Prevention · · 8 min read

Preconception health: a checklist before pregnancy

The first weeks of pregnancy are when the baby's brain and spine take shape, often before a woman knows she is pregnant. That is why the most important steps come first: starting folic acid, reviewing medicines and vaccines, and getting health conditions under control. Here is a clear checklist, including what depends on the future father and when to seek help if conception takes longer.

Illustration of a calendar with one day circled in red, a pill bottle with a yellow label and a checklist with two ticked boxes on a pale blue background

In short

  • See your provider before you try to conceive, with a list of questions about your health history, conditions, medicines and lifestyle.
  • The CDC says to have enough folic acid in your body at least one month before and during early pregnancy to help prevent certain birth defects of the brain and spine.
  • Review every medicine and supplement with your provider, and do not stop a prescribed one on your own.
  • Ask which vaccines you need before pregnancy, and get chronic conditions under control.
  • Stop smoking and alcohol, work toward a healthy weight, and include your partner in the plan.

Folic acid: why it comes first

The CDC explains that neural tube defects, serious birth defects of the brain and spine, form in the first few weeks of pregnancy, often before people know they are pregnant. By the time someone learns they are pregnant it may be too late to prevent one, which is why the CDC recommends daily folic acid for anyone who could become pregnant, starting at least one month before conception and continuing through early pregnancy.

MedlinePlus adds that food sources of folate include leafy green vegetables, fruits, dried beans, peas and nuts, and that enriched breads, cereals and grain products contain folic acid. If food does not provide enough, a supplement can fill the gap. Ask your provider about the right type and amount for you, particularly if you have had a pregnancy affected by a neural tube defect, since the advice differs.

The checklist

The CDC's planning-for-pregnancy checklist and the NHS planning page cover the following:

  1. See your provider.Discuss your health history, current medical conditions and lifestyle. Bring a list of questions.
  2. Start folic acid.Take it at least a month before trying and continue in early pregnancy, as the CDC advises. The NHS also lists vitamin D as a supplement to ask about.
  3. Review medicines.Go over all prescriptions, over-the-counter medicines, supplements and vitamins, as the CDC says.
  4. Check vaccines.Ask which vaccines you need before pregnancy. The NHS says to have the MMR vaccine before pregnancy if you have not already.
  5. Check screening.The NHS says to check whether your cervical screening is due, and to get tested for sexually transmitted infections if you or your partner may have one.
  6. Collect family history.Your provider may refer you for genetic counseling, according to the CDC.

Chronic conditions: get stable first

The CDC says to tell your provider about any ongoing medical conditions so they can be managed before pregnancy. The NHS says to speak to your provider if you or your partner live with a condition such as epilepsy, diabetes, sickle cell disease or HIV, so the plan can be adapted to you.

Weight matters too. The NHS says being underweight or overweight can make it harder to get pregnant, and that overweight in pregnancy raises the risk of high blood pressure, pre-eclampsia, gestational diabetes and blood clots. The CDC suggests working toward a healthy weight. Mental health counts: the CDC advises talking to your provider if worry, sadness or stress persists.

Medicines to talk through

The NHS says not to stop any prescribed medicine until you have spoken to your provider or specialist, who can advise on the safest option while you are trying to conceive. That applies to over-the-counter medicines and herbal remedies, too, for you and your partner.

The CDC adds that you should avoid harmful chemicals, contaminants, bug spray, and cat or rodent feces at home and at work, and that you should stop using drugs that are not prescribed to you.

Alcohol, smoking and everyday habits

The CDC says to stop drinking alcohol and to stop smoking, and that your provider, a quitline or an alcohol treatment center can help if you cannot manage on your own. The NHS says to get support to stop smoking and to avoid alcohol while trying for a baby.

The father's side of the plan

The NHS counts you and your partner as a unit: speak to a provider if your partner takes prescribed or over-the-counter medicines or herbal remedies, has a fertility issue such as low sperm count, or has a condition that could affect conception. Sexually transmitted infection testing applies to both of you, and so does help with smoking and alcohol.

A partner's support makes the habit changes much easier to keep.

Timing and ovulation

The NHS says you are most likely to conceive around ovulation, usually about 14 days before your next period, though that depends on your cycle length. If you are 39 or under and have sex without contraception every two to three days, you will likely conceive within a year.

Timing varies from person to person, and it is normal for it to take months.

When to seek help if it is not happening

The NHS advises seeing your provider if you have been trying for one year or more, if you or your partner have a fertility issue such as endometriosis or low sperm count, or if you need help to stop smoking, drinking or using drugs. Previous cancer treatment is another reason to ask sooner, and your provider can refer you for tests if needed.

Red flags and questions for your provider

Make an appointment before you start trying. Red flags once you are pregnant: call 911 for severe belly pain, heavy bleeding, fainting or a seizure.

Questions to bring:

  • Which vaccines do I need before pregnancy?
  • Are my medicines and supplements safe to continue while I try to conceive?
  • Do my chronic conditions need adjusting first?
  • Do I need genetic counseling based on my family history?
  • What should my partner check?

Questions and answers

When should I start folic acid?

At least one month before you start trying and through early pregnancy, according to the CDC. The CDC also recommends it for anyone who could become pregnant, even without a plan, because neural tube defects form so early.

Which vaccines do I need before pregnancy?

It depends on your history, so ask your provider. The NHS names MMR as one to have before pregnancy if you have not already.

Do I need to stop my medicines before pregnancy?

Not on your own. The NHS says not to stop any prescribed medicine until you have spoken to your provider, who can suggest the safest option.

How long does it usually take to get pregnant?

The NHS says that people aged 39 or under who have sex every two to three days without contraception will likely conceive within a year.

When should I ask for help?

After a year of trying, or sooner if you or your partner have a fertility issue, a chronic condition, or earlier cancer treatment, as the NHS advises.

Sources

  1. CDC — Planning for pregnancy
  2. CDC — About folic acid
  3. NHS — Planning your pregnancy
  4. MedlinePlus — Folic acid

Sources checked on 29 October 2026.

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