Before the Bump: A TTC To-Do List
Lem and June Collections
A guiding principle for me as a childbirth educator is to encourage proactive preparation. We can never predict exactly how birth will unfold, and we can never guarantee a specific outcome. But being proactive is all about controlling what we can and “clearing the path”.
Some of this information is valid and important for partners, too, so make sure to work together in being proactive for preconception health!
Let’s look at ten things to do before (or while) you try to conceive.
1. Schedule a Preconception Appointment
A great first step in being proactive is to schedule a preconception appointment. The basic purpose of this appointment is to discuss your plans for having children, ask questions, and address any concerns. Some of the other tips in this post are topics that may come up during this visit.
Choose a Care Provider
Consider scheduling this appointment with a provider you are considering for prenatal care and birth support. This is a great time to start thinking about who this provider might be. Your choice of care provider can have an effect on your available options (like where you give birth) and your birth experience. It’s ideal to find someone who supports and prioritizes your right to make decisions about your own body. Sometimes the care provider you’ve seen for years for routine care isn’t the best fit once you become pregnant.
💡 Tip: If you are seeing a new care provider, make sure to have your medical records forwarded to their office. You can call your previous provider’s office and ask for them to be sent over.
Verify Health Insurance
As you’re researching your options for care provider and birth location, you may need to consider any limitations imposed by your health insurance plan.
If you don’t have insurance, make sure to check out this link:
Health coverage if you’re pregnant, plan to get pregnant, or recently gave birth | Healthcare.gov
Be aware that you can only sign up for health insurance during open enrollment periods or as a result of major life changes (like having a baby). You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time, though.
Gather Health History Information
Your provider will want to discuss your health history, as well as your family health history. It can be helpful to gather this information in advance. Your provider may provide you with a form or you can use this one:
🔗 Family Health History Form | March of Dimes
2. Prioritize Routine Care and Management of Medical Conditions
Before trying to conceive, get caught up on any necessary routine care appointments. If you have any medical conditions, it’s important to make sure those are addressed and managed prior to pregnancy. This includes:
Routine well checks with your primary care provider
Yearly gynecological exam
Dental appointments
Mental health management
Management of chronic illness or other medical conditions
3. Get Proactive About Your Fertility
Transition Off Birth Control
If you’re currently using birth control, talk to your care provider about transitioning off of it. Specifics will vary by the form of contraception you are using.
Consider Tracking Your Menstrual Cycles
It’s really helpful to start tracking your menstrual cycles, if you aren’t already. This can give you and your care provider valuable information about your fertility. Also, knowing the first day of your last menstrual period can help establish a due date in pregnancy.
If you want or need to be as proactive as possible in your trying to conceive journey, there are ways to track the small window of peak fertility that occurs each cycle. Also, there are certain lifestyle choices that can affect fertility, like smoking, alcohol consumption, stress, and poor nutrition. Sperm quality can also be affected by certain lubricants, hot tubs, tight clothing, long bike rides, and more. If you have any questions or concerns about your or your partner's fertility, definitely bring them up with your care provider.
If you want more information on all of this, check out my blog post below. It also acknowledges that not everyone trying to conceive has ready access to all three essential components (egg, sperm, and uterus) and links to a great resource to check out on this.
4. Ensure You’re Getting Enough Folic Acid Prior to Pregnancy
You can reduce the risk of neural tube defects (birth defects of the brain and spine) by ensuring you are getting 400 mcg of folic acid each day, starting at least a month before conception. You can meet your daily needs by eating fortified foods and/ or taking a supplement (more on supplements in #5).
While this a well-established and sound recommendation, you may hear individual health care professionals, nutritionists, and birth workers recommending supplements containing “natural food folate” instead. Check out my blog post for more on this:
🔗 MTHFR and the Folate Debate | Navigating Birth and Beyond Blog
5. Discuss Any Medications and Supplements You Are Currently Taking With Your Care Provider
Medications
Many people take medications during pregnancy. If you’re trying to conceive and taking a medication, it is so beneficial to have a discussion with your care provider in advance and get a plan in place. Some medications are contraindicated in pregnancy (and could even cause severe birth defects). For most, it comes down to informed decision-making regarding benefits and risks.
‼️ Important: Check with your care provider before starting or stopping any medications.
Supplements
It’s important to discuss any supplements you are taking, as well. Your nutritional needs change during pregnancy, so your care provider may recommend switching to a prenatal vitamin supplement at that point. While it‘s best to get necessary vitamins and minerals from foods, supplements can help you fill in any gaps.
6. Make Sure Your Immunizations Are Up-to-Date
Your care provider can help you figure out if there are any vaccines you need.
The link below talks about accessing your vaccination record, if necessary, as well as making sure you’re up to date on the MMR vaccine BEFORE pregnancy.
🔗 Vaccines Before Pregnancy | Centers for Disease Control and Prevention
It’s ultimately your choice as to which vaccines you choose to receive. It’s important to note that there is a lot of misinformation surrounding this sometimes controversial topic. Reliable information and research evidence is crucial in informing your decisions. Check out the link below for more information:
7. Get Tested for Sexually Transmitted Infections
You may or may not be tested for sexually transmitted infections (STIs) during routine care appointments unless you ask. STIs are really common and often very treatable. Symptoms aren't always present, so STIs can go unnoticed. Unfortunately, untreated STIs can have a negative impact on fertility and can be passed to babies before and during birth.
Ask your care provider about getting tested or use the link below for more information and to find a local clinic where you can get tested.
🔗 Yes Means Test | American Sexual Health Association
8. Consider Genetic Carrier Screening
There are optional tests that can be done before or during pregnancy to determine whether or not you and/or your partner are a carrier for certain genetic disorders. Genetic carrier screening for certain disorders (cystic fibrosis, for example) is offered to anyone trying to conceive/ all pregnant people. Screening for other disorders may be recommended to those whose risk factors are higher, which is determined by ethnicity, family history, and personal health history. Keep in mind, both partners have to be carriers for a child to inherit a disorder. Even then, it isn't a guarantee. A genetic counselor can help you make decisions about additional screening. They can also talk to you about the likelihood of passing down a genetic disorder and possible options, if necessary.
9. Consider Potential Impacts at Home and at Work
Pregnancy and postpartum can be a catalyst for major change. Start considering the potential impacts at home and at work.
At Home
Workload is going to increase when you bring home a baby. Start having discussions with your spouse or partner about what household equity might look like for you. It is not uncommon for much of the increased load to fall to one person, which can lead to resentment and other issues. Check out the website below for a great book recommendation (and more( to help with these discussions.
At Work
It’s never too early to start thinking about how having a baby will impact employment. Do you have access to paid maternity and paternity leave? If you’re working full-time, will you continue doing so after your baby arrives? Are you (or your partner) considering switching to part-time hours or any other changes? Are you (or your partner) considering becoming a stay-at-home parent? What are some options you might have for child care?
10. Focus on Health and Wellness
Now is a great time to start focusing on your health and wellness, if you aren’t already! A lot of what I’ve already mentioned in this post is part of it, but there is more to taking care of yourself.
Here’s a list of some areas to consider:
A printable version of this checklist is available in my Free Resource Library. Click the button below to access this and more!