Your doctor will review your general health. Do you have any problems that will need special care during pregnancy? Depression, epilepsy and high blood pressure are all examples. If you are at risk of a disease like diabetes, your doctor might suggest testing. Some medical problems can make it harder to get pregnant. If this happens, your doctor may be able to suggest measures that can help.
If you take any medications, make sure they are still safe to take when you are pregnant. If they are not, change to a safer medication before getting pregnant. This is important, as much of the harm that medications can do to your baby can happen very early, even before you know you are pregnant. By changing to a different medication before pregnancy, you avoid exposing your baby to possible damage in those first few early weeks. You also have time to check that the new medication works well for you, so that you are as healthy as possible when your pregnancy starts.
Let your doctor know about any over-the-counter medications or herbal products you use, to be sure that they are safe during pregnancy.
If you are not already taking vitamins, your doctor will probably suggest that you start. The most important one is folic acid, which helps to prevent problems called neural tube defects. These disorders include spina bifida, a serious condition where babies are born with a hole over their spinal cord. You can take folic acid by itself, or in a prenatal vitamin that has folic acid in it. How much you need depends on factors like your weight and whether you have had a baby with spina bifida before. Your doctor can advise you. It is best to start taking folic acid at least three months before you get pregnant.
Nearly everyone should take vitamin D supplements, especially women planning a pregnancy. A good dose for most people is 2000 IU per day. Some people need more. Your doctor can tell you if this is true for you. While taking the right vitamins is important, it is best not to overdo it. Some vitamins, like vitamin A, can be dangerous if too much is taken in pregnancy. If you take more than one type of tablet containing vitamin A, it is easy to get too much. Be sure your doctor knows about all of the vitamins you are taking, and checks that you are taking the right amount.
Depending on your medical history, your doctor may also suggest testing your immunity. Certain diseases, including chicken pox (varicella) and German measles (rubella), can be very serious if they happen during pregnancy. Although there are vaccines for both of these diseases, vaccination is not safe if you are already pregnant. It is best to test your immunity while you are still planning pregnancy. If you do need the vaccines, you can get them before your pregnancy starts. This way, you will not have to worry about catching these dangerous diseases during your pregnancy. (If you are already immune, you do not need the shots.)
If you have not had at least one dose of the pertussis (whooping cough) vaccine as an adult, you should also have this shot. Pertussis is a common disease that is dangerous for babies to catch. Protect yourself so that you do not get sick and pass the illness on to your baby. The pertussis vaccine is safe in pregnancy, but it is better to get it before you get pregnant if possible. This vaccine is given together with the tetanus and diphtheria vaccines.
Are there genetic diseases in your family, such as cystic fibrosis, sickle cell disease, thalassemia, or any other inherited condition? How about the family of the father-to-be? If so, your doctor can help you decide whether to have genetic testing before you get pregnant. If testing is available, it might help you figure out if you or the baby’s father has the genes for the disease. It may be that you do have the genes, even if you are not sick. The tests can tell you how high the risk is that your baby might have the disease. If you and the baby’s father are blood relatives, such as cousins, you also have a higher risk of having a baby with a genetic disease. In this case, you may want to talk to your doctor about genetic testing.
Your doctor is likely to give some other advice. If you smoke, drink alcohol, or use any illegal drugs, your doctor will suggest that you stop before trying to get pregnant. If you have trouble stopping, cut back as much as you can. Ask your doctor for help with quitting. Many programs can help, and there are even some medications you could try. Smoking, alcohol and drugs can all harm your baby – even in the first few weeks before you know you are pregnant. Many women continue their habits until they get a positive pregnancy test, and spend the rest of the pregnancy worrying. You can save yourself a lot of grief if you stop now.
Stop using any unnecessary chemicals now, and avoid exposure to pesticides and other chemicals, as they can cause birth defects. (See the article about pesticides on page <?> of this magazine.) Learn to live with the dandelions. In a few years, your child may be picking a bouquet of them for you! If you use dangerous chemicals at work, check your employer’s Materials Safety Data Sheets to see if they are safe for pregnant women. If not, avoid them when you are trying to get pregnant.
Even before you are pregnant, it is important to eat a healthy diet. Eat lots of fruit and vegetables, and be sure to have some foods with iron. Whole grains are a good idea as well. Some types of fish contain omega-3 fats that help with babies’ brain development. Salmon is one of the healthiest and safest fish for pregnant women to eat. If you like it, try to have it once a week if you can. Stay away from most ‘junk foods,’ and avoid raw or undercooked meat and fish.
Your doctor will probably measure your height and weight, and can tell you if your weight is healthy. Being overweight or underweight can cause problems in pregnancy. It can even make it harder to get pregnant. If you are overweight, try to get to a healthier weight now. Dieting and weight loss are not safe in pregnancy. If you are underweight, gaining weight now will help your baby to grow well. Your doctor can make suggestions or refer you to a dietitian for advice.
Do not be surprised if your family doctor asks you about violence in your family. Your home needs to be safe, both for you and your new baby. If you are being abused, it might get even worse if you get pregnant. If you are being hurt or threatened, talk to your doctor about it.
It is a good idea to start keeping track of your periods. Each month, write down what day your period starts. When you get pregnant, this information will be very helpful in figuring out your due date.
Many people do not know that healthy teeth are an important part of overall health. Diseased teeth have a lot of bacteria, and can cause inflammation that affects the rest of the body. Pregnant women who have healthy teeth have healthier pregnancies. Have a check-up with your dentist before you get pregnant. Some dental procedures, such as x-rays, are safer when you are not pregnant. As well, if any problems are found, they can be fixed before your pregnancy starts.
You can see that there are many aspects of planning a pregnancy you need to discuss with your doctor! Fortunately, there is much you can do before you get pregnant to prepare for a healthy pregnancy and baby.