Can you promote a healthy pregnancy before getting pregnant?

This plan includes your and your partner’s plans for the number and timing of pregnancies based on your values and life goals. Sharing your life plan with your health care provider can help address any potential problems before you conceive.

You can reduce the chance that you will be diagnosed with gestational diabetes (high blood sugar diagnosed during pregnancy) by taking steps to improve your diet and lifestyle before you get pregnant. Gestational diabetes can increase the risk to your health as well as your infant’s. In addition, pre-pregnancy exercise is also associated with lower risk for gestational diabetes, and the benefit increases with more vigorous levels of exercise.

Here are some specific dietary suggestions for women who are planning for a pregnancy:

• Increase your intake of fiber. Eating 10 more grams of fiber in the form of cereals, fruits, and vegetables is associated with 26% lower risk of gestational diabetes.
• Reduce consumption of sugar-sweetened cola. Women who drank five or more such beverages per week before they got pregnant were at greater risk of gestational diabetes.
• Eat less red meat, processed meats, and animal fats and cholesterol. Eating less of these foods before pregnancy can decrease the chances of developing diabetes when you are pregnant.
• Replace animal protein with protein from nuts to lower your risk of gestational diabetes. Studies have shown that substituting vegetable protein for animal protein before pregnancy can decrease risk of gestational diabetes by about half.

Folic acid is a B vitamin (B9). It helps produce and maintain new cells. This is especially important during times when the cells are dividing and growing rapidly such as infancy and pregnancy.

The United States Public Health Service recommends that all pregnant women and “women of childbearing age [15 to 44 years] in the United States who are capable of becoming pregnant should consume [a supplement containing] 0.4 mg of folic acid per day for the purpose of reducing their risk of having a pregnancy affected with spina bifida or other NTDs.” 

Although a related form of folic acid (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid. Studies show that taking folic acid for 3 months before getting pregnant and for 3 months after conceiving can reduce the risk of NTDs such as spina bifida by up to 70%.

Ask your health care provider if you need a booster for any vaccines. Some vaccines can be given during pregnancy, but the rubella (German measles) and varicella (chicken pox) vaccines are recommended before you get pregnant.

Many health problems affect not only the pregnant woman but also the developing infant. Some examples are diabetes, hypertension (high blood pressure), infections, asthma, seizure disorders, and maternal phenylketonuria (an inherited condition in which the pregnant woman’s body can’t break down the amino acid phenylalanine, resulting in high levels in her blood). Getting health problems under control before and during pregnancy reduces the risk of miscarriage and stillbirth as well as other health problems for the infant.

During pregnancy, these behaviors can increase the risk for sudden infant death syndrome (SIDS), preterm birth, fetal alcohol spectrum disorders, and NTDs. If you are trying to quit smoking, drinking, or doing drugs and you need help, talk to your health care provider about support groups or about medications.

Advice, tips, and support to help women quit smoking (including expecting mothers) are available through the Smokefree Women website.

Obesity may make it more difficult to become pregnant. Having overweight or obesity also puts you at risk for complications during pregnancy, such as high blood pressure, preeclampsia, gestational diabetes, and stillbirth, and increases the chances of cesarean delivery.

NICHD researchers have found that obesity can increase your child’s risk of a congenital heart defect (a problem with the heart that is present at birth) by 15%. Research has also uncovered a link between obesity and NTDs.

Talk to your health care provider about what a healthy weight is for you and about a plan to help you achieve it.

Your health care provider will ask for information about your family’s genetic and health history. You may be referred for genetic counseling if certain conditions run in your family or if a family member was born with a physical abnormality or an intellectual and developmental disability.