{ "release_id": "cb1244a2c7003676", "id": "maternal:guide-planning-a-pregnancy", "owner": "maternal", "kind": "patient_guide", "slug": "planning-a-pregnancy", "name": "Planning a pregnancy", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "What the sources say about folic acid, blood pressure, smoking and alcohol when planning a pregnancy, and what MedlinePlus says about medicines during pregnancy.", "summary_technical": "Static guide from MedlinePlus pages, an NICHD page and two task force abstracts. It gives no dose.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": "2027-04-15", "identifiers": [], "navigation": { "maternal": { "life-stage": [ "preconception" ], "care-area": [ "preconception-health" ] } }, "payload": { "purpose": "preparing_for_care", "audience": "People planning a pregnancy, and the people with them", "about": [ "maternal:preconception-care", "maternal:folic-acid-supplementation", "maternal:smoking-cessation-in-pregnancy", "maternal:prenatal-alcohol-exposure", "maternal:chronic-hypertension-in-pregnancy" ], "reading_grade_target": 9, "scope_note": "Written from US government pages and two task force abstracts. NICHD is the US National Institute of Child Health and Human Development. It does not cover every topic the sources raise, such as family history or mental health before pregnancy.", "warning_blocks": [], "sections": [ { "heading": "Care before pregnancy", "statements": [ { "id": "care-1", "text": "Care before pregnancy is care a person gets before becoming pregnant.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2" } ] }, { "id": "care-2", "text": "A health care provider can help a person who is planning a pregnancy work out which steps to take.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2" } ] }, { "id": "care-3", "text": "NICHD says a visit before pregnancy can improve the chances of a healthy pregnancy.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Can you promote a healthy pregnancy before getting pregnant?, paragraph 3" } ] }, { "id": "care-4", "text": "Taking action on health issues before pregnancy can prevent many future problems for the parent and baby.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 3" } ] } ] }, { "heading": "Folic acid", "statements": [ { "id": "fa-1", "text": "Folic acid is a B vitamin that helps the body make healthy new cells.", "cites": [ { "snapshot_id": "maternal:medlineplus-folicacid-2026-10-15", "locator": "Summary, paragraph 1" } ] }, { "id": "fa-2", "text": "Having enough folic acid before and during pregnancy can prevent major birth defects of the baby's brain or spine.", "cites": [ { "snapshot_id": "maternal:medlineplus-folicacid-2026-10-15", "locator": "Summary, paragraph 1" } ] }, { "id": "fa-3", "text": "Neural tube defects are abnormalities of the brain, spine or spinal column that can occur in a developing fetus.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Can you promote a healthy pregnancy before getting pregnant?, paragraph 2" } ] }, { "id": "fa-4", "text": "In 2023, the US Preventive Services Task Force (USPSTF) again recommended a folic acid supplement for all people planning a pregnancy or able to become pregnant.", "cites": [ { "snapshot_id": "maternal:pubmed-37526713-2026-10-14", "locator": "Abstract, RECOMMENDATION, sentence 1, fragment 1 of 2" }, { "snapshot_id": "maternal:pubmed-37526713-2026-10-14", "locator": "ArticleTitle" }, { "snapshot_id": "maternal:pubmed-37526713-2026-10-14", "locator": "Journal issue, PubDate" } ] }, { "id": "fa-5", "text": "The task force had high certainty that folic acid supplements have a substantial net benefit in preventing neural tube defects in the children of these people.", "cites": [ { "snapshot_id": "maternal:pubmed-37526713-2026-10-14", "locator": "Abstract, EVIDENCE ASSESSMENT, sentence 1, fragment 1 of 2" }, { "snapshot_id": "maternal:pubmed-37526713-2026-10-14", "locator": "Abstract, EVIDENCE ASSESSMENT, sentence 1, fragment 2 of 2" } ] } ] }, { "heading": "Health problems before pregnancy", "statements": [ { "id": "hp-1", "text": "A provider can help find and take care of problems like diabetes or high blood pressure that might affect the parent and baby later.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 1" }, { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2" } ] }, { "id": "hp-2", "text": "NICHD says many health problems affect both the pregnant woman and the developing baby, such as diabetes and high blood pressure.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Talk to your health care provider about your diabetes or other medical conditions, paragraph 1" } ] }, { "id": "hp-3", "text": "NICHD says controlling health problems before and during pregnancy lowers the risk of miscarriage and stillbirth, as well as other health problems for the baby.