Getting ready for pregnancy

Before trying for pregnancy, review your medicines, folic acid and vaccination records. The NHS and CDC recommend discussing your health before trying to conceive, especially if you have an existing condition or take regular medicines.

Bring the questions that matter to you. That might mean asking how pregnancy could fit around treatment you already need, or where to get help with smoking. The appointment is a chance to ask for help, without having to account for every choice you’ve made.

Folic acid starts before a positive test

Folic acid helps the developing brain and spine. It can prevent neural tube defects, which happen early in pregnancy, often before someone knows they are pregnant. That’s why the advice starts before conception.

In the UK, the NHS recommends 400 micrograms of folic acid every day when trying to get pregnant, ideally 3 months before, and for the first 12 weeks of pregnancy. If you discover a pregnancy before taking it, the NHS advice is to start as soon as you find out.

In the US, the CDC also recommends 400 micrograms daily. It advises starting at least 1 month before conception and continuing during pregnancy. Advice differs between countries in how the lead time is expressed; use your local guidance and ask your pharmacist or doctor about a suitable supplement.

Advice has changed recently: the NHS now says ideally 3 months before pregnancy. Some people need a different prescription, including people with diabetes, certain blood conditions or a previous pregnancy affected by a neural tube defect. Ask your GP or doctor about your circumstances rather than choosing a higher-strength product yourself.

Check vaccines before you start trying

Ask your GP surgery or doctor to review your vaccination record, particularly MMR, which protects against measles, mumps and rubella. The NHS recommends checking this before pregnancy. MMR is not suitable during pregnancy; CDC advice is to have it a month or more before pregnancy. Ask the clinician giving the vaccine when you can start trying.

If you cannot find a record, say so when you book. Ask what needs checking rather than guessing from a childhood memory. Keep the agreed plan with your other appointment notes.

Review the treatment you already take

Tell your clinician about prescriptions, medicines bought without a prescription, vitamins and other supplements. Include herbal remedies. Do not stop a prescribed medicine without talking to your doctor. The NHS advises discussing the safest treatment option while trying to get pregnant.

Long-term conditions such as epilepsy, diabetes, sickle cell disease and HIV are reasons to arrange a pre-pregnancy discussion. If you have a partner, the NHS advises discussing their conditions and medicines too. A useful opening is: “I’m thinking about pregnancy. What needs reviewing before I try?”

Make everyday changes with support

The NHS recommends avoiding alcohol while trying to conceive and getting support to stop smoking. CDC advice also recommends stopping alcohol, smoking and certain drugs before pregnancy. If stopping is difficult, contact your GP or doctor for help; you can talk openly about what is making it difficult.

Weight can also affect conception: the NHS says weight that is too low or too high can make pregnancy harder to achieve. Ask for advice suited to your health and circumstances. If you have worries about food or weight, bring those up too.

Arrange the checks that apply to you

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, before trying if you have a long-term condition, take medicines or need help with smoking or alcohol. The NHS also recommends checking whether cervical screening is due and having STI testing if you think you or a partner may have an infection.

Before leaving, ask which checks to arrange now, who will review your medicines and who to contact with follow-up questions. Write down what you’ve agreed to do next and anything you’re still deciding.