Getting ready for pregnancy: Preconception health

KEY POINTS

  • Having a healthy baby starts before you get pregnant.

  • Get a pre-pregnancy checkup to make sure your body is ready for pregnancy. At your checkup, share your family health history with your provider.

  • Take a vitamin supplement with 400 micrograms of folic acid in it each day to help prevent birth defects of the brain and spine in your baby.

  • Get to a healthy weight before you get pregnant. Eat healthy foods and do something active every day.

  • Don’t smoke, drink alcohol or abuse street or prescription drugs. All of these can harm your baby when you do get pregnant.

What is pre-pregnancy health?

Pre-pregnancy health is your health before pregnancy. Being healthy before pregnancy can help improve your chances of getting pregnant. It also can help prevent pregancy complications when you do get pregnant. Good pre-pregnancy health includes getting a pre-pregnacy checkup and talking with your health care provider about health conditions that can affect your pregnancy. It also includes taking folic acid to help prevent birth defects and making changes in your life that may affect the health of your baby when you do get pregnant.

If you’re thinking about getting pregnant, start focusing on your health at least 3 months before you start trying to get pregnant. If you have health conditions that may affect a pregnancy, you may need longer to get your body ready to have a baby.

What is a pre-pregnancy checkup?

A pre-pregnancy checkup is a medical checkup you get before pregnancy. It helps your health care provider make sure you’re healthy and that your body is ready for pregnancy. The checkup helps your provider treat and sometimes prevent health conditions that may affect your pregnancy. For example, your provider checks to make sure your vaccinations are up to date and gives you any you need before pregnancy. 

If you can, get your pre-pregnancy checkup with the health care provider you want to take care of you when you do get pregnant. You can get a pre-pregnancy checkup any time. Get one even if you’ve already had a baby. Your health may have changed since you were last pregnant. 

What is your family health history and why is it important before you get pregnant?

Your family health history is a record of any health conditions and treatments that you, your partner and everyone in your families have had. It’s a good idea to start putting your family history together before you get pregnant so you can share it with your provider at your checkup. Use the March of Dimes Family Health History Form to gather information.

Your family health history can help your provider:

  • 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, such as 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 can lower the chances of you having the same complication in your next 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 such as diabetes, high blood pressure, lupus and PKU can improve your chances of having a healthy pregnancy and a healthy baby.

What is folic acid?

Folic acid is a B vitamin that every cell in your body needs for healthy growth and development. Taking it before and during early pregnancy can help prevent birth defects of the brain and spine (also called neural tube defects or NTDs). Birth defects are health conditions that are present at birth. Birth defects 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.

To help prevent NTDs in your baby, start taking a vitamin supplement with 400 mcg of folic acid every day before you get pregnant. A supplement is a product you take to make up for certain nutrients that you don’t get enough of in the foods you eat. Start taking 400 mcg of folic acid each day at least 1 month before pregnancy and through the first 12 weeks of pregnancy. Your folic acid supplement can be:

  • A multivitamin. This is a pill that contains many vitamins and other nutrients that help your body stay healthy.
  • A prenatal vitamin. This is a multivitamin that has nutrients you need during pregnancy. Your health care provider may give you a prescription for prenatal vitamins, or you can get them over the counter without a prescription. 
  • A supplement that contains just folic acid.

Because nearly half of all pregnancies in the United States are unplanned, you should take a vitamin supplement with 400 mcg of folic acid each day even if you’re not trying to get pregnant.

If you’re at high risk for having a baby with an NTD, take 4,000 mcg of folic acid each day to help prevent an NTD. Start taking 4,000 mcg per day 3 months before you get pregnant and through the first 12 weeks of pregnancy. Ask your provider how to safely get this much folic acid. It’s not safe to take several multivitamins or prenatal vitamins because you can get too much of other nutrients, which may be harmful to your health. Your provider can help you figure out the best and safest way for you to get the right amount of folic acid. You’re at high risk if:

  • You’ve had a pregnancy with an NTD in the past.
  • You or your partner has an NTD.
  • Your partner has a child with an NTD.

You also can get folic acid from food, like fortified bread, breakfast cereal, pasta and products made from a kind of flour called corn masa, like tortillas and tortilla chips. Check the product label to see how much folic acid you get in each serving. Some fruits and vegetables also are good sources of folic acid. When folic acid is naturally in a food, it’s called folate. Foods that are good sources of folate are beans, leafy green vegetables, broccoli and orange juice. 

