Pre-pregnancy To-Do List

Pre-pregnancy and pre-conception planning can help you feel really confident as you embark on your pregnancy journey. Not only does having a pre-pregnancy to-do list help to give you clearer timelines and choices, but it may also increase your chances of having a healthy, uncomplicated pregnancy – particularly if you face any fertility or health challenges that might be successfully managed in advance of trying to get pregnant.

Read on below for our pre-pregnancy to-do list.

Make an appointment with your doctor

If you are planning to become pregnant, now could be a good time to visit your GP or reproductive health specialist. This way you can discuss any issues that might affect your chances of conceiving, your reproductive health, or your pregnancy. It is also a useful time to review whether you need any vaccinations or are due pap smear. For example, you may need to update your Measles Mumps and Rubella (MMR) vaccine; if this is the case you should avoid getting pregnant for one month following the vaccine, which means you’ll need to use contraception during this period.

Quit cigarettes and alcohol

Tobacco and alcohol are not good for you at the best of times but when you’re about to begin the journey towards conception, pregnancy and parenthood, it is the perfect time to stop.

Drinking alcohol in pregnancy and smoking can negatively affect fetal development and both may have a lasting impact throughout baby’s early and later years of development. Furthermore, both cigarettes and alcohol can increase the risk of miscarriage. Talk to your GP about the best ways to quit.

Work towards a healthy pregnancy body weight

Talk to your GP about achieving a healthy conception bodyweight. Being underweight reduces your chances of conception and, should you become pregnant, increases the risk of birth complications, including premature birth.

Being overweight also reduces the chances of conception while increasing the risk of gestational diabetes and a pregnancy-related blood pressure condition called preeclampsia. If you would benefit from losing weight, now is the time to do it; the NHS recommends that women do not try to lose weight during pregnancy, as it may not be safe. Furthermore, there is no evidence that it will reduce the risk of complications. So, if you want to lose weight, start now.

Dr Diane Farrar has written an article exclusively for My BabyManual on preconception care for women who are overweight or obese.

Review your prescription and over-the-counter medicines

Speak with your GP about any prescriptions you are taking as well as any over-the-counter medicines you take. This includes supplements, vitamins and herbs as some of these may have an impact on conception and pregnancy. Now’s the time to start taking a prenatal vitamin or folic acid supplement, this will lower your risk of birth defects.

Discuss contraception

If you have been using the pill, the mini pill or a contraceptive injection, your GP may advise you to wait until you have had a normal period before attempting to conceive; the same applies if you have been using a progesterone implant or an intrauterine device.

Speak supplements

If you are planning to get pregnant, you should begin taking a supplement of 400 micrograms of folic acid every day – this should minimise the risk of developmental problems in the early stages of pregnancy. You may be advised to take a slightly higher dosage supplement if:

You or the baby’s biological father have a neural tube defect.
You have previously had a pregnancy that is affected by a neural tube defect.
Either parent has a family history of neural tube defects.
You have diabetes or take anti-epilepsy medicine.

Furthermore, The Department of Health and Social Care advises that you take a vitamin D supplement – discuss this with your GP.

Lastly, be sure to cease taking any vitamin A (retinol) supplements at this stage as excessive amounts of vitamin A could harm your baby.

Genetic testing

If you have a family history of certain inherited health disorders or are of advanced maternal age, your GP may consider you as a candidate for pre-pregnancy genetic testing. You may wish to discuss this during your consultation.

Consider a test for sickle cell and thalassaemia

Sickle cell disease (SCD) and thalassaemia are types of inherited blood disorder. They mainly affect people with African, Caribbean, Mediterranean, Indian, Pakistani, Southeast Asian and Middle Eastern genetic origins. Although you will be offered screening for these during your pregnancy, if you wish, you can request free pre-pregnancy screening from either your GP or a local sickle cell and thalassaemia centre.

Check your oral health

According to a study by the European Society of Human Reproduction and Embryology there may be a connection between good oral health and your chances of conceiving. But not only is gum disease linked to reduced fertility, it also has associations with early birth and low birth weight.

Eat and drink for conception

Not only will giving up processed and junk food in favour of fresh and healthy alternatives increase your chances of conception, it will also ensure you are in good shape for a future pregnancy while also reducing the risk of gestational diabetes. The bulk of your diet should be comprised of fresh fruit and vegetables, whole grains and a broad range of plant and animal proteins.

Avoid high mercury fish

Certain fish – for example, king mackerel, marlin, orange roughy, shark, swordfish, tilefish, yellowfin (ahi) tuna, and bigeye tuna – contain high levels of mercury. These should be avoided in the pre-pregnancy stage as mercury is a heavy metal and takes up to a year to be eliminated from the body.

Reduce your coffee intake

A piece of Dutch research from 2011 found that caffeine may have an adverse affect on a woman’s fertility. The study, which involved 9,000 women, concluded that drinking more than four cups of coffee a day reduced the chances of conception by around one-quarter. Fertility aside, now is a good time to cut your coffee consumption as once you are pregnant you should limit your caffeine consumption to 200 milligrams (mg) a day (equivalent to 2 mugs of instant coffee). This is because excess caffeine in pregnancy is linked to low birthweight and heightened risk of miscarriage.

Boost your physical fitness

Getting physically fit can help you achieve a healthy body weight, can boost your immune system and ultimately, will help you achieve conception. It will also help you to be in good condition for pregnancy and the demands of labour itself. However, do not over-exercise as this can be counterproductive.

Question your environment

Now is a good time to consider the health of the environments in which you work and live. For example, if you regularly come into contact with and/or inhale harmful chemicals, environmental contaminants, and other toxic substances, you may wish to attempt to make some lifestyle changes.

Synthetic chemicals, pesticides, fertilisers, insect repellents, cleaning products and other substances can impair reproductive systems and potentially harm the development of a fetus.

Protect yourself from domestic abuse

If you are thinking about becoming pregnant, now is the time to take steps to protect yourself against domestic abuse. Pregnancy can be a trigger for domestic violence which means your unborn baby is at risk as well as yourself. Domestic violence can lead to miscarriage, infection, premature birth, and even death.

You can get free and confidential help by speaking with:

Your GP
A social worker
The National Domestic Abuse Helpline, run by Refuge – call Freephone 0808 2000 247.
Refuge – A charity helping victims of domestic abuse
Women’s Aid – a federation providing services for survivors of domestic abuse.

Begin planning your finances

Taking a good look at your finances before you get pregnant can be a real eye-opener. How much will you be able to spend on a cot, a pram and pushchair, car seat, clothing, nappies and other ongoing expenses? Will you need to move house so that you have extra room. Can you afford to give up work and what maternity benefits will you be entitled to. These are big questions that will feel much easier to answer if you address them in advance, so that you can move forward towards getting pregnant with full financial confidence.