Preconception Checkup: Plan a Healthy Pregnancy

A preconception checkup is a visit with your doctor before you try to get pregnant. It helps you start pregnancy as healthy as possible by reviewing your health, medicines, vaccines and habits, and by starting folic acid early.

Ideally, begin planning a few months ahead. This guide lists what to do, which tests and vaccines may be suggested, how to manage long-term conditions and how your partner can help.

Why plan ahead?

The first weeks of pregnancy are when a baby's organs begin to form, often before a woman knows she is pregnant. The CDC points out that this is exactly why folic acid should already be in your body early. The NICHD says that preconception care helps lower risks, from birth defects to problems linked to chronic illness, by dealing with them beforehand.

Planning does not mean you must be perfect. It means making a few sensible changes and getting medical advice for your own situation.

Start folic acid early

Folic acid helps prevent neural tube defects, which are serious birth defects of the baby's brain and spine. The CDC advises 400 micrograms daily for women who could become pregnant, starting at least one month before trying and continuing through pregnancy. MedlinePlus and the NICHD also say at least 400 micrograms. Women with a past pregnancy affected by a neural tube defect need a different plan, so talk to your doctor first. Do not use high-dose products without medical advice.

Natural folate is found in leafy greens, beans and oranges, and fortified foods help too. See folic acid and prenatal vitamins for more.

What a preconception visit usually covers

1. Health and family history: your periods, past pregnancies or miscarriages, and conditions in the family, including inherited disorders.
2. Check-ups and tests: blood pressure, weight and any tests your doctor feels you need. The NHS also suggests checking that cervical screening is up to date.
3. Vaccines: your doctor reviews what you have had.
4. Medicines and supplements: everything you take, including herbal remedies.
5. Lifestyle: food, activity, sleep, smoking, alcohol and stress.
6. Planning together: the timing of pregnancy and what to expect.

Vaccines to review

The NICHD says rubella and chickenpox (varicella) vaccines should be given before pregnancy, and the NHS advises the MMR vaccine if you have not had it. Which vaccines suit you depends on what you have had before. Bring any vaccination record you have, and ask your doctor whether you need a blood test for immunity. Our guide to vaccinations every woman should know goes into more detail.

Tip: Take a written list of all medicines, vitamins and herbal or ayurvedic products you use, and a photo of any vaccination card. It saves time and makes your visit more useful.

Long-term health conditions

The NICHD recommends getting conditions such as diabetes, high blood pressure, seizure disorders and asthma under control before pregnancy. The NHS says to talk to your doctor before trying if you or your partner has a condition such as epilepsy, diabetes, sickle cell disease or HIV.

• Diabetes: steady sugar levels before pregnancy are safer. See diabetes screening for women.
• Thyroid: ask whether a check is suitable for you. Read thyroid problems in pregnancy.
• Blood pressure: your doctor may want it controlled first.
• Mental health: the NICHD advises seeking help for ongoing depression, anxiety or stress before pregnancy.

When to be cautious: Never stop or change a regular medicine on your own, even if you want to get pregnant. The NHS stresses that you should speak to your doctor first. Some medicines are not safe in pregnancy, and some conditions get worse if treatment is stopped.

Lifestyle changes that help

• Eat a balanced diet: more vegetables, fruit, lentils and whole grains, less sugary drinks and fatty meat.
• Reach a healthy weight: the NHS and NICHD note that being underweight or overweight can make pregnancy harder.
• Move daily: MedlinePlus suggests about 30 minutes of brisk activity on most days.
• Stop tobacco, alcohol and drugs: the NHS and MedlinePlus advise stopping them, and doctors can help you do it.
• Limit caffeine: MedlinePlus links more than about two cups of coffee a day with trouble conceiving and miscarriage.
• Manage stress and sleep and keep up your dental check-ups.

Our healthy lifestyle habits article offers more daily tips.

Your partner matters too

Partners can share their health history, and the NICHD notes that carrier screening for inherited disorders may be offered to both. The NHS advises testing for sexually transmitted infections if either of you may have one, and talking to a doctor if your partner has a long-term condition or takes medicines. Stopping smoking and alcohol together makes it easier.

Timing and when to seek fertility help

The NHS says that having sex every 2 to 3 days makes pregnancy likely within a year for most couples where the woman is 39 or under, and that conception is most likely around ovulation, usually about 14 days before the next period. Try our ovulation calculator to estimate your fertile days. If you have been trying for a year or more, or you know of a problem such as endometriosis or low sperm count, see a doctor; our infertility guide explains when. Our infertility and reproductive care speciality offers fertility counselling.

When to see a doctor

Book a preconception visit if you are planning pregnancy in the next few months, you have a long-term condition or take regular medicines, you have had a miscarriage, a stillbirth or a baby with a birth defect, or you are over 35 or under 18 and want to plan well. You can also come before you start trying, which is the ideal time.

Talk to a doctor

A preconception visit takes less time than most people expect and can give you confidence before pregnancy. You can book an appointment or call +91 944 103 0587. This article is for general awareness and is not a substitute for a doctor's advice.