How to prepare for pregnancy

If you've decided to take the plunge into parenthood, and you have a little time, preparing for pregnancy is an important first step. To give yourself the best chance for a healthy pregnancy and a healthy baby, there are some things to do before you head down the road to conception.

Schedule a preconception visit

As soon as you're ready to try for pregnancy, call your ob-gyn, midwife, or family practice doctor for a preconception checkup. At your visit, your healthcare provider will help you identify things that might affect your pregnancy. They'll probably:

• Review your personal and family medical history (to find out if your baby might be at higher risk for certain genetic conditions)
• Evaluate your present health and any medications or supplements you're taking. Certain medications and supplements are unsafe during pregnancy, and some may need to be switched before you even try to conceive.
• Discuss diet, weight, exercise, and any unhealthy habits you may have (such as smoking, drinking, or taking drugs)
• Recommend a prenatal vitamin
• Make sure you're up to date on your immunizations and test you for immunity to childhood diseases such as chicken pox and rubella
• Perform a pelvic exam and Pap smear
• Test you for sexually transmitted infections if you're at risk
• Talk about past pregnancies, if this isn't your first
• Answer any questions you have

In addition, you may be referred to a specialist if you have certain medical conditions (such as asthma, diabetes, or high blood pressure) that need to be controlled before you get pregnant.

Consider meeting with a genetic counselor

If you have any concerns about your chances of having a child with a genetic disorder or birth defect, you might want to meet with a genetic counselor while you're preparing for pregnancy.

A genetic counselor can help you decide if there's cause for concern (because of inherited diseases, exposures, past pregnancy history, or ethnic background) and which screening tests might be helpful for you at this point and in the future.

For example, even before you conceive, genetic carrier screening can help you find out whether you or your partner is a carrier for serious inherited illnesses such as cystic fibrosis, Tay-Sachs or sickle cell disease. All it takes is a saliva or blood sample from each of you, and it's covered by most health insurance policies.

If both parents carry a recessive gene for a disorder, their child will have a 1-in-4 chance of having the gene and getting the disorder and a 1-in-2 chance of being a carrier of the disorder. If one parent is a carrier, there's a 1-in-2 chance that the child will also be a carrier of the disorder.

Start taking prenatal vitamins

It's not too early to start taking prenatal vitamins to make sure you get enough of the vital nutrients your body needs for a healthy pregnancy and baby. These include iron, calcium, omega-3 fatty acids, and – perhaps most importantly – folic acid.

By taking 400 micrograms (mcg) of folic acid a day for at least one month before you conceive and during your first trimester, you can cut your chances of having a baby with neural-tube defects such as spina bifida and anencephaly. Starting before pregnancy is highly recommended, because the neural tube closes by day 28 after conception, often before the woman knows she's pregnant. There are some other important things to keep in mind when it comes to a prenatal vitamin. Read our prenatal vitamin guide here.

If you're unsure about what to take, ask your healthcare provider to recommend a supplement.

Give up bad habits – and get help if you need it

Preparing for pregnancy means getting as healthy as possible. And that includes giving up bad habits. If you smoke or take drugs, now's the time to stop. Smoking or taking drugs can lead to miscarriage, premature birth, low-birth-weight babies, and other complications. Smoking can also increase your baby's risk of SIDS. Keep in mind that some drugs can stay in your system even after their noticeable effects have worn off.

What's more, research suggests that tobacco use can affect your fertility and lower your partner's sperm count. In fact, studies have shown that even secondhand smoke may reduce your ability to get pregnant.

You'll want to avoid alcohol, too. While moderate drinking (one drink a day for women) may be okay before you become pregnant, it's possible that you'll become pregnant before you know it and wind up drinking with a developing fetus in tow. Once you're pregnant, experts recommend that you stop drinking completely. Alcohol crosses the placenta, and can possibly affect development and cause lifelong cognitive and behavioral problems.

