Preconception Checkup: Why you need one and what to expect

To give your baby the best start in life, it's a good idea to get your own health squared away before you get pregnant. Think about preconception care as preventive medicine for you and for the child you're planning to conceive.
A complete medical history and physical exam a few months to a year before you start trying to conceive will help you determine what steps you may still need to take to become physically and emotionally ready to have a baby. They'll also give your practitioner an important baseline to refer to during your pregnancy.

Taking your History and Providing Counseling:
The first thing your healthcare practitioner will do is ask a long list of questions about your health and lifestyle. (If you already have a relationship with your practitioner, he may know much of this information and be looking for you to fill in the blanks.)
Your practitioner will look for any current or past conditions that might affect your ability to get pregnant or your health and your baby's health once you do get pregnant.

Gynecological History:
Your practitioner will ask you about your periods. (If you're not already keeping a menstrual calendar, now is a good time to start.) He'll also ask what kind of birth control you're using. With certain methods, such as Depo-Provera , it may take a relatively long time for your fertility to return. Ask about switching methods if you'd like to conceive soon.
Next he'll ask about your Pap smears and whether you've ever had a sexually transmitted infection (STI) . Many STIs can be "silent" – meaning they don't cause any symptoms – but they can cause problems in pregnancy (or fertility problems in the case of pelvic inflammatory disease).

If you're not in a monogamous relationship, or if you or your partner has a history of multiple sexual partners, it's especially important to be screened for STIs now.

Obstetric History
Your practitioner will ask if you've been pregnant before. (This includes ectopic pregnancies and abortions.)
A previous ectopic pregnancy could make you less fertile. And if you get pregnant after an ectopic pregnancy, your caregiver may recommend a very early ultrasound to make sure this pregnancy isn't ectopic.
A history of recurrent miscarriage might mean that you should have chromosomal testing or be checked for certain health problems.

She'll ask if you had any mental health issues (such as postpartum depression ) during or after any of your pregnancies.
Finally, she'll ask if you've given birth to a baby who had any problems. If you've had a baby with a neural tube defect, such as spina bifida, taking a much higher daily dose of folic acid before and during your next pregnancy reduces the risk of this happening again.

Medical History:
Your practitioner will want to know if you have any medical conditions that could complicate your pregnancy, such as asthma,
diabetes, high blood pressure, blood clotting disorders, and thyroid disease .
If you have a chronic medical condition, your practitioner can help you manage it or refer you to a specialist who can.
The type or dose of medication you're taking to treat a chronic condition may need to be adjusted before and during pregnancy. (However, do not stop taking medication you've been prescribed unless advised to do so by your caregiver.)
She'll also want to know if you've ever had surgery or been hospitalized for any other reason or had problems with anesthesia.