Preconception Health

Women and men should prepare for pregnancy before becoming sexually active — or at least three months before getting pregnant. Some actions, such as quitting smoking, reaching a healthy weight, or adjusting medicines you are using, should start even earlier. The five most important things you can do for preconception health are:

1. Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning or capable of pregnancy to lower your risk of some birth defects of the brain and spine, including spina bifida. All women need folic acid every day. Talk to your doctor about your folic acid needs. Some doctors prescribe prenatal vitamins that contain higher amounts of folic acid.
2. Stop smoking and drinking alcohol.
3. If you have a medical condition, be sure it is under control. Some conditions that can affect pregnancy or be affected by it include asthma, diabetes, oral health, obesity, or epilepsy.
4. Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary or herbal supplements. Be sure your vaccinations are up to date.
5. Avoid contact with toxic substances or materials that could cause infection at work and at home. Stay away from chemicals and cat or rodent feces.

Preconception care can improve your chances of getting pregnant, having a healthy pregnancy, and having a healthy baby. If you are sexually active, talk to your doctor about your preconception health now. Preconception care should begin at least three months before you get pregnant. But some women need more time to get their bodies ready for pregnancy. Be sure to discuss your partner’s health too. Ask your doctor about:

• Family planning and birth control.
• Taking folic acid.
• Vaccines and screenings you may need, such as a Pap test and screenings for sexually transmitted infections (STIs), including HIV.
• Managing health problems, such as diabetes, high blood pressure, thyroid disease, obesity, depression, eating disorders, and asthma. Find out how pregnancy may affect, or be affected by, health problems you have.
• Medicines you use, including over-the-counter, herbal, and prescription drugs and supplements.
• Ways to improve your overall health, such as reaching a healthy weight, making healthy food choices, being physically active, caring for your teeth and gums, reducing stress, quitting smoking, and avoiding alcohol.
• How to avoid illness.
• Hazards in your workplace or home that could harm you or your baby.
• Health problems that run in your or your partner’s family.
• Problems you have had with prior pregnancies, including preterm birth.
• Family concerns that could affect your health, such as domestic violence or lack of support.

Bring a list of talking points (PDF, 182 KB) to be sure you don’t forget anything. If you run out of time at your visit, schedule a follow-up visit to make sure everything is covered.

Your partner can do a lot to support and encourage you in every aspect of preparing for pregnancy. Here are some ways:

• Make the decision about pregnancy together. When both partners intend for pregnancy, a woman is more likely to get early prenatal care and avoid risky behaviors such as smoking and drinking alcohol.
• Screening for and treating sexually transmitted infections (STIs) can help make sure infections are not passed to female partners.
• Male partners can improve their own reproductive health and overall health by limiting alcohol, quitting smoking or illegal drug use, making healthy food choices, and reducing stress. Studies show that men who drink a lot, smoke, or use drugs can have problems with their sperm. These might cause you to have problems getting pregnant. If your partner won’t quit smoking, ask that he not smoke around you, to avoid harmful effects of secondhand smoke.
• Your partner should also talk to his doctor about his own health, his family health history, and any medicines he uses.
• People who work with chemicals or other toxins can be careful not to expose women to them. For example, people who work with fertilizers or pesticides should change out of dirty clothes before coming near women. They should handle and wash soiled clothes separately.

The genes your baby is born with can affect your baby’s health in these ways:

• Single gene disorders are caused by a problem in a single gene. Genes contain the information your body’s cells need to function. Single gene disorders run in families. Examples of single gene disorders are cystic fibrosis and sickle cell anemia.
• Chromosome disorders occur when all or part of a chromosome is missing or extra, or if the structure of one or more chromosomes is not normal. Chromosomes are structures where genes are located. Most chromosome disorders that involve whole chromosomes do not run in families.

Talk to your doctor about your and your partner’s family health histories before becoming pregnant. This information can help your doctor find out any genetic risks you might have.

Depending on your genetic risk factors, your doctor might suggest you meet with a genetic professional. Some reasons a person or couple might seek genetic counseling are:

• A family history of a genetic condition, birth defect, chromosomal disorder, or cancer
• Two or more pregnancy losses, a stillbirth, or a baby who died
• A child with a known inherited disorder, birth defect, or intellectual disability
• A woman who is pregnant or plans to become pregnant at 35 years or older
• Test results that suggest a genetic condition is present
• Increased risk of getting or passing on a genetic disorder because of one’s ethnic background
• People related by blood who want to have children together

During a consultation, the genetics professional meets with a person or couple to discuss genetic risks or to diagnose, confirm, or rule out a genetic condition. Sometimes, a couple chooses to have genetic testing. Some tests can help couples to know the chances that a person will get or pass on a genetic disorder. The genetics professional can help couples decide if genetic testing is the right choice for them.