanding how your care team works before pregnancy can make it easier to feel comfortable with your choices later.
The American College of Nurse-Midwives provides information about midwifery care and the role of certified nurse-midwives.
Your Simple Preconception Health Checklist
If you want a quick checklist to save or print, start here:
☐ Schedule a preconception appointment
☐ Review your medical history and previous pregnancies
☐ Make a complete list of medications and supplements
☐ Ask whether you should take a prenatal vitamin
☐ Get 400 mcg of folic acid daily unless your provider recommends a different amount
☐ Check your vaccination records
☐ Make sure chronic medical conditions are well controlled
☐ Review your family health history
☐ Ask whether genetic counseling or carrier screening is appropriate
☐ Stop smoking and other nicotine use
☐ Avoid alcohol and recreational drugs while trying to conceive
☐ Review your nutrition and physical activity
☐ Schedule a dental checkup if needed
☐ Address mental health concerns and review any medications
☐ Discuss workplace or household chemical exposures
☐ Review reproductive and sexual health
☐ Talk with your partner about relevant health and family history
☐ Ask questions about pregnancy and birth care options
Do You Need a Preconception Appointment if You Feel Healthy?
Yes. Even people who feel completely healthy can benefit from a preconception visit.
Some conditions do not cause noticeable symptoms but can affect pregnancy. A preconception appointment also provides an opportunity to review medications, vaccinations, family history, nutrition, and other factors that may not come up during a routine appointment.
It is also a chance to ask questions before pregnancy rather than trying to find answers after you see a positive pregnancy test.
What If You Become Pregnant Before Completing the Checklist?
Don’t panic! Many pregnancies are unplanned, and you do not have to complete every item on a checklist before pregnancy can be healthy.
If you think you may be pregnant, contact your healthcare provider and schedule prenatal care. Start taking a prenatal vitamin containing folic acid if you are not already taking one, and talk with your provider about any medications, supplements, alcohol, nicotine, medical conditions, or other exposures that may need attention.
When Should You See a Healthcare Provider Before Trying to Conceive?
Make an appointment before trying to conceive if you have a chronic medical condition, take prescription medication, have had a complicated pregnancy, have experienced recurrent pregnancy loss, have concerns about fertility, or simply want guidance before getting started.
You may also want to schedule a visit if you are unsure whether your vaccinations are current or if you have questions about genetic screening.
For some people, a preconception appointment can be fairly straightforward. For others, it may involve several steps. Starting early gives you more time to address anything that comes up.
Frequently Asked Questions About Preconception Health
How long before pregnancy should you start taking care of your health?
Ideally, start preparing about three months before trying to conceive. Some changes, such as managing chronic conditions or changing certain medications, may need to begin earlier.
What vitamins should I take before pregnancy?
A prenatal vitamin containing at least 400 mcg of folic acid is commonly recommended for people who could become pregnant. Your healthcare provider may recommend a different amount or additional nutrients based on your medical history.
Is 400 mcg of folic acid enough for everyone?
No. While 400 mcg is the general recommendation, some individuals may need a higher dose because of specific medical or pregnancy histories. Ask your healthcare provider what amount is appropriate for you.
Should I stop taking prescription medications before pregnancy?
No. Do not stop prescription medication without talking with your healthcare provider. Some medications need to be changed before pregnancy, but abruptly stopping certain medications can also be harmful.
Do I need to see my doctor if I am healthy?
A preconception appointment can still be helpful even if you feel healthy. It gives your provider an opportunity to review medications, vaccinations, family history, lifestyle factors, and any conditions that could affect pregnancy.
Should my partner have a preconception checkup?
It can be helpful, particularly if there are fertility concerns, significant medical conditions, medication issues, or a family history of genetic conditions. Your healthcare provider can advise whether an evaluation is appropriate.
When should I stop drinking alcohol if I am trying to get pregnant?
Talk with your healthcare provider about alcohol use when planning pregnancy. Because pregnancy can begin before you know you are pregnant, avoiding alcohol while trying to conceive eliminates exposure during very early pregnancy.
What if I have a chronic condition such as diabetes or high blood pressure?
Talk with your healthcare provider before trying to conceive. Getting a chronic condition well controlled and reviewing medications before pregnancy can help reduce potential complications.
Can a midwife provide preconception care?
Many certified nurse-midwives provide preconception counseling and care, along with pregnancy, birth, postpartum, and reproductive healthcare. The services available vary by practice, so ask your midwife or healthcare provider what is included.
A Healthy Pregnancy Begins Before Conception
Preparing for pregnancy does not mean achieving some unrealistic version of perfect health. It means giving yourself time to address the things you can control, ask questions, review medications and health conditions, and make a plan with your healthcare provider.
A preconception visit is a simple place to start. Whether you are planning your first pregnancy or hoping to grow your family again, a little preparation before conception can help you enter pregnancy feeling informed and prepared.
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This information is intended to be general guidance. If you have questions or concerns about preconception, our experienced midwives are here to help in Tampa, Wesley Chapel and St. Petersburg!