What a preconception checklist covers
If you are thinking about pregnancy, the weeks before conception are a good time to review your health, your medicines, your vaccination record, and any substances or exposures that could affect a future pregnancy. According to the CDC, the steps you take before pregnancy can affect the health of a future baby, and preparing your body may look different for different people.
This guide organizes those steps into a simple 30-day checklist you can bring to a healthcare appointment. It is general education, not a substitute for individualized medical advice.
Answer first: what should I do in the 30 days before a preconception visit?
Start a healthcare provider visit, begin taking folic acid if you have not already, gather your medicine list, and locate your vaccination record. These four items form the core of most preconception conversations, and each is discussed in more detail below.
30-day preconception appointment checklist
- Book the appointment. Schedule a visit with a healthcare provider to talk about your health history and any current medical conditions.
- List every medicine you take. Write down all prescription medicines, over-the-counter medicines, supplements, and vitamins so your provider can review them with you.
- Start or continue folic acid. The CDC recommends getting 400 micrograms of folic acid daily, ideally starting at least one month before pregnancy.
- Pull your vaccination record. Ask your provider or prior clinics for your immunization history so gaps can be identified early.
- Note substances and habits to discuss. Be ready to talk openly about alcohol use, smoking, and any drug use with your provider.
- Think through home and work exposures. Make a short list of chemicals, contaminants, or hazards you may encounter regularly.
- Gather family health history. Ask relatives about medical conditions, birth defects, or pregnancy complications that run in the family.
- Check in on your mental health. Note any ongoing stress, anxiety, or mood concerns to bring up with your provider.
- Loop in your partner. Encourage your partner to review their own health history, medicines, and vaccination status too.
Health history and medical conditions
Talking with a healthcare provider about your health history is a foundational step in preconception planning. The CDC advises bringing a list of talking points that covers any current medical conditions, all medicines you take, your vaccination status, and lifestyle and behavior factors. Writing these down ahead of time helps make sure nothing gets missed during a short appointment.
Medicines: what to review, not what to stop
Every medicine you take, including prescriptions, over-the-counter products, supplements, and vitamins, is worth reviewing with a healthcare provider before pregnancy. This is a review conversation, not a signal to stop or change a prescription on your own. Some medicines are important to keep taking as prescribed, and stopping certain treatments without medical guidance can carry its own risks. A provider can help weigh the benefits and risks of each medicine and adjust a plan if needed.
Folic acid: the 400-microgram recommendation
Folic acid is a form of vitamin B9. The CDC states that having enough folic acid in your body at least one month before and during early pregnancy can help lower the risk of serious birth defects of the developing baby’s brain and spine, known as neural tube defects.
The general recommendation is 400 micrograms of folic acid daily. Because individual needs can vary — for example, for people with certain medical histories or those taking specific medicines — ask a healthcare provider what dose and timing is right for your situation rather than choosing a high-dose supplement on your own.
Vaccines to review before pregnancy
Reviewing your vaccination record before pregnancy is part of a preconception visit. CDC guidance highlights a few areas worth discussing with a provider:
- MMR (measles-mumps-rubella). Rubella infection during pregnancy can be serious and may cause miscarriage or birth defects. If you are not up to date on the MMR vaccine, the CDC recommends getting it before pregnancy, and advises waiting about one month after vaccination — with immunity confirmed by a blood test — before trying to conceive.
- Vaccines recommended during pregnancy. The CDC notes that a pregnant woman should get vaccinated against whooping cough (Tdap), flu, COVID-19, and RSV at the appropriate points in pregnancy. Reviewing your baseline status before pregnancy helps your provider plan timing.
- Other vaccines. Depending on your history, a provider may discuss hepatitis B or hepatitis A vaccination, or travel-related vaccines if international travel is planned.
Vaccine recommendations can be individualized and may be updated over time, so confirm current guidance with a healthcare provider rather than relying on a fixed schedule.
