A 3-Month Guide to Preparing for Pregnancy

If you're reading this, chances are you're thinking about having a baby soon. But before the serious baby-making efforts begin, check out this get-ready-to-get-pregnant guide.

Already started trying? No problem. It's never too late to make lifestyle changes that will improve your health and the health of your future child.

3 Months Before

Most experts agree that a great first step in trying to conceive is scheduling a physical with a health care provider. During this pre-conception checkup, your provider can advise you on things to expect as you plan for pregnancy, like stopping birth control, determining what medications are safe, and managing any health conditions. In addition, this is an excellent time to get to the dentist.

Schedule a checkup

Since it takes two to do the reproductive tango, you should schedule a pre-conception checkup for yourself and your partner. During this exam, your health care provider will review your and your partner's health histories among other routine health checks.

"Understanding patients' gynecological history and past pregnancy experiences can be very important in helping them plan healthy pregnancies," says John R. Sussman, M.D., associate professor in the department of obstetrics and gynecology at the University of Connecticut School of Medicine.

The health care provider may also verify that your immunizations are up-to-date at this exam. Chickenpox and rubella are the two main ones to concern yourself with now. If you're not immune to both diseases, it's ideal to receive these vaccines three months before trying to conceive. That's because both are "live" vaccines, so they're not recommended during pregnancy.

Clean out your medicine cabinets

Your medicine cabinet is probably filled with over-the-counter medications you take for headaches, allergies, or constipation, and perhaps a variety of herbal products, too. Now is the time to start thinking about what's in there. Some of these products contain ingredients that could affect fertility or harm your fetus. A pre-pregnancy appointment is a good time to ask a health care provider about what's safe once you start trying to conceive.

Learn about stopping your birth control

If you're using a barrier birth control method, such as condoms or a diaphragm, you can continue to use it until the day you officially start "trying." But if you're on the birth control pill or other hormonal forms of contraception, you might want to switch to a barrier method of contraception now.

Even though some people begin ovulating almost immediately after stopping oral contraceptives, for others, it may take several months. Injectables, like Depo Provera, can take even longer, and contraceptives like the implant or IUD require a visit to the doctor to remove.

Visit the dentist

Gum disease is associated with preterm delivery, so see a dentist to ensure you're in good dental health before getting pregnant. If you need dental treatments, X-rays, or medications, it's also optimal to take care of those before getting pregnant.

Consider on-the-job safety

If you're concerned about workplace exposures or risks—such as harmful chemicals, prolonged standing, or even intense stress—talk to your employer, and do some research. Accommodations like a different workstation or a chair could be simple solutions to exposure and stress on the job. Of course, your partner should also do some digging about their potential work exposures, too.

Ensure chronic health conditions are managed

If you have chronic health conditions such as high blood pressure, thyroid disease, diabetes, epilepsy, heart disease, or lupus, you'll need to manage them before and during pregnancy carefully. For example, with diabetes, the odds of having a healthy pregnancy and baby increase if you can get your blood sugar under control before becoming pregnant.

A pre-conception checkup should include a test for diabetes if the health care provider suspects you may be at risk. Current or past depression, anxiety, or mood disorders should also get special attention.

2 Months Before

Once you get through medical appointments and consult with health care providers, you can focus on simple ways to improve your fertility and overall health. Evaluate your nutritional intake and activity level to ensure you are in the healthiest place to start a pregnancy.

Up your vitamins and veggies

The U.S. Department of Agriculture (USDA) uses "MyPlate" to recommend balanced meals made up of vegetables, fruits, grains, and proteins. So, evaluate how your nutrition aligns with these recommendations and make adjustments to include more of the food groups you might be lacking. In addition, some health care providers recommend taking a prenatal vitamin when you start trying to conceive.

One of the most critical ingredients in your multivitamin supplement is folate or folic acid. The American College of Obstetricians and Gynecologists (ACOG) recommends taking a vitamin that includes 400 micrograms (mcg) of folic acid daily to reduce the risk of neural-tube defects such as spina bifida in babies.

However, if you previously had a baby with a neural tube defect, they recommend approximately 10 times that amount, or 4 milligrams (mg), starting three months before pregnancy. So, talk to your health care provider to ensure you take the right amount for you.

Assess your weight

According to ACOG, having excess weight is a risk factor for certain pregnancy-related complications. These complications include high blood pressure, preeclampsia, gestational diabetes, and obstructive sleep apnea. As a result, if you have excess weight or obesity, ACOG recommends losing weight before pregnancy to reduce these pregnancy-related risk factors.

