Once you’ve decided you’re ready to become a parent, there’s often a strange sense of urgency that comes over you. It’s like a switch is flipped; one day you’re perfectly happy enjoying a mimosa after sleeping in on a leisurely Saturday, then the next you’re eager to toss your prosecco and give up on the idea of ever feeling rested again. At this point, you want a baby in your arms. So what’s next? Should you see your OB-GYN before trying to conceive to ensure the process is as efficient and successful as possible? Or do you wait until you actually become pregnant before you make the appointment?
It’s funny because we all know how a baby is made (it’s been drilled into our heads since we hit puberty, after all), but until now, your focus has likely been on how to avoid a surprise pregnancy, so the idea of actively trying to conceive can seem foreign. As it turns out, it’s usually not as simple as we were led to believe, and it often requires physical awareness and careful calculation since there is only a small window of time each month when conception is even possible.
You probably have a lot of questions and want to ensure you’re physically ready for the journey. While you can certainly try to rely on Dr. Google for advice and answers, your best bet is to call up your OB-GYN and set up a pre-conception counseling session and checkup.
What Is Pre-Conception Counseling?
Pre-conception counseling is exactly what it sounds like: a one-on-one meeting with your doctor that you set up before you start actively trying to get pregnant. “Anticipating pregnancy is exciting, but can also cause some anxiety,” Ngina K. Connors, MD, MBA, OB-GYN and Maternal-Fetal Medicine Specialist, tells Pregnancy & Newborn. “Meeting with your provider can ease some of your concerns prior to conception by helping you know what to expect during pregnancy.” Additionally, if you are planning to conceive with a partner (rather than with a donor), it’s a good idea to bring them along to the meeting as well, as the information will be equally as useful and important to them.
As for what you will discuss in this meeting, it can vary based on your and/or your partner’s health, your timeline, and other factors. MargEva M. Cole, MD, Certified Menopause Practitioner and OB-GYN, explains that in these meetings patients can expect to cover topics such as “optimal timing for conception, diet, supplements, risk factors, etc.”
The American College of Obstetricians and Gynecologists (ACOG) and the American Society of Reproductive Medicine (ASRM) both recommend patients set up an appointment with their provider before becoming pregnant. In fact, these organizations also encourage providers to bring up the topic of becoming pregnant with their patients, even when it’s not an official pre-conception counseling appointment, by asking patients if they would like to become pregnant in the next year. The ACOG and ASRM believe that addressing the topic with patients offers “an opportunity to counsel about wellness and healthy habits which may improve reproductive and obstetric outcomes should [a patient] choose to reproduce.”
Do You Need a Physical Checkup Before Trying to Conceive?
Regardless of whether or not you’re trying to get pregnant, it’s important to set up regular wellness checks with your physician to monitor both your overall and reproductive health. So, ideally, by the time you’re ready to conceive, you’re all up to date with your checkups and an additional exam won’t be needed. However, if you’re behind on your checkups, then it’s a good idea to add this appointment to your pre-conception counseling session as well. According to Dr. Cole, “Persons trying to conceive should be up to date on their routine health screening (pap smears, STD screens, vaccinations) and can be with their OB-GYN or primary care physician (PCP) prior to conception to make sure all is up to date.”
Questions to Ask Your OB-GYN Before Trying to Get Pregnant
Your pre-conception counseling session is an excellent opportunity for you and/or your partner to ask your doctor all of the burning questions you have about trying to conceive (and you’ll get much more personalized responses than you would from any Google search). You may already have a list of inquiries ready to go, but if you’re not sure where to start, here are some good things to ask during your appointment.
Do I have any risk factors?
There are a variety of things that can make getting pregnant more difficult or pose potential risks once you are pregnant. It’s important to discuss these risk factors with your physician to know what to expect and ensure you’re being properly cared for throughout the process. “If [the patient] has any medical problems (thyroid, high blood pressure, etc.), it is important that they discuss management with their PCP or OB prior to pregnancy to maximize their best chances for a healthy pregnancy,” says Dr. Cole. Other medical conditions Dr. Connors says should be discussed during pre-conception counseling include heart disease, diabetes, hypertension, and a history of blood clots. She also notes, that for patients with complicated medical histories, “Pre-conception counseling is also available with a maternal-fetal medicine specialist, a physician who specializes in high-risk pregnancies.”
When should I stop taking birth control?
If you’ve ever talked to your friends about this, you’ve probably heard stories about it taking months before they were able to conceive after they stopped taking birth control, or it happening within a month of it. The timeline is different for everyone, and the type of birth control you’re on may play a factor. Chances are high that your physician will advise you to be prepared to get pregnant within a month of stopping your birth control (because it can happen), but they will also discuss a reasonable timeframe to expect based on your personal situation.
