Starting a family means overwhelming change. By planning ahead, you can begin to prepare emotionally and physically for pregnancy and parenthood. Here are some suggestions that can put you on the path toward a healthy and enjoyable pregnancy.

Your preconception checkup

Start by seeing your health care provider for a preconception physical exam. Ideally, this should occur six months before you try to get pregnant. Tell your provider you want to get pregnant, and together you can discuss your health status and prospects. At your visit, you should:

• Address any major health problems. If you have a chronic illness such as high blood pressure, diabetes, asthma, lupus, or epilepsy, discuss how this affects your pregnancy plans.
• Discuss the safety of any prescription or nonprescription medications you use. Your provider may advise you to eliminate some drugs now and to plan on stopping or changing others as soon as you know you're pregnant. Don't forget to discuss your vitamins and supplements as well; even "natural" products might impair your fertility or harm an unborn baby.
• Ask your provider whether you fall into any high-risk categories for genetic disorders and whether you should see a genetic counselor for advice or testing. If you or your partner are over a certain age, have a family history of disease, have certain ethnic backgrounds, or have been exposed to significant radiation, your children may be at increased risk of disorders.
• Update your immunizations. Your provider can test you for immunity against preventable diseases that pose risks to pregnant women or their babies. It's best to update your vaccinations at least three months before conceiving.
• Test for and treat other disorders and infections before you conceive. Once you're pregnant, not only do you have to worry about the illness itself, but you're also limited in your choice of treatments.
• Talk about your contraception history . If you've been using birth control pills, Norplant, Depo-Provera, or an IUD, ask your provider how long you should wait before trying to conceive.
• Evaluate your weight. Both overweight and underweight can affect your fertility and the health of any baby you conceive. If you have a weight problem, ask your provider for guidance on achieving a healthier weight.
• Discuss your nutritional needs. Your provider can give you eating guidelines that will ensure proper nourishment of a new embryo. You will probably also be told to take a supplement containing folic acid, which can significantly reduce the risk of certain birth defects. Because you need sufficient levels of this vitamin in your body at the time of conception, you should start taking it as soon as you plan on trying to conceive.

Your environment

After you schedule your preconception exam, you might consider these additional steps:

• Wean yourself from alcohol, recreational drugs, and tobacco. These substances can reduce your fertility and seriously injure a baby. And avoiding them will make you a healthier mom.
• Take care of any teeth and gum problems before you conceive. Experts recommend minimizing anesthesia and routine X-rays while pregnant. Also, pregnancy makes the gums sensitive, so dental work is more uncomfortable.
• Consider what changes you may need to make in your home and work environment if you become pregnant. Avoid home renovations or hobbies involving chemicals while you are trying to conceive. Does your workplace expose you to illnesses, X rays, paints, solvents, pesticides, cleaning agents, or other possible hazards? Look into precautions, a transfer, or a leave of absence.

Your finances

Having a baby isn't cheap. Advance planning can help keep the costs manageable. For example:

• Check your health care coverage. Does it cover prenatal care, tests, hospital costs, and newborn care? If you have restrictions on providers, facilities, or visits, make appropriate choices -- or consider changing or supplementing your coverage. If you don't have health insurance, do your best to get some, even if it's a bare-bones policy. If you experience any complications, you'll be glad you have coverage.
• If you work, investigate your options for maternity leave. Find out whether the Family and Medical Leave Act (FMLA) or the Pregnancy Discrimination Act applies to your company. Check your partner's options as well.
• Start thinking about how you will budget and pay for pregnancy and childrearing. Will you need childcare? Can you start saving now?

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