Planning for your pregnancy

You should see your doctor about 3 to 6 months before trying to get pregnant.

What happens at a pre-pregnancy checkup?

Your doctor will ask you about:

• any health problems you or your partner have (if you have a partner)
• your medical history
• your vaccination history
• your lifestyle — such as your diet, drug and alcohol use

Your doctor may organise for you to have:

• blood tests
• a breast check
• a cervical screening test

My emotional and mental wellbeing

Looking after your mental health is important when planning for pregnancy. Your doctor may offer to screen you for depression and anxiety.

If you've had mental health issues in the past, talk with your doctor about your management plan, if you have one. Your doctor can also explain how these conditions may affect your pregnancy and refer you to support services that are right for you.

My family medical history

It's important to tell your doctor if you have a family history of genetic conditions such as:

• spina bifida
• cleft palate
• thalassemia
• fragile X
• cystic fibrosis

Also talk with your doctor if you:

• take anti-epilepsy medicines
• have polycystic ovarian syndrome (PCOS)
• have endometriosis

It is also a good idea to have your teeth checked by a dentist before getting pregnant.

Do I need genetic screening or genetic counselling?

It's advised that anyone planning a pregnancy has genetic carrier screening. It checks whether you and your partner carry certain inherited conditions that could affect your baby. Most carriers don't know they're carriers because they're healthy and often have no family history.

For a child to be at higher risk, both parents usually need to carry the same condition. These conditions can stay hidden in families for generations, so screening is an important tool that many prospective parents may find helpful when making informed choices.

This includes screening for:

• cystic fibrosis (CF)
• spinal muscular atrophy (SMA)
• fragile X syndrome

Genetic counselling is advised if you have a greater chance of a heritable disorder. This will be worked out based on your family history and ethnic background. Some genetic counselling is covered by Medicare. You can check any potential out-of-pocket fees when making your appointment with the genetic counsellor.

Screening for infections

Your doctor will arrange for you to have blood tests to see if you have:

• hepatitis B
• hepatitis C
• HIV
• other sexually transmitted infections (STIs)

What vaccinations do I need?

Your doctor will check your vaccination history.

They may arrange for you to have the:

• measles, mumps and rubella (MMR) vaccine
• varicella (chickenpox) vaccine
• diphtheria, tetanus and pertussis (whooping cough) vaccine
• hepatitis B vaccine

Making healthy lifestyle choices before your pregnancy will help you and your baby in the future.

Diet and weight

Try to enjoy foods from all 5 food groups in a way that fits your cultural preferences and dietary needs. This could include traditional meals or foods that are important to you and your family. Eating a balanced mix of vegetables, fruits, grains, protein sources and dairy (or alternatives) helps to support your health before pregnancy.

Learn more about healthy eating.

If your BMI is over 30, losing some weight before pregnancy can improve health outcomes for you and your baby. Even a small amount of weight loss can make a difference. Focus on gradual, healthy changes, like adding more vegetables and whole grains, reducing sugary drinks, and finding ways to move more each day. If you'd like extra support, talk to your GP or a dietitian, they can help you set realistic goals and connect you with resources that fit your lifestyle and cultural preferences.

Should I quit smoking, drugs and alcohol?

If you're planning a pregnancy, you should stop:

• smoking or vaping
• drinking alcohol
• taking illicit drugs — illegal drugs or prescription medicines for another person

Drinking alcohol at any stage of pregnancy can cause fetal alcohol spectrum disorder (FASD) which can lead to lifelong health and developmental problems for your baby.

It's also best for your baby if your partner and household avoid smoking and illicit drugs.

Smoking is harmful for your unborn baby. It may affect the size and health of your baby. Smoking is also linked to an increased chance of miscarriage and infertility in both males and females.

Illicit drugs can also be harmful to you and your baby.

Talk with your doctor or health worker if you need help to stop using alcohol, cigarettes, vapes or illicit drugs.

If you want to quit smoking, call Quitline on 13 QUIT (13 7848) to speak with a counsellor.

Folic acid

Taking a folic acid supplement before and during early pregnancy helps reduce the risk of your baby being born with a neural tube defect (NTDs), such as spina bifida.

Most people are advised to take 400 micrograms of folic acid every day. Start taking the supplements 12 weeks before you start trying to conceive (get pregnant).

Continue taking folic acid supplements every day until you are more than 12 weeks pregnant.