Substances: alcohol, smoking, and drug use
The CDC notes that drinking alcohol, smoking, and using certain drugs can cause problems during pregnancy, including premature birth, birth defects, and infant death. If you are trying to conceive and are having difficulty stopping alcohol, tobacco, or drug use, the CDC suggests contacting a healthcare provider, a local Alcoholics Anonymous group, or a local treatment center for support — this is a health conversation, not a judgment.
Environmental and workplace exposures
The CDC advises avoiding harmful chemicals, environmental contaminants, and other toxic substances where possible, including certain metals, fertilizers, pesticides, and animal waste, both at home and in the workplace, since these can affect the reproductive systems of men and women. If your job involves regular contact with chemicals or hazardous materials, it is worth discussing workplace exposure with a healthcare provider or occupational health resource.
Weight, family history, and mental health
- Weight. The CDC notes that people who are overweight or obese have a higher risk of complications during pregnancy, and that being underweight also carries health risks — a provider can help set realistic, individualized goals.
- Family health history. Collecting information about your family’s health history can help identify factors that might affect a baby or your ability to become pregnant. A provider may recommend genetic counseling based on this history, prior pregnancy loss, infertility, or a known genetic condition.
- Mental health. The CDC encourages talking with a healthcare provider about ongoing worry, anxiety, sadness, or stress that interferes with daily life, and notes that providers can also connect people to support if they are in a stressful or unsafe environment.
Partner health
Preconception planning is not one-sided. A partner’s health history, current medicines, vaccination status, and exposures can also matter, so it is reasonable to encourage a partner to review the same categories — health history, medicines, vaccines, substances, and exposures — with their own healthcare provider.
Who should be especially cautious
- People managing a chronic condition such as diabetes, thyroid disease, high blood pressure, or an autoimmune condition, since medicine and management plans may need coordination before pregnancy.
- People currently taking prescription medicine, since some medicines require careful review or adjustment under medical supervision rather than being stopped independently.
- People with a personal or family history of pregnancy loss, infertility, birth defects, or genetic conditions, who may benefit from genetic counseling.
- People who are pregnant or think they might already be pregnant should ask a provider before receiving the MMR vaccine, since it is generally not given during pregnancy.
- People in occupations with regular chemical, radiation, or biological exposure, who may need a workplace-specific safety review.
Limitations of this guide
This checklist summarizes general preconception guidance from the CDC and is not a complete medical evaluation. It does not account for your personal medical history, current medicines, or individual risk factors. Vaccine and medicine recommendations can change and should be confirmed with a healthcare provider at the time of your visit, since guidance is periodically updated.
Frequently asked questions
How soon before pregnancy should I start folic acid?
The CDC recommends getting 400 micrograms of folic acid daily, with benefit tied to having enough folic acid in your body at least one month before and during early pregnancy. Ask a healthcare provider about timing and dose that fits your situation.
Should I stop taking my prescription medicine before trying to get pregnant?
Do not stop a prescription medicine on your own. Bring a full list of your medicines, including over-the-counter products and supplements, to a healthcare provider so they can review each one with you and advise on any changes.
What vaccines might come up in a preconception visit?
Topics commonly reviewed include MMR (measles-mumps-rubella) status before pregnancy, and vaccines recommended during pregnancy such as Tdap (whooping cough), flu, COVID-19, and RSV. A provider can confirm what applies to your history and current guidance.
Does my partner need to do anything for preconception planning?
Partner health can matter too. It is reasonable for a partner to review their own health history, medicines, vaccination status, and exposures with a healthcare provider as part of the same planning process.
Educational disclaimer
This article is for general educational purposes only and is based on publicly available guidance from the CDC. It is not medical advice, does not diagnose or treat any condition, and is not a substitute for a consultation with a qualified healthcare provider. Do not start, stop, or change any medicine or supplement, including folic acid dosing, without individualized guidance from your provider. If you have questions about your health, medicines, vaccines, or a specific pregnancy plan, speak with a licensed healthcare professional. For more general reproductive health education, visit Reproductive Health Center.