Deciding When to Have a Baby

Medically Reviewed by Traci C. Johnson, MD on June 21, 2016
4 min read

Picking colors for the baby’s room is fun, but here are some practical tips you’ll want to think about before you consider getting pregnant.

Get healthy. "The No. 1 thing I tell women is health, health, health. I would love her to time the pregnancy for when she is healthiest," says Jeanne Conry, MD, PhD, president of the American Congress of Obstetricians and Gynecologists. "For a woman who is overweight or obese, the No. 1 factor for predicting a healthy baby is how healthy she is."

Before you get pregnant you should shoot for a body mass index (BMI) of less than 30. Being overweight can raise your chances of a condition called preeclampsia, or can cause other health problems such as high blood pressure or gestational diabetes. Now's the time to make sure you exercise, eat healthy, and lose any extra pounds. If you smoke, drink, or use illegal drugs, stop.

Make a plan. Meet with your doctor for a pregnancy planning checkup. If you have any underlying health problems like diabetes, high blood pressure, asthma, or depression, get them under control. Talk to your doctor about medications you take -- prescription or over-the-counter -- including supplements. They will probably suggest a prenatal vitamin or multivitamin with at least 1,000 micrograms of folic acid as soon as you start thinking about becoming a mom. Folic acid helps prevent major birth defects of a baby's brain and spine, and you need to start taking it before you get pregnant. The minimal folic acid supplementation is 400 micrograms a day starting prior to pregnancy.

Vaccinations and tests. Make sure you're up to date on vaccinations like measles, chickenpox, tetanus, diphtheria, pertussis, and the flu. If you're unsure whether you've had the vaccines, your doctor can do a simple blood test to check. In any case, it won't hurt to get them again. Your doctor may also want to do screening tests for genetic conditions like cystic fibrosis. This would be a good time to talk to you doctor to see if any prepregnancy screening tests are right for you.

Life events. What's going on in your life? Career? School? Other kids? Sometimes it's hard for a woman to figure out when to take a break from a career or other responsibilities.

Balancing lifestyle demands with the idea of adding to your family can be tough, which can lead to stress, Conry says.

"You don’t ovulate regularly when you're under a lot of stress," says Andrea Zuckerman, MD, chief of women's care at Tufts Medical Center. "If you're going through something that's taking up a lot of time and energy, you can't concentrate on pregnancy by exercising and eating right."

Financial health. You don't have to be rich to have a baby, but it helps to have a job and some money in the bank. According to the USDA, you can spend roughly $12,000 on child-related expenses during the first year of your baby's life. Think diapers, car seat, high chair, child care, and doctor visits. And until that kid turns 18? You can expect to spend somewhere around $241,080 -- and that doesn't include college.

It's a good idea to make sure you and your baby will be covered by health insurance. Under the Affordable Care Act, insurance plans have to cover maternity and newborn care before and after your baby is born. If you work, check with your boss to see if you'll get time off with pay when the baby is born.

Age and family planning. Your chances of getting pregnant fall you get older, so experts suggest you try before you turn 35 if you can. There's also a higher chance of having a baby with Down syndrome or other genetic problems the older you get.

There are many exceptions, of course.

"I see a lot of patients who are older than in the past and are having their first child. Today it's not uncommon to see women have their first child in their late 30s or early 40s," says Shari Lawson, assistant professor at Johns Hopkins University School of Medicine. "If you are healthy, you can have a healthy pregnancy."

If you want to have several children, plan on trying to space them at least 18 months apart, Lawson suggests. "That gives you the opportunity to bond with your first child, breastfeed, and also to get back to your pre-pregnancy weight and make sure you haven’t developed any medical conditions."

Don’t let the stress of deciding when to get pregnant get to you. "We plan so many things in our lives, but you can't necessarily plan when you get pregnant," Zuckerman says. It is, however, best to be as prepared as possible.