Stopping unhealthy habits can be very difficult. Don't hesitate to talk with your healthcare provider. They can talk with you about tools to help you quit smoking or refer you to a program to help you stop taking drugs, for example. Your local health department may also be able to help by putting you in touch with counselors, group programs, and other assistance.

Read about opioid use and addiction during pregnancy.

Join our community of moms who are working to quit smoking

Eat well

Start making smart food choices now so your body will be stocked up with the nutrients you need for a healthy pregnancy.

Each day, try to eat:

• At least 2 cups of fruit and 2 1/2 cups of vegetables
• Plenty of whole grains
• Foods that are high in calcium – like milk, calcium-fortified orange juice, and yogurt
• A variety of protein sources, such as beans, nuts, seeds, soy products, poultry, and/or meats
• Iron-rich foods, such as beans, lentils, fortified cereals, beef, turkey, liver, and shrimp. Also eat foods that help with iron absorption, such as orange juice, strawberries, grapefruit, broccoli, and peppers.

Read about vegan and vegetarian diets during pregnancy.

Note: If you're a big fan of fish, start watching your intake. While fish is an excellent source of omega-3 fatty acids (which are very important for your baby's brain and eye development), protein, vitamin D, and other nutrients, some fish also contains high levels of mercury, which can be harmful.

Most experts agree that pregnant women should eat some fish, and that the best approach is to avoid those fish that are highest in mercury and limit your consumption of all fish. The U.S. Food and Drug Administration (FDA) recommends that women who are pregnant or breastfeeding eat between 8 and 12 ounces each week of a variety of seafood that's lower in mercury. They also recommend that women of childbearing age not eat:

• shark
• swordfish
• king mackerel
• marlin
• orange roughy
• bigeye tuna
• tilefish
• more than one serving (6 ounces) of solid white canned tuna per week
• fish caught in local waters, unless you're certain there are no contaminants

Here are the 12 best foods to eat when pregnant.

And here are 10 healthy snacks for pregnancy.

Aim for a healthy weight

Attaining and maintaining a healthy weight is one of the best things you can do to prepare for pregnancy. Being overweight or underweight (having a high or low body mass index, or BMI) can make it harder for some women to become pregnant. It can also affect your pregnancy.

Being overweight during pregnancy is associated with high blood pressure and preeclampsia, preterm birth, and gestational diabetes. And obesity increases your risk of macrosomia, birth injury, cesarean birth, and birth defects (especially NTDs).

Women who start pregnancy with a low BMI and fail to gain enough weight are at increased risk of having a baby with low birth weight and having a preterm birth.

The best time to get to a healthy weight is in preparation for pregnancy rather than during pregnancy. Talk to your healthcare provider about the best way to achieve your weight goals.

Establish a regular exercise routine

An exercise program is an important part of keeping your mind and body healthy. The American Academy of Obstetricians and Gynecologists (ACOG) recommends 150 minutes of moderate physical activity each week, along with muscle-strengthening activities on two or more days a week.

You might walk or cycle most days of the week, for example, and weight train on a few of those days. To increase flexibility, add stretching or yoga, and you'll have a well-rounded fitness program. Once you're pregnant, keep exercising unless you have certain pregnancy complications.

If exercising hasn't been a priority for you lately, ease into an exercise routine. Start with something tame, like walking 10 to 20 minutes a day. Add more activity into your daily routine by taking the stairs instead of the elevator or parking your car a few blocks away from work.

Learn the best kinds of exercise for pregnancy.

Don't forget your mental health

Your mental health is an important part of your overall health. Here are some things to think about when preparing for pregnancy:

Stress. While we don't know the exact connections between stress and fertility, we do know that high stress levels can affect your hormone function, which can in turn affect your menstrual cycles. We also know that stress isn't healthy, and your goal right now is to become as healthy as possible.

