Planning for baby? Here’s why a pre-pregnancy checkup matters

Thinking about having a baby? Before you start tracking ovulation apps or stocking up on prenatal vitamins, there’s one step that often gets skipped: a pre-pregnancy checkup. 

Think of it as a routine physical but tailored specifically for conception. It gives you and your doctor the chance to identify any potential risks early and create a plan for a healthy pregnancy.  

“It’s important to prepare your body for a healthy pregnancy and journey ahead,” says Michael Krew, MD, a maternal-fetal medicine specialist at Akron Children’s. “For about 40 weeks, your body is home to a growing baby during its most critical stages of development — and your health plays a major role in your baby’s growth.” 

A healthy pregnancy starts long before you see that positive result on a pregnancy test. Learn why a pre-pregnancy checkup matters and what to expect at your appointment.  

When to schedule a pre-pregnancy appointment 

Schedule your pre-pregnancy appointment with your Ob-Gyn about three to six months before you start trying to get pregnant. That way if there are any concerns, you have time to make recommended changes before becoming pregnant. 

Even if you’ve been pregnant before, don’t skip this important step.  

“Your health, medications and lifestyle may have changed since your last pregnancy,” says Dr. Krew. “And if you had a problem in your last pregnancy, like a premature birth, birth defect or miscarriage, your doctor can help you avoid it the next time.” 

What happens at a pre-pregnancy checkup? 

So, what actually happens at a pre-pregnancy checkup? Here’s a breakdown of what your doctor will likely cover: 

Your health (and your family’s health) 

Your doctor will review your current health and ask about family history. This can help spot any concerns that might increase your chances for a high-risk pregnancy.  

Your family history provides insights into any genetic conditions that could affect the health of your baby. (It’s important to review your partner’s medical and family history for this same reason.) You may need genetic counseling and testing to understand your child’s chances of inheriting a genetic condition. 

It’s also a good time to talk about your mental health. If you’ve struggled with anxiety, depression or other mental health problems, you’re more likely to have them during or after you have a baby.  

Untreated anxiety or depression can increase the risk of pregnancy problems. So, your doctor may recommend therapy or counseling to work through any issues before becoming pregnant.  

Chronic conditions  

If you have a preexisting condition like high blood pressure, obesity or diabetes, your doctor will work with you to get it under control before pregnancy. 

Uncontrolled high blood pressure can increase the risk of complications like preeclampsia during pregnancy. Undiagnosed diabetes can lead to birth defects, early birth and even miscarriage. 

“Preexisting conditions put mom’s health at risk, too,” says Dr. Krew. “High blood sugar levels can damage your organs. And hypertension increases your risk of a heart attack, stroke or kidney failure.” 

Having a preexisting condition doesn’t mean you can’t have a healthy pregnancy. But it does mean close monitoring and being in your best health possible to avoid problems.  

Your doctor may recommend lifestyle changes like diet and exercise to manage your condition, or you might need to adjust your medication.  

Lifestyle habits 

Be prepared to talk about your lifestyle — and honesty matters. Your doctor might ask you about smoking cigarettes or marijuana, alcohol use, diet, exercise and stress levels. It’s not about judgement but improving your health. Unhealthy habits can pose risks to your unborn baby.  

Your doctor can help you make realistic changes like improving your diet, getting active, managing stress and quitting smoking. Small steps now can make a big difference later. 

Medication review 

Review any prescription, over-the-counter meds and supplements you’re taking with your doctor. Some drugs are considered safe during pregnancy, but others should be avoided. So, you’ll need time to transition to safer options and doses. If that’s not possible, your provider may refer you to a maternal-fetal medicine specialist for further evaluation. 

If you’re currently on birth control, it’s also a great time to talk about when and how to stop, and what to expect with your cycle afterward. 

“If you’re on birth control, your doctor can guide you on getting off and how long the effects will last,” says Dr. Krew. “Your provider also can talk to you about your period cycles and how best to determine when to conceive.” 

In addition, ask your doctor about other medications or supplements you should add. It’s recommended all women start taking 400 micrograms of folic acid at least three months prior to getting pregnant.  

Getting enough folic acid in early pregnancy can lower the risk of neural tube defects (problems caused by incomplete development of the brain or spinal cord), such as spina bifida, and other pregnancy complications. 

Reproductive health check 

Your visit also will likely include a physical exam, pelvic exam and may include screenings like a Pap smear or blood tests. Your doctor wants to assess your reproductive health and check for infections and sexually transmitted diseases that could lead to problems during pregnancy. 

Your doctor also will make sure your vaccinations are up to date. Some vaccines — like rubella or chickenpox — need to be given before pregnancy. But others (like the flu and COVID vaccines) are safe to get while pregnant. Keeping up to date on vaccines is important because some of these illnesses can cause serious problems for you and your growing baby.   

What to expect after a pre-pregnancy checkup 

After your visit, your doctor may recommend a mix of lifestyle changes, treatments or follow-up visits to monitor progress and prepare your body for pregnancy.  

“Your doctor isn’t there to tell you whether you should or shouldn’t get pregnant,” says Dr. Krew. “In most cases, it’s a conversation between you and your doctor to better understand any risks and work together to create the best possible plan for a healthy baby.” 

A pre-pregnancy checkup ensures you’re informed, prepared and in the best possible health for this next chapter in your life. Because at this stage, it’s not just about taking care of yourself anymore. It’s about preparing for the possibility of new life — and giving your baby the best possible start.