Before you can conceive, obviously you have to get rid of your birth control. But it's usually not as simple as quitting and then becoming pregnant the next week. You should stop using oral contraceptives, NuvaRing, or the Patch about two cycles before you want to get pregnant; have an IUD removed a month before; and let the last dose of injectable forms of birth control, like Depo-Provera, wear off three months before conception, says Lisa Mazzullo, M.D., co-author of Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception. This will give your hormone levels a chance to reset, and will allow you to track your period and learn when ovulation -- the time you're most likely to get pregnant -- occurs. That said, some couples get pregnant right after stopping birth control. Always use barrier contraceptives so you don't get pregnant before you plan to.
Studies have shown that being both underweight and overweight can have an effect on fertility and fetal health. Talk with your healthcare provider to determine what your ideal weight is and what steps you need to take to get there.
Even if you're at your ideal weight, being physically active before (and during) pregnancy has benefits. The more fit you are, the easier your pregnancy and delivery may be. You can continue with your regimen if you're already active; just be sure not to overdo it. Right before you conceive is not the time to be training for a marathon or lifting massive weights. If you're just beginning a workout program, it's not good to push yourself too hard. Whether you're a fitness buff or a newbie, discuss your physical activity with your healthcare provider to get the green light.
The research on caffeine's effect on fertility and pregnancy is conflicting -- some studies report that caffeine contributes to miscarriage; others claim it doesn't. To be on the safe side, experts advise limiting your caffeine intake to 200 milligrams a day (about two 6-ounce cups of coffee). But remember, it's not just a coffee or tea thing: Chocolate, sodas, energy drinks, and some cold and pain medications also have caffeine.
Stress can affect fertility, pregnancy, and a baby's health. In one study, researchers found that pregnancy was more likely to occur during months when couples reported that they felt good and relaxed, and less likely during months when the couples felt tense or depressed. Taking time for yourself every day, exercising, journaling, getting massages, talking with your partner, and getting enough sleep can make it easier to unwind. If you're having problems managing stress, seek help from a professional.
You really are what you eat. And so is your baby-to-be. To start your pregnancy off right, eat foods from each of the five food groups: fruits, vegetables, grains, lean proteins (like chicken, eggs, and beans), and dairy products. Avoid foods high in fat and sugar, and make sure you're getting enough fluids, Dr. Mazzullo says. Making dietary changes when you're still in the trying-to-conceive stage will pave the way for an easier pregnancy diet makeover once you become pregnant, not to mention helping you to stay at a healthy weight.
Having enough folic acid can help prevent birth defects in a baby's head and spine. "It's important that women get 400 milligrams of folic acid every day as well as eating high-folate foods," says Janis Biermann, M.S., senior vice president for education and health promotion at the March of Dimes. Most prenatal vitamins will meet your daily folate needs. Some good food sources for folic acid include leafy vegetables, beans, citrus fruits, whole grains, and folate-enriched cereals and breads. Experts recommend upping your folic acid intake three months before trying to have a baby.
Women who smoke before pregnancy are about twice as likely to experience a delay in conception and about 30 percent more likely to be infertile than women who don't smoke, according to Centers for Disease Control (CDC). Babies born to women who smoke during pregnancy are more likely to have a low birth weight, to be born prematurely, or to die of sudden infant death syndrome (SIDS).
If you smoke, quit -- the earlier, the better. "Being off all tobacco at least one to three months before you conceive is best," Dr. Mazzullo says. If you plan to quit on your own, try at least a month in advance to make sure you can do it. For smokers using cessation assistance, like nicotine gums or patches or prescription Zyban or Chantix, Dr. Mazzullo suggests that you allow enough time for the medication to work and then wean yourself off of it for at least a month prior to conception.
Some studies say it's okay to have a few drinks during pregnancy, but others have shown that heavy drinkers have a harder time conceiving than women who drink lightly or abstain. Ultimately, "we don't actually know what a safe level of alcohol is in pregnancy or exactly when during pregnancy alcohol might have its most severe effects," says Myra J Wick, M.D., medical co-editor of Mayo Clinic Guide to a Healthy Pregnancy. "If a patient is actively trying to conceive, I recommend that she not drink at all," she adds. The same goes for marijuana and other illicit drugs. If you wouldn't give it directly to your baby, make sure it's out of your system before (and during) pregnancy so that you don't pass it along.
Yes, we know you'll see your ob-gyn's face more than enough once you're actually pregnant. Still, it's important to see her before you're with child. Dr. Mazzullo advises that all women who are expecting to become pregnant should have a pre-conception visit to get a STI screening, make sure any chronic health issues, like diabetes or asthma, are under control, discuss any genetic disorders and/or issues with previous pregnancies, and get an overall view of her health.
"When you're planning your pregnancy, it's a good idea to make sure your vaccinations are up-to-date so that you can avoid any illnesses that may be detrimental to the pregnancy or baby," Biermann says. You should have vaccinations for the seasonal flu vaccine, MMR (measles, mumps, and rubella), Tdap (tetanus, diphtheria, and pertussis), and chickenpox if you're never had it or been vaccinated against it. Because some of the vaccines contain live viruses, you may need to get them one to three months before you become pregnant.
It can take a while for some medications to clear from the body, and many meds aren't baby-friendly. "Go through your list of medications -- both prescription and over-the-counter -- with your provider to make sure none of them would be harmful to the pregnancy," says Dr. Wick. Don't forget to include any herbal supplements and vitamins on the list.
Women with gum disease are four to seven times more likely to have an underweight or premature baby, according to a study in the Journal of the American Dental Association. Schedule a pre-pregnancy dental visit to make sure your oral health is in good standing (and so that you'll have time to correct any issues).
The FDA recommends that pregnant women avoid eating certain fish -- swordfish, shark, king mackerel and tilefish -- because of their high levels of mercury, and to limit their intake of low-mercury fish, like canned tuna, shrimp, catfish, and salmon to 12 ounces a week. Too much mercury can damage a baby's developing brain and nervous system. Although there is no specific recommendation for women who haven't yet conceived, Dr. Wick says it's a good idea to follow the guidelines for pregnant women so you'll already have this habit in place.
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