Everything You Need to Do In the Year Before You Get Pregnant
Even though conception is seen as a miracle, there are steps you can take to prepare your body for pregnancy and boost your odds a year in advance.
Once you let it slip that you're trying to start a family to your mother-in-law, you're immediately bombarded with unsolicited advice and health tips on how to prepare your body for pregnancy and boost your odds of conception. Even when you attempt to sort through this information with an in-depth Google search, you're still left feeling overwhelmed. So, aside from getting down to business with your partner, what's really important to do in the year leading up to a pregnancy?
"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." To get your body in tip-top shape to improve your chances of having a healthy pregnancy, add these important dates and daily to-dos to your planner in the year before ideally conceiving. (Related: How the Chances of Getting Pregnant Change Throughout Your Cycle)
What to Do In the Year Before Pregnancy
Get a physical exam.
You might imagine that your ob-gyn should be the first to hear about your pregnancy plans, but you should set up a time to meet your physician to find out how your current health status may affect your ability to conceive and carry a baby to term. Book a physical exam in the year before pregnancy and make sure you speak with your doctor about all of the following metrics.
Blood pressure: Ideally, your blood pressure readings 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). (BTW, your PMS symptoms could be telling you something about your blood pressure.)
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 Daniel Potter, M.D., author of What to Do When You Can't Get Pregnant. High blood sugar levels also up your risk for gestational diabetes, which affects up to 7 percent of pregnant women.
Medication: Your life—and your pregnancy—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. During your physical exam, ask your doctor if your prescriptions may be linked to birth defects and whether there are safer alternatives for you to take.
Vaccinations: If you get measles, rubella (German measles), or chickenpox while pregnant, you are at risk of miscarriage and birth defects, according to the American College of Obstetricians and Gynecologists and Stanford Children's Health. Most American women were inoculated at a young age (or may have chickenpox immunity because they had the disease as a kid), but some of these vaccinations require booster shots. (Yes, there are a few vaccines you need as an adult.)
Start managing your stress level.
When you're under pressure, your body pumps out adrenaline and cortisol to boost your strength, focus, and reflexes. But high levels of chronic stress can lead to irregular menstrual cycles and, during pregnancy, can predispose you to perinatal depression and affect fetal neurological development, according to research published in Obstetric Medicine.
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. What's more, “stress hormones like cortisol can disrupt communication between the brain and the ovaries, leading to irregular ovulation and difficulty conceiving,” Anate Aelion Brauer, M.D., a reproductive endocrinologist and an assistant professor of obstetrics-gynecology at the New York University School of Medicine, previously told SHAPE. But if you notice stress manifesting itself in physical symptoms, make lifestyle changes to reduce stress levels now. In the year before pregnancy, get in the habit of getting eight hours of sleep per night and seeking out ways to relax. "Even small things, like deep breathing or picturing a calming image, can make a difference," says Dr. Gaudet. (Try these stress-reducing essential oils to decompress.)
Book an appointment with your gynecologist.
In the year before pregnancy, visit your gynecologist to discuss your pregnancy hopes and plans. Be sure to ask your ob-gyn questions about your ability to conceive and the best ways to boost your odds. The U.S. National Library of Medicine recommends asking your doctor:
You should also undergo a Pap smear and pelvic exam, to check for cancer and spot any problems with your vagina, uterus, cervix, and ovaries that could cause problems in your pregnancy if left untreated, according to March of Dimes. "These may be signs of hormonal problems that can lead to infertility," says Dr. Potter. Don't forget to ask for a full STI screening, as STIs during pregnancy can cause complications like preterm labor and premature birth, according to the Mayo Clinic. (Related: What Ob-Gyns Wish Women Knew About Their Fertility)
Help your partner get their health on track.
In order to become pregnant, your partner's health matters almost as much as your own. Start by encouraging them to quit their vices: Smoking cigarettes can hurt sperm motility and sperm count while having more than one alcoholic drink a day may affect sperm production. To further ensure their sperm is healthy and motile, ask them to steer clear of hot tubs and saunas, which can overheat sperm cells and significantly impair sperm function. Weight loss can help increase your odds of pregnancy too, as a 20-pound increase in weight can raise your partner's risk of infertility by 10 percent.
