Most women know they need to see a doctor or midwife and make lifestyle changes while pregnant. But, it is just as important to start making changes before you get pregnant. These steps will help you prepare yourself and your body for pregnancy and give you a better chance of having a healthy baby.

See your doctor or midwife before you get pregnant. Even if you feel you are healthy and ready for a pregnancy, your doctor or midwife can do plenty ahead of time to help you prepare.

• Your doctor or midwife will discuss your current health, your health history, and your family's health history. Some health problems in your family can be passed on to your children. Your doctor or midwife may refer you to a genetic counselor.
• You may need blood tests, or you may need to get caught up on vaccines before you are pregnant.
• Your doctor or midwife will talk with you about medicines, herbs, and supplements you may be taking. They can affect an unborn baby. Your general health care provider may recommend medicine changes before you get pregnant.
• Long-term health problems, such as asthma or diabetes, should be stable before you get pregnant.
• If you are obese, your provider will recommend losing weight before pregnancy. Doing so will reduce your risk of complications in pregnancy.

If you smoke or use other forms of tobacco, drink alcohol, or use drugs, you should stop before you get pregnant. They can:

• Make it harder for you to get pregnant
• Increase the chance of miscarriage (lose the baby before it is born)

If you need help quitting smoking, alcohol, or drugs, talk to your provider.

Alcohol can harm a growing fetus (unborn baby), even in small amounts. Drinking alcohol while you are pregnant can cause long-term problems for your baby, such as intellectual disability, behavioral issues, learning disabilities, and facial and heart defects.

Smoking is bad for unborn babies and puts your child at greater risk of health problems later in life.

• Women who smoke during pregnancy are more likely to have a baby with a lower birth weight.
• Smoking also makes it harder for you to recover from your pregnancy.

Medicines that are not prescribed by a provider (including street drugs) can be dangerous for you to take at any point in your life.

You should also cut down on caffeine when you are trying to get pregnant. Women who daily consume more than 2 cups (500 mL) of coffee or 5 cans (2 L) of soda that contains caffeine may have a harder time getting pregnant and a greater chance of miscarriage.

Limit unnecessary medicines or supplements. Discuss with your provider about both prescribed and over-the-counter medicines and supplements you take before you try to conceive. Most medicines have some risks, but many have unknown risks and have not been thoroughly studied for safety. If medicines or supplements are not absolutely necessary, do not take them.

Maintain or strive for a healthy body weight.

A balanced diet is always good for you. Follow a healthy diet before you get pregnant. A few simple guidelines are:

• Reduce empty calories, artificial sweeteners, and caffeine.
• Eat foods that are high in protein.
• Fruits, vegetables, grains, and dairy products will make you healthier before you get pregnant.

A moderate intake of fish will help both you and your baby to be healthy. The FDA states that fish is part of a healthy eating pattern. Some types of seafood contain mercury and should not be eaten in large amounts. Pregnant women should:

• Eat up to 3 servings of fish a week of 4 ounces (oz) each.
• Avoid large ocean fish, such as shark and tilefish.
• Limit tuna intake to 1 can (85 g) of white tuna or 1 tuna steak per week, or 2 cans (170 g) of light tuna per week.

If you are underweight or overweight, it is best to try to reach your ideal weight before you get pregnant.

• Being overweight during pregnancy may increase your chances of problems, such as high blood pressure, diabetes, miscarriage, stillbirth, birth defects, and needing a cesarean birth (C-section).
• It is not a good idea to try to lose weight during pregnancy. But it is very good idea to attain a healthy body weight before becoming pregnant.

Take a vitamin and mineral supplement that includes at least 0.4 milligrams (400 micrograms) of folic acid.

• Folic acid reduces the risk of birth defects, especially problems with the baby's spine.
• Start taking a vitamin with folic acid before you want to get pregnant.
• Avoid high doses of any vitamin, especially vitamins A, D, E, and K. These vitamins can cause birth defects if you take more than the normal recommended daily amounts. Regular pregnancy prenatal vitamins do not have excessively high doses of any vitamin.

Exercising before you get pregnant may help your body deal with all of the changes that you will go through during the pregnancy and labor.

Most women who already exercise can safely maintain their current exercise program throughout the most of their pregnancy.

And most women, even if they are not currently exercising, should start on an exercise program of 30 minutes of brisk exercise 5 days per week, both before conceiving and throughout pregnancy.

The amount of exercise you are able to do during pregnancy should be based on your overall health and how active you are before you get pregnant. Talk to your doctor or midwife about what kind of exercise, and how much, is good for you.

While you are trying to get pregnant, try to relax and reduce stress as much as possible. Ask your doctor or midwife about techniques to reduce stress. Get plenty of good quality sleep and make time to relax. These steps may make it easier for you to become pregnant.

Cline MK, Young N. Antepartum care. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier 2024:1281-1288.

Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 5.

Hobel CJ, Williams J. Antepartum care: preconception and prenatal care, genetic evaluation and teratology, and antenatal fetal assessment. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 7.

Lateef OM, Akintubosun MO. Sleep and reproductive health. J Circadian Rhythms. 2020;18:1 PMID: 32256630 pubmed.ncbi.nlm.nih.gov/32256630/.