So do what you can to reduce stress in your life. Eliminate unnecessary stressors as much as you can, and explore methods for reducing stress, such as yoga, meditation, massage, and deep-breathing exercises. Take time to de-stress with long walks, time with good friends, quiet time, and exercise.

Getting enough sleep can help you better cope with stress throughout the day and contribute to your overall health, too. If you need help dealing with stress, your healthcare provider can refer you to a therapist.

Depression. Women who suffer from depression are more likely to have problems with fertility than women who don't, says Alice Domar, PhD., Chief Compassion Officer at Inception Fertility.

Domar suggests that all women, but especially those with a personal or family history of depression, do a mental health check before they get pregnant. If you notice signs of depression, such as a loss of interest and pleasure in things that you used to enjoy, a change in appetite or sleep patterns, a loss of energy, or feelings of hopelessness and worthlessness, ask your provider for a referral to a mental health professional for a consultation.

Domestic violence. Physical harm or emotional abuse by a partner is unlikely to get better during pregnancy or after your baby is born. If you're the victim of domestic violence, reach out for help through your healthcare provider or by getting in touch with the National Domestic Violence HotlineOpens a new window at (800) 799-7233.

Visit the dentist

Don't forget about your oral health when you're preparing for pregnancy. Hormonal shifts during pregnancy can make you more susceptible to gum disease. Higher progesterone and estrogen levels can cause the gums to react differently to the bacteria in plaque, resulting in swollen, red, tender gums that bleed when you floss or brush (gingivitis). Almost 60 to 75 percent of pregnant women have gingivitis.

The good news is that women who take care of their periodontal health before they get pregnant cut down on their chance of experiencing gum problems in pregnancy. See your dentist for a checkup and cleaning now if you haven't done so in the past six months. And keep up on your dental care once you're pregnant, making sure to inform your dentist and hygienist that you’re pregnant (if it isn’t physically obvious yet).

Reduce environmental risks

You may not be able to entirely eliminate all environmental dangers, but you can do your best to keep as many of them as possible out of your life now. Some jobs can be hazardous to you and your unborn child, for example. If you're routinely exposed to chemicals (such as dry cleaning solvents) or radiation, you'll need to make some changes before you conceive.

Also, keep in mind that some at-home products can also be dangerous for a developing baby. Lead (in drinking water from old pipes), mercury (in fish), certain pesticides and fertilizers (in the yard or on the farm), and cat litter containing feces are all potentially harmful in pregnancy.

Talk to your provider about your daily routine, and see if you can come up with ways to avoid or eliminate hazards in your home and workplace while you're preparing for pregnancy.

Figure out when you ovulate

Some women just stop using birth control when they're ready to get pregnant and let fate decide when they'll conceive. Others chart their periods and track symptoms to try to pinpoint their fertile days each month.

You can use our Ovulation Calculator to get a rough estimate of when you're most fertile. If you want to be more exact, start charting your basal body temperature (BBT) and the changes in your cervical mucus. Tracking these symptoms over several months can help you figure out when you're ovulating during each cycle.

Ovulation predictor kits can also help you figure out when you're ovulating by detecting hormones in your urine, or changes in chloride in the saliva or on the skin, that signal ovulation is about to occur. These kits cost about $15 to 50 per cycle and are available at drugstores.

Toss your birth control

So you're ready to bid adieu to birth control. If you have concerns or questions, talk with your healthcare provider before making the move. Otherwise, ditching contraception might be as easy as moving the condoms or diaphragm to the back of the dresser drawer.

If you're on the Pill, the patch, or the ring, you can simply stop using them. You don't have to wait for the end of a monthly cycle to stop. If you have an IUD, your provider can take it out at any time, and your fertility will typically be the same as it was before you had it inserted.

For many women, fertility returns as soon as they stop using these methods, but some may take a month or so to start ovulating again. If you're using the birth control shot (Depo-Provera), however, it can a year or more after your last shot for you to start ovulating again. You'll know ovulation is back to normal when you're getting your period regularly. (Note that you can get pregnant before you get a period, however, because ovulation happens before your period.)

