Preconception Checkups: What They’re For and Why They Matter

Preconception appointments are a preemptive and proactive measure of optimizing your health and, possibly, your chances of getting pregnant. You can expect your healthcare provider to take the following steps during your visit:

• Assess your physical health – Your doctor will take a look at your physical health, and review your medical history for significant features. You’ll also likely discuss any chronic conditions and your lifestyle habits, so it helps to bring an attitude of honesty to your appointment.
• Review medications and supplements – Certain prescriptions, supplements, and even herbs can sometimes pose a risk for people who are pregnant and breastfeeding. Others may impact your fertility and make it harder for you to conceive. Your doctor will assess the medicines you take and make recommendations if you need to switch any of them. (Keep in mind that it’s best to continue taking your medications as prescribed until you’ve consulted with your doctor. Don’t make any adjustments on your own.)
• Discuss your mental and emotional well-being – Preparing for pregnancy necessitates a complete picture of your health—mental, emotional, physical, and otherwise. For this reason, it’s important to talk through any mental health considerations you have in anticipation of trying for a baby. You might also talk about stress management techniques and your general sense of readiness for becoming a parent.

It’s also recommended to do any carrier screenings for genetic conditions before you conceive.

Additionally, depending on factors like your pregnancy history, or if you’re exploring assisted methods of getting pregnant, your doctor may also bring up fertility counseling. However, this step is typically reserved for later appointments (especially if you encounter any challenges getting pregnant).

What happens at a preconception checkup?

The structure of preconception appointments can vary widely. Factors like your health history, your healthcare provider, and your family planning goals can all impact the procedures taken during your appointment.

That said, the primary goal of a preconception checkup is to start discussing how to prepare for pregnancy and having a baby physically, mentally, and behaviorally. Doing so typically involves the following steps.

#1 A Thorough Medical History Review

To kick off your preconception visit, your doctor will run through your medical history, covering:

• Past illnesses or injuries
• Past surgeries
• Chronic conditions
• Pregnancy history

By getting a sense of your clinical background, they’ll be able to identify potential pregnancy risks or precautions, as well as which tests to run later in the appointment. For instance, if you have prediabetes, you’re at higher risk of developing gestational diabetes. In this case, you’d require additional testing, and your doctor would likely want to discuss lifestyle adjustments you can make to protect your pregnancy.

#2 Physical Examination

A routine physical is a standard feature of the preconception checkup. Your healthcare provider will take your vitals, like blood pressure and weight.

It’s also likely your provider will ask questions about your gynecological health, as several reproductive conditions raise the risk of pregnancy complications. These include:

• Polycystic ovarian syndrome (PCOS)
• Endometriosis
• Pelvic inflammatory disease (PID)
• Uterine fibroids
• Uterine cysts
• Menstrual irregularity

Sometimes, they’ll conduct a pelvic, breast, and abdominal exam to take a closer look at your reproductive anatomy.

#3 Lab Tests and Screenings

Your healthcare provider may suggest blood tests to screen for certain health conditions, as well as immunity to certain infectious illnesses. You may also be given:

• An STI screening
• A Pap test
• A urine test
• A mental health screening

#4 Vaccination Updates

It’s important to ensure your vaccinations are up-to-date before pregnancy, as some infections can lead to complications or be passed on to your baby. Vaccinations your doctor will likely want covered before you get pregnant include:

• Hepatitis B
• Human papillomavirus (HPV)
• Rubella
• Varicella (chicken pox)
• Measles
• Mumps

Additionally, your healthcare provider may ask you about flu or coronavirus vaccinations to reduce your chances of infection (and the resultant illness) while you’re pregnant. You can get a flu shot during pregnancy; these are typically recommended between 27 and 36 weeks.

#5 Nutritional and Lifestyle Consultation

If the essential nature of a prenatal vitamin indicates anything, it’s the importance of nutrition during and prior to pregnancy. As an example, prenatal supplements contain folic acid which helps reduce the risk of spina bifida—but only if you’re taking it during conception.

In addition to recommending a prenatal supplement, your doctor may ask about your diet and eating habits. Being overweight and underweight plays an important role in fertility, so if body size is a concern, you might discuss weight gain or loss protocols to enhance your chances of conception.

Other lifestyle factors that might affect a healthy pregnancy are also likely to come into the conversation. You might discuss:

• Your level of physical activity
• Your caffeine habits
• Your alcohol use habits
• Your tobacco use habits
• Your use of other recreational substances

#6 Family Planning Discussion

Apart from your own physical and mental health and habits, it’s common to discuss your specific family plans and goals with your healthcare provider. It might be the case that you’re in the beginning of the process, and you’re not quite sure what your goals, plans, or options are.

If that sounds true for you, that’s completely normal! Your provider can be an excellent resource and sounding board for advice on timing and planning your pregnancy, optimizing your chances of conceiving, and any other questions you have along the way.

Preparing for Your Preconception Checkup

Putting a little extra time and effort into preparing for your appointment can help ensure you have a comprehensive assessment and get all of the questions you have addressed. It’s also an opportunity to open up lines of communication with your doctor—you’d be surprised how many random, pressing questions can crop up along the way, even before you conceive!

As such, consider taking the following steps before arriving at your preconception care appointment.

Gather Medical Records and Information

Take some time to itemize your medical history so you have it handy by check-in time. If you can, try bracketing out the last few years and jot down any significant medical events or illnesses. If you’ve undergone fertility treatments in the past, or have a history of pregnancy complications, be sure to include those as well.

Additionally, a few weeks before your checkup, collect your family medical history, as well as your partner’s family history. Your healthcare provider will want to know whether you or your partner have a family history of:

• Generic disorders
• Birth defects
• Pregnancy-related conditions, such as gestational diabetes or preeclampsia
• Chronic conditions, like diabetes or heart disease

Document Medications and Supplements

Do your best to record all of the medications and supplements you’re currently taking, whether prescribed or over-the-counter. Your list can also include medicines you take on occasion—even something run-of-the-mill, like over-the-counter allergy medication or painkillers (many of these aren’t suitable to take during preconception or pregnancy).

By reviewing your medications, your doctor can let you know if anything on your list carries prenatal health risks. They can also offer safe alternatives.

Additionally, if you take herbs or herbal teas, jot these down, as even some botanicals can carry adverse risks for people who are pregnant or breastfeeding.

Consider Your Lifestyle

A lot of people ignore less-than-ideal health habits until they’re getting ready to have a baby (when it becomes a potential pregnancy hazard). With this in mind, it’s important to discuss your (and, if applicable, your partner’s) lifestyle as truthfully as possible with your doctor—even if it feels scary.

Bear in mind that nobody is a saint, and no pregnancy is perfect! If you need to retire poor habits—staying up until 3am scrolling, having a sleeve of Oreos for lunch, or going a little overboard at happy hour—know that you have plenty of time and support to make changes if necessary.

Prep a List of Your Questions

It’s your turn to jot down any questions, concerns, or topics you want to address with your doctor. If you have specific worries about your fertility status, genetic risk factors, pregnancy hazards, or anything else, don’t be shy about sharing them during your visit!

Remember, your doctor’s job is to support you and your future baby, from your preconception visit, to your first prenatal appointment, to your 12-week ultrasound and beyond. The more proactive you are about getting your questions answered, the better prepared you’ll feel once that future pregnancy test declares, “Yes!”

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