Patient education: How to plan and prepare for a healthy pregnancy (The Basics)

Should I see a doctor before I try to get pregnant? — Yes. Before you start trying, it's very important to see your doctor or nurse for a "pre-pregnancy check-up." Your doctor or nurse will ask you about things that could affect your pregnancy. For instance, they might ask about your diet, lifestyle, use of birth control, past pregnancies, medicines, and any diseases that you have or that run in your family.

There are several things that you and your doctor or nurse can do to make sure that your pregnancy is as healthy as possible. These things should be done before you try to get pregnant if possible:

●Discuss any medicines or herbal drugs you take and find out if you need to make changes

●Discuss whether you are up-to-date on your vaccines

●Start taking a multivitamin that has folic acid (also called folate)

●Know which foods you should avoid and which foods are best

●Stop smoking, drinking alcohol, or taking drugs not prescribed for you by a doctor

●Understand the risks to you and your baby if:

•You have any medical conditions

•There are diseases that run in your family or your partner's family

●Discuss whether there are any harmful substances in your home or work

●Try to keep a healthy weight

Each of these issues is explained in more detail below.

Ask if the medicines you take are safe — If you take any medicines, supplements, or herbal drugs, ask your doctor if it is safe to keep taking them while you are pregnant or trying to get pregnant. Some medicines take a long time to leave your body completely, so it's important to plan ahead. In some cases, your doctor and nurse will want you to switch to different medicines that are safer for the baby. Your doctor and nurse might need to slowly get you off some medicines because it could harm you to stop them all of a sudden. This is especially important for if you take certain medicines used to treat seizures, high blood pressure, lupus, or rheumatoid arthritis.

Check if you need any vaccines — If you want to get pregnant, it's important to be up-to-date on your vaccines. This includes vaccines against measles, mumps, rubella, tetanus, diphtheria, polio, chickenpox (also called varicella), and possibly hepatitis. Many people got these vaccines as children. Still, it is important to check that you have had all the vaccines you need. If not, you could get sick with the diseases the vaccines protect against, which could cause problems for you or your baby. It's also important to get the coronavirus 2019 (COVID-19) vaccine when you are able, as well as a flu shot every year.

Some vaccines cannot be given during pregnancy or in the month before pregnancy. It's important to get these vaccines more than a month before you start trying to get pregnant.

Start taking a multivitamin — If you want to get pregnant, take a "prenatal" multivitamin every day that has at least 400 micrograms of folic acid. This helps prevent some of the problems a baby can be born with. Start taking the multivitamin at least a month before you start trying to get pregnant. That's because by the time you find out you are pregnant, your baby has already formed many body parts that rely on folic acid and other vitamins to develop normally.

It is important not to take too much of any vitamin during pregnancy, especially vitamin A. Show your doctor or nurse the vitamins you plan to take to make sure the doses are safe for you and your baby.

Check your diet — In general, try to eat a balanced diet rich in fruits, vegetables, and whole grains.

Some foods are not safe to eat during pregnancy. If you are trying to get pregnant, the following can help you stay safe:

●Do not eat raw or undercooked meat. Avoid eating shark, swordfish, king mackerel, or tilefish because they can have high levels of mercury. Check with your doctor or nurse about the safety of fish caught in local rivers and lakes.

●Limit the amount of caffeine you have to no more than 1 or 2 cups of coffee each day. Tea and cola also contain caffeine, but usually not as much as coffee.

●Be careful to avoid germs in your food that could make you sick. Wash your hands with soap and water before preparing or touching food. Wash or peel fruits and vegetables before eating them. Pregnant people should also avoid certain foods that can carry germs. These include deli meats and milk, cheese, or juice that has not been pasteurized (also called "unpasteurized").

Stop smoking, drinking alcohol, or taking illegal drugs — If you smoke, drink alcohol, or take drugs not prescribed for you by a doctor, now more than ever it is important that you stop. Even small amounts of these substances from time to time during pregnancy could hurt your baby. This includes electronic cigarettes ("vaping") or marijuana.

It's not enough to stop as soon as you find out you are pregnant. By then the baby has already begun to form and could be harmed by smoking, alcohol, or drugs. If you need help quitting, speak with your doctor or nurse. There are treatments that can help.

Ask about risks — Ask your doctor what the risks to you and your baby might be if:

●You have any medical conditions – If you have a medical problem, it could cause problems for you or your baby during pregnancy. People who have certain medical conditions should work with their doctor to get their conditions under control before they get pregnant. This includes people with diabetes, high blood pressure, asthma, thyroid conditions, seizure disorders, HIV infection, and other problems. If you have one of these conditions and it is not well controlled, it can cause problems for both you and your baby during pregnancy.

●You or your partner has a family history of a medical condition – If you or your partner has a history of a condition that could be passed on to your baby, your doctor might recommend genetic counseling. Genetic counseling can help you understand the chances are that your baby will also have the condition. A genetic counselor can also talk to you about what your options if your baby does have a genetic problem.

Check your home and work for harmful substances — People often have chemicals or substances in their home or work that could hurt an unborn baby. Dealing with these substances can sometimes be complicated and time consuming, so it's important to plan ahead. For instance, people who live in homes built before 1978 often have lead paint on their walls or woodwork. Lead in chips or dust from this paint could harm a baby. Ask your doctor or nurse how to deal with this and other harmful substances you might have around you.

Try to keep a healthy weight — Weighing too little or too much can make it harder to get pregnant and lead to problems during pregnancy. It's a good idea to try to reach a healthy weight before you try to get pregnant.

Is there anything my partner can do? — There are some things the male partner can do, too. For example, they should stop smoking and using drugs, and limit alcohol. The doctor or nurse might ask questions about their health and medical history, too.

It can help for your partner to support you, for example, by making healthy changes to their diet along with you.

When you are ready to start trying to get pregnant, your doctor or nurse can talk to you about how to increase your chances. For pregnancy to happen through sex, your partner's sperm needs to fertilize your egg (figure 1). Having sex at certain times during your monthly cycle can increase the chances of pregnancy. To make sure your partner's sperm are as healthy as possible, it can also help to have sex every 2 or 3 days, and for them to avoid ejaculating in between these times.

If you do not have a male partner and are planning to get pregnant in another way (for example, with a sperm donor), it can still be helpful to have the support of your partner, family, or friends. If you do not feel that you have support, or if you are struggling with relationships or feeling unsafe in any way, talk with your doctor or nurse. They can help.

More on this topic

Patient education: Vaccines and pregnancy (The Basics)
Patient education: Avoiding infections in pregnancy (The Basics)
Patient education: Nutrition before and during pregnancy (The Basics)
Patient education: Care during pregnancy for people with type 1 or type 2 diabetes (The Basics)
Patient education: Smoking in pregnancy (The Basics)
Patient education: Quitting smoking (The Basics)
Patient education: Lead poisoning (The Basics)
Patient education: Taking over-the-counter medicines during pregnancy (The Basics)
Patient education: Acid reflux (gastroesophageal reflux disease) during pregnancy (The Basics)
Patient education: Alcohol and drug use in pregnancy (The Basics)

Patient education: Vaccination during pregnancy (Beyond the Basics)
Patient education: Avoiding infections in pregnancy (Beyond the Basics)
Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics)
Patient education: Quitting smoking (Beyond the Basics)