Ultimate pre-pregnancy checklist: Essential steps to take before having a baby

A doctor holding medical records, emphasizing the importance of pre-pregnancy checkups and documentation.
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Created with Carolyn Kay, MD, Obstetrics & Gynecology, USA

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In a nutshell

Preparing for pregnancy involves thorough preconception checkups, genetic carrier screening, and lifestyle adjustments like taking folic acid, tracking your menstrual cycle, and quitting smoking.

Going through all steps of preparation might take a bit of effort, but growing a human being is life changing and at the end of the day, you will likely be glad to be educated and prepared for what to expect during your pregnancy. 

Pregnancy preparation is an empowering process that enables you to gain solid knowledge and understanding of your future pregnancy that can help you make the best decisions both for yourself and for your baby. And it’s good to begin it before conception to prepare yourself best. It should consist of a thorough preconception checkup and testing to address any potential obstacles early. There are also other things to do before having a baby, such as cycle tracking, taking folic acid supplementation, planning your budget, and more.

While all these preparatory steps might feel a little overwhelming, the benefits are clear:

  • Optimized health for easier conception and pregnancy;
  • Timely and relevant addressing of chronic conditions (if any);
  • Emotional readiness for parenting;
  • Well-defined finances;
  • Deeper knowledge and skills of how to deal with different situations that might arise during pregnancy and beyond;
  • A stronger relationship with your partner.

To help you gain all these benefits and effectively prepare for pregnancy, we have created a comprehensive pre-pregnancy checklist that should help you understand all the options that you have out there and decide which testings, checkups, and other steps you can take to prepare for your pregnancy effectively. 

👉Find out more: Best age to get pregnant with PCOS

We will cover different stages of pregnancy preparation and share some handy advice on recommended testing, preconception checkups, and other important considerations that you can follow or decline based on your unique situation and a consultation with your healthcare practitioner.

A comprehensive checklist for pre-pregnancy preparation, including vaccines, medical history assessment, physical exams, dental health checks, pelvic ultrasound, urinalysis, blood tests, STI screening, and genetic carrier screening.

Pre-pregnancy testing

1. Genetic carrier screening

Genetic carrier screening detects the carriage of genes for disorders like spinal muscular atrophy, cystic fibrosis, or fragile X syndrome.

It is recommended for all pregnant (or planning-to-be-pregnant) women to take this screening. Many of these disorders result from recessive genes, so a primary concern is that even if neither you nor your partner experience any tangible symptoms, you may possess and pass down the gene without knowing it.

👉Find out more: Boosting your fertility: Tips for getting pregnant in your 30s

Trying to get pregnant?

Femia offers the most accurate tool for determining ovulation and fertile days

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2. Blood tests

The first blood test that might be good to take is blood typing. Identifying your blood type is crucial for a number of reasons, including predicting some conditions that may occur during pregnancy, lowering risk for certain health conditions, and even predicting the possible blood type in the future child (if the second parent’s blood type is known).

The rhesus (Rh) factor of both parents-to-be is the next important test to consider. The result will be either positive or negative and may impact the conception and pregnancy.

If a mother is Rh negative and the father is Rh positive, this can lead to Rh incompatibility between the mother and a child. The mother’s body may perceive an Rh-positive fetus as a foreign threat and activate immunogenic pathways to produce antibodies that attack a fetus. This incompatibility may not cause any issues, especially during the first pregnancy. But it can affect any subsequent pregnancies. So it’s good to know the blood types and Rh factors of both parents-to-be to be able to address potential complications. But keep in mind that this incompatibility only happens when there is an Rh negative mother and Rh positive father. It’s not an issue if a mother is Rh positive and a father is Rh negative.

A complete blood count (CBC) is one more test that can help you prepare for conception and pregnancy. This test provides a good understanding of your overall health and points to the levels of important elements in your blood. Namely, one important thing it scans is the level of hemoglobin—a crucial protein that delivers oxygen to the unborn baby and, thus, should be sufficient in a female’s body. Also, healthcare practitioners may also do thyroid testing and screen for diabetes (like a hemoglobin A1c test) if there are any preconditions for that.

