Any woman of childbearing age needs to maximize their health in the event that they become pregnant. At a basic level, general good health principles always apply: a balanced diet, avoiding smoking and use of other substances, being mindful of alcohol use, maintaining a healthy weight, and regular exercise. Daily folic acid is important for fetal development and may help reduce the risk of pre-term labor or premature birth. Maximizing health prior to becoming pregnant increases the likelihood of a full-term pregnancy and healthy baby.
If a woman is ready for a pregnancy and hasn’t had a full physical exam with a pelvic exam, then they should arrange to have that done. They will get a comprehensive well woman exam with individualized testing and counseling, for instance if they need a pap, an STD screen, or labs done. We take a thorough medical history, a menstrual history, and a family history to assess the risk of having a baby with a genetic disorder. We review their medications, if any, and make recommendations with regards to what is safe to continue during pregnancy, and which aren’t. If someone needs to be transitioned to a medication that is safer during pregnancy, for instance certain meds for high blood pressure, we will initiate that. If it happens that a woman becomes pregnant unexpectedly, we would ask them to call us prior to stopping their meds because some meds, like thyroid meds and meds for diabetes, epilepsy, or asthma, need to be continued during the pregnancy.
Many women ask when they should stop using contraception prior to trying to get pregnant. Generally speaking, the pill, IUDs, and Nexplanon can be removed when the patient is ready, and they can start trying for a pregnancy as soon as their normal periods resume. Women who are using Depo Provera may consider stopping earlier as some women will not have a period for a year after their last shot. Remember the folic acid!
For more information we recommend the patient pages on ACOG.org, where they can find the most current information, and can access current guidelines for women’s health care.