Does your weight before you get pregnant affect your pregnancy? 

Yes. You’re more likely to have health problems during pregnancy if you’re overweight (weigh too much) or underweight (weigh too little). These problems include:

  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. Babies born prematurely may have more health problems at birth and later in life than babies born later. 
  • Birth defects. These are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works.
  • Diabetes. Diabetes is when you have too much sugar (called blood sugar or glucose) in your blood. Too much blood sugar can damage organs in your body, including blood vessels, nerves, eyes and kidneys. Diabetes can cause problems during pregnancy.
  • High blood pressure (also called hypertension). High blood pressure is when the force of blood against the walls of your blood vessels is too high. High blood pressure can cause problems during pregnancy.

Talk to your provider about the right weight for you. Your provider may check your body mass index (also called BMI). BMI is a measure of body fat based on your height and weight. It can help you find out if you need to gain or lose weight. To find out your BMI, go to cdc.gov/bmi. Your BMI before pregnancy helps your provider figure out the right amount of weight for you to gain during pregnancy

How much physical activity do you need each day?

The Centers for Disease Control and Prevention (also called CDC) recommends that adults get 2½ hours a week of moderate-intensity activity, like fast walking, and strength-training 2 days a week. These recommendations change depending on the intensity of your workouts. And you don’t have to do all 2½ hours at once. Do a little bit each day to break it up throughout the week. 

If you’re already physically active, keep it up! If you’re starting or re-starting exercise, take it slowly. Talk to your provider before you start any physical activity if:

  • You have heart disease or are at risk for heart disease.
  • You’ve had a stroke or are at risk for having a stroke.
  • You have diabetes or are at risk for having diabetes.
  • You’re obese. If you're obese, you have an excess amount of body fat and your body mass index (also called BMI) is 30 or higher. BMI is a measure of body fat based on your height and weight.
  • It can help you find out if you need to gain or lose weight..
  • You’ve had surgery or you have an injury or disability.
  • You’ve had eye surgery or laser treatment on your eyes, or you have a bleeding or detached retina. The retina is the nerve tissue that lines the back of the eye.

Physical activity can help reduce your risk of having certain health conditions that can cause problems for you and your baby during pregnancy, such as diabetes, high blood pressure and heart conditions. It also can help you manage stress, sleep better and quit smoking.

What can you do before you get pregnant to help you have a healthy pregnancy? 

Here’s what you can do:

  • Don’t smoke, drink alcohol or take street drugs. All of these can make it harder for you to get pregnant. And they’re harmful to your baby when you do get pregnant. Tell your provider if you need help to quit. Also, stay away from secondhand smoke. This is smoke from someone else’s cigarettes, cigar or pipe.
  • Take prescription drugs exactly as your provider says. Don’t abuse prescription drugs. A prescription drug is one your provider says you can take to treat a health condition. You need a prescription (an order from your provider) to get the drug. When you take any medicine, don’t take more than your provider says you can take, don’t take it with alcohol or other drugs and don’t take anyone else’s prescription medicine. Make sure any provider who prescribes you medicine knows that you’re trying to get pregnant.
  • Protect yourself from viruses and infections that may affect pregnancy. These include toxoplasmosis and lymphocytic choriomeningitis (also called LCMV). Toxoplasmosis is an infection you can get from eating undercooked meat or touching cat poop. You can get LCMV from caring for rodents, such as hamsters, mice and guinea pigs. If you have these kinds of pets or a cat, ask someone to care for them and to clean the litter box for you. Make sure any meat you eat is fully cooked.
  • Don’t use harmful chemicals at home or work. Ask your provider if chemicals you use can affect your chances of getting pregnant or your baby’s health when you do get pregnant. Some chemicals can cause birth defects in your baby. If you work with chemicals, talk to your boss about changing job duties before and during pregnancy.
  • Reduce your stress. High levels of stress can cause problems during pregnancy, so find ways to manage stress before you get pregnant. Being active, eating healthy and getting plenty of sleep can you deal with stress. If you’re really stressed out, tell your provider. He can help you find a counselor to help you reduce and handle your stress. And get help if you’ve been abused by your partner. Abuse sometimes gets worse during pregnancy.

More information

Last reviewed: September 2020