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A 10-Step Checklist for Pre-Pregnancy Planning

The Definitive Guide to Conceiving Successfully & Preparing for Pregnancy

Well-informed preconception planning reduces risks to you and your future child, increasing your chances of conception for a healthy pregnancy.  Creating a pre-pregnancy plan can be exciting yet nerve-wracking, sometimes causing anxiety in hopeful mothers and couples who are attempting to conceive for the very first time.

In my many fulfilling years as a fertility specialist, I’ve provided care to hundreds of women on their path to motherhood. Preparing for pregnancy while facing infertility challenges can be daunting but I’ve learned that sharing pre-pregnancy advice, professional expertise, and basic, practical tips for conceiving successfully can make a huge difference. When preparing for your pregnancy with a preconception strategy that works for you, you want to understand a few fundamentals beforehand.

To help you learn the basics, I developed a 10-step checklist for pre-pregnancy planning and shared it with you below. This list was carefully designed from the top recommendations I feel are the most important to your preconception health.

1. Take Folic Acid Daily to Reduce the Risk of Birth Defects

The American College of Obstetrics and Gynecology (ACOG) recommends that all women of childbearing age take folic acid (0.8mg) every day, and the easiest way to do this is with a standard prenatal vitamin.

Folic acid has been shown to play an important role in lowering the risk for certain birth defects, including neural tube abnormalities like Spina Bifida. Women with certain genetic mutations may need a higher dose of folic acid to reduce these health risks during pregnancy.  Your fertility physician can assist you in determining whether or not this is an important precaution if you are having difficulty conceiving or experiencing miscarriage.

2. Maintain a Nutritious and Well-Rounded Pregnancy Diet

Eating a variety of healthy foods is important for good health, especially during pregnancy. It is important for your daily diet to include a variety of whole grains, fruits, and vegetables. You will also want to cut down on fats like butter and minimize your intake of fried foods. Choose lean meats and poultry (chicken or turkey without skin) when shopping for protein at the supermarket. Do not eat large fish while pregnant, including shark, Swordfish, Tilefish, and King Mackerel because they contain high levels of mercury, which have been associated with reduced pregnancy rates.

For snacking, choose:

Hydration is very important during preconception and pregnancy, so drink plenty of fluids every day. Limit or omit coffee, tea, and other caffeinated drinks like soda. For more information, check out the comprehensive pregnancy nutrition information from the American College of Obstetrics and Gynecology.

3. Develop a Consistent, Sustainable Exercise Regimen

It’s crucial for you and your new baby’s health to develop a regular and moderate exercise program that you can continue during pregnancy at a steady pace without injury or exhaustion. Begin slowly and build up this exercise routine reasonably and gradually. Try to set a goal of exercising at least 30 minutes per day on most days of the week while you’re pregnant. Avoid Bikram or other forms of “hot” yoga where you’ll be exposed to intense heat. This also means avoiding saunas and hot tubs during pregnancy.

In a recent fertility article, we examine the importance of light exercise for new moms after IVF treatment more closely. If you have any questions about whether or not your favorite exercise is appropriate, ask your OB/GYN or fertility specialist.

4. Make Your Preconception Plan for Pregnancy Weight Gain

If you are underweight or overweight, incorporate this issue into your pre-pregnancy planning and try to reach a healthy weight before attempting to conceive.  A normal body mass index (BMI) is between 20-24 kg/m2, and you can refer to the helpful chart below to understand before trying to get pregnant:

Underweight women may have a harder time getting pregnant and are more likely to have smaller babies at childbirth. Women who are overweight may experience high blood pressure or diabetes during pregnancy. In both cases, women preparing for pregnancy can experience greater difficulty while trying to conceive and are at a higher risk for miscarriage due to elevated body mass index.  

5. Be Cautious and Aware of Pre-Existing Medical Conditions

Any preconception plan should acknowledge existing medical conditions that could potentially affect your pregnancy. It’s best to err on the side of caution here because nearly all existing health issues can affect the health of your unborn baby, including:

Please note that certain over-the-counter medications & herbal remedies, when taken on a regular basis, can put you at higher risk of having a baby with birth defects.

Please discuss your medical conditions and medications with your physician before you get pregnant.  Even if you feel that your condition has been treated or is currently under control, it may become a problem during pregnancy or impact your ability to conceive in the first place.

6. Ask Your Physician about Pre-Pregnancy Immunization

Some conception issues and pregnancy-threatening infections can be prevented by proper immunization. Before you try to get pregnant, ask your OB/GYN or fertility specialist if you should be immunized against Rubella (German Measles) and Chickenpox (Varicella). If you are not immune to these infections, you may want to receive vaccination prior to planning a pregnancy.

It is recommended that you wait at least one month after being vaccinated before trying to conceive. Additionally, please remember to get a flu vaccine when you are pregnant! Respiratory complications caused by Influenza are far more severe in pregnant mothers than the average healthy adult.

7. Know the Common Office & Household Substances to Avoid

Exposure to everyday substances found in the home or workplace could make it more difficult to become pregnant and may harm your developing baby during pregnancy. Try to avoid:

To minimize your exposure to these chemicals, wear rubber gloves and work in a well-ventilated area if cleaning your home during pregnancy.

8. Stop Smoking NOW - Your Baby’s Life Depends on it

If you smoke cigarettes, one of the most important things you can do to improve your own health is to quit smoking now. This is even more crucial to the fragile health of the tiny miracle growing inside you during pregnancy. Smoking may also make it harder for you to get pregnant during the preconception planning phase of your fertility journey.  It has been shown demonstrably that smoking has an adverse effect on your body’s ability to produce high-quality eggs during ovulation.  

Women who smoke are more likely to have serious health problems in pregnancy and childbirth, experiencing premature birth and bearing underweight babies who have medical problems throughout their lives.

Do it for your baby, they don’t have a say in the matter but suffer all the consequences. If you are trying to stop smoking, contact your physician for a referral to a tobacco cessation program. There are many effective options out there today!

9. Relationship Challenges & the Issue of Drug Abuse

You might not be aware that if your male partner is using marijuana, it may significantly decrease your chances of conception dramatically. Furthermore, if you use drugs like alcohol, cocaine, or crack during pregnancy, you can cause irreparable harm to your unborn child. If you or someone in your family has a problem with drugs or alcohol, speak with your physician for your best chance at recovery.

As far as relationships go, the fertility process can put quite a strain on both you and your partner, which is bad for your relationship and unborn child. Remember that you are never alone, and we’re all in this together.

10. Know Your Family’s Genetic History of Birth Defects

If you, the father of your baby, or any close family members (children, parents, sisters/brothers, aunts/uncles) have a history of birth defects or inherited medical conditions, you may have a higher chance of having a baby with the same challenges.

Genetic screening tests can help identify if you may have a higher chance of having a baby with certain genetic or inherited conditions. For more information, go to to find specific recommendations from the American College of Obstetrics and Gynecology.

If you have an additional preconception planning tip, please leave a comment below. If you know someone preparing for pregnancy, share our checklist with them! If you’d like to know more, contact our friendly fertility team today.

You can do this! We’re here to help.

Additional information:

Dr. Danielle Lane Danielle E Lane, MD, Reproductive Endocrinology and Infertility Specialist

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