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Talk to your health care provider about your diabetes or other medical conditions, paragraph 1, fragment 1 of 2" }, { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Talk to your health care provider about your diabetes or other medical conditions, paragraph 1, fragment 2 of 2" } ] } ] }, { "heading": "High blood pressure", "statements": [ { "id": "bp-1", "text": "High blood pressure can cause problems for the parent and baby during pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What is high blood pressure in pregnancy?, paragraph 2" } ] }, { "id": "bp-2", "text": "MedlinePlus calls treatment for high blood pressure important before, during and after pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What is high blood pressure in pregnancy?, paragraph 2" } ] }, { "id": "bp-3", "text": "Chronic hypertension is high blood pressure that starts before the 20th week of pregnancy or before pregnancy begins.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the types of high blood pressure in pregnancy?, chronic hypertension" } ] }, { "id": "bp-4", "text": "Some people may have chronic hypertension long before pregnancy and not know until a blood pressure check at a prenatal visit.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the types of high blood pressure in pregnancy?, chronic hypertension, fragment 1 of 2" }, { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the types of high blood pressure in pregnancy?, chronic hypertension, fragment 2 of 2" } ] }, { "id": "bp-5", "text": "Chronic high blood pressure or chronic kidney disease before pregnancy makes high blood pressure in pregnancy more likely.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "Who is more likely to develop high blood pressure in pregnancy?, lead-in" }, { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "Who is more likely to develop high blood pressure in pregnancy?, list item 1" } ] }, { "id": "bp-6", "text": "High blood pressure usually has no symptoms, and people usually find out when a provider measures it.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the symptoms of high blood pressure in pregnancy?, paragraph 1" } ] }, { "id": "bp-7", "text": "MedlinePlus lists medicine to control blood pressure as one treatment in pregnancy, along with a talk with the provider about which medicines are safe for the baby.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the treatments for high blood pressure in pregnancy?, lead-in" }, { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What are the treatments for high blood pressure in pregnancy?, list item 4" } ] } ] }, { "heading": "Medicines in pregnancy, from MedlinePlus", "statements": [ { "id": "md-0", "text": "This MedlinePlus page is written for people who are already pregnant.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, paragraph 1" } ] }, { "id": "md-1", "text": "Some medicines are safe to take during pregnancy, but many are not.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, paragraph 1" } ] }, { "id": "md-2", "text": "Some medicines can harm a developing baby, including prescription drugs, over-the-counter medicines, and herbs and supplements.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, paragraph 1" }, { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, list item 1" }, { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, list item 2" }, { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, list item 3" } ] }, { "id": "md-3", "text": "For medicines during pregnancy, MedlinePlus advises, \"Always talk to your provider before you stop or start any medicine.\"", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Should I stop taking my medicine during pregnancy?, paragraph 1" } ] }, { "id": "md-4", "text": "A person may take medicine to treat a health problem they had before pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Should I stop taking my medicine during pregnancy?, paragraph 1" } ] }, { "id": "md-5", "text": "During pregnancy, not using a medicine that is needed may be more harmful to the pregnant person and the fetus than using it.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Should I stop taking my medicine during pregnancy?, paragraph 1" } ] }, { "id": "md-6", "text": "MedlinePlus ties the choice to the medicine's risks and benefits and describes it as a decision for the person and the provider to make together.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Should I stop taking my medicine during pregnancy?, paragraph 1" } ] } ] }, { "heading": "Smoking, alcohol and drugs on the NICHD list", "statements": [ { "id": "nl-1", "text": "During pregnancy, smoking, alcohol and drugs can increase the risk of sudden infant death syndrome, preterm birth, fetal alcohol spectrum disorders and neural tube defects, says NICHD.