To ensure optimal health and readiness for pregnancy, you may also consider checking your immunity to certain diseases, including chickenpox and rubella.

3. STI screening

Sexually transmitted infections (STIs) come in different types, including:

  • Hepatitis;
  • HIV;
  • Trichomonas;
  • Herpes;
  • Syphilis;
  • And others.

It can be a good idea to include STI screening in your preconception testing. You may consider this opportunity due to two primary reasons:

  1. STIs may impact both female and male fertility, complicating and lengthening the conception process.
  2. Some STIs can be transmitted to the fetus and result in different health challenges. 

By testing for STIs early, you can ensure that you are on the safe side or treat infections before the pregnancy.

👉Find out more: How to boost fertility in your 30s

Preconception checkup

1. Choosing a healthcare provider

As step one, you will want to find and plan a checkup with a healthcare specialist. We recommend you to consider the following care providers:

  • Family doctor. A doctor who specializes in taking care of pregnant women and delivering babies.
  • Midwife. A specialist who hold the education and training needed to assist women in primary, prenatal, and obstetric care. Midwives typically work together with obstetricians and gynecologists, as they have a different skill set from physicians.

Whichever specialist you select, bear in mind two crucial points: 1) it should be a professional you trust and feel comfortable with to minimize stress; and 2) it can be a good idea to consider getting your checkup with a provider who will take care of you during pregnancy later.

A woman consulting with a doctor, discussing pre-pregnancy health and preparation.

2. Medical history review

When you have your appointment with your chosen specialist, one of the first things you will likely do with them is a thorough medical history review.

Personal and family medical histories as well as overall pedigree are commonly used as tools in preconception consultation. A history review can help your healthcare providers make an informed risk assessment and take a data-driven approach to further reproductive decision-making.

Additionally, a healthcare practitioner may also ask your travel history to learn if you’ve visited places where certain diseases, such as Zika, are endemic. They may ask you about your exposure to Toxoplasmosis, which can occur from cat litter. And they might also do screening for mental health disorders and ask you about any traumatizing events, such as intimate partner violence.

3. Current health assessment

During a preconception checkup, a healthcare provider should also assess your current health condition. This can involve the following components:

  • Physical exam. A general physical examination might include a checkup of your weight, blood pressure, skin, lungs, heart, etc.
  • Pelvic exam. A healthcare provider might perform an examination of your pelvic organs (e.g. vagina, cervix, uterus, etc.) to ensure they are healthy.
  • Cervical screening. This screening may include checking up for viral DNA or  abnormal cells to identify risk of cervical cancer and check the overall health of the cervix.

Additionally, your healthcare provider will likely collect additional information about your work and life that might affect conception or pregnancy. They may ask you about the birth control methods you are using, your smoking or drinking habits, medications you take, and whether you get exposed to any harmful chemicals at home or work.

Based on your personal and family medical history, your specialist may also recommend that you see a genetic counselor.

👉Find out more: Pelvic floor massage 101: How to relieve pain and improve function

4. Vaccinations

During a checkup, healthcare providers typically assess your vaccination history to ensure that you have immunity against diseases that might affect your pregnancy.

A specialist will check if you are up to date with the following recommended vaccines:

  • COVID-19
  • Flu (Influenza)
  • MMR (measles, mumps, rubella)
  • Tetanus, diphtheria, pertussis (Tdap or Td)
  • Hepatitis
  • Human papillomavirus (HPV)

After examining the received vaccines, a specialist may recommend that you get additional immunizations according to the recommended schedule.

Things to do before having a baby

1. Folic acid supplementation

Folic acid is one of the most important supplements for women seeking to get pregnant. Our bodies convert manufactured folic acid into the nutrient folate, which is a core nutrient required for DNA replication. It plays a significant role in amino acid synthesis and vitamin metabolism and. is required for the growth and development of the fetus.

Folic acid supplementation implemented before conception is linked to a lower risk of neural tube defects (NTDs). Studies suggest it can also protect against other fetal structural anomalies, such as congenital heart defects, and may reduce the risk of preterm birth. Consider starting prenatal vitamins before conception to ensure adequate nutrient intake. 

