Every time a baby is born, as doctors, we think about our pregnant patients and wish they would have reached out to someone to talk to before their pregnancy to tell them more about getting pregnant and having a healthy baby ... even before trying to conceive.

The best time to start your pre-trimester pregnancy preconception prep is at least 2-3 months before pregnancy, during the pre-trimester period. Here is a handy preconception checklist.

There is a lot to know before getting pregnant. Knowledge is power. Here are the things we wish our patients had known before getting pregnant.

See your doctor first

See your doctor first (both of you) for a preconception visit including pre-trimester tests. The pre-trimester, the time prior to conception, is a time of preparation. When you see your doctor, certain tests can be performed based on your history and the doctor's examination.

For example, if you think there is a possibility that you have a sexually transmitted disease, it is best to find out as soon as possible because it can affect not only your chances getting pregnant but also the development of the pregnancy. Some medical issues and infections are treatable, and treatment should optimally be completed prior to conception. Make sure you get vaccinations before pregnancy. Consult a genetic counselor if indicated.

Learn what tests are offered during pre-trimester/preconception period.

Learn everything

When you are trying to conceive, there is a lot of information you have to learn about pregnancy that you never thought you would. First of all, it is very important to begin a healthy lifestyle at least three months before you start trying to conceive. Making sure both your (and his) body and mind are in the best shape will improve fertility, decrease the risks of miscarriage and birth defects, and decrease pregnancy complications.

Start a prenatal vitamin before getting pregnant

Women trying to get pregnant should take a daily prenatal vitamin supplement which should include folic acid. Megavitamins should not be taken because they contain double or even triple the recommended daily allowances of vitamins and minerals. High doses of vitamin A have been implicated in producing birth defects. The best idea is to avoid megavitamins and instead follow the recommendation that has proven benefit: take a prenatal vitamin containing folic acid.

Start taking folic acid before conceiving

Start taking a prenatal vitamin supplement with folic acid and Omega-3 at least 1-2 months before pregnancy. Folic acid intake in the mother prior to and during pregnancy has been shown to reduce the risk of birth defects involving the brain and spinal cord.

The United States Public Health Service recommends folic acid for all women of child-bearing capacity. Studies have shown that if folic acid is begun at least 4 weeks prior to conception, the risk of birth defects of the spinal cord and skull can be reduced by more than 70%.

In women with or even without a history of having infants with birth defects of the spinal cord or skull, folic acid should be taken one month before conception and continued through the 12th week of pregnancy. In fact, continuing prenatal vitamins through pregnancy and even though nursing is probably wise. These prenatal vitamins are available over-the-counter. If a particular brand makes you feel nauseated, simply switch to another brand or try taking the vitamin at night.

Healthy food is important even before pregnancy

Healthy food is important. It's a fact: It is important to eat well-balanced meals at all times, but this is even more essential when you are trying to get pregnant, and during pregnancy. Many nutrients including vitamins and minerals are needed for the proper development of the baby. You should eat the right foods and keep away from the wrong ones. Most foods are safe; however, there are some foods that you should avoid during pregnancy. Some foods are safe and others are not safe during pregnancy because changes in hormones can cause a woman's immune system to become suppressed. Avoid certain foods like undercooked meat, and deli food (they can transmit toxoplasmosis or listeria).

It takes two

The pre-trimester (or time of preconception) is not just for women but for men, too. A man plays a large part in the pre-trimester period. His health prior to conception is essential for the chances of getting pregnant and having a healthy baby. There are many things men should and can do, not only for their own health but also for the women and children in their lives. Not only women have to consider the health of their bodies before conception, during the pre-trimester — men also need to get life in order and start working toward a healthier, happier body and life.

Improve his health

His pre-trimester of the pregnancy is important, too! Many of the same changes women should make prior to conceiving are mirrored in suggestions for men. Taking a couple’s approach to preconception health may make it easier to adopt lifestyle changes. Every man needs a check-up once a year even if they feel healthy. Yearly check-ups and physicals help doctors keep an ongoing medical record of overall health. You may not notice small changes in blood pressure, blood glucose or cholesterol, but your doctor can quickly compare test results from this year to previous years to recognize changes. Early detection of health conditions is the best way to head off long-term disease and chronic illness.