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Avoid smoking, drinking alcohol, and taking drugs, heading" }, { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Avoid smoking, drinking alcohol, and taking drugs, paragraph 1" } ] }, { "id": "nl-2", "text": "NICHD names support groups and medications as things to discuss with a provider for help quitting smoking, drinking or drugs.", "cites": [ { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Avoid smoking, drinking alcohol, and taking drugs, paragraph 1, fragment 1 of 2" }, { "snapshot_id": "maternal:nichd-before-pregnancy-2026-10-15", "locator": "Avoid smoking, drinking alcohol, and taking drugs, paragraph 1, fragment 2 of 2" } ] } ] }, { "heading": "Smoking", "statements": [ { "id": "sm-1", "text": "Smoking while pregnant raises the risk of a baby being born too small, too early or with birth defects.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandsubstanceuse-2026-10-15", "locator": "Tobacco, paragraph 2" } ] }, { "id": "sm-0", "text": "In 2021, the USPSTF recommended behavioral interventions and approved medicines for quitting smoking for adults who are not pregnant.", "cites": [ { "snapshot_id": "maternal:pubmed-33464343-2026-10-14", "locator": "Abstract, RECOMMENDATIONS, sentence 1, fragment 1 of 2" }, { "snapshot_id": "maternal:pubmed-33464343-2026-10-14", "locator": "Abstract, RECOMMENDATIONS, sentence 1, fragment 2 of 2" }, { "snapshot_id": "maternal:pubmed-33464343-2026-10-14", "locator": "Journal issue, PubDate" } ] }, { "id": "sm-2", "text": "For pregnant people, the same statement recommended that clinicians ask all of them about tobacco, advise them to stop, and provide behavioral interventions for quitting to those who use it.", "cites": [ { "claim": "maternal:claim-uspstf-2021-tobacco-behavioral-interventions-pregnancy" }, { "snapshot_id": "maternal:pubmed-33464343-2026-10-14", "locator": "Journal issue, PubDate" } ] }, { "id": "sm-3", "text": "The same statement says the evidence on quit-smoking medicines in pregnant people is too limited to judge their benefits and harms.", "cites": [ { "claim": "maternal:claim-uspstf-2021-tobacco-pharmacotherapy-pregnancy-insufficient" }, { "snapshot_id": "maternal:pubmed-33464343-2026-10-14", "locator": "Journal issue, PubDate" } ] } ] }, { "heading": "Alcohol", "statements": [ { "id": "al-1", "text": "Alcohol can harm a baby at any stage of pregnancy, even the earliest stages, before a person knows they are pregnant.", "cites": [ { "snapshot_id": "maternal:medlineplus-fasd-2026-10-15", "locator": "Summary, paragraph 1" } ] }, { "id": "al-2", "text": "Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs).", "cites": [ { "snapshot_id": "maternal:medlineplus-fasd-2026-10-15", "locator": "Summary, paragraph 1" } ] }, { "id": "al-3", "text": "Fetal alcohol spectrum disorders last a lifetime.", "cites": [ { "snapshot_id": "maternal:medlineplus-fasd-2026-10-15", "locator": "Summary, paragraph 4" } ] }, { "id": "al-4", "text": "There is no known amount of alcohol that is safe to drink during pregnancy and while trying to get pregnant.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandsubstanceuse-2026-10-15", "locator": "Alcohol, paragraph 1" } ] }, { "id": "al-5", "text": "On its page about these disorders, MedlinePlus advises, \"To prevent FASDs, you should not drink alcohol while you are pregnant, or when you might get pregnant.\"", "cites": [ { "snapshot_id": "maternal:medlineplus-fasd-2026-10-15", "locator": "Summary, final paragraph" } ] } ] } ], "checklists": [ { "heading": "Topics the sources cover", "items": [ { "id": "ck-1", "text": "Folic acid, a step MedlinePlus lists for planning a pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2" }, { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 2" } ] }, { "id": "ck-2", "text": "Diabetes and other problems that might affect the parent and baby later, which MedlinePlus lists.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 1" } ] }, { "id": "ck-3", "text": "High blood pressure, which MedlinePlus calls important to treat before, during and after pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-high-blood-pressure-in-pregnancy-2026-10-15", "locator": "What is high blood pressure in pregnancy?, paragraph 2" } ] }, { "id": "ck-4", "text": "Medicines, herbs and supplements, which MedlinePlus covers for pregnancy.", "cites": [ { "snapshot_id": "maternal:medlineplus-pregnancyandmedicines-2026-10-15", "locator": "Is it safe to take medicine during pregnancy?, paragraph 1" } ] }, { "id": "ck-5", "text": "Smoking, alcohol and drugs, which MedlinePlus lists under things to avoid.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 4" } ] }, { "id": "ck-6", "text": "Vaccines, which MedlinePlus lists under getting up to date.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 3" } ] }, { "id": "ck-7", "text": "A healthy weight, which MedlinePlus lists as a step.", "cites": [ { "snapshot_id": "maternal:medlineplus-preconceptioncare-2026-10-15", "locator": "Summary, paragraph 2, list item 5" } ] } ] } ], "questions": [ { "text": "Which health problems could affect a pregnancy?", "grounded_in": [ "hp-1", "hp-2", "ck-2" ] }, 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