The rationale behind early folic acid supplementation is that the critical time to have folate is during organogenesis–around 3-8 weeks. Since for many people it’s hard to know for sure when they got pregnant, it’s advised to start taking folic acid right when just planning a pregnancy.

Bottles of folic acid and omega-3 supplements, essential for pre-pregnancy health.

2. Tracking your menstrual cycle

Different stages of your menstrual cycle have different effects on your fertility. The highest likelihood of conceiving is during the ovulation period.

The variability of your menstrual cycle also matters. Studies reveal that women with high variability tend to have a 51% lower pregnancy probability per cycle.

Due to these reasons, your menstrual cycle, its stages, and variability are important things to consider before having a baby. By tracking your cycle, you can enhance the likelihood of conception by planning intercourse during your ovulation period.

Trying to get pregnant?

Femia offers the most accurate tool for determining ovulation and fertile days

Try Femia now

3. Financial planning

According to the latest figures, the average cost of pregnancy, childbirth, and post-partum care in the US is $18,865. There are also many additional expenses after childbirth, which is why financial planning should be among the top things to do before having a baby.

To prepare well, consider auditing your current income, emergency fund, and other assets to define a budget for medical expenses, baby supplies, and other things. Consider the potential loss of income due to maternity leave and its impact on your household. The more details you plan ahead, the easier it should be to overcome the potential financial challenges.

4. Lifestyle adjustments

If you are wondering what lifestyle changes to make before getting pregnant, the universal recommendations are pretty well-known. To ensure the best health for yourself and your future baby, you should consider:

  • Quitting smoking
  • Abstaining from drinking alcohol 
  • Limiting caffeine consumption
  • Maintaining a healthy diet

It’s also recommended to maintain healthy physical activity. Consider joining a gym or sports team. You may also find prenatal yoga or fitness classes beneficial even before pregnancy.

5. Support system

The process of conception preparation and pregnancy can be draining and stressful for women. It can also be a very emotionally vulnerable time for some women, hence the need for a strong support system. 

A good support system could consist of multiple elements:

  • Partner support
  • Family support
  • Friends support
  • Neighbors support
  • Co-workers support
  • Support from mentors and spiritual leaders
  • Efficient counseling and helpful resources

Questions from the Femia community

  • How soon should I start preparing for pregnancy?

    According to doctors, the average time frame for pregnancy preparation is around six months before conception. This is the usual time you’ll need to get through all checkup stages and testings as well as gradually implementing the necessary lifestyle adjustments to ensure that you are in your best health when trying to conceive. However, it’s important to understand that the same preparation may take shorter or longer depending on their needs. There is no universal standard as everyone’s journey is unique.

  • What should I avoid when trying to get pregnant?

    The general rule of thumb is to avoid smoking, alcohol consumption, recreational drugs, and exposure to harmful chemicals. It is also recommended to steer clear of excessive caffeine consumption, excessive exercise, and extreme weight fluctuations.

  • Can stress affect my chances of getting pregnant?

    Yes. Studies on women undergoing in vitro fertilization confirmed that high levels of stress can impact fertility. When planning a pregnancy, looking into effective stress management tactics may increase the likelihood of conceiving.

  • Do I need to stop taking my current medications?

    Some medications might be safe for conception and pregnancy, but not all. Consult with your healthcare provider about the specific medications you are taking to decide whether they are safe or you should quit them to conceive.

  • How can my partner support me in preparing for pregnancy?

    A strong support system is important for seamless and positive conception preparation. Your partner can demonstrate support by accompanying you during medical appointments, adopting healthy lifestyle changes together with you, and providing emotional support.

The bottom line

Pregnancy planning is a sophisticated and all-encompassing process that covers a range of crucial topics. Effective planning and preparation involve pre-pregnancy testing, preconception checkups, folic acid supplementation, cycle tracking, financial planning, lifestyle adjustments, and building a support system. 

It’s smart to start getting ready for conception early. Talk to your healthcare provider for tailored advice to make sure your pregnancy journey is as healthy as possible.

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