Before the Bump: A TTC To-Do List

A guiding principle for me as a childbirth educator is to encourage proactive preparation. We can never predict exactly how birth will unfold, and we can never guarantee a specific outcome. But being proactive is all about controlling what we can and “clearing the path”. You can read more in my blog post, linked below:

🧭 Clearing the Path: Benefits of Proactive Prep for Birth and Beyond

A great first step in being proactive and prepared for pregnancy is to schedule a preconception appointment. The basic purpose of this appointment is to discuss your plans for having children, ask questions, and address any concerns. This post is designed to help you prepare for this important visit and for pregnancy.

Consider Care Provider Choice

Consider scheduling this appointment with a provider you are considering for prenatal care and birth support. This is a great time to start thinking about who this provider might be, though you can always change later, if necessary. Your choice of care provider can have an effect on your available options (like where you give birth) and your birth experience. It’s ideal to find someone who supports and prioritizes your right to make decisions about your own body. Sometimes the care provider you’ve seen for years for routine care isn’t the best fit once you become pregnant. Check out my blog post below to learn more:

🧭 Foundational Decisions: Choosing a Birth Location and Care Provider

Verify Health Insurance

As you’re researching your options for care provider and birth location, you may need to consider any limitations imposed by your health insurance plan. Make sure to:

• Verify coverage (care provider and potential birth location)
• Review health care plan (deductible, out-of-pocket costs, etc.)

If you don’t have insurance, make sure to check out this link:

🔗 Health coverage if you’re pregnant, plan to get pregnant, or recently gave birth | Healthcare.gov

Be aware that you can only sign up for health insurance during open enrollment periods or as a result of major life changes (like having a baby). You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time, though.

Transfer Medical Records

If you do end up choosing a new care provider, make sure to have your medical records transferred to their office. Contact your current provider when you’re ready to start the process. You can also check out the link below to find out more:

🔗 Your Rights to Access Your Medical Records Under HIPAA | Verywell Health

Gather Health History and Fill Out Other Forms

Your provider will want to discuss your health history, as well as your family health history. It can be helpful to gather this information in advance. Your provider may provide you with a form or you can use this one:

🔗 Family Health History Form | March of Dimes

Make sure you fill out any other forms in advance. This is also a great time to set up your online account/ portal, if applicable.

Prioritize Routine Care and Management of Any Medical Conditions

You’ll also want to get caught up on any necessary routine care appointments. If you have any medical conditions, it’s important to make sure those are addressed and managed prior to and during pregnancy. 

• Routine well check with your primary care provider
• Yearly gynecological exam
• Dental appointment
• Mental health care
• Management of chronic illness or other medical conditions

Also, trying to conceive can take time. Throughout this process, make sure you continue staying up-to-date on all of this.

Ensure You’re Getting Enough Folic Acid Prior to Pregnancy

You can reduce the risk of neural tube defects (birth defects of the brain and spine) by ensuring you are getting 400-800 mcg of folic acid each day, starting at least a month before conception. You can meet your daily needs by eating fortified foods and/ or taking a supplement (more on supplements further down).

While this a well-established and sound recommendation, you may hear individual health care professionals, nutritionists, and birth workers recommending supplements containing “natural food folate” instead. 

Learn more in my blog post, linked below:

🧭 MTHFR and the Folate Debate

Get Proactive About Your Fertility

If you’re currently using birth control, talk to your care provider about transitioning off of it. Specifics will vary by the form of contraception you are using.

Once you’re no longer on birth control, it’s really helpful to start tracking your menstrual cycles. This can give you and your care provider valuable information about your fertility. Also, knowing the first day of your last menstrual period can help establish a due date in pregnancy.

Also, if you want or need to be as proactive as possible in your trying to conceive journey, there are ways to track the small window of peak fertility that occurs each cycle. 

Also, there are certain lifestyle choices that can affect fertility, like smoking, alcohol consumption, stress, and poor nutrition. Sperm quality can also be affected by certain lubricants, hot tubs, tight clothing, long bike rides, and more. If you have any questions or concerns about your or your partner's fertility, definitely bring them up with your care provider.

