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Thinking about having a baby? Don't wait for the results of a home pregnancy test before you see a doctor. The best time to have that first prenatal visit is before you get pregnant.

A pre-conception checkup helps assure that you are physically healthy and emotionally prepared for pregnancy.

What to expect

During your pre-conception checkup, your doctor will check your health and identify any risks that might affect a pregnancy.

You can expect the following during a pre-conception visit:

• Physical exam. This includes any needed health screening tests, such as a pap smear or blood tests to check for antibodies to rubella (German measles). Also update any immunizations you need.
• Review of your medical history. This includes a review of any prescription or over-the-counter medications or supplements you are taking.
• Review your family's medical background.
• Questions about your diet and habits, such as whether you drink alcohol or caffeine, or smoke. Also discuss any potential exposure to toxic chemicals or infectious material (such as cat poop) at work or at home.
• Review past pregnancies and birth control use.
• Referral for genetic counseling, if needed.

If you have a health concern, such as diabetes, high blood pressure or a seizure disorder, make sure you talk to your doctor before you get pregnant.

It's also important to learn and share your family medical history. Ask family members about any health conditions they have. Check specifically for birth defects or other chronic health problems. This can help your doctor identify risk factors and refer you for genetic counseling, if needed.

The importance of diet and vitamins

Your diet is an important part of a healthy pregnancy. Talk to your doctor about your current weight and whether it might help to gain or lose some weight before you become pregnant.

• Underweight women are at higher risk to deliver a baby with low birth weight.
• Overweight women are at higher risk for maternal complications, such as high blood pressure and gestational diabetes.

All women, even if they are well-nourished, should start taking prenatal vitamins before they are pregnant, particularly folic acid. Folic acid helps prevent certain birth defects, such as spina bifida, where the brain or spinal cord does not form properly.

The March of Dimes recommends that all women who could become pregnant take a multivitamin containing 400 micrograms of folic acid every day. You should take it starting before pregnancy through the first trimester.

Certain factors may change how much folic acid you should take. Ask your doctor how much folic acid is right for you.

Now is also a critical time to look at tobacco and alcohol use. You probably already know that you should avoid tobacco and alcohol while you're pregnant. Talk to your doctor about your habits and what you need to do for a healthy pregnancy.

• Cigarette smoking raises the risk for miscarrying and for delivering a low birth-weight infant.
• Drinking alcoholic beverages can cause fetal alcohol syndrome. This is a pattern of birth defects that includes mental retardation and heart, skeletal and facial problems.

A checkup before you get pregnant can help increase your odds for a healthy pregnancy and healthy baby. Medical conditions can be managed, risk factors modified and health habits improved.

Sources: Centers for Disease Control and Prevention. Preconception care questions and answers. Accessed April 29, 2008. National Women's Health Information Center. Before you start trying. Accessed April 29, 2008. March of Dimes. Before pregnancy: preconception. Accessed May 25, 2008. American Academy of Pediatrics. Folic acid for the prevention of neural tube defects. Accessed May 1, 2008.

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