A woman’s chance of becoming pregnant
decreases with age, particularly after the age of 35 because both the number
and quality of eggs get lower. A man’s ability to have a baby also declines
with age, though not as much as women’s. If the male partner is over 40, this
can make it harder for the woman to get pregnant, especially if she is also
over 40. However more than 8 in 10 of couples will conceive within a year if
the woman is under 40 years of age, and they have regular sex (every
2 to 3 days) without using contraception.
- At any age, it is a good
idea to be as healthy as possible before you get pregnant.
- See your GP if you haven’t
conceived after a year of trying or within six months of trying to conceive if
you are over 36.
While most women have healthy pregnancies and
babies, the chance of complications in pregnancy increases with age. Such
complications include miscarriage, pre-eclampsia (high blood pressure and
protein in the urine) or having a baby with a chromosomal abnormality, for
instance Downs syndrome. All women, regardless of their age, have a chance of
having a baby with a chromosomal abnormality, however this chance increases
with maternal age.
women are offered antenatal screening to detect baby’s that have a high chance
of conditions such as Downs syndrome.
- It is important that
you attend all your antenatal care appointments so problems can be spotted as
early as possible.
- Find more information about screening in pregnancy here (this information is available in multiple languages)
Fertility begins to improve
quickly when you and your partner go smokefree. After 12 months of trying,
women who are smokefree are twice as likely to be pregnant than women who smoke
tobacco. Even smoking a small number of cigarettes a day can make getting
pregnant more difficult. Second-hand smoke (breathing in tobacco smoke from
others) is also likely to reduce your chances of conceiving. Smoking has been
shown to reduce the quality of both the egg and sperm.
Smoking in pregnancy is damaging to the health of you and
your baby in many ways. Smoking in pregnancy is the biggest risk factor for
stillbirth and infant death. Carbon monoxide (CO) monitoring is used by
midwives for all women during pregnancy to detect harmful level of carbon
monoxide. This may be due to smoking, exposure
to secondhand smoke or to unsafe levels of carbon monoxide from other sources,
including faulty cooking and heating appliances. To learn more about smoking in
pregnancy, including about e-cigarettes and how to get support to quit, visit our stop smoking page by clicking here.
it is best for both you and your partner to stop smoking before you try to
become pregnant. However, if you are pregnant, it is still important to stop
smoking. The earlier you stop smoking the healthier you and your baby will be.
you are pregnant, let your midwife know that you or our partner smokes as they
can help you to get the right support to stay smokefree. You may also want to
encourage others whose secondhand smoke you are exposed to e.g. family members
or friends, to get support.
Drinking a lot of alcohol, or drinking
alcohol frequently, can affect fertility in both men and women. The UK Chief
Medical Officers recommend that if you are pregnant or planning to become
pregnant, the safest approach is not to drink alcohol at all to keep risks to
your baby to a minimum.
If having treatment to assist fertility,
studies have also shown that even light drinking can reduce the chances of success. Drinking excessively
can damage the egg and sperm.
There is no known safe level of alcohol to
drink during pregnancy. The UK Chief Medical Officers guideline suggest the
risk of harm to the baby is likely to be low if a woman has drunk only small
amounts of alcohol before she knew she was pregnant or during pregnancy. Drinking
heavily during pregnancy can cause a baby to develop fetal alcohol syndrome
(FAS) which is a serious condition (read more about it by clicking here.
- If you are planning to
become pregnant and would like support to reduce or stop drinking alcohol, including
if you are worried that you might be dependent on alcohol, speak to your GP or the
specialist alcohol treatment service in your area (using the link above).
- Once you stop
contraception it is best to avoid alcohol as you may get pregnant straight
- If you are pregnant, let
your midwife know how much alcohol you drink including if you are worried that
you might be dependent on alcohol as they can discuss this with you and help
you to access support if it might help.
Using drugs, such as cannabis, cocaine, and
new psychoactive substances (also known as ‘legal highs’) can affect fertility
in both men and women.
Cannabis is the most commonly used recreational
drug. In women, heavy cannabis use can cause hormones to be unbalanced so women
who use it are more likely to find it difficult to get pregnant.
Some prescription drugs can also lead to
dependence and are not suitable to take during pregnancy.
Illegal drugs may cause serious problems in
pregnancy and affect your baby’s growth and development. Some prescription
drugs can also lead to dependence and are not be suitable to take during pregnancy.
- Once you stop
contraception it is advised to avoid taking illegal drugs (and new psychoactive
substances) as you may become pregnant at any point.
- If you would like support
to quit, including if you are worried that you might be dependent
on drugs, speak to your GP or the specialist drug treatment service in your
area. If you are pregnant, let your midwife know what drugs you are taking and
how, as they can help you to access support.
- The FRANK website is also a good source of information,
both about the different types of drugs, and the local help available if you
are concerned about your drug use: INCLUDE LINK TO NEW HT DRUG SECTION
- If you are concerned that you are dependent on a
prescription medication, speak to your midwife or a doctor so they can help you
get the right support.
If you’re planning to get pregnant, eating a
healthy, balanced diet will help you stay well throughout pregnancy and be good
for your baby’s health. The best foods for getting pregnant are the
same as those for general well-being. For
both men and women, being overweight or underweight can affect fertility, cause
health problems during pregnancy and during birth, as well as affect the future
health of a child. Men can also improve the chances of a
pregnancy with a healthy, balanced diet because sperm quality can be affected.
