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Disclaimer: This guide is for education only and is not a substitute for professional medical advice. Always confirm medicine, supplement and product decisions with your obstetrician, midwife, pharmacist or healthcare provider.

Guide

Planning a Pregnancy: What to Sort Out First

Published 2026-07-08 | By SafeMama Editorial Team | Editorial policy

Planning a Pregnancy: What to Sort Out First pregnancy safety guide image

Short answer

Start folic acid before conceiving and get any regular medicines reviewed. ACOG describes prepregnancy care as covering supplements, existing conditions, medication, vaccination status and lifestyle, because several of these are more useful to address before pregnancy than during it.

Folic acid now, medicines reviewed

Planning Pregnancy in pregnancy: how to think about it

ACOG guidance on prepregnancy care exists because several of the most useful interventions work best before conception rather than after it. Folic acid is the clearest case: it reduces the risk of neural tube defects, and the neural tube closes within the first weeks, frequently before someone knows they are pregnant. Starting after a positive test misses much of that window. Medication review is the second: adjusting or switching a long-term medicine is far easier to plan, monitor and stabilise before pregnancy than in the middle of it. Vaccination is a third, because live vaccines including MMR and varicella are given before conception rather than during. Existing conditions benefit from being well controlled at the point of conception, which is particularly true for diabetes and epilepsy. None of this means an unplanned pregnancy is a problem to be fixed; it means that where planning is possible, these are the things worth using it for.

Planning Pregnancy: safer choices

  • Taking folic acid daily before conceiving and through the first 12 weeks. The neural tube closes very early, often before a pregnancy is confirmed, which is why timing matters more than dose fiddling.
  • Asking for a medication review before conceiving if you take anything regularly. Changes are easier to plan and monitor before pregnancy than after.
  • Checking vaccination status, since live vaccines such as MMR are given before conception rather than during pregnancy.
  • Discussing existing conditions such as diabetes, epilepsy, thyroid disease or high blood pressure with the team that manages them, because control before conception matters.
  • Stopping smoking and alcohol before conceiving rather than after, which removes the question of exposure in the earliest weeks.

Planning Pregnancy: what to avoid or double-check

  • Do not wait for a positive test to start folic acid. By then the window it protects has largely passed.
  • Do not stop regular medication in anticipation of pregnancy without advice. Review it rather than abandoning it.
  • Avoid assuming a higher folic acid dose is automatically better. Some situations need a higher dose and most do not, so ask rather than guess.
  • Do not delay seeking advice if you have had a previous pregnancy complication. That history often changes what is recommended before the next one.

How SafeMama helps

SafeMama can check folic acid and prenatal vitamin doses, identify what is in a combination supplement, and show the active ingredients in medicines you take, which is useful preparation for a prepregnancy review.

Open the SafeMama app, scan the barcode or search the ingredient, then use the result as a starting point for a conversation with your healthcare provider.

Sources

Frequently asked questions

When should I start taking folic acid?

Before conceiving, and continuing through the first 12 weeks. The neural tube closes in the first weeks, often before a pregnancy is confirmed, so starting after a positive test misses much of the benefit.

Should I stop my medication before trying to conceive?

No, get it reviewed instead. Changes are easier to plan and monitor before pregnancy, but stopping without advice risks the condition itself becoming the problem.

Do I need a higher dose of folic acid?

Some situations do, including certain medical conditions and previous affected pregnancies. Most do not. Ask a GP or midwife rather than choosing a dose yourself.

Which vaccines should I sort out beforehand?

Live vaccines such as MMR and chickenpox are given before conception rather than during pregnancy, so checking your status beforehand is worthwhile.

I have diabetes or epilepsy. What should I do first?

Speak to the team that manages the condition before conceiving. Control at the point of conception matters, and treatment plans often need reviewing.

My pregnancy was not planned. Have I missed the window?

Not entirely. Start folic acid now, get medicines reviewed promptly, and tell your midwife your history. Most of these steps still help once started.

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