Your Pre-Pregnancy Checkup
Caring for your health before you become pregnant is good for you and your baby.
It's called preconception care. The goal is to check for any potential risks to you and your baby during pregnancy -- and to address any medical issues you may have before you get pregnant.
It's about becoming your healthiest self -- physically and emotionally -- before you take that next step into pregnancy.
You can get started by making a preconception counseling appointment with your health care provider. Here's what to expect.
What Happens at a Preconception Doctor's Appointment?
A preconception appointment is the perfect time to ask your doctor all the things that are on your mind -- whether it's your diet, prenatal vitamins, or any health concerns that run in your family.
During a preconception office visit, you and your doctor will discuss your:
- Reproductive history: This includes any previous pregnancies, your menstrual history, contraceptive use, previous Pap test results, and any sexually transmitted diseases or vaginal infections you've had in the past.
- Medical history: This includes any health problems you have now, so you can get those under control before you get pregnant.
- Surgical history: Have you had any surgeries, transfusions, and hospitalizations? If so, tell your doctor. It is especially important to inform your doctor of any gynecologic surgeries you may have had, including surgeries for fibroids or abnormal pap smears. A history of previous gynecologic surgeries may affect how you are managed during your pregnancy.
- Current medications: Tell your doctor about any prescription or over-the-counter medications you are taking or have taken. In some cases, it may be time to make a change to help prevent birth defects. Also tell your doctor about any herbal medicines or supplements you take.
- Family health history: Tell your doctor about any medical conditions that run in your family, such as diabetes, hypertension, or history of blood clots.
- Home and workplace environment: You'll talk about possible hazards -- such as exposure to cat feces, X-rays, and lead or solvents -- that could affect your ability to become pregnant or maintain a healthy pregnancy.
- Your weight: It's a good idea to reach your ideal body weight before you get pregnant. This means losing weight if you are overweight to reduce your risk of complications during pregnancy; or gaining weight if you are underweight to reduce the risk of delivering a low birth-weight baby.
- Lifestyle factors: Your doctor will ask you questions about you and your partner's habits that could influence your pregnancy, such as smoking, drinking alcohol, and using recreational drugs. The goal is to help you stop any habits that could stand in the way of a healthy pregnancy. Your doctor will keep it confidential, so feel free to be open.
- Exercise: Tell your doctor what type of exercise you do -- and if you don't work out, tell them that, too. Generally, you may continue your normal exercise routine while pregnant unless you are instructed to decrease or modify your activities.
- Diet: Your doctor will ask you about what you eat and drink. It's ideal to go into pregnancy with good dietary habits already in place. That includes eating a variety of foods rich in fiber, and getting enough calcium, folic acid, and other nutrients.
- Caffeine: Before you get pregnant, your doctor may recommend limiting caffeine to no more than 300 milligrams (mg) per day. That's about the amount in two 8-ounce cups of coffee. Remember, caffeine isn't just in coffee and tea -- it's also in chocolate, some soft drinks, and certain medications.
- Prenatal vitamins: Before you're pregnant, you should be taking a folic acid supplement. Folic acid makes it less likely that your baby will have a neural tube defect, and it's best to start taking it before you conceive. Your doctor will likely recommend taking 400 micrograms (mcg) of folic acid daily before conception and in early pregnancy.
Your doctor may also:
- Do a physical exam to evaluate your heart, lungs, breasts, thyroid, and abdomen. A pelvic exam and Pap smear may also be performed.
- Order lab tests: Some of the conditions screened for include rubella, hepatitis, HIV, syphilis, and others as indicated.
- Discuss how to chart menstrual cycles to help detect ovulation and determine the time when you are most likely to get pregnant.
- Check on your vaccinations. If you are not protected against rubella or chickenpox, your doctor may recommend the appropriate vaccines and delaying attempts to conceive for at least one month.
- Discuss genetic counseling: Genetic counseling can help you understand your chance of having a child with a birth defect. It may be advised for older mothers and people with a family history of genetic problems, birth defects, or mental retardation.