Things you should do before you try to get pregnant

You’re thinking about trying to get pregnant? Here’s what to do now to get healthy, have fun, and feel prepared to start trying to conceive.You’ve decided to take the plunge into parenthood. Wait month or two, at least. To give yourself the best chance for a healthy pregnancy and a healthy baby, there are some important things you need to do before you head down the road to conception.

1. Schedule a preconception visit
2. Take folic acid (and watch out for vitamin A)
3. Give up drinking, smoking, and drugs
4. Stock only healthy foods
5. Give up cup of coffee
6. Get your weight in check
7. Fish can be fishy. Pay attention to the fish you eat
8. Create your own exercise program
9. See your dentist
10. Get in touch with your medical roots
11. Consider money matters
12. Find your stress remedy
13. Avoid infections
14. Reduce environmental risks
15. Figure out when you ovulate
16. Toss your birth control

1. Preconception visit

You don’t have to have a doctor or midwife lined up yet to deliver your baby. Call your ob-gyn, midwife, or family practice doctor now for a preconception checkup. Your practitioner will review your personal and family medical history, your present health, and any medications you’re taking. Certain medications are dangerous during pregnancy, and some have to be switched before you even try to conceive because they’re stored in your body’s fat and can linger there.
Your practitioner should also discuss diet, weight, exercise, and any unhealthy habits (such as smoking, drinking, and taking drugs) with you; recommend a multivitamin; make sure you’re up to date on your immunizations; test you for immunity to childhood diseases such as chicken pox and rubella; and answer any questions you have. If it’s been a year since you had a checkup, you can also expect to have a pelvic exam and a pap smear, and to be tested for sexually transmitted diseases if you’re at risk.
Many couples may also want to pursue genetic testing for specific conditions, such as sickle cell disease, Tay-Sachs, or cystic fibrosis, based on their ethnic background or family history.
2. Take folic acid
Taking a folic acid supplement is crucial. By taking 400 mcg of folic acid a day for at least one month before you conceive and during your first trimester, you can cut your chances of having a baby with neural-tube defects such as spina bifida by 50 to 70 percent, according to the Centers for Disease Control (CDC). Taking folic acid helps prevent some other birth defects as well.
You can buy folic acid supplements at the drugstore, or you can take a prenatal or regular multivitamin. Check the label on multivitamins to make sure they contain the 400 mcg of folic acid you need.
Also check to make sure that your multivitamin doesn’t contain more than the recommended daily allowance of 770 mcg RAE (2,565 IU) of vitamin A, unless most of it’s in a form called beta-carotene. Getting too much of a certain kind of vitamin A can cause birth defects.
If you’re unsure about what to take, ask your healthcare provider to recommend a supplement.

3. Give up drinking, smoking, and drugs

If you smoke or take drugs, now’s the time to stop. Numerous studies have shown that smoking or taking drugs can lead to miscarriage, premature birth, and low-birth weight babies. Keep in mind that some drugs can stay in your system even after their noticeable effects have worn off.

What’s more, research suggests that tobacco use can affect your fertility and lower your partner’s sperm count. In fact, studies have shown that even secondhand smoke may affect your chances of getting pregnant.

Alcohol can also get in the way of getting pregnant, so it’s a good idea to cut back when you start trying. Abstain altogether during the last two weeks of your cycle in case you’ve conceived. Drinking alcohol during pregnancy can cause birth defects and a host of other problems for your developing baby.

4. Stock only healthy foods
You’re not eating for two yet, but you should start making nutritious food choices now so that your body will be stocked up with the nutrients you need for a healthy pregnancy.
Try to get at least 2 cups of fruit and 2 1/2 cups of vegetables every day, as well as plenty of whole grains and foods that are high in calcium — like milk, calcium-fortified orange juice, and yogurt. Eat a variety of protein sources, such as beans, nuts, seeds, soy products, poultry, and meats.

5. Give up cup of coffee
While there’s no consensus on exactly how much caffeine is safe during pregnancy, experts agree that pregnant women and those trying to conceive should avoid consuming large amounts.
Some studies have found an association between high caffeine consumption and decreased fertility. And too much caffeine has also been linked to a risk of miscarriage in some (but not all) studies.
The March of Dimes advises pregnant women to limit their caffeine consumption to 200 milligrams per day, about the amount in one cup of coffee, depending on the brew. That would be a good goal to aim for now.
See a chart showing the amount of caffeine in various coffee brews, other drinks, and select foods, in our article on caffeine during pregnancy.

6. Get your weight in check
You may have an easier time conceiving if you’re at a healthy weight. Having a low or high body mass index (BMI) makes it harder for some women to become pregnant. (In one study, having a BMI below 20 or over 24 negatively affected fertility.) Calculate your BMI.

