Thinking Of Having A Baby? The Time To Talk To Your Doctor Is Now

With your calendar laid out in front of you, you carefully count the days between your last period and when your next one should have started. Maybe you even double- and triple-check just to be sure. An at-home pregnancy test confirms what those little flutters of emotion have led you to suspect: You’re pregnant. And while most people know that a missed period or positive at-home pregnancy test means you need to see your OB/GYN ASAP, what you may not know is that a critical window has likely already passed.

By the time most women learn that they're pregnant, they're usually about six weeks along and the baby's neural tube—which becomes the spinal cord, spine, brain, and skull—has already formed. And while most babies are completely fine when their mothers start folic acid supplements at the six-week mark, women who start taking prenatal supplements at least one month prior to conceiving dramatically reduce the potential for serious neural tube defects.

This is just one of the many reasons why your doctor isn't being nosy by asking if you're thinking of getting pregnant within the next year. The American College of Obstetricians and Gynecologists actually encourages providers to ask women that question, but if yours hasn't brought up the topic, make sure you do. Starting this conversation as early as possible gives you and your doctor the opportunity to take proactive steps so you can be physically and mentally prepared for what's to come, says Dr. Stephanie McNally, MD, an OB/GYN with Northwell Health.

Here are 6 things you should know about preconception care:

Folic acid is perhaps the most important one, thanks to the above-mentioned impact supplementation has on reducing birth defects. Most women who are trying to get pregnant should be taking 400 mcg daily, says McNally. If you end up getting pregnant with multiples—or if you've previously had a baby with a neural tube defect—your doctor may advise you to take a higher dose.

This is also a good time for your internist or OB/GYN to run routine blood tests to check for vitamin and mineral deficiencies. If you're lacking in any important nutrients, such as vitamin D or iron (indicated by anemia), you should start supplementing now, McNally adds.

If you have a chronic health problem, talk to your doctor about how it might impact your chances of getting pregnant as well as any changes you might need to make to prepare for a pregnancy. Certain medications are not ideal to use during pregnancy and may increase your risk of serious complications, so depending on your health status, your provider might advise stopping them or switching to a safer alternative.

Even if you believe you're perfectly healthy, getting a routine checkup from your internist is a good idea, suggests McNally. That's the best way to find out if you have a common yet potentially serious issue, such as diabetes or thyroid disease. "It's a good idea to address these now so we're not playing catch-up later," she says.

Meanwhile, you should also see your OB/GYN for an exam. In addition to getting a Pap test to screen for cervical cancer, "other gynecologic issues like fibroids or cysts need to be addressed, because they can affect your chances of getting pregnant," says McNally.

Depending on what your checkups reveal—and what you already know about your personal health history—you might need to consult with a maternal-fetal medicine doctor in addition to a regular OB/GYN and your usual primary care provider.

Some vaccines, including the measles vaccine, can't be administered during pregnancy. That's why the best way to keep you and your future baby safe is to make sure you're up to date on immunizations before you start trying to conceive. "Make sure you're protected against measles, mumps, and rubella, as well as varicella [also called chickenpox]," explains McNally. “Your doctor can order a simple blood test to see if you have antibodies to these diseases in your bloodstream.”

Women who are obese have a harder time getting pregnant and also have a higher risk of complications during pregnancy compared to women who are a healthy weight. "If you're overweight, use this time to get nutritional counseling and follow an exercise regimen that will help lower your body mass index," says McNally.

While anyone can develop postpartum depression, women who have depression or an anxiety disorder prior to getting pregnant are at highest risk. They're also more apt to experience anxiety and depression during pregnancy. If you're currently taking medication for a mental health condition, talk to your provider now to make sure you know about any changes that might have to be made in preparation for pregnancy, says McNally.

Whether you use medication or not, it's also a good idea to make sure you understand the warning signs of perinatal and postpartum depression and that you identify sources of support now so you know where to turn if you should need help later.

While some genetic tests are conducted once you're pregnant, planning ahead has major benefits.

Often as simple as a blood test, these screening tools will tell you if you're a carrier for one or more of 283 different inherited diseases, including many that are recessive (meaning both partners must carry the same defect in order for a child to be impacted).

While McNally warns that sometimes all this information "could open Pandora's box," it provides you with the opportunity to get some important health information. If, for instance, you are a carrier for cystic fibrosis, your partner can be tested now. If they turn out to be positive as well, you can then decide whether you want to risk trying to conceive naturally or if you'd rather explore IVF with preimplantation genetic diagnosis (PGD), which would guarantee that an implanted embryo does not have this disease. Talk to your doctor or a genetic counselor to learn more.

• Pausing pregnancy plans during a pandemic—questions to consider before conceiving during COVID.
• Thinking of trying at-home fertility kits? What you need to know.
• What you should know about thyroid disease before you get pregnant.