Planning a pregnancy: what to do before you conceive
Preparing for pregnancy starts before the test is positive. According to the NHS, the most important steps are to start taking 400 micrograms of folic acid a day (ideally 3 months before you start trying), to check your vaccines and your cervical screening, to discuss any long-term conditions and the medicines you take with your doctor, and to sort out your habits – no cigarettes or alcohol, and a healthy weight. If you are on the contraceptive injection, bear in mind that your fertility may take up to a year to return after stopping.
- The NHS recommends 400 micrograms of folic acid a day – ideally from 3 months before conception until the 12th week of pregnancy.
- Some women need a higher dose of 5 mg on prescription – with diabetes, epilepsy, HIV, sickle cell disease, thalassaemia or a neural tube defect in the family.
- Before pregnancy, the NHS advises checking whether you have had the MMR vaccine (measles, mumps, rubella) and whether you are due for cervical screening.
- Do not stop prescribed medicines before talking to your doctor.
- After the contraceptive injection, fertility can take up to 1 year to return after the last dose.
Why should folic acid start before conception?
According to the NHS, folic acid reduces the risk of neural tube defects in the baby, such as spina bifida, and may also help against cleft lip and palate or some heart conditions. Food alone usually does not provide enough, so the NHS recommends a 400 microgram supplement every day.
The key thing is timing: start while you are still trying to get pregnant – ideally 3 months before – and continue until the 12th week of pregnancy. If you find out about the pregnancy later, start straight away. Taking it for longer does not harm the baby.
When is a higher dose of folic acid needed?
The NHS states that some women need 5 mg a day, which is prescribed by a doctor. This applies if you are planning a pregnancy or are before the 12th week and:
- you, the baby's father or a close relative of either of you has a neural tube defect;
- a previous pregnancy was affected by such a defect;
- you have diabetes;
- you have a blood disorder such as sickle cell disease or thalassaemia;
- you take medicines for epilepsy or HIV.
If you fall into any of these groups, discuss it with your doctor before you stop contraception – precisely so that you start in time.
What check-ups and vaccines should you sort out before pregnancy?
The NHS lists several checks that are easier to do while you are not yet pregnant:
- MMR vaccine (measles, mumps, rubella) – if you have not had it, get it to protect the baby during pregnancy.
- Cervical screening – check whether you are due and, if so, book an appointment.
- Test for sexually transmitted infections – if you or your partner may have an infection.
- Long-term conditions and cancer treatment – if you have a health condition or have been treated for cancer, talk to your doctor about planning.
How does contraception affect the return of fertility?
The NHS advises not to stop any prescribed medicine, including contraception taken for medical reasons, before talking to your doctor or specialist. When planning, it is also good to know how quickly fertility can return after the different methods.
For example, with the contraceptive injection, which lasts 8 to 13 weeks depending on the type, the NHS states that fertility can take up to 1 year to return to its previous level. If you are planning a pregnancy in the coming months, this is an important conversation for the doctor's surgery.
Besides folic acid, the NHS also recommends vitamin D – 10 micrograms a day at least from October to March, when there is not enough sun. Be careful with supplements containing vitamin A (retinol) and cod liver oil – they are not recommended in pregnancy.
Which habits matter before conception?
According to the NHS, there are several changes that increase the chances of a healthy pregnancy:
- Cigarettes – get support to stop.
- Alcohol and drugs – avoid them; your GP can help.
- Diet – a balanced, healthy diet.
- Weight – being too underweight or too overweight can make conceiving harder. Being overweight in pregnancy is linked to high blood pressure, pre-eclampsia, gestational diabetes and blood clots, but these risks can be reduced.
On conception itself, the NHS notes that if you are under 40 and have sex without contraception every 2–3 days, you will most likely get pregnant within one year. The most fertile time is around ovulation – usually around 14 days before your next period, depending on the length of your cycle.
When should you see a doctor?
The NHS recommends talking to your GP before you start trying or while trying, if:
- you or your partner live with a condition such as epilepsy, diabetes, sickle cell disease or HIV;
- you or your partner take prescribed medicines, over-the-counter medicines or herbal remedies;
- you have a known fertility problem – for example endometriosis or a low sperm count;
- you cannot have sex or find it difficult, for example because of a disability;
- you have been trying through sex for 1 year or more without success;
- you need help to stop smoking, drinking alcohol or using drugs.
Frequently asked questions
If I am already pregnant and have not taken folic acid, is it too late?
No. The NHS advises starting as soon as you find out you are pregnant and continuing until the 12th week.
Should I take vitamin D all year round?
According to the NHS, 10 micrograms a day are needed at least from the start of October to the end of March. Year-round use can be considered if you cover most of your skin when outdoors, spend a lot of time indoors or have dark skin. Do not exceed 100 micrograms a day.
How long is it normal for getting pregnant to take?
The NHS states that if you are under 40 and have sex without contraception every 2–3 days, you will most likely get pregnant within one year. With artificial insemination, 6 to 12 cycles of treatment may be needed.
Sources
- NHS – Trying to get pregnant – last reviewed by the NHS: 2 June 2026
- NHS – Pregnancy vitamins and supplements – last reviewed by the NHS: 3 June 2026
- NHS – What is the contraceptive injection? – last reviewed by the NHS: 8 February 2024
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].