Your checkup before pregnancy

KEY POINTS

  • A preconception checkup is a medical checkup you get before pregnancy to help make sure you’re healthy when you get pregnant.

  • At your preconception checkup, your provider looks for health conditions that may affect your pregnancy and the health of your baby.

  • Get a preconception checkup even if you’ve already had a baby. Your health may have changed since you were last pregnant.

  • A preconception checkup is especially important if you’ve already had a premature baby, a baby with a birth defect, a miscarriage or stillbirth.

  • If certain health conditions run in your family, you may want to see a genetic counselor.

What is a preconception checkup and why is it important?

A preconception checkup helps your health care provider make sure that your body is ready for pregnancy. If you can, get your checkup from the health care provider you want to take care of you during pregnancy. You can get a preconception checkup any time — even up to a year before you want to get pregnant.

Some medical conditions, like diabetes, high blood pressure and being overweight can affect pregnancy and your fertility (your ability to get pregnant). Smoking, using street drugs and abusing prescription drugs can affect them, too. Your provider can help you manage health conditions and make changes in your life to help your baby be born healthy.  

Get a preconception checkup even if you’ve already had a baby. Your health may have changed since you were last pregnant. If you had a problem in a past pregnancy, your provider may be able to help you avoid the same problem in your next pregnancy. Get a preconception checkup if you’ve had: 

  • Premature birth. This is birth that happens before 37 weeks of pregnancy.
  • A baby with birth defects. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops or in how the body works.
  • Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
  • Stillbirth. This is when a baby dies in the womb before birth, but after 20 weeks of pregnancy.

What happens at a preconception checkup?

At your preconception checkup, your provider:

  • Checks your overall health and for any health problems 
  • Takes your family health history. This is a record of any health problems and treatments that you, your partner and everyone in both of your families has had. 
  • Answers your questions about getting pregnant and what to expect during pregnancy
  • Talks to you about when to stop using birth control before trying to get pregnant. Birth control is methods, like condoms and birth control pills, you use to keep from getting pregnant. Your provider may suggest you stop using birth control a few months before you start trying to get pregnant to let your body have a few normal menstrual cycles. Having normal cycles before pregnancy can help your provider figure out your due date when you do get pregnant. Your menstrual cycle is the process of your ovaries releasing an egg (called ovulation) every month. The egg moves through the fallopian tubes to the uterus. The uterus (also called the womb) is where your baby grows during pregnancy. If the egg isn’t fertilized by a man’s sperm, it passes through the vagina along with blood and tissue from the uterus. This is called your period.

Your provider may:

  • Give you a physical exam that includes taking your weight and checking your blood pressure
  • Give you a pelvic exam. This is an exam of the pelvic organs, like the vagina, cervix, uterus and ovaries, to make sure they’re healthy. The cervix is the opening to your uterus that sits at the top of the vagina. If you have any problems in these organs, getting treatment before pregnancy may help prevent problems during pregnancy. Treatment also can help if you have fertility problems (problems getting pregnant). 
  • Do a Pap test. This is a medical test in which your provider collects cells from your cervix to check for cancer. 
  • Run blood tests to check your blood type and Rh factor. Rh factor is a protein found on red blood cells. If your Rh factor is negative, it can cause problems for your baby if her Rh factor is positive.   
  • Check you for health conditions, like being underweight or overweight, diabetes and sexually transmitted diseases, like genital herpes and human immunodeficiency virus (also called HIV).
  • Recommend that you see a genetic counselor if certain health conditions run in your family. A genetic counselor has training to help you understand about genes, birth defects and other medical conditions that run in families, and how they can affect your health and your baby's health.

How can your family health history affect pregnancy?

Your family health history can help you, your provider and your genetic counselor look for health conditions that may run in your family. It’s a good idea to start putting your family history together before your preconception checkup so you can share it with your provider at your checkup. You and your partner can use a family health questionnaire (.PDF, 83KB) to gather information.

Your family health history can help your provider and your genetic counselor: 

  • Identify health conditions that run in your or your partner’s family or ethnic group. An ethnic group is a group of people, often from the same country, who share language or culture. Certain genetic conditions, like sickle cell disease and Tay-Sachs disease, are more common in people from certain ethnic groups. For example, people who are Ashkenazi Jews are more likely than others to have Tay-Sachs and other genetic conditions. 
  • Find the cause of a condition you had in a past pregnancy.  Your provider may use tests like blood tests or ultrasound to help find the cause of the condition. Getting treatment often can lower the chances of you having the same complication in another pregnancy.  
  • Treat health conditions before pregnancy. Some chronic (long-lasting) health conditions can lead to pregnancy problems and, sometimes, birth defects. Getting treatment before pregnancy for conditions like diabetes, high blood pressure, lupus and PKU, can improve your chances of having a healthy pregnancy and a healthy baby.
  • Make sure any medicines you take are safe during pregnancy. A prescription medicine is a medicine your health care provider says you can take to treat a health condition. You have to have a prescription (order) from your provider to get the medicine. You can buy over-the-counter (also called OTC) medicines, like pain relievers and cough syrup, without a prescription. Some prescription and OTC medicines may be harmful to a baby during pregnancy. You may need to stop taking a medicine or switch to one that’s safer for your baby. Don’t stop taking any prescription medicine without your provider’s OK. Stopping certain medicines, like medicines for asthma, depression or diabetes, can be more harmful to you or your baby than taking the medicine. Tell your provider about any medicine you take.
  • Check that your vaccinations are up to date. Vaccinations contain medicine that makes you immune to certain diseases. If you’re immune, you can’t get the disease. Infections like chickenpox and rubella (also called German measles) can harm you and your baby during pregnancy. It’s best to get caught up on vaccinations for these infections before you get pregnant. 

What tests can you get before pregnancy to help you find out about genetic conditions that may affect your baby?

If your provider or genetic counselor thinks you may have a genetic condition that may affect your pregnancy, they may recommend these tests before you get pregnant:

  • Preconception carrier screening. This test checks blood or your saliva to see if you or your partner is a carrier of certain genetic conditions that could affect your baby, like cystic fibrosis, sickle cell disease and Tay Sachs disease. If you’re a carrier, you don’t have the condition yourself, but you have a gene change for it that you can pass to your baby. If both you and your partner are carriers of the same condition, the risk that your baby has the condition increases. You and our partner can get this test during pregnancy, too. But getting tested before pregnancy can help you and your partner look at your baby’s risk and make decisions about getting pregnant. 
  • Preimplantation testing (also called preimplantation genetic diagnosis or PGD). You may want this kind of testing if you or your partner is a carrier (you’ve been tested to find out) and you’re having fertility treatment called in vitro fertilization (also called IVF). In IVF, an egg and sperm are combined in a lab to create an embryo (fertilized egg) which is then implanted (put) into your uterus. This testing checks cells from the embryo for gene changes before they’re implanted in your uterus. Only healthy embryos (without a gene change) are implanted.

Your provider or genetic counselor can help you understand your test results and the chances of passing a genetic condition to your baby. 

Do you need a dental checkup before pregnancy?

Yes. Keep your regular dental checkups before and during pregnancy. Some studies show a link between gum disease and having a premature or low birthweight baby. Low birthweight means your baby weighs less than 5 pounds, 8 ounces at birth. If you have gum disease, getting treatment before pregnancy may prevent health problems in you and your baby. 

When you see your dentist, tell him you’re planning to get pregnant. And when you visit your dentist during pregnancy, make sure he knows you’re pregnant. 

More information

Last reviewed: December, 2016