If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Preconception health and health care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby. For some women, getting their body ready for pregnancy takes a few months. For other women, it might take longer. Whether this is your first, second, or sixth baby, the following are important steps to help you get ready for the healthiest pregnancy possible.

Whether or not you’ve written them down, you’ve probably thought about your goals for having or not having children, and how to achieve those goals. For example, when you didn’t want to have a baby, you used effective birth control methods to achieve your goals. Now that you’re thinking about getting pregnant, it’s really important to take steps to achieve your goal—getting pregnant and having a healthy baby!

Before getting pregnant, talk to your doctor about preconception health care. Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy. He or she also will discuss any previous pregnancy problems, medicines that you currently are taking, vaccinations that you might need, and steps you can take before pregnancy to prevent certain birth defects.

If your doctor has not talked with you about this type of care―ask about it!

Medical Conditions

If you currently have any medical conditions, be sure they are under control and being treated. Some of these conditions include: sexually transmitted diseases (STDs), diabetes, thyroid disease, phenylketonuria (PKU), seizure disorders, high blood pressure, arthritis, eating disorders, and chronic diseases.

Lifestyle and Behaviors

Talk with your doctor or another health professional if you smoke, drink alcohol, or use “street” drugs; live in a stressful or abusive environment; or work with or live around toxic substances. Health care professionals can help you with counseling, treatment, and other support services.

Medications

Taking certain medicines during pregnancy can cause serious birth defects. These include some prescription and over-the-counter medications and dietary or herbal supplements. If you are planning a pregnancy, you should discuss the need for any medication with your doctor before becoming pregnant and make sure you are taking only those medications that are necessary

Vaccinations (shots)

Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having lifelong health problems

Folic acid is a B vitamin. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine.

Folic acid is a B vitamin. It helps the body make healthy new cells. Everyone needs folic acid. For women who may get pregnant, it is really important. Getting enough folic acid before and during pregnancy can prevent major birth defects of her baby's brain or spine.

Foods with folic acid in them include

• Leafy green vegetables
• Fruits
• Dried beans, peas, and nuts
• Enriched breads, cereals and other grain products

If you don't get enough folic acid from the foods you eat, you can also take it as a dietary supplement.

Smoking, drinking alcohol, and using street drugs can cause many problems during pregnancy for a woman and her baby, such as premature birth, birth defects, and infant death.

If you are trying to get pregnant and cannot stop drinking, smoking, or using drugs―get help! Contact your doctor or local treatment center.

Avoid toxic substances and other environmental contaminants harmful materials at work or at home, such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces. These substances can hurt the reproductive systems of men and women. They can make it more difficult to get pregnant. Exposure to even small amounts during pregnancy, infancy, childhood, or puberty can lead to diseases.

People who are overweight or obese have a higher risk for many serious conditions, including complications during pregnancy, heart disease, type 2 diabetes, and certain cancers (endometrial, breast, and colon). People who are underweight are also at risk for serious health problems.

The key to achieving and maintaining a healthy weight isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating and regular physical activity.

If you are underweight, overweight, or obese, talk with your doctor about ways to reach and maintain a healthy weight before you get pregnant.

Eating healthy foods is more important now than ever! You need more protein, iron, calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for two" doesn't mean eating twice as much. Rather, it means that the foods you eat are the main source of nutrients for your baby. Sensible, balanced meals combined with regular physical fitness is still the best recipe for good health during your pregnancy.

Healthy eating is a way of eating that improves your health and helps prevent disease. It means choosing different types of healthy food from all of the food groups (fruits, vegetables, grains, dairy, and proteins), most of the time, in the correct amounts for you. Healthy eating also means not eating a lot of foods with added sugar, sodium (salt), and saturated and trans fats.

Healthy eating also means getting nutrients primarily from food rather than from vitamins or other supplements. Some women might need vitamins, minerals, or other supplements at certain times in life like before or during pregnancy. But most women, most of the time, should get their essential nutrients from what they eat and drink.

What you eat and drink is influenced by where you live, the types of foods available in your community and in your budget, your culture and background, and your personal preferences. Often, healthy eating is affected by things that are not directly under your control, like how close the grocery store is to your house or job. Focusing on the choices you can control will help you make small changes in your daily life to eat healthier.