What to Do Six Months Before Pregnancy
Schedule a check-up with your dentist.
Your teeth probably aren't your top priority while you're attempting to get pregnant, but the health of your pearly whites can affect much more than your breath. Nearly 50 percent of adults at least 30 years old have some form of gum disease, according to the Centers for Disease Control and Prevention (CDC), but "among pregnant women, it's closer to 100 percent," says Karla Damus, Ph.D., a senior research associate with the March of Dimes. Hormonal changes make the mouth more hospitable to bacterial growth, and severe gum infections can release bacteria into the bloodstream that travel to the uterus and cause infections that could complicate pregnancy, which is why a dental exam is actually pretty important in the year before pregnancy.
The American Academy of Periodontology estimates that women with periodontal disease are seven times more likely to deliver a preterm or low-birth-weight baby. "We don't know exactly how gum disease affects pregnancy outcomes," says. Damus. "But we do know that good oral hygiene and regular checkups are important."
Maintain a healthy weight.
Twelve percent of all infertility cases are a result of a woman either weighing too little or too much, according to the American Society of Reproductive Medicine. Why? Women who have too little body fat can't produce enough estrogen, causing reproductive cycles to come to a halt, while women who have too much body fat produce too much estrogen, which can prevent the ovaries from releasing eggs. Reaching and maintaining a healthy weight can boost your odds of conception and even reduce the risk for complications during pregnancy.
What to Do Three Months Before Pregnancy
Stick to a healthy diet.
Start making choices of healthy foods that boost your metabolism and optimize your hormone levels, like complex carbohydrates (such as fruits, vegetables, and whole grains), which contain fiber that slows digestion and stabilizes your glucose levels. Protein also helps build a healthy placenta—the newly formed organ present only in a pregnant person's uterus to provide nutrients and oxygen to the fetus—and produces red blood cells, and one great source of protein, fish, is also rich in omega-3 fatty acids, which will help your future baby's brain and nervous system.
Think before you drink.
Sorry, those brunch mimosas might have to wait. "Alcohol raises your future child's risk of physical and mental disabilities, so cut out drinking once you're actively trying to conceive," says Mary Jane Minkin, M.D., professor of obstetrics and gynecology at Yale School of Medicine. Before then, the occasional glass shouldn't harm an eventual pregnancy, though two-or more-a day is a different story. Heavy drinking may increase your estrogen levels, which can cause irregular menstrual cycles and deplete your body of folic acid—a nutrient that helps prevent major birth defects to a baby's brain and spine.
Cut back on caffeine.
Pregnant women are more likely to miscarry if they and their partners drink more than two caffeinated beverages daily in the weeks leading up to conception, according to a 2016 study by researchers at the National Institutes of Health. Still, female fertility doesn't seem to be impacted by caffeine intake below 200 milligrams per day, so consider drinking just one or two 6- to 8-ounce cups of coffee daily, according to the Mayo Clinic. If you're a triple-espresso gal, you might want to scale back now: Caffeine withdrawal can cause headaches and nausea, which only make morning sickness worse.
Consider choosing organic food.
Certain environmental toxins may stay in your system and endanger your developing baby, says Dr. Potter. "To avoid pesticides, buy organic food or make sure to wash fruits and vegetables with mild soap." Inhaling certain solvents, paints, and household cleaners have also been shown to cause birth defects and increase miscarriage risk, so make sure your home and workplace are well ventilated.
What to Do One Month Before Pregnancy
Start taking prenatal vitamins.
Out of all the vitamins you need to have a successful, healthy pregnancy, folic acid is most important. The nutrient is essential in helping to prevent neural tube defects—major birth defects of the baby’s brain and spine. The CDC recommends that women who are trying to get pregnant consume 4,000 mcg of folic acid each day one month before becoming pregnant and through the first three months of pregnancy.
You should also consider taking an iron supplement to prepare your body for pregnancy too. Research has found that babies who are iron-deficient develop more slowly and show brain abnormalities, but a 2011 study by the University of Rochester showed that the critical period for iron intake starts in the weeks before conception and continues throughout the first trimester.