Learning Center

What You Need to Know Before You Get Pregnant

Preconception Information or What You Need to Know Before You Get Pregnant

  1. Rubelle Titer – This is a lab test to determine if you are immune to German Measles. If you are not you will need to be immunized and avoid trying to get pregnant for one month after you receive the final vaccine.
  2. Prenatal Vitamins and Folic Acid (at least 400 micrograms daily) – Studies have shown that incorporating these into your diet for three months prior to conception decreases your chance of your baby developing neural tube defects i.e. spina bifida and other brain defects. If  you or your family have a neural tube defect you will need to take 4 grams daily. Be sure to notify me that you have this history as I will need to write a prescription for this higher dose.
  3. Smoking – If you and/or your partner smoke you should STOP NOW, while you are trying to conceive. You greatly increase your chances of losing an otherwise normal pregnancy if you smoke prior to getting pregnant. Sperm is adversely affected by the products found in tobacco. Smoking while pregnant also appears to result in having a child who is more irritable and more likely to have behavioral problems.
  4. Exercise – You should start an exercise program now incorporating at least five days of cardio into your regimen. If you need a program please let me know and I will provide one for you. If you start a program now you will be able to continue it throughout your entire pregnancy. Exercise in pregnancy results in less pain while pregnant and in labor and better health for both you and your unborn baby.
  5. If you work in a healthcare environment, nursing home, hospital, etc. make sure you receive the Hepatitis B vaccine prior to getting pregnant.
  6. If you have any medical problems such as hypertension or diabetes these conditions need to be addressed prior to trying to get pregnant. Uncontrolled diabetes can result in pregnancy loss and birth defects.
  7. Herpes testing – 90% of people who have herpes do not know they are infected with the virus. An outbreak can occur at the time of labor and may not be detected. This can have very serious consequences for the newborn baby i.e. brain damage and death. If the pregnant mother is treated with Valtrex for the last month of her pregnancy these consequences can be greatly lessened.
  8. Cystic Fibrosis Testing – This is a very serious medical condition that can be passed on to your child if you and your partner are carriers of the gene. If you test positive for the gene your partner needs to be checked to see if he has the gene. If you both carry the gene then you will need to be referred for genetic counseling.

Infertility Intercourse Timing

The first day of your period is day number 1. Count out the days to the 9th, 11th, 13th and 15th days of your cycle. Have intercourse on these days only during the week.

  1. Start Prometrium on the ______ of each month.
  2. Call when menses (period) starts. On day 3 start Clomid for 5 days.
  3. On day 21 come to office for Progesterone blood test (call for appt first)
  4. Repeat above sequence every month.


Nicole is an outstanding midwife. She is knowledgeable, kind-hearted, understanding and easy to talk to. With her help and encouragement I was able to give birth naturally. My "birth" day was better than I imagined and I am grateful for such an awesome midwife. I will come back to Nicole EVERY time!

- Bobbie Garland, RN