Preconception planning can help you and your partner understand how to boost your chances of a healthy pregnancy. Here's what to expect during a preconception appointment.
By Mayo Clinic Staff
If you've decided to get pregnant, you might be emotionally prepared to have a baby — but is your body ready for the task ahead?
To help ensure a healthy pregnancy, schedule a preconception appointment with your health care provider as soon as you begin thinking about pregnancy. A preconception appointment is especially important if you're in your 30s or 40s or you have any chronic health conditions or special concerns. Be ready to answer questions like these.
If you've been taking birth control pills, ovulation is possible as soon as two weeks after you stop taking the pill — although it takes longer for some women. You don't need to take a pill-free break before trying to conceive. However, it'll be somewhat easier to estimate when you ovulated and when your baby is due if you have at least one normal period before conceiving. If you plan to wait a few months, use a backup form of birth control while your menstrual cycle gets back to normal.
If you've been using certain types of long-term birth control — such as progestin implants or injections — your return to fertility might take somewhat longer. Still, most women conceive within 12 months of stopping any type of reversible birth control.
Infections such as chickenpox (varicella), German measles (rubella) and hepatitis B can be dangerous for an unborn baby. If your immunizations aren't complete or you're not sure if you're immune to certain infections, your preconception care might include one or more vaccines — preferably at least one month before you try to conceive.
If you have a chronic medical condition — such as diabetes, asthma or high blood pressure — make sure it's under control before you conceive. In some cases, your health care provider might recommend adjusting your medication or other treatments before pregnancy. Your health care provider also will explain any special care you might need during pregnancy.
Tell your health care provider about any medications, herbs or supplements you're taking. Depending on the product, your health care provider might recommend changing doses, switching to something else or stopping the product before you conceive.
This is also the time to start taking prenatal vitamins. Why so early? The baby's neural tube — which becomes the brain and spinal cord — develops during the first month of pregnancy, possibly before you even know that you're pregnant. Taking prenatal vitamins before conception helps prevent neural tube defects.
Sexually transmitted infections such as gonorrhea, syphilis and chlamydia can interfere with your ability to conceive. These infections also pose risks to both mother and baby during pregnancy. If you're at risk of a sexually transmitted infection — or you think you or your partner might have an infection — ask your health care provider about preconception screening and treatment.
Sometimes family medical history — either your history or your partner's — increases the risk of having a child who has certain medical conditions or birth defects. If genetic conditions are a concern, your health care provider might refer you to a genetic counselor for a preconception assessment.
After 35, the risk of fertility problems, pregnancy loss and certain chromosomal conditions increases. Some pregnancy-related complications, such as gestational diabetes, are more common in older mothers as well. Your health care provider can help you put these risks into perspective, as well as develop a plan to give your baby the best start.
Your health care provider will ask about previous pregnancies. Be sure to mention any complications you might have had, such as high blood pressure, gestational diabetes, preterm labor, premature birth or birth defects.
If you had a previous pregnancy involving a neural tube defect, your health care provider will likely recommend a higher daily dose of folic acid than what's found in most prenatal vitamins.
If you have any concerns or fears about another pregnancy, share them with your health care provider. He or she will help you understand the best ways to boost your chances of a healthy pregnancy.
Healthy lifestyle choices during pregnancy are essential. For example:
- Your health care provider will likely discuss the importance of a healthy diet, regular physical activity and managing stress.
- If you're underweight or overweight, your health care provider might recommend addressing your weight before you conceive.
- It's also important to avoid alcohol, illegal drugs and exposure to toxic substances.
- If you smoke, ask your health care provider about resources to help you quit.
If possible, ask your partner to attend the preconception visit with you. Your partner's health and lifestyle — including family medical history and risk factors for infections or birth defects — are important because they can affect both you and the baby.
July 03, 2012
- Sackey JA. Preconception evaluation and counseling. http://www.uptodate.com/index. Accessed April 19, 2012.
- Hochberg L, et al. Folic acid for prevention of neural tube defects. http://www.uptodate.com/index. Accessed April 19, 2012.
- Frequently asked questions. Pregnancy FAQ060. Later childbearing. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq060.pdf?dmc=1&ts=20120419T1440124241. Accessed April 19, 2012.
- Frequently asked questions. Pregnancy FAQ056. Good health before pregnancy: Preconception care. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq056.pdf?dmc=1&ts=20120419T1446190920. Accessed April 19, 2012.
- Hatcher RA, et al. Contraceptive Technology. 19th ed. New York, N.Y.: Ardent Media; 2007:193.
- Routine prenatal care. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html. Accessed April 19, 2012.
- Zieman M. Overview of contraception. http://www.uptodate.com/index. Accessed April 19, 2012.