Preconception checkup: what is reviewed before pregnancy

The American College of Obstetricians and Gynecologists calls this appointment a prepregnancy care checkup and describes it as the first step in planning a pregnancy. Its purpose follows from timing: the major organs develop in the first 8 weeks of pregnancy (ACOG, Good Health Before Pregnancy, reviewed 2025). This page sets out what a preconception checkup covers in US guidance, and how the NHS approaches the same ground.

A preconception checkup covers history, medicines, vaccines and lifestyle

ACOG and the CDC describe much the same ground. Between them, their lists cover:

• current medical conditions, and past pregnancies and any complications in them;
• every medicine taken, including over-the-counter medicines, supplements, vitamins and herbal remedies;
• vaccination history;
• diet, weight, physical activity, and the use of tobacco, alcohol and drugs;
• family health history, which may lead to a referral for genetic counseling;
• the risk of sexually transmitted infections, including an HIV test, which ACOG recommends for all women;
• mental health, and safety at home, including intimate partner violence.

Sources: ACOG, reviewed 2025; CDC, Planning for pregnancy, 2025.

Vaccines are checked first, because some cannot be given in pregnancy

ACOG advises having the vaccines recommended for one's age before trying to conceive, because some cannot be given during pregnancy (reviewed 2025). Rubella is the main example: infection in pregnancy can cause miscarriage or serious birth defects. The CDC recommends a blood test before pregnancy to check immunity, the MMR vaccine for anyone who is not up to date, and, as a precaution, waiting one month after the vaccine before becoming pregnant (CDC, Vaccine recommendations before, during, and after pregnancy, 2024). The NHS likewise lists the MMR vaccine among the checks before trying for a baby, for anyone who has not already had it (NHS, Planning your pregnancy, 2026).

Long-term conditions and medicines are planned for, not stopped

The NHS advises speaking to a GP before trying to conceive if either partner lives with a condition such as epilepsy, diabetes, sickle cell disease or HIV, or takes prescribed or over-the-counter medicine or herbal remedies, and advises against stopping a prescribed medicine before that conversation (NHS, 2026). ACOG suggests bringing medicines to the appointment in their original packaging, so their safety in pregnancy can be checked (reviewed 2025). Several of these conditions also change the folic acid dose in UK guidance, as the guide to folic acid for pregnancy explains. What a supplement may contain, and where US and UK advice differs, is in the guide to prenatal vitamins.

The NHS lists checks rather than one routine appointment

ACOG describes a single prepregnancy visit. NHS guidance on planning a pregnancy is organized differently: it lists three checks to have before trying, and the situations in which to see a GP (NHS, 2026). The three checks are:

• the MMR vaccine, for anyone who has not had it;
• cervical screening, if it is due;
• a test for sexually transmitted infections, if either partner may have one.

The situations for seeing a GP include a long-term condition, regular medicines or herbal remedies, a known fertility issue such as endometriosis or a low sperm count, difficulty having sex, trying for a year or more without a pregnancy, and needing help to stop smoking, drinking or using drugs.

Both partners can take part in preparing for pregnancy

ACOG advises a male partner to give up smoking, alcohol and drugs before a couple tries to conceive, and the NHS names either partner's conditions, medicines and fertility issues as reasons to see a GP. The guide to male fertility covers when a man's fertility is assessed and how.

These questions follow from the guidance above

• Is my vaccination record complete, and do I need a rubella immunity test?
• Do any of my medicines need to change before pregnancy?
• Which folic acid dose applies to me?
• Does my family history call for genetic counseling?
• Is my cervical screening, or any other routine test, due?