Most couples start thinking about their health the day the pregnancy test is positive. That is understandable, and it is also a few months too late for some of the things that matter most.
The healthiest pregnancies tend to begin before conception, when there is still time to sort out a medication, settle a long term condition or build up a vitamin your baby will need in the very first weeks. This article is about that preparation, not about contraception, which our separate article on birth control covers.
What preconception care actually means
Preconception care is simply a health check and tidy up before you try to conceive. It is a quiet, unglamorous appointment that pays off later.
At that visit a doctor will review your general health, your past pregnancies if any, and your family history. It is a chance to check that any long term condition is well controlled, to review your medicines, and to make sure your vaccinations are up to date, because a few infections such as rubella are far safer to be protected against before pregnancy than during it.
This is also the time to be honest about lifestyle. Stopping smoking, cutting out alcohol, reaching a healthier weight and getting regular exercise all improve your chances of conceiving and of a healthy pregnancy. None of this needs to be perfect. It just needs a start.
Folic acid, and why the timing matters
Folic acid is a B vitamin that helps a baby's spine and brain form correctly in the earliest weeks. Because that development happens before most women realise they are pregnant, the standard advice is to start a daily folic acid supplement while you are still trying, not after.
Most women take a standard daily dose, but some need a higher amount, for example if they have diabetes, take certain medicines, or have had a pregnancy affected by a spine problem before. A short conversation with a doctor sorts out which group you are in.
Long term conditions deserve attention first
If you live with a condition such as high blood pressure, diabetes, a thyroid problem, asthma or epilepsy, pregnancy is very possible, but it is much safer when the condition is well controlled and your medicines have been reviewed beforehand.
Some medicines that are perfectly fine day to day are not the best choice in pregnancy, and a doctor can often switch you to a safer alternative in good time. Never stop a prescribed medicine on your own because you are trying to conceive. Ask first, because for some conditions the illness itself is the bigger risk.
We manage chronic conditions here as part of ongoing care, so this can be built into the same relationship over the months before you start trying.
Spacing your pregnancies
How long to wait between babies is a common and sensible question. In general, giving your body time to recover between a birth and the next pregnancy is better for both mother and baby, and a very short gap carries slightly higher risks.
There is no single perfect number that suits everyone, and your age and your own health all factor in. If you are weighing up the timing of a next child, it is worth a conversation rather than a guess.
Fertility basics: what is normal
Fertility is the ability to conceive, and it is more variable than people expect. For most healthy couples having regular unprotected sex, pregnancy happens within a year, and many conceive within the first several months. It very often takes longer than couples imagine, and that wait alone is usually not a sign anything is wrong.
A woman is most likely to conceive around the time an egg is released each month, which is roughly in the middle of the menstrual cycle. Getting to know your own cycle helps you understand your most fertile days. Age also matters, and fertility gradually declines with age for women, and more slowly for men too.
When to seek help conceiving
There is a widely used rule of thumb for when to ask for help, and it depends mostly on age.
Come in sooner than these timelines if your periods are very irregular or absent, if you have had pelvic infections, surgery or miscarriages, or if there is a known reason for concern on either side. Fertility involves both partners, so it is best when both come together.
A first assessment is straightforward. It usually involves a conversation, an examination, blood tests to check hormones and general health, and an ultrasound to look at the womb and ovaries. These are all available here. If the results point to a treatment that needs a specialist, such as assisted conception, we will refer you onward.
What to do next
If a baby is somewhere on your horizon, book a preconception consultation before you start trying, and begin folic acid now. If you have already been trying for a while and the timelines above apply to you, do not keep waiting on your own. Coming in early rarely means anything is wrong, and it very often shortens the road ahead.
Thinking about a baby? Start with a preconception check at Newtown.
A consultation, laboratory blood tests and ultrasound at 55 Woodford Street let our doctors check your health before you conceive and look into any difficulty getting pregnant. We manage chronic conditions like blood pressure and diabetes that matter in pregnancy, and we refer to specialists for delivery care and fertility treatment when that is the right next step. Our Accident and Emergency department is open 24 hours.
This article is for general education only and is not a substitute for personal medical advice, diagnosis or treatment. Always consult a qualified healthcare provider about your own health. If you believe you have a medical emergency, call or visit our 24-hour Accident and Emergency department immediately.