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Planning a pregnancy

What the sources say about folic acid, blood pressure, smoking and alcohol when planning a pregnancy, and what MedlinePlus says about medicines during pregnancy.

Care before pregnancy

  • Care before pregnancy is care a person gets before becoming pregnant.1
  • A health care provider can help a person who is planning a pregnancy work out which steps to take.1
  • NICHD says a visit before pregnancy can improve the chances of a healthy pregnancy.2
  • Taking action on health issues before pregnancy can prevent many future problems for the parent and baby.3

Folic acid

  • Folic acid is a B vitamin that helps the body make healthy new cells.4
  • Having enough folic acid before and during pregnancy can prevent major birth defects of the baby's brain or spine.4
  • Neural tube defects are abnormalities of the brain, spine or spinal column that can occur in a developing fetus.5
  • 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.6, 7, 8
  • 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.9, 10

Health problems before pregnancy

  • A provider can help find and take care of problems like diabetes or high blood pressure that might affect the parent and baby later.1, 11
  • NICHD says many health problems affect both the pregnant woman and the developing baby, such as diabetes and high blood pressure.12
  • 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.13, 14

High blood pressure

  • High blood pressure can cause problems for the parent and baby during pregnancy.15
  • MedlinePlus calls treatment for high blood pressure important before, during and after pregnancy.15
  • Chronic hypertension is high blood pressure that starts before the 20th week of pregnancy or before pregnancy begins.16
  • Some people may have chronic hypertension long before pregnancy and not know until a blood pressure check at a prenatal visit.17, 18
  • Chronic high blood pressure or chronic kidney disease before pregnancy makes high blood pressure in pregnancy more likely.19, 20
  • High blood pressure usually has no symptoms, and people usually find out when a provider measures it.21
  • 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.22, 23

Medicines in pregnancy, from MedlinePlus

  • This MedlinePlus page is written for people who are already pregnant.24
  • Some medicines are safe to take during pregnancy, but many are not.24
  • Some medicines can harm a developing baby, including prescription drugs, over-the-counter medicines, and herbs and supplements.24, 25, 26, 27
  • For medicines during pregnancy, MedlinePlus advises, "Always talk to your provider before you stop or start any medicine."28
  • A person may take medicine to treat a health problem they had before pregnancy.28
  • During pregnancy, not using a medicine that is needed may be more harmful to the pregnant person and the fetus than using it.28
  • 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.28

Smoking, alcohol and drugs on the NICHD list

  • 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.29, 30
  • NICHD names support groups and medications as things to discuss with a provider for help quitting smoking, drinking or drugs.31, 32

Smoking

  • Smoking while pregnant raises the risk of a baby being born too small, too early or with birth defects.33
  • In 2021, the USPSTF recommended behavioral interventions and approved medicines for quitting smoking for adults who are not pregnant.34, 35, 36
  • 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.36, 37
  • The same statement says the evidence on quit-smoking medicines in pregnant people is too limited to judge their benefits and harms.36, 38

Alcohol

  • Alcohol can harm a baby at any stage of pregnancy, even the earliest stages, before a person knows they are pregnant.39
  • Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs).39
  • Fetal alcohol spectrum disorders last a lifetime.40
  • There is no known amount of alcohol that is safe to drink during pregnancy and while trying to get pregnant.41
  • 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."42

Topics the sources cover

  • Folic acid, a step MedlinePlus lists for planning a pregnancy.1, 43
  • Diabetes and other problems that might affect the parent and baby later, which MedlinePlus lists.11
  • High blood pressure, which MedlinePlus calls important to treat before, during and after pregnancy.15
  • Medicines, herbs and supplements, which MedlinePlus covers for pregnancy.24
  • Smoking, alcohol and drugs, which MedlinePlus lists under things to avoid.44
  • Vaccines, which MedlinePlus lists under getting up to date.45
  • A healthy weight, which MedlinePlus lists as a step.46

Questions to ask

  1. Which health problems could affect a pregnancy?
  2. Is a folic acid supplement part of the plan, and how much and how often is advised?
  3. Which medicines, herbs and supplements in use are known to affect a pregnancy?
  4. How do the risks and benefits of a needed medicine weigh against each other in a pregnancy?
  5. How is blood pressure checked before a pregnancy, and what treatment fits if it is high?
  6. What help is there for quitting smoking or alcohol, and which options fit a pregnancy?
  7. Which vaccines are due before a pregnancy?