If you’re not in a healthy range, losing or gaining weight may give you the boost you need to conceive. Getting to a healthier weight can also help you get your pregnancy off on the right foot. Talk to your healthcare provider about the best way to achieve your weight goals.

7. Fish can be fishy
If you’re a big fan of fish, start watching your intake. While fish is an excellent source of omega-3 fatty acids (which are very important for your baby’s brain and eye development), as well as protein, vitamin D, and other nutrients, it also contains mercury, which can be harmful.
Most experts agree that pregnant women should eat some fish, and that the best approach is to avoid those fish that are highest in mercury and limit your consumption of all fish. The FDA recommends that women of childbearing age not eat shark, swordfish, king mackerel, or tilefish, and eat no more than 6 ounces (1 serving) of solid white canned tuna per week. Other experts suggest a longer list of fish to avoid. It’s also a good idea to avoid fish you’ve caught in local waters unless you’re certain there are no contaminants.
The FDA and EPA recommend that pregnant women eat up to 12 ounces (2 servings) a week of fish that are not high in mercury. (Good choices include herring, farm-raised rainbow trout, salmon, and sardines.)

8. Create your own exercise program
Start and stick to a fitness plan now, and you’ll be rewarded with a healthy body that’s fit for pregnancy. Plus, working up a little sweat is a great way to relieve the stress that can get in the way of getting pregnant.

A healthy exercise program includes 30 minutes or more of moderate exercise, such as walking or cycling and weight training, on most days of the week.
To increase flexibility, try stretching or yoga, and you’ll have a really well-rounded fitness program. Once you’re pregnant, it’s okay — even recommended — to continue exercising. (That’s unless if you have pregnancy complications and have been told not to, of course.)

If exercising hasn’t been a priority for you lately, you’ll need to ease into an exercise routine. Start with something tame, like walking ten to 20 minutes a day. Add more activity into your daily routine by taking the stairs instead of the elevator or parking your car a few blocks away from work.

9. See your dentist
When you’re preparing for pregnancy, don’t forget about your oral health. Hormonal shifts during pregnancy can make you more susceptible to gum disease. Increased progesterone and estrogen levels can cause the gums to react differently to the bacteria in plaque, resulting in swollen, red, tender gums that bleed when you floss or brush.
The good news is that women who take care of their periodontal health before they get pregnant cut down on their chances of experiencing gum complications in pregnancy. See your dentist for a checkup and a cleaning now if you haven’t done so in the last six months.

10. Family Roots
Find out what you can about your and your partner’s family medical history, including any genetic or chromosomal disorder like Down syndrome, sickle cell anemia, cystic fibrosis, Tay-Sachs disease, or bleeding disorders. You’ll also want to know if any relatives have mental retardation or other developmental delays or were born with an anatomical birth defect, like a cardiac or neural tube defect.
Your practitioner will ask you a series of questions at your preconception visit, and your answers will help determine whether specific prenatal tests should be recommended, or if you or your partner should consider genetic counseling before you even start trying.

11. Save the money
According to a 2009 report from the U.S. Department of Agriculture, families in the middle-income group will spend $286,050 to raise a child from birth through age 17. Find out how much you’re likely to spend with our Cost of Raising a Child Calculator.
For the more immediate future, you’ll want to consider the cost of pregnancy and delivery. Without insurance, a typical vaginal delivery can cost about $9,000 and a cesarean section about $15,000. Neonatal intensive care can cost $2,000 to $3,000 a day.
If you have health insurance, give the company a call and find out what kind of prenatal coverage they offer. If you’re lucky enough to have a choice of plans, compare coverage and providers. If you have a particular doctor or midwife in mind, find out if she’s in your plan or how much it would cost to go out of network for her care.
Find out what your deductibles are for prenatal visits and delivery, and ask what tests and procedures your insurance covers. If you have a high deductible, try to put a little aside now so you won’t be slammed with exorbitant bills when the baby arrives.

12. Find your stress remedy
Women who suffer from depression are twice as likely to have problems with fertility as women who don’t, according to Alice Domar, director of the Domar Center for Mind/Body Health at Boston IVF. As she points out, “If someone is clinically depressed, she can barely take care of herself, much less a baby. From an evolutionary point of view, it makes sense that it’s hard to get pregnant when you’re depressed.”

Domar suggests that all women, but especially those with a personal or family history of depression, do a mental health check before they get pregnant. If you notice signs of depression, such as a loss of interest and pleasure in things that you used to enjoy, a change in appetite, a change in sleep pattern, a loss of energy, or feelings of hopelessness and worthlessness, ask your practitioner for a referral to a therapist or psychiatrist for a consultation.
The two most effective treatments for depression are cognitive-behavioral therapy (CBT) and medication, and many patients do best with a combination of both. If medication becomes necessary, a psychiatrist can help you find an antidepressant that’s safe to take while you’re trying to conceive and during your pregnancy. You also may want to try stress management techniques, such as yoga and meditation, which research suggests can help depressed women conceive.

