Pregnancy Planning with your Healthcare Provider | Fertility Out Loud

What to Discuss With Your Healthcare Provider When Planning for Pregnancy

By Connie Stark, RNC, C.P.C., & Takera Mitchell, RN, BSN

The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.

You’ve decided that you are ready to begin the journey to parenthood. This can be an exciting time, as you prepare and plan for pregnancy. When getting started in trying to conceive (TTC), one of the initial steps is scheduling a check-up appointment with your OB/GYN. An OB/GYN is a healthcare provider who specializes in planning for and providing care throughout pregnancy. 

Preparing for pregnancy begins before you get pregnant and includes healthy lifestyle choices that provide the best environment for your baby to develop. Your physical and emotional well-being are important, with a goal to be able to maintain your best self before and during pregnancy. You’ll want to schedule a preconception visit with your obstetrics provider to discuss your current health, health history (including OB history), medications, and any social risks that may affect your fertility and early pregnancy.

This pregnancy planning visit with your OB/GYN typically includes many questions about:

  • Your medical history (including all vaccines such as rubella and Covid-19) and any medical conditions (such as history of high blood pressure, diabetes, sexually transmitted infections or diseases [STIs or STDs], and mental health conditions) 
  • Your family’s medical history (including if there’s a family history of any specific genetic conditions) 
  • Your partner’s or donor’s medical history
  • Your diet, exercise, and lifestyle habits 

The visit will also likely involve a physical exam (such as a pap smear) and lab work (blood tests). You may have a conversation about nutrition and prenatal vitamins, including the importance of folic acid. The American College of Obstetricians and Gynecologists (ACOG) currently recommends 400 micrograms of folic acid in a daily prenatal vitamin, starting at least 1 month before pregnancy and continuing through the first 12 weeks of gestation (to prevent neural tube defects). There may also be additional foods, vitamins, or supplements (like iron) your OB/GYN recommends to support the TTC process, as well as a healthy pregnancy. Most, if not all, of this can be done over the counter. A focus on pre-pregnancy nutrition is important to support your body in being best prepared to carry a baby in a healthy environment where the baby can grow and thrive. 

Ask your OB/GYN about their take on body mass index (BMI). Knowing how BMI can impact pregnancy can help guide you to implement lifestyle changes that best support your preparation for pregnancy. Try to understand what is considered a healthy BMI range when trying to get pregnant and find out what they recommend doing to achieve a healthy weight. You can also ask and learn about how much weight gain might be expected (and even advised) during pregnancy. 

Lifestyle habits are important to discuss with your OB/GYN as well. This is a great time to ask about any prescription drugs you might be taking, as well as recommendations for consuming caffeine and drinking alcohol before and during pregnancy. You may also want to discuss other lifestyle habits like smoking cigarettes, exposure to hot tubs, herbal supplements, and anything else you think could be impactful. 

Know that pre-pregnancy and pregnancy can bring about lots of changes that may be emotional, physical, and financial. Your mental health matters—ask your OB/GYN about common emotional changes that may occur and how you can best keep them under control. Also find out if there are certain medications that you should take or avoid if you experience physical pain or discomfort. Learn about the financial expectations related to office visits for prenatal care during pregnancy, as well as hospital costs related to delivery. It’s a good time to connect with a benefits coordinator in your OB/GYN’s office who can review your insurance and help you prepare for any financial obligations. Having information in advance can help things feel more manageable. This appointment is a great time to ask questions and verbalize your family planning goals. 

Here are 10 questions to discuss during a preconception visit with your OB/GYN:

  1. Does my insurance cover my OB care?
  2. Can you provide me with recommendations for healthy lifestyle habits (eating, drinking, exercise, emotional health, and otherwise)?
  3. Should I take any vitamins or supplements?
  4. Do I need any vaccines prior to getting pregnant?
  5. Do I have a healthy body weight (BMI)?
  6. Does my partner’s health need any testing or evaluation to prepare for pregnancy?
  7. How many months should I wait to follow up with you if I am not pregnant?
  8. What is the best way to communicate or to ask non-urgent questions during office hours?
  9. At what hospital would I deliver?
  10. How do I manage my month-to-month menstrual cycle and the best time to have intercourse (before, during, or after ovulation)?

If you have a partner or spouse, consider having a detailed conversation with them about your family planning goals before seeing your OB/GYN. This can help you develop a timeline for your anticipated pregnancies. Timing your pregnancies can be helpful in planning for insurance, careers, and other life experiences. You can also discuss how you want to handle situations like visits to the OB/GYN, how you will get results, and your hospital selection for delivery. 

Keep in mind that if you do run into any TTC or fertility issues, your OB/GYN will likely refer you to a fertility specialist (reproductive endocrinologist or RE). A reproductive endocrinologist is a healthcare provider who specializes in diagnosing and treating fertility challenges. The current recommendation is to see an RE if you’re under 35 and have been TTC for over a year, or if you’re over 35 and have been TTC for more than 6 months. 

There is rarely a perfect time for pregnancy, but there may be a better or more ideal time for you and your family. Planning for this special event can help you feel better prepared for pregnancy and ultimately the arrival of your baby. Your OB/GYN is an essential part of this journey. Take the time to build this relationship and be open to the guidance they can provide. The relationship between you and your OB/GYN often becomes a lifelong relationship that extends beyond your pregnancy years. 

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