Some healthcare providers recommend using a barrier method and waiting until you have a couple of normal periods before trying to conceive, because this can help you establish a more accurate due date. But it's completely safe to start trying right away if you want to. And if you do get pregnant before your periods become regular again, don't worry – you can have an early ultrasound to date your pregnancy.

Read more about what you need to know about giving up birth control.

Involve your partner

If you have a partner, they can provide support and encouragement for you throughout pregnancy – especially if you're making changes to your lifestyle – and delivery.

If they're fathering the child, their diet and lifestyle is also important. Sperm count and semen quality can be lowered by alcohol, smoking, steroid use, drug use, and unhealthy eating habits. Very hot environments – such as hot tubs, steam rooms, and saunas – can also affect sperm count.

Try to attend your preconception appointment – as well as prenatal appointments – together, so that you're both well informed about the pregnancy and how your baby is doing. If you're taking childbirth classes, share those, too.

Take a look at your family's finances

To reduce stress during your pregnancy and into the future, you'll want to be prepared for the cost of your pregnancy care and delivery – for starters.

If you have health insurance, give the company a call and find out:

• What kind of prenatal coverage they offer
• If the doctor or midwife you have in mind is in your plan or how much it would cost to see her out of network
• What your deductibles are for prenatal visits and delivery. If you have a high deductible, try to put a little aside now so you won't be slammed with exorbitant bills when the baby arrives.
• What tests and procedures your insurance covers. (Preconception and prenatal care visits and many prenatal tests should be completely covered, thanks to the Affordable Care Act.)

If you're lucky enough to have a choice of plans, compare coverage and providers.

If you don't have health insurance, look into options available to you on HealthCare.govOpens a new window. You can also contact your local health department to see what programs and resources are available in your area to help pregnant women and babies get the medical care and other services they need. Or visit the U.S. Department of Health & Human Service's website page on health assistance programs for pregnant women, mothers, and childrenOpens a new window.

Find out how much you're likely to spend with our Cost of Raising a Child Calculator.

Talk about your decision as a family

Have you thoroughly explored what it'll mean to have a baby in the household – or to add a child to the family? Is your partner on board?

Here are some key questions you might explore together:

• Have you considered what lifestyle changes you'll need to make once there's a child in the family?
• Have you thought through how you and your partner will divide household labor and childcare responsibilities and how you'll balance work and family?
• Are you prepared to parent a special-needs child if you have one?
• Are you and your partner equally committed to becoming parents?
• If you and your partner have religious, ideological, or cultural differences, have you discussed how they will affect how you raise your child?
• Do you have family members or close friends you can count on for support?
• Do you have financial resources, and is your financial situation (your income, job) stable?
• Is your housing secure?
• Are you prepared for the impact pregnancy and childbirth can have on you physically and mentally?

It's also a good idea to start asking other parents about their parenting experiences – what are the challenges they're facing? What are the most difficult parts of parenting (as well as the joys)? You could also visit friends or family who have small children to get a feel for what life is like with a baby or toddler.

Talk with your provider if you're concerned about trying to conceive

You may get pregnant as soon as you stop using birth control, or it may take some time. Check out our article on how to get pregnant fast for some tips on predicting ovulation and timing sex for conception.

Most couples trying to conceive get pregnant within six months. There are factors that affect how long it takes, though – such as age and lifestyle habits.

If you're younger than 35 and have been trying for a year or more, talk with your OB-GYN or a fertility specialist. If you're 35 or older, talk with your provider or a specialist after six months. They can help you identify what obstacles might be preventing pregnancy and provide guidance for next steps you might take.

Learn more:

• How and what to eat if you want to get pregnant
• Getting pregnant: When to have sex
• Pregnancy symptoms: 10 early signs of pregnancy
• How soon after quitting smoking can I try to get pregnant?