Of course, being underweight carries risks, too. According to the Department of Health and Human Services Office on Women's Health, people who are underweight are more likely to experience fertility problems, go into preterm labor, and have a low-birth-weight baby.

Remember, plenty of people with a wide variety of body types and weights have healthy pregnancies. So, try to look at improving your nutrition and physical activity as holistic goals rather than weight-related goals.

Get with the (fitness) program

If you already have a regular fitness routine, by all means, continue it (unless you are into marathons or extreme sports, in which case you should consult a health care provider to make sure your activities are safe and don't negatively affect your fertility).

If you've been more into the couch than cardio, consider starting a program now that you can continue throughout your pregnancy. Being physically active when you're pregnant can help relieve pregnancy aches and pains. It also boosts your energy, helps you sleep, improves your mood, helps you cope with stress, and can help prepare your body for labor.

1 Month Before

One month before getting pregnant, evaluate what less-than-healthy habits you can eliminate, like smoking and drinking. In addition, this is a great time to cut back on your caffeine consumption.

Kick your smoking habit

"There are so many things you don't have the ability to change to maximize your chances of having a healthy baby. Smoking is one thing you can change," says Arlene Cullum, M.P.H., of the Sutter Medical Center in Sacramento, California.

According to the Centers for Disease Control and Prevention (CDC), smoking carries pregnancy-related risks, including fertility problems, fetal growth restriction, preterm delivery, fetal lung and brain damage, abnormal bleeding during pregnancy and birth, certain congenital disorders, and sudden infant death syndrome (SIDS).

If you don't smoke but your partner does, tell them it's time to quit. That's because secondhand smoke also increases pregnancy-related risks. For example, a 2021 study on secondhand smoke exposure in pregnancy found that fetal risk factors were similar to gestational parent smoking. Specifically, compared to those who were not exposed, babies exposed to secondhand smoke in utero were twice as likely to be born with low birth weight or low birth length.

Stop drinking alcohol

No one has ever been able to determine a safe level of alcohol consumption during pregnancy, so ACOG recommends that you stop drinking once you start trying to conceive and during pregnancy. According to the March of Dimes, people who drink during pregnancy face an increased risk of premature birth, fetal brain damage, fetal alcohol spectrum disorders (FASD), miscarriage, stillbirth, and low birth weight.

Quitting alcohol can be easier when your partner joins you in abstaining. Not only is it a supportive thing to do, but alcohol can also negatively affect male fertility. So quitting is a good idea for gestational and non-gestational parents alike.

Limit caffeine consumption

You don't have to cut out caffeine entirely, but now is an excellent time to evaluate your intake and reduce consumption. That's because excessive intake (more than 300 mg daily) has been linked to fertility problems and an increased risk of miscarriage, preterm delivery, and low birth weight, so moderation is key.

ACOG recommends limiting caffeine to no more than 200 mg daily, which is about two 8-ounce cups of brewed coffee, two shots of espresso, or four 8-ounces cups of black tea.

Start Your Engines!

Once you're actively trying to conceive, you should take a few more steps to stack the odds of a healthy pregnancy in your favor.

Find out which foods are safe

Experts recommend that you steer clear of certain foods during pregnancy and while trying to get pregnant. While seafood can be a healthy part of a pregnancy diet, you should avoid fish that are high in mercury such as mackerel and swordfish to reduce the risk of heavy metal toxicity.

In addition, to limit the risk of listeria infection, ACOG recommends avoiding undercooked meat or seafood, deli meats, all foods made with raw or lightly cooked eggs, unpasteurized soft cheeses, unpasteurized milk and juices, and raw vegetable sprouts. Some herbal teas are also not considered safe during pregnancy, so discuss herbal teas with a health care provider first.

Delegate the dirty (and unsafe) work

If possible, ask others to handle chores that are unsafe during pregnancy, such as painting, using solvents or pesticides, and cleaning the cat box or rodent cage. If you have to do these chores yourself, be sure to ventilate the room well, wear gloves, and wear a mask.

Keep sperm healthy

Wearing boxers promotes a lower scrotal temperature (and hence a more sperm-friendly environment) than wearing briefs. So, if possible, have your partner switch to boxers while trying to conceive. In addition, sperm will benefit from keeping the laptop off the lap and limiting cycling to no more than two hours a day, six days a week.