Your checkup before pregnancy

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 depression, diabetes, high blood pressure and not being at a healthy weight can affect pregnancy and your fertility (your ability to get pregnant). Smoking or abusing street or prescription drugs can also affect them. Your provider can help you manage health conditions and make changes in your life to help your baby is 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:

• Preterm 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 provider do you see for a preconception checkup?

If you can, get your preconception checkup with the provider you want to take care of you when you do get pregnant (also called your prenatal care provider). You can choose your prenatal care provider from several different kinds of doctors and nurses. All of these providers can take care of you during pregnancy and can deliver your baby:

• An obstetrician (also called OB) is a doctor who has education and training to take care of pregnant women and deliver babies. The American College of Obstetricians and Gynecologists can help you find an OB in your area. 
• A family practice doctor (also called a family physician) is a doctor who can take care of every member of your family. This doctor can take care of you before, during and after pregnancy. The American Board of Family Medicine can help you find a family doctor in your area. 
• A maternal-fetal medicine (also called MFM) specialist is an OB with education and training to take care of women who have high-risk pregnancies. If you have health conditions that may cause problems during pregnancy, you may want you to see a MFM specialist. The Society for Maternal-Fetal Medicine can help you find a specialist in your area.
• A family nurse practitioner (also called FNP) is a nurse with education and training to take care of every member of your family. The American Association of Nurse Practitioners can help you find an NP in your area. 
• A women’s health nurse practitioner (also called WHNP) is a nurse with education and training to take care of women of all ages, including pregnant women. The American Association of Nurse Practitioners can help you find a WHNP in your area. 
• A midwife is a health care provider who has education and training to take care of women of all ages, including pregnant women. Make sure your midwife is certified by the American Midwifery Certification Board (also called AMCB) or the North American Registry of Midwives (also called NARM). The AMCB certifies certified midwives (also called CMs) and certified nurse-midwives (also called CNMs). NARM certifies certified professional midwives (also called CPMs). ACNM and NARM can help you find a midwife in your area.

What happens at a preconception checkup?
At your preconception checkup, your provider checks your overall health to make sure your body is ready for pregnancy. You and your provider can talk about:

• Folic acid.  Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take folic acid before pregnancy and during early pregnancy, it can help protect your baby from birth defects of the brain and spine (called neural tube defects), and birth defects of the mouth (called cleft lip and palate). Before pregnancy, take a multivitamin with 400 micrograms (also called mcg) of folic acid in it each day.
• Health conditions that can affect your pregnancy. These include diabetes, depression, high blood pressure and not being at a healthy weight. Your provider checks you for infections, like toxoplasmosis, and sexually transmitted infections (also called STIs), like genital herpes and human immunodeficiency virus (also called HIV). Your provider also asks about your family health history to see if any health conditions run in your family or your partner’s family. Use the March of Dimes Family Health History Form to get started your family health history and share the form with your provider. If your provider sees that certain health conditions run in your family, she may recommend that you see a genetic counselor. This is a person who is trained 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.
• Medicines you take. Your provider will want to make sure any medicine you take is safe for your baby. This includes prescription and over-the-counter (also called OTC) medicines, supplements and herbal products. Tell your provider about any medicine you take.
• Vaccinations. 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.
• Smoking, drinking alcohol and abusing prescription or street drugs. Your provider can help you if you need help to quit. 
• Unsafe chemicals at home or work. Some chemicals, like cleaning products, paint and weed killer, can be harmful to your baby during pregnancy. Talk to your provider about how to protect yourself to help keep your baby safe.
• When to stop using birth control. Birth control (also called contraception) is the method 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. This lets your body have a few normal menstrual cycles. Having normal cycles before pregnancy can help your provider figure out your due date when you 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.
• Test your blood to check your blood type and Rh factor. Rh factor is a protein found in red blood cells. If your Rh factor is negative, it can cause problems for your baby if her Rh factor is positive.   
• 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.

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

Before pregnancy, you can have carrier screening tests that check your blood or saliva to see if you’re a carrier of certain genetic conditions. Genetic conditions are passed from parents to children through genes. Genes are parts of your body's cells that store instructions for the way your body grows and works. 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. Getting tested before pregnancy can help you and your partner look at your baby’s risk and make decisions about getting pregnant. Your partner can get tested, too. Carrier screening is your choice. You don’t have to do it if you don’t want to, even if your provider recommends it.

All women who are thinking about getting pregnant can get screened for:

• Cystic fibrosis (also called CF). CF is a condition that affects breathing and digestion. Digestion is the way your body processes the food you eat.
• Spinal muscular atrophy (also called SMA). SMA is a disease that attacks nerve cells in the spinal cord. It weakens muscles and can affect movement, breathing and swallowing.
• Thalassemias. These are blood conditions that cause the body to make fewer healthy red blood cells and less hemoglobin than normal. Hemoglobin is a protein in red blood cells.
• Hemoglobinopathies. These conditions affect red blood cells in the body.

Some women get carrier screening for certain conditions that run in families or ethnic groups. An ethnic group is a group of people, often from the same country, who share language or culture. You may want to get carrier screening if these conditions run in your family or ethnic group::  

• Fragile X syndrome. This condition happens when the body can’t make enough of a protein it needs for the brain to grow and develop. If Fragile X syndrome runs in your family, your provider may recommend carrier testing.
• Tay Sachs disease. This is a condition that causes nerve cells in the brain and spine to die. It’s more common in people who are Central and Eastern European Jewish (also called Ashkenazi Jews), French-Canadian, Louisiana Cajun or Old Order Amish of Pennsylvania.

If you or your partner are a carrier and you’re having fertility treatment called in vitro fertilization (also called IVF), you may be interested in a test called preimplantation testing (also called preimplantation genetic diagnosis or PGD). 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 test 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

• Centers for Disease Control and Prevention (CDC)
• Show Your Love Preconception Health
• Womenshealth.gov

Last reviewed September 2020