Patient Education
Preconception Care
Prenatal vitamins, immunity checks, genetic screening, and the biology of conception — before you are pregnant, not after.
Much of what shapes a healthy pregnancy happens before conception. The neural tube closes in the first weeks, often before a woman knows she is pregnant, which is why folic acid matters months in advance rather than at the first prenatal visit. Immunity, chronic conditions, medications, and genetic carrier status are all far easier to address beforehand.
Preconception care is also for women who are not in a hurry. Knowing where you stand — immunity, cycle patterns, carrier screening — is useful information whether you plan to conceive next month or in three years.
Signs it is worth being seen before conceiving
- Irregular or absent periods, which can make timing and ovulation harder to predict
- A previous miscarriage, stillbirth, or pregnancy complication
- A chronic condition such as diabetes, thyroid disease, epilepsy, or high blood pressure
- Taking a regular medication whose safety in pregnancy you have not checked
- A family history of a genetic or inherited condition on either side
- Age over 35, or trying for more than a year without conceiving
Risk factors worth addressing beforehand
- Not taking folic acid before conception, which raises the risk of neural tube defects
- Smoking, alcohol, and recreational drug use
- Uncontrolled diabetes or thyroid disease at the time of conception
- Medications that are unsafe in early pregnancy
- No immunity to rubella or chicken pox, both of which are dangerous in pregnancy
- Travel to areas with active Zika transmission
- Being significantly under or over a healthy weight
- Untreated sexually transmitted infections
What the preconception evaluation covers
- A detailed medical, surgical, obstetric, and family history
- Blood work for rubella and varicella immunity, so gaps can be vaccinated before conceiving
- Genetic carrier screening, offered before pregnancy rather than during it
- Thyroid function, blood count, and blood type with antibody screen
- Screening for sexually transmitted infections
- A review of every prescription, over-the-counter medication, and supplement you take
- Cervical cancer screening brought up to date
Treatment and preventive options
- Starting a prenatal vitamin with folic acid at least a month, ideally three, before conceiving
- Vaccinating against rubella and chicken pox where immunity is absent — these are live vaccines and must be given before pregnancy
- Switching any medication that is not safe in pregnancy to one that is
- Bringing diabetes, thyroid disease, and blood pressure under good control
- Support to stop smoking and to eliminate alcohol
- Discussing the biology of conception and the fertile window, so the timing works in your favor
- Referral for fertility evaluation when conception is taking longer than expected
Dr. V on prenatal vitamins
Part of her preconception series, alongside videos on rubella and chicken pox immunity and on Zika virus.
When to book an appointment
- You are thinking about conceiving in the next year.
- You have a chronic condition or take a regular medication.
- You have had a miscarriage or a difficult previous pregnancy.
- You want carrier screening done before rather than during a pregnancy.
Frequently Asked Questions
1Why do I need prenatal vitamins before I am pregnant?
2Is there anything I can do to reduce the chance of a birth defect?
3Why do genetic testing before I am pregnant?
4Does my partner's health matter?
5How long should I wait after stopping contraception?
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The best pregnancy is a planned pregnancy.
Book a preconception visit to get the groundwork right. Dr. Varkey also runs a free seminar on optimizing mother and baby's health before conception.
Request an Appointment