Start folic acid now
Folic acid supplementation ideally begins at least one month before conception, though three months is better. It reduces the risk of neural tube defects — conditions affecting the brain and spine — by up to 70%. The standard recommendation is 400mcg daily; your doctor may suggest 5mg if you have a family history of neural tube defects, diabetes, or are on certain medications. Most prenatal vitamins include the right amount.
Get your health baseline checked
A preconception appointment with your gynaecologist is time well spent. You'll want to check your thyroid function, iron levels, blood sugar, and immunity to rubella and chickenpox. If you have a chronic condition like diabetes, hypertension, or an autoimmune disorder, getting it stable before pregnancy leads to significantly better outcomes. This is also the time to review any medications — some are not safe in pregnancy and need to be switched.
Nutrition and weight
You don't need to eat for two before you're even pregnant, but improving your diet now creates a better environment for early fetal development. Focus on iron-rich foods (spinach, lentils, red meat), calcium, and omega-3 fats. If your BMI is significantly above or below the healthy range, your doctor may suggest addressing this before conception, as both extremes increase pregnancy complications.
What to stop
Alcohol, smoking, and recreational drugs should ideally be stopped before conception, not just once you get a positive test. High caffeine intake (more than 200mg/day) is associated with reduced fertility and increased miscarriage risk, so it's worth cutting back. If you're taking vitamin A supplements (as opposed to beta-carotene), stop — high doses are teratogenic. Switch to a dedicated prenatal vitamin instead.