Sources

  1. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2. Retrieved .
  2. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Can you promote a healthy pregnancy before getting pregnant?, paragraph 3. Retrieved .
  3. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 3. Retrieved .
  4. Folic Acid | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 1. Retrieved .
  5. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Can you promote a healthy pregnancy before getting pregnant?, paragraph 2. Retrieved .
  6. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement Publication, JAMA, Abstract, RECOMMENDATION, sentence 1, fragment 1 of 2. Retrieved .
  7. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement Publication, JAMA, ArticleTitle. Retrieved .
  8. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement Publication, JAMA, Journal issue, PubDate. Retrieved .
  9. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement Publication, JAMA, Abstract, EVIDENCE ASSESSMENT, sentence 1, fragment 1 of 2. Retrieved .
  10. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement Publication, JAMA, Abstract, EVIDENCE ASSESSMENT, sentence 1, fragment 2 of 2. Retrieved .
  11. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2, list item 1. Retrieved .
  12. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Talk to your health care provider about your diabetes or other medical conditions, paragraph 1. Retrieved .
  13. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Talk to your health care provider about your diabetes or other medical conditions, paragraph 1, fragment 1 of 2. Retrieved .
  14. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Talk to your health care provider about your diabetes or other medical conditions, paragraph 1, fragment 2 of 2. Retrieved .
  15. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What is high blood pressure in pregnancy?, paragraph 2. Retrieved .
  16. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the types of high blood pressure in pregnancy?, chronic hypertension. Retrieved .
  17. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the types of high blood pressure in pregnancy?, chronic hypertension, fragment 1 of 2. Retrieved .
  18. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the types of high blood pressure in pregnancy?, chronic hypertension, fragment 2 of 2. Retrieved .
  19. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), Who is more likely to develop high blood pressure in pregnancy?, lead-in. Retrieved .
  20. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), Who is more likely to develop high blood pressure in pregnancy?, list item 1. Retrieved .
  21. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the symptoms of high blood pressure in pregnancy?, paragraph 1. Retrieved .
  22. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the treatments for high blood pressure in pregnancy?, lead-in. Retrieved .
  23. High blood pressure in pregnancy (MedlinePlus health topic) Webpage, National Library of Medicine (MedlinePlus), What are the treatments for high blood pressure in pregnancy?, list item 4. Retrieved .
  24. Pregnancy and Medicines (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Is it safe to take medicine during pregnancy?, paragraph 1. Retrieved .
  25. Pregnancy and Medicines (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Is it safe to take medicine during pregnancy?, list item 1. Retrieved .
  26. Pregnancy and Medicines (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Is it safe to take medicine during pregnancy?, list item 2. Retrieved .
  27. Pregnancy and Medicines (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Is it safe to take medicine during pregnancy?, list item 3. Retrieved .
  28. Pregnancy and Medicines (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Should I stop taking my medicine during pregnancy?, paragraph 1. Retrieved .
  29. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Avoid smoking, drinking alcohol, and taking drugs, heading. Retrieved .
  30. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Avoid smoking, drinking alcohol, and taking drugs, paragraph 1. Retrieved .
  31. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Avoid smoking, drinking alcohol, and taking drugs, paragraph 1, fragment 1 of 2. Retrieved .
  32. Can you promote a healthy pregnancy before getting pregnant? | NICHD Webpage, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Avoid smoking, drinking alcohol, and taking drugs, paragraph 1, fragment 2 of 2. Retrieved .
  33. Pregnancy and Substance Use (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Tobacco, paragraph 2. Retrieved .
  34. Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement Publication, JAMA, Abstract, RECOMMENDATIONS, sentence 1, fragment 1 of 2. Retrieved .
  35. Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement Publication, JAMA, Abstract, RECOMMENDATIONS, sentence 1, fragment 2 of 2. Retrieved .
  36. Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement Publication, JAMA, Journal issue, PubDate. Retrieved .

  37. The USPSTF recommends that clinicians ask all pregnant persons about tobacco use, advise them to stop using tobacco, and provide behavioral interventions for cessation to pregnant persons who use tobacco. It grades this an A recommendation and concludes with high certainty that the net benefit of behavioral interventions for tobacco smoking cessation on perinatal outcomes and smoking cessation in pregnant persons is substantial.

    Applies to Maternal
    • Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.
    • Primary care (the review evaluated primary care interventions).
    • United States (statement of the US Preventive Services Task Force); the abstract names no country.
    • Pregnancy
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Not applicable (recommendation context)

    Limitations. The PubMed abstract prints each grade after its statement, so the A for the pregnancy statement appears at the start of the next sentence. The same statement covers all adults 18 years or older, including pregnant persons; this claim is about the pregnancy part only. The abstract gives no benefit numbers for pregnant persons. USPSTF certainty levels are the task force’s own wording and not a GRADE rating, so certainty is not assessed.

  38. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of pharmacotherapy interventions for tobacco cessation in pregnant persons, because few studies are available. It labels this an I statement.

    Applies to Maternal
    • Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.
    • Primary care (the review evaluated primary care interventions).
    • United States (statement of the US Preventive Services Task Force); the abstract names no country.
    • Pregnancy
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Not applicable (recommendation context)

    Limitations. An I statement is a statement about the evidence, not a recommendation against medicines. The same USPSTF statement also concludes that the evidence on e-cigarettes for smoking cessation in adults, including pregnant persons, is insufficient (an I statement); that is outside this claim’s population. The PubMed abstract prints each grade after its statement, so the I for the pharmacotherapy statement appears at the start of the next sentence.

  39. Fetal Alcohol Spectrum Disorders | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 1. Retrieved .
  40. Fetal Alcohol Spectrum Disorders | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 4. Retrieved .
  41. Pregnancy and Substance Use (MedlinePlus health topic) Webpage, MedlinePlus, National Library of Medicine, Alcohol, paragraph 1. Retrieved .
  42. Fetal Alcohol Spectrum Disorders | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, final paragraph. Retrieved .
  43. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2, list item 2. Retrieved .
  44. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2, list item 4. Retrieved .
  45. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2, list item 3. Retrieved .
  46. Preconception Care | MedlinePlus Webpage, MedlinePlus, National Library of Medicine, Summary, paragraph 2, list item 5. Retrieved .

About this guide

Written for
People planning a pregnancy, and the people with them
What it covers
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.
Pages it explains
Sources checked
2026-10-15
Next check due
2027-04-15
Reading level
Estimated grade 9.0 (target 9)

Every sentence cites a source. Words in quotation marks are the source's own; the rest is the atlas's summary.

https://maternal.openmedicalatlas.org/guides/planning-a-pregnancy/ · Release cb1244a2c7003676, built 2026-10-15