Three months before my first positive test, I thought I was ready. I had the prenatal vitamins, the fertility app, the ovulation predictor kits. I was not ready. Here is what actually matters when you are trying to conceive — and what does not.
What Actually Matters
Start folic acid early. Not when you get the positive test. Three months before. Neural tube development happens in the first 4 weeks — often before you even know you are pregnant. 400-800mcg daily. This is non-negotiable.
Know your cycle. Not just "it comes every month." Know the length. Know if it varies. Know when you ovulate. My cycles were 31 days, not 28. That 3-day difference meant my "standard" due date was off by almost a week. Use our Cycle Tracker to figure this out before you need it.
Get your vaccines updated. MMR and varicella need to be done before pregnancy — you cannot get them while pregnant. Flu and Tdap can be done during, but it is easier to get them out of the way.
Check your medications. Some common meds are not safe in pregnancy. ACE inhibitors, some antidepressants, certain acne medications. Talk to your provider about switching before you conceive.
What Does Not Matter As Much
The perfect diet. Yes, eat healthy. No, you do not need to become a raw vegan. Balanced meals, limited processed food, adequate protein. That is it. The stress of a "perfect" diet is worse than an occasional french fry.
The perfect weight. BMI is a flawed metric. Focus on being active and nourished, not a number on the scale. I have seen "overweight" women have easier pregnancies than "normal" weight women who were malnourished.
Every supplement under the sun. Prenatal vitamin + folic acid + vitamin D if you are deficient. That is it. You do not need 47 different supplements. Your wallet and your liver will thank you.
The Emotional Prep
Honestly? This is the part nobody talks about. Pregnancy is a massive identity shift. Your body changes. Your priorities change. Your relationships change. Some people handle it gracefully. Others — like me — handle it with a lot of crying and ice cream.
Talk to your partner about division of labor. Not just "who changes diapers" — who handles night wakings, who manages pediatrician appointments, who takes mental health days. These conversations prevent resentment later.
And if you are struggling to conceive? That is normal too. One in eight couples need help. There is no shame in it. I have held hands with patients through IVF, IUI, and everything in between. The path to parenthood is not always straight. It is still valid.
— Sophie Miller, CNM
Sophie Miller, CNM is a Certified Nurse-Midwife in Portland, Oregon. This article reflects personal experience and clinical observations. For medical advice, consult your healthcare provider.