Your healthy pregnancy timetable

If you're serious about getting pregnant-or if you're already trying-you may be sorting through a whole lot of unsolicited advice. What's really important? "Make your health a priority this year," says Tracy Gaudet, M.D., director of the Duke Center for Integrative Medicine and author of Body, Soul, and Baby. "You'll have time to really tune in to your body and change any bad habits before you conceive."

One year before

• Get a physical
  You might imagine that your ob-gyn should be the first to hear about your pregnancy plans, but talk with your regular doctor to find out how your health may affect your ability to conceive and carry a baby to term. Make sure that you address:
  • Your blood pressure Ideally, it should be lower than 120/80. Borderline hypertension (120-139/80-89) or high blood pressure (140/90) predisposes you to preeclampsia, a pregnancy high-blood-pressure disorder that can decrease blood flow to the fetus and increase the risk of premature birth; it can also raise your odds of stroke, heart attack, and kidney disease down the line. If your blood pressure is high, cut back on sodium, up your exercise level, or take medication (many are safe, even during pregnancy).
  • Your blood sugar If you have diabetes, a family history of the disease, or certain risk factors such as extra weight or irregular periods, request a hemoglobin A1c test-it'll reveal your average glucose levels for the past three months. "High levels could mean your body is producing extra insulin, which can interfere with ovulation and lead to pregnancy complications," says Potter. It also ups your risk for gestational diabetes, which affects up to 7 percent of pregnant women.
  • Your medications Your life-and your preg nancy- depends on the effective treatment of certain conditions like asthma, thyroid problems, diabetes, and depression. But some drugs (including acne and seizure medications) could pose a grave risk to a developing fetus. Ask your doctor if your prescriptions may be linked to birth defects and whether there are safer alternatives for you to take.
  • Your vaccinations If you get measles, rubella (German measles), or chicken pox while pregnant, you have an increased risk of miscarriage and birth defects. Most American women were inoculated at a young age (or may have chicken pox immunity because they had the disease as a kid), but some of these vaccinations require booster shots.

• Assess your stress level
  When you're under pressure, your body pumps out adrenaline and cortisol to boost your strength, focus, and reflexes. But an overabundance of these stress hormones can lead to depression, irregular menstrual cycles (which can make getting pregnant difficult), and even pregnancy complications. A University of Michigan study found that pregnant women with high cortisol levels were 2.7 times more likely to miscarry than women with normal levels. "There's not always a direct correlation- some people with high-pressure jobs conceive easily, and women in less demanding jobs can have all sorts of trouble," says Falcone. But if you notice stress manifesting itself in physical symptoms, make lifestyle changes now. Aim for eight hours of sleep per night, and seek out ways to relax. "Even small things, like deep breathing or picturing a calming image, can make a difference," says Gaudet.