Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit, the AAFP patient education website.

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Am Fam Physician. 2002;65(12):2521-2522

Why is it important to prepare for pregnancy?

You probably won't know you are pregnant for the first three to four weeks. By then, your baby is already forming major organs and structures. Some medicines, illnesses, or bad habits (like smoking or drinking alcohol) can affect your baby before you even know you are pregnant. To be safe, you should act like you are already pregnant before you try to get pregnant.

When should I see my doctor?

Get a checkup from your doctor before you try to get pregnant. Your doctor will ask you and the baby's father about your medical and family histories. You can discuss your pregnancy plans with your doctor and ask questions.

Is exercise okay?

Yes. Regular moderate exercise is good for you and your baby and can be continued during pregnancy. Do not get overheated and avoid using hot tubs in early pregnancy. If you plan to do any especially vigorous forms of exercise, discuss this with your doctor first.

Should I take vitamins?

Taking 400 micrograms of folic acid (a B vitamin) every day before you become pregnant and during early pregnancy helps prevent birth defects of the brain and spinal cord. It is safe to take a daily multivitamin tablet. Avoid high doses of vitamins because they can be harmful.

Do I need to change my diet?

You should eat a balanced diet with foods rich in folic acid, such as green leafy vegetables, broccoli, oranges, and bananas. Your diet should also include enough iron and calcium. If you cannot drink milk, you can get calcium from fortified orange juice, fortified breads and cereals, or calcium supplements. Do not drink more than two cups of coffee or six glasses of tea or soda per day. Try to reach a healthy weight before pregnancy. Women who are very overweight or underweight may have more problems with pregnancy. You should not be on a weight-loss diet during pregnancy.

What else should I avoid?

You should avoid toxic substances and chemicals at work and at home. Smoking cigarettes increases your risk of miscarriage or having a baby with a low birth weight. Your doctor can help you stop smoking. Alcohol and illegal drugs such as cocaine, marijuana, and heroin can cause birth defects or other problems in your baby. If you cannot stop using drugs, ask your doctor for help.

What do I need to know about genetic diseases?

The older you are, especially if you are older than 35, the higher your risk for having a baby with Down syndrome or other genetic problems. You can be tested for some of these problems during your pregnancy.

If you have a high risk of passing a genetic disease to your baby, your doctor can refer you to a genetic counselor for education and help. People who are black or from the Middle East or India can be tested for sickle cell disease and thalassemia. If your family is from the region of the Mediterranean Sea or Southeastern Asia, you might be screened for thalassemia. If your family is of European Jewish or French Canadian origin, consider screening for Tay-Sachs disease. If you or the baby's father has a family history of cystic fibrosis or congenital hearing loss, you might be tested to see if you carry one of these traits. There are many other genetic diseases that can be detected by testing. Problems in previous pregnancies, such as repeated early miscarriages, may show a need for genetic evaluation.

What tests should I have before I get pregnant?

You should consider testing for sexually transmitted diseases (STDs), such as HIV and syphilis. Treatment can prevent you from passing a virus to your baby. Other STDs such as gonorrhea and chlamydia should be treated before pregnancy.

Do I need any immunizations?

If you are not immune to rubella, you will need a booster shot of MMR (measles, mumps, and rubella) at least one month before you get pregnant. If you have never had chickenpox, you should have two injections of this vaccine at least one month before pregnancy. You may need the series of three hepatitis B vaccines if you have not had them before. A flu shot is also recommended for pregnant women, usually between October and December.

What can I do to avoid infections?

Pregnant women should not clean a cat's litter box and should wear gloves while gardening. Pregnant women should eat meat only if it is well cooked. These precautions help protect against toxoplasmosis, an infection that can cause birth defects. Women in child care or health care jobs should wash their hands often. They should also use gloves when touching body fluids of sick children to protect from viral infections that can harm the growing baby.

What if I have health problems?

If you take any medicines regularly, ask your doctor if you can take them when you are pregnant. If you have diabetes, hypertension, asthma, or epilepsy, the condition should be well controlled before pregnancy.

When should I stop taking my birth control pills?

Discuss this with your doctor. Usually, you should stop birth control pills at least two months before trying to get pregnant. Then your periods can return and your cycles can be tracked. However, it will not hurt the baby if you get pregnant right after stopping the pill.

Can I work during my pregnancy?

Most women without special risks can work during pregnancy. Physical jobs may need to be modified during pregnancy. Sometimes, problems occur during pregnancy, and you may need to take time off from work. Be sure you understand your employer's rules about parental leave benefits as well as the maternity coverage of your health insurance plan. Consider putting money into savings to cover your expenses if you have to take time off work during pregnancy.

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Copyright © 2002 by the American Academy of Family Physicians.

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