Violence can lead to injury and death among women at any stage of life, including during pregnancy. The number of violent deaths experienced by women tells only part of the story. Many more survive violence and are left with lifelong physical and emotional scars.

If someone is violent toward you or you are violent toward your loved ones―get help. Violence destroys relationships and families.

Collecting your family’s health history can be important for your child’s health. You might not realize that your sister’s heart defect or your cousin’s sickle cell disease could affect your child, but sharing this family history information with your doctor can be important.

Based on your family history, your doctor might refer you for genetic counseling. Other reasons people go for genetic counseling include having had several miscarriages, infant deaths, or trouble getting pregnant (infertility), or a genetic condition or birth defect that occurred during a previous pregnancy.

Mental health is how we think, feel, and act as we cope with life. To be at your best, you need to feel good about your life and value yourself. Everyone feels worried, anxious, sad, or stressed sometimes. However, if these feelings do not go away and they interfere with your daily life, get help. Talk with your doctor or another health professional about your feelings and treatment options.

Once you are pregnant, be sure to keep up all of your new healthy habits and see your doctor regularly throughout pregnancy for prenatal care.

The Hidden Realm

No relationship can be closer than that of a mother and her unborn child—yet the miraculous process taking place inside of you may seem as much of a mystery to you as to anyone else. A grainy black-and-white ultrasound image can be inspiring and reassuring, but it doesn’t show you very much about your baby.

What does this developing life really look like at 6 days after conception, at 6 weeks, at 6 months? How do intricately complex organs like the eyes form? When does your baby first suck his or her thumb—inside the womb? What does the embryonic heart look like when it starts beating, only about 21 days after conception? How much does your baby’s brain grow in the space of a month?

The moment a sperm penetrates the egg, chemical messengers relay news of the event to the brain, and the mother’s body immediately prepares for the new life. Tubal muscle movements and tiny hairlike projections called cilia transport the fertilized egg through the tube and into the uterus. The microscopic fertilized egg bores into the lush lining of womb, secures its site, and commences to grow with a vengeance.

Early Days

Whether they will become flatworms, lizards, or humans, embryos all develop in much the same way. The human embryo at about a month, when it is no bigger than a grain of rice, appears to be a tiny reptile, complete with tail.

Changes take place with amazing rapidity. About 21 days after conception the tiny, rudimentary heart begins to beat. At around 2 months, the embryo begins to acquire a clearly human aspect. The tail shrinks and toes and fingers become distinct. Inside the embryo, nerves feather themselves throughout the body and sex organs start to develop.

The months of pregnancy progress and the beauty and logic of the unfolding of life become clear. As though in a long, slow dance, eyes travel toward the front of the face while ears gradually climb up the head. Buds become limbs, toes and fingers emerge, facial features form—the fetus kicks, sucks his thumb, smiles.

After 9 months, this portion of your baby’s fantastic journey is complete. Everything lies in readiness for life outside of your protective womb—and the next stage of the journey.

Welcome to Your Baby’s World

The fertilized egg, termed a zygote, divides into 2 cells after about 24 hours, 4 cells after 48 hours, and 6-12 cells in 3 days. At about 5 days, the zygote has transformed into a hollow ball called the blastocyst.

The heart develops by folding in upon itself like a piece of origami. The early heart is not much more than two simple tubes that have fused together, twisted, and looped back on themselves. By week 5, the twisted tube fuses and becomes a two-chambered heart with one atrium and one ventricle. By week 6, a vertical wall known as the septum grows up into the middle of the two chambers.

By the time the baby is born, the brain will contain about 100 billion neurons—almost all the neurons it will ever have. The ear begins its development in the neck area and migrates up to the side of the head.

The embryo floats in an interior ocean—the amniotic fluid—contained by a membrane called the amnion. Salt is dissolved in the amniotic fluid in the same proportions as it is in our blood, tears, and the Earth’s oceans.

A woman's body undergoes enormous changes during pregnancy. The heart and kidneys must work harder because blood volume is higher. Cardiac output increases 30-50%. Heart rate increases to 80-90 beats per minute. The enlarged uterus, which reaches the lower edge of the rib cage by 36 weeks, compresses the bladder and intestines. This makes it necessary to urinate frequently, and it may also cause constipation. The mother’s spine curves more to balance the weight of the growing uterus.