For many couples today, a preconception visit is the first step on the road to a healthy pregnancy. Preconception visits were first recommended in 1989 by a federal panel of experts from the U.S. Department of Health and Human Services. The popularity of preconception visits today illustrates an encouraging fact: Women are taking charge of their reproductive health more than ever before.

The idea behind a preconception visit is that a couple and an OB/GYN doctor will begin working together on a program personally designed to provide a quick and easy conception. Hopefully, a couple will then benefit by experiencing a healthy pregnancy while decreasing the risk of miscarriage and baby birth defects.

Wanted: A Wealth of Information
At a preconception visit, most doctors will want a detailed "his and hers" health history. Information about the future parents-to-be's health histories is usually requested in the following categories:

• Reproductive Health: Although your OB/GYN will have your medical history on file, your doctor may want to know some information about your partner's reproductive history. This includes the number of children he has fathered and if he has fathered any children with birth defects.
• Family Medical History: Since the family history of both parents can affect a pregnancy, your doctor will want to know if any of the following conditions are in either partner's family background:
  • High blood pressure
  • Diabetes
  • Birth defects
  • Cystic fibrosis (CF)
  • Mental retardation
  • Any inherited diseases associated with birth defects, such as sickle cell anemia, Tay-Sachs disease or Thalassemia
• Complete Personal Medical History: Your doctor will need to know a personal history on both perspective parents in relation to diseases, conditions or infections that can effect fertility. They include:
  • Sexually-transmitted diseases such as gonorrhea, syphilis and genital herpes
  • Infections of the reproductive tract including PID (pelvic inflammatory disease)
  • Heart disease
  • Epilepsy
  • German measles
  • Mumps
  • Chronic health threats including arthritis, colitis, high cholesterol and weight problems

Life Style
Because life style can influence one's ability to conceive, be prepared to answer questions relating to where you live, where you work, your occupation and how your leisure time is spent.

In addition, your physician will probably ask you:

• How much alcohol you each consume on a regular basis
• What your eating habits are, including any vitamins taken
• If either of you smoke, and if so, how much
• If either of you has used recreational drugs, and if so, what and when
• If either of you work with radiation or are exposed to any toxic chemicals
• If you own a cat, because of toxoplasmosis, an infection linked to a parasite found in cats' intestines

What to Ask
While much information is required from a couple at a preconception visit, the appointment should be an exchange of communication with you and your partner also asking your doctor any questions that either of you may have. Some questions suggested by both patients and doctors include:

• Are over-the-counter and prescription medications safe to take? Include over-the-counter cold and headache remedies.
• Do you offer help with weight loss before pregnancy, if obesity is a factor?
• Do any blood tests need to be done to measure immunity to certain infections such as rubella and chicken pox?
• What are the initial signs of pregnancy?

Make Some Changes
The March of Dimes Birth Defects Foundation recommends that all women who could become pregnant take a multi-vitamin containing 400 micrograms of folic acid daily to help prevent birth defects.

At a preconception visit, patients are often prescribed prenatal vitamins to ensure they are getting the proper amount of folic acid prior to conception. Laura Gaebelein, a new mother from North Royalton, Ohio, recalls the strong emphasis her doctor placed on folic acid at her preconception visit.

"After talking with my doctor, he checked the over-the-counter multi-vitamin I was already taking to make sure it provided enough folic acid," she says. "Since it did, I was able to continue taking it while trying to conceive."

Doctors also encourage eating healthy foods that are high in folic acid. Orange juice, green leafy vegetables, beans and whole grain products are naturally rich in folates, which are the natural forms of folic acid. Some products such as fortified breakfast cereals, enriched grain products and vitamin supplements are a source of a synthetic form of folic acid that is easier for the body to digest than the natural form. One bowl of Cheerios, for example, provides 50 percent of the amount needed daily.

Dr. Kathleen Neal, an OB/GYN in Cleveland, Ohio, tells her patients to stop drinking alcohol entirely before they plan to conceive. "We don't know what the safe limit of alcohol intake is in relation to fetal alcohol syndrome," she stresses. She also advises patients to have caffeine only in moderation.

Mary Carocci of Sagamore Hills, Ohio gave birth to her first child in June. She summarizes her preconception visit with her doctor with these words of advice that he told her: "Act as if you are pregnant today. Treat your body as if you are already pregnant."

In addition to prescribing prenatal vitamins, her doctor suggested a healthy diet that included consuming caffeine and alcohol in moderation for both Carocci and her husband. She was surprised to learn that the average couple takes one year to conceive.

"The doctor emphasized that we shouldn't get too anxious about conceiving," she says.

Both Carocci and Gaebelein agree that much of what was discussed at their preconception visits was really common sense and good nutrition. Dr. Neal confirms this with her standard words of wisdom to patients: "Healthy moms typically have healthy babies."