You can also include foods rich in folate as part of your meals, such as:

• green leafy vegetables
• broccoli
• oranges
• avocado
• fortified breads and cereals

Your doctor may tell you to take more than 400 micrograms of folic acid if you have a higher chance of having a baby with a neural tube defect. This may be the case if you:

• take anti-epilepsy medicine
• have diabetes
• are living with overweight or obesity
• already have a child with a neural tube defect
• have a member of your family with a neural tube defect
• have a condition that affects how well you absorb food

Iodine

The amount of iodine you need each day will also increase during pregnancy. Your baby needs iodine for their brain and nervous system development.

Most people are advised to take 150 micrograms a day. Continue to take this supplement during pregnancy.

You can also include foods rich in iodine as part of your meals, such as:

• fortified bread
• seafood
• dairy foods

If you have a thyroid condition speak with your doctor before taking an iodine supplement.

Find out more about vitamins and supplements during pregnancy.

If you plan to get pregnant you will need to stop using contraception.

There are no clear directions on when to stop using the pill (oral contraception). Some healthcare professionals suggest that you wait to have 3 periods, before trying to get pregnant. The time it takes for your fertility to return will be different for each person.

Before stopping your contraception and trying to fall pregnant, it's a good idea to talk to your doctor.

Do I need to have my birth control device removed?

Some long-acting reversible contraception (LARC) will need to be removed before you can fall pregnant.

Long-acting reversible contraception include:

• intrauterine devices (IUDs)
• contraceptive implants

You can have your LARC removed at any time. Your fertility should go back to normal straight away.

Most healthy couples become pregnant within 6-12 months of trying.

Males and females are more likely to experience fertility challenges as they age.

If you think you or your partner are having fertility issues, speak with your doctor. You do not need to go through fertility challenges alone, support is available.

How often should we have sex?

To improve your chances of getting pregnant, focus on your fertile window (the days leading up to and including ovulation). Sperm can live inside the reproductive tract for up to 5 days, and an egg survives for about 24 hours after ovulation. This means having unprotected vaginal sex about every 2-3 days in the week before and around ovulation gives sperm the best chance to meet the egg.

What is ovulation?

Ovulation is the time when you're most fertile. It's when an egg is released from your ovaries.

The best time to get pregnant is in the days leading up to and the day of ovulation. Your most fertile days will depend on your menstrual cycle length. If you are unsure, speak to your doctor for personalised advice.

Many people find it helpful to track ovulation using methods that suit them, such as monitoring changes in cervical mucus, using a calendar or app, or trying an ovulation detection kit. These tools can give you more confidence and choice when planning a pregnancy.

See your doctor for advice if you aren't pregnant after trying for:

• 12 months, if you are 35 years of age or younger
• 6 months, if you are 36 years of age or older

Your doctor can refer you to a fertility specialist.

What if I'm using fertility treatments?

Fertility treatments can help you become pregnant.

If you don't become pregnant using intra-uterine insemination (IUI) after 3 to 4 tries, it's likely that your fertility specialist will recommend moving to IVF.

IVF success depends on several factors, including both your health and your partner's fertility. It often takes multiple cycles to achieve pregnancy, and success rates vary. Age can play a role because egg quality tends to decline over time, but sperm health is equally important.

Lifestyle factors such as nutrition, stress and underlying health conditions can also influence outcomes.

Your fertility team can guide you through options and support you both in making choices that give the best chance of success.

There are many things to consider before having a baby.

Current living situation

Think about who can help and support you when you have a baby. This may include your parents, friends and other family members.

Domestic and abusive relationships can affect your baby before birth. It can harm both you and your baby. The stress of living with violence can also affect how your baby develops.

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Financial situation

Having a baby can be expensive. It's possible to plan for most of these costs, but some costs can be unexpected. The earlier you start planning, the better.

Find out what paid parental leave your employer offers. Also check if you can use your annual or long-service leave when you have your baby.

Learn more about paid and unpaid parental leave.

Depending on your income and assets, you may be able to apply for government benefits. Find out more about government payments for families.

Work situation

Talk to your doctor or midwife about any health risks at work, such as heavy lifting, exposure to chemicals or prolonged standing. Washing your hands regularly can help reduce the risk of infections that may harm your baby.

It's also reasonable to ask for workplace adjustments to support your health and comfort during pregnancy. This might include:

• flexible hours or breaks to manage fatigue
• a comfortable chair or ability to sit if your job involves standing
• adjustments to tasks that involve heavy lifting or exposure to harmful substances
• a private space for rest or, later, breastfeeding

Discuss your needs with your employer early — most workplaces have policies to support pregnant employees. If you're unsure, your GP or midwife can provide a letter recommending adjustments.

Speak to your doctor for more information about planning your pregnancy.

Learn more about preconception health for women and men.

NSW Health has the Thinking of having a baby brochure in English and other languages.