13. Avoid infections

It’s important to steer clear of infections when you’re trying to get pregnant, especially those that could harm your baby-to-be.

You’ll want to stay away from certain foods such as unpasteurized soft cheeses and other dairy products, cold deli meats, and raw and undercooked fish and poultry. These foods can harbor dangerous bacteria that cause listeriosis, a food-borne illness that can lead to miscarriage or stillbirth. You should also avoid unpasteurized juices because they can contain bacteria such as salmonella or E. coli.
Be sure to wash your hands frequently when preparing meals, and make sure your fridge is set between 35 and 40 degrees Fahrenheit (2 and 4 degrees Celsius) and your freezer is at or below 0 degrees F (-18 degrees C) to keep cold foods from going bad.
It’s a good idea to wear gloves when digging in the garden or sandbox, and to get someone else to change the litter box to avoid contracting toxoplasmosis, another infection that can be dangerous for a developing baby.
Finally, make sure you get a flu shot, to avoid coming down with flu when you’re pregnant. Get vaccinated as soon as the vaccine for the coming season becomes available. Getting the flu while pregnant can lead to serious complications, such as pneumonia and preterm labor.

14. Reduce environmental risks
You may not be able to entirely eliminate all environmental dangers, but you can do your best to keep as many of them as possible out of your life now. Some jobs can be hazardous to you and your unborn children, for example. If you’re routinely exposed to chemicals or radiation, you’ll need to make some changes before you conceive.

Also, keep in mind that some cleaning products, pesticides, solvents, and lead in drinking water from old pipes can be dangerous for a developing baby. Talk to your doctor or midwife about your daily routine, and see if you can come up with ways to avoid or eliminate hazards in your home and workplace.

PictureCaption:BEVERLY HILLS, CA – MAY 6: Students play ball at Beverly Hills High School within sight of a 165-foot-tall oil well decorated with flower designs in 2000 by children suffering from cancer and other serious diseases May 6, 2003 in Beverly Hills, California. Abandoned wells on the campus of the school allegedly leak cancer-causing fumes, according to a complaint filed by Erin Brockovich and legal colleague Ed Masry. The action by Brockovich, whose fight against environmental pollution inspired the film that won Julia Roberts an Academy Award, alleges that the fumes have created a cancer cluster of 280 cases of Hodgkin’s disease, non-Hodgkin’s lymphoma and thyroid cancer since the 1970s, a rate that is 20 times higher than the national average. Masry’s firm is representing 25 personal-injury claims against the school district and Beverly Hills.

15.Figure out when you ovulate
Some women simply stop using birth control when they’re ready to get pregnant and let fate decide when they’ll conceive. Others take a more calculated approach by charting their periods and tracking symptoms to try to pinpoint their fertile days each month.
Use our ovulation calculator to get a rough estimate. If you want to be more exact, start charting your basal body temperature (BBT) and the changes in your cervical mucus. Tracking these symptoms over several months can help you figure out when you’re ovulating during each cycle.

Ovulation predictor kits can also help you figure out when you’re ovulating by detecting hormones in your urine, or changes in chloride in the saliva or on the skin, that signal ovulation is about to occur. These kits cost $10 to $50 per cycle and are available at drugstores.

16. Toss your birth control
Are ready to bid adieu to birth control. For some people, ditching contraception is as easy as moving the condoms or diaphragm to the back of the dresser drawer. But going off hormonal contraception can require a bit more planning.

If you’ve been using the Pill, for example, you may want to finish your current pack to avoid irregular bleeding. It may take a few months for your cycle to return to normal, but many women are fertile the first month after they stop taking the Pill. Some become fertile almost immediately. The same holds true for the contraceptive patch and ring.
Some practitioners recommend using a barrier method (such as a condom) until you have a normal period after stopping the Pill, the patch, or the ring. Waiting until you have a normal period can help you establish a more accurate due date and schedule any tests you plan to have in your first trimester. (It’s a good idea to start keeping track of your cycles now, if you don’t already. You can simply mark on a regular calendar any days you have bleeding.)
If you do get pregnant before your periods become regular again, don’t be concerned. You can have an early ultrasound to date your pregnancy.
Good luck!

PICTURE Caption:PARIS, FRANCE – JUNE 24: Elena Perminova and her kids Nikita (L) and Egor attend the Baby Dior Boutique Opening at Village Royal on June 24, 2014 in Paris, France.