Dr. Petrikovsky says the visit should take place at least three months before you begin trying to conceive. "We recommend that visit because you should start prenatal vitamins at least three months prior to conception," he says. "It's very important to build your body up. You especially want to make sure you have enough folic acid, which can help prevent birth defects like spina bifida." In fact, folic acid in the prevention of birth defects is probably the biggest advancement in 10 years, he adds.
According to the Centers for Disease Control and Prevention, 50 to 70 percent of neural tube defects can be prevented if women have adequate levels of folic acid leading up to and following conception.
In addition to supplements, women should also be sure to eat a balanced diet, including the four food groups, especially plenty of green vegetables and fruit, like apples, he says. Your doctor also will probably recommend that you either stop, or at least cut back, on your caffeine and alcohol intake, and stop smoking. Poor nourishment and smoking have been linked to fertility problems, miscarriages, premature births, and low birth weight, Dr. Powell points out.
As for alcohol, she says, "I have people who come to me worried because they had a few too many drinks on New Year's Eve before they realized they were pregnant. I tell them a small amount of alcohol in moderation is extremely unlikely to affect pregnancy early on. What we don't know is what the safe limits of alcohol use are later on in pregnancy, so at that point I suggest they abstain."
One common misconception women have regarding their preconception and pregnancy is that they should take it easy and not really exercise, Dr. Powell says. Actually, the opposite is true. "It helps relieve the stress for women who are trying to get pregnant, it helps prevent gestational diabetes in women once they become pregnant and it helps build their stamina for labor and delivery," she says.
Another recommendation, from the American Academy of Periodontology, is that women visit their dentist to have a periodontal evaluation during their preconception planning. "Evidence is mounting suggesting that having periodontal disease may make women seven times more likely to deliver a preterm or low birth weight baby. The likely culprit is a labor-inducing chemical found in dental plaque called prostaglandin," according to a press release issued by the academy.
In the meantime, do what you can to ensure a healthy pregnancy and baby, Dr. Petrikovsky says, and then remember, "About 97 percent of all babies are healthy, so that's a good reason to relax."