How often should I be having intercourse?
Again, you know that in order to become pregnant the old-fashioned way, you have to have sex. But, is there a certain frequency you should be doing it? When is the best time to do it? What about intervals? Does position matter? As awkward as it may be to have this conversation with your provider, it’s still important, because we know that getting pregnant is all about timing, and being well-informed of all of the logistics is what will give you the best chance of success.
How do I track ovulation?
The reason timing is key to trying to conceive is because of ovulation. Ovulation only happens once during a menstrual cycle, lasting for about 24 hours, and based on the life of a sperm and an egg, the ACOG says there is about a seven-day window for successful conception. While this may seem easy enough on the surface, you have to know when you’re ovulating in order to find this window of time, and everyone’s cycle is a little different, so it can be really difficult to pinpoint exactly when you’re ovulating. Your OB-GYN will be very useful in helping you learn how to identify and predict at what point in your cycle you ovulate.
Are there any concerns about my family history that I should be aware of?
Your baby’s DNA will be 50 percent made up of your DNA, and 50 percent made up of your partner’s DNA, which is why Dr. Connors suggests asking your OB-GYN, “Are there any concerns about my family history that I should be aware of?” There are a number of conditions that are hereditary or genetic, and if you or your partner are either diagnosed with or at risk of developing any of them, it’s important to discuss them with your doctor. There may be tests that are recommended, or at the very least, having this information ahead of time will help your OB ensure you and your baby are getting the best possible care throughout your pregnancy.
What medications or supplements should I start or stop taking?
As you discuss your personal medical history, it’s essential to let your doctor know what medications you’re currently taking. While a lot of medications are considered safe during pregnancy, just as many are not, so you may need to find alternative options or potentially even stop taking certain medications altogether. Similarly, if you’re not already taking a prenatal vitamin, now is the time to chat with your doctor about when to start and if there are any other supplements they recommend you begin taking to help ensure a healthy pregnancy. All women of childbearing age are encouraged to take a folic acid supplement daily, even if they have no plans to conceive, in an effort to help prevent birth defects from forming early on in pregnancy.
Are there any lifestyle changes I should make?
Whether you’re one to enjoy a glass of vino at the end of the day, you consider pizza to be a primary food group, or your idea of exercise is bouncing around a trampoline park a few times a week, you need to have an honest conversation with your doctor about your lifestyle during your pre-conception counseling session to ensure you’re making appropriate changes. In addition to maintaining a healthy weight and exercising in a safe way, Dr. Cole says patients should also “make sure to eat a healthy well-balanced diet, take a folate-containing supplement, and refrain from smoking tobacco or marijuana, drinking alcohol, or using drugs as they conceive.” If there’s some type of food, recreational activity, or another lifestyle measure you think could be questionable, don’t be afraid to bring it up to your physician during this appointment; they aren’t judging you, they just need to have all of the information necessary to keep you and your future little one healthy.
When should I come in for my first prenatal visit?
Another question Dr. Connors recommends patients ask is when they should be seen for their first prenatal visit. For low-risk pregnancies, you may be surprised by how long you’ll have to wait to get that first ultrasound and checkup, and if your pregnancy is considered high-risk, there might be more urgency to getting your appointment scheduled than you realize. Your OB will let you know where you fall, and can also tell you any symptoms to look for that should prompt a visit before your standard first prenatal appointment.
How long does it take to get pregnant?
This is the answer everyone wants to know, isn’t it? Waiting for those two little lines to appear on a pregnancy test is excruciating, and after a few negative results, panic can start to set in and make the process of trying to conceive all the more stressful. Because of this, most providers are prepared for this question. In order to answer it truthfully, your physician will take your health and history into consideration (again, this is why it’s important to be totally honest during your consultation), but even so, keep in mind that they cannot guarantee anything. The best they can do is manage your expectations to help put your mind at ease for the journey ahead.
When should I see a fertility specialist?
Unfortunately, conception doesn’t come easily for everyone, and when that happens you might start to stress over thoughts of infertility. To avoid this panic, ask your doctor upfront when it would be appropriate to start exploring fertility support. During your appointment, be sure to share with your provider if you have irregular periods, a history of miscarriage, or any other concerns so they can take this information into consideration when answering this question for you.
For something seemingly so simple, there are a lot more variables that go into trying to conceive than many of us realize. By visiting your OB-GYN before trying to get pregnant, you can help set yourself up for successful conception and healthy pregnancy.