Learn more about fertility in my blog post, linked below:

🧭 Fertility 101

Discuss Current Medications and Supplements With Your Care Provider

Many people take medications during pregnancy. If you’re trying to conceive and taking medication, it is so beneficial to have a discussion with your care provider in advance and get a plan in place. Some medications are contraindicated in pregnancy (and could even cause severe birth defects). For most, it comes down to informed decision-making regarding benefits and risks. 

‼️ Important: Check with your care provider before starting or stopping any medications.

It’s important to discuss any supplements you are taking, as well. Your nutritional needs change during pregnancy, so your care provider may recommend switching to a prenatal vitamin supplement at that point. While it‘s best to get necessary vitamins and minerals from foods, supplements can help you fill in any gaps. 

Make Sure Your Immunizations Are Up-To-Date

Your care provider can help you figure out if there are any vaccines you need. Most are safe to get while you’re expecting. However, if you need the MMR vaccine, make sure you’re up-to-date BEFORE pregnancy. It can be helpful to bring an updated vaccination record, if your care provider doesn’t already have this information.

Check out the link below to learn more about vaccine recommendations and accessing your vaccination records, if necessary.

🔗 Vaccine Recommendations Before, During, and After Pregnancy | Centers for Disease Control and Prevention

It’s ultimately your choice as to which vaccines you choose to receive. It’s important to note that there is a lot of misinformation surrounding this sometimes controversial topic. Reliable information and research evidence is crucial in informing your decisions. Check out the link below for more information:

🔗 Voices for Vaccines

Get Tested for Sexually Transmitted Infections

Ask about getting tested for sexually transmitted infections. You may or may not have been tested during routine well checks unless requested. Preconception is a great time to be proactive on this.

Testing for certain STIs (syphilis, HIV, and hepatitis) is a routine part of prenatal care. Others (chlamydia and gonorrhea) may only be done if you’re considered “at risk” or if you ask.

STIs are really common and often very treatable. Symptoms aren't always present, so STIs can go unnoticed. Unfortunately, untreated STIs can have a negative impact on fertility and can be passed to babies before and during birth.

Consider Genetic Carrier Screening

There are optional tests that can be done before or during pregnancy to determine whether or not you and/or your partner are carriers for certain genetic disorders. Genetic carrier screening for certain disorders (cystic fibrosis, for example) is offered to anyone trying to conceive/ all pregnant people. Screening for other disorders may be recommended to those whose risk factors are higher, which is determined by ethnicity, family history, and personal health history. Keep in mind, both partners have to be carriers for a child to inherit a disorder. Even then, it isn't a guarantee. A genetic counselor can help you make decisions about additional screening. They can also talk to you about the likelihood of passing down a genetic disorder and possible options, if necessary.

🔗 Carrier Screening | ACOG

Consider Potential Impacts at Home and at Work

Pregnancy and postpartum can be a catalyst for major change. Start considering the potential impacts at home and at work.

Workload is going to increase when you bring home a baby. Start having discussions with your spouse or partner about what household equity might look like for you. It is not uncommon for much of the increased load to fall to one person, which can lead to resentment and other issues. Check out the website below for a great book recommendation (and more) to help with these discussions.

🔗 Fair Play

If you will be parenting solo, check out this book for tips and advice on managing the load:

🔗 Doing it All as a Solo Parent

It’s never too early to start thinking about how having a baby will impact employment. Do you have access to paid maternity and paternity leave? If you’re working full-time, will you continue doing so after your baby arrives? Are you (or your partner) considering switching to part-time hours or any other changes? Are you (or your partner) considering becoming a stay-at-home parent? What are some options you might have for child care?

Focus on Health and Wellness

Now is a great time to start focusing on your health and wellness, if you aren’t already! A lot of what I’ve already mentioned in this post is part of it, but there is more to taking care of yourself. 

Here’s a list of some areas to consider:

• Nutrition
• Food safety
• Exercise
• Substance use
• Exposures and other hazards
• Relationships

After reading through the resources above, note down any questions and concerns you have to discuss with your care provider at your visit. Also, consider any lifestyle changes you want or need to make now that you are trying to conceive.