Improve her health

Physical pregnancy may last 40 weeks or about nine months, but preparation for that journey starts months or years in advance with the pre-trimester period. Try to get to your optimal health. Simple changes to diet and lifestyle may take days or weeks to complete, but other health issues can take longer to resolve. Your preconception health is extremely important to your pregnancy health. Learn what you should increase, cut down and cut out completely in your diet and lifestyle before you get pregnant. 

Be at your optimal weight

Both extremes, underweight or overweight, can impair your health and fertility and may have an adverse effect on your pregnancy. Having a healthy body weight helps maximize fertility success rates. Weight fluctuations either 20% above or below a woman's target range can disrupt estrogen levels which regulate ovulation. To figure out if you are at your optimal weight calculate your body mass index (BMI). The optimal number for a BMI between 19.5-24.9 (for both of you).

Find out if you need to see an infertility specialist

Sometimes you have tried getting pregnant for a year only to find out you should have seen an infertility specialist right at the beginning. If you are under 35 and you did not get pregnant within one year, or 35 and over and did not get pregnant after 6 months, or if you have any medical issues, you should see an infertility specialist. Take the Infertility Specialist Test to find out if you should see an infertility specialist (reproductive endocrinologist) now.

Prescribed medication, OTC, and herbs

Review all your medications including over-the-counter and herbs. It is a safe assumption that the medications deemed unsafe for use during pregnancy are also unsafe while you are trying to conceive (TTC), also referred to a preconception. Schedule an appointment with your obstetrician and bring every medication you are currently taking – prescription, supplement and over-the-counter. Your doctor will likely give you guidance for common medications and even some less common over-the-counter products, but supplements are a different story.

Stop smoking, drugs, and excessive drinking

Stop smoking, drinking alcohol, or taking street drugs. Both of you have to stop smoking. Studies have shown that smoking ten or more cigarettes per day has a negative effect on egg production. In men, cigarette smoke constricts blood vessels which in turn negatively effects sperm by altering oxygen consumption and nutrient intake. Alcohol and caffeine can similarly affect hormones and the ability to conceive.

When to stop birth control

Some women spend many years on birth control because they want to wait until the perfect time to get pregnant. Once they have decided that time has arrived they can often be impatient for the pregnancy to begin. Do you really have to wait to get pregnant after stopping the pill? While it is impossible to predict exactly when you will get pregnant there are a few norms to be aware of so you will be able to have realistic expectations.

Find out the best time to get pregnant

With every menstrual cycle, a woman has a 25% chance of becoming pregnant if she’s having unprotected sex, ovulates regularly and if the man has enough sperm. It may take a few months to actually get there. It is therefore important to find out the best time to get pregnant during your menstrual cycle.

See your dentist before conception

Gum disease that's not treated has been associated with adverse pregnancy outcome such as preterm deliveries. Getting regular checkups ensures that your teeth won't have an adverse effect on your pregnancy. So see your dentist before getting pregnant and take care of all the issues.

Make sure your insurance is up to date

One of the many things you may worry about when you find out you're pregnant are your finances, and right at the top of the list comes being able to pay for prenatal care, labor, and delivery. Will your health insurance cover pregnancy? What if you don't have health insurance? Your pregnancy may become expensive. Having all the proper tests done, seeing a doctor, hospital bills, baby bills. Learn everything you need to know in the pregnancy and maternity insurance guide

Find a great doctor and hospital

Finding a good hospital for maternity is among the top priorities for pregnant couples to ensure optimal care for both mom and baby. There are many things to consider such as doctor privileges, the average length of stay, number of patients on the floor, and the nurse-to-patient ratio. You should also find out if private rooms are available if night visitors are allowed, and what the NICU is like, should you need it. Learn the 12 tips on finding a good hospital and maternity unit.

Try to relax

Hormones like cortisol or epinephrine which rise and often remain high during times of chronic stress play a key role in allowing some women to get pregnant when they couldn't get pregnant before. Different women may respond to stress in different ways and this may impact fertility in different ways. Learn more about exactly why you need to relax to get pregnant and how to do it.

Read More:
The Pre-Trimester: All You Need To Know
Pre-Trimester Checklist