If you are trying to get
pregnant eating a healthy, varied diet will help you to get most of the
vitamins and minerals you need. All women need to take folic acid tablets (see
section on folic acid below for further information) before getting pregnant to
offer protection against neural tube defects such as spina bifida in the early
stages of pregnancy. It is almost impossible to get enough folic acid through
your diet to give the most protection.
When pregnant, guidelines recommend you and your baby will
benefit from a healthy diet in which you get five portions of fruit or
vegetables each day (with at least 3 portions of vegetables). A healthy
balanced diet will give you most of the vitamins and minerals you need for your
developing baby and help keep you and baby healthy and strong ahead of birth. Some foods should be
avoided during pregnancy to minimize the risk of food poisoning which can be
harmful to you and your baby (see link below for more information on specific
foods). A poor diet can also
damage your teeth. Hormonal changes during pregnancy can make gums more
vulnerable to plaque, leading to inflammation and bleeding. The best way to prevent
or deal with gum problems is to practice good oral hygiene. Pregnant women, or women
who have had a baby in the past 12 months are entitled to free NHS dental care
(you'll need a Maternity Exemption Certificate from you midwife or doctor).
Before and during pregnancy
- There is lots of information on having a healthy diet,
foods to avoid, and vegetarian and vegan diets during pregnancy on our staying healthy during pregnancy page under the 'eat
well during pregnancy' section - to access it, click here.
- Aim to eat a variety of healthy foods every day. Making
some improvements to your diet will have a positive effect, do as much as you
can. Talk to your midwife for advice if needed.
women should take 400mcg of folic acid every day for two months before trying
for a baby and until 12 weeks
pregnant. You will need a higher dose of folic acid tablets if you have some
health conditions such as diabetes, epilepsy or have a BMI (Body Mass Index)
over 30. See the section on folic acid below for further information.
- Do not eat for two - during the last three months of
pregnancy you may need an additional 200 calories a day.
- Weight gain during pregnancy varies greatly. For more
information on what to expect see the 'weight gain in pregnancy' section by clicking here.
- Practice good oral hygiene during pregnancy (ask your
midwife how to apply for a Maternity Exemption Certificate).
Being a healthy weight is helpful if you are planning
to have a baby. Your BMI (Body Mass Index) is a measure that uses your height
and weight to work out if your weight is in a healthy range (a BMI calculator
is available here.
an unhealthy (overweight or underweight) BMI can affect your fertility, cause
health problems during pregnancy and during birth, as well as affect the future
health of a child.
Having a high BMI can reduce your chances of
getting pregnant. The ideal BMI for getting pregnant is between 18.5 and 24.9.
This is known as the healthy range. If you have a high BMI, bringing it closer
to the healthy range before trying for a baby will help you get pregnant as
well as improving the health of your future pregnancy and child. If you have a
high BMI bringing it down, even by 1 or 2 points, can make a positive difference.
A high BMI in a man can also affect the
quality and quantity of their sperm, which can contribute to difficulty
Having a BMI below 18.5 is classed as
underweight, which can make it harder to get pregnant.
a low BMI can also cause periods to become irregular or stop. This can be a
sign that ovulation is not happening (releasing an egg from your ovary each
month), which is needed to get pregnant. If you are not having periods, putting
on weight to get to a healthy BMI may help this.
- Everyone regardless of BMI should aim to eat a healthy,
balanced diet as well as being physically active (see nutrition and physical
activity sections below for further information). Before pregnancy, if you have
a high BMI, bringing your BMI down 1 or 2 points towards the healthy range will
reduce your risks and increase your chances of conceiving.
- If you are finding it difficult to achieve a healthy weight
your GP who may be able to help you access weight management or other
specialist support around increasing/losing weight. Some services accept self-referrals
which you may be able to find details of on the Internet for a service in your
- See section below for information explaining more about
folic acid. For women who have a BMI over 30, a higher daily dose of folic acid is needed (5mg
daily). Ask your pharmacist or GP if you are unsure what dose may be suitable
for you. The GP will need to write a prescription for you.
- If you are unsure what your BMI is, you may find this
calculator helpful - to access it, click here.
Exercise/being active can
boost your chances of becoming pregnant. Women who do regular, moderate
exercise typically get pregnant more quickly than women who don’t exercise
regularly. Any activity which raises your heart rate, makes you breathe faster
and makes you feel warmer counts.
Being active by doing
regular moderate exercise before you get pregnant can reduce your risk of
having problems in pregnancy, such as gestational diabetes or pre-eclampsia (high
blood pressure and protein in the urine) that might harm you or your baby.
Feeling low or anxious can
be common if you are trying to become pregnant. Staying active can help to
boost your mood and lessen stress. If feeling low or anxious persists, visiting
a GP can help to get the right support.
during pregnancy is safe and healthy for mother and baby, however if you play a
sport where there is contact/risk of contact or potential risk of falling
(especially in later stages when balance/centre of gravity alters due to larger
baby bump) you should avoid these and opt for a non-contact sport or activity.
As your bump gets bigger you may find that you feel light headed
or dizzy lying on your back. This is because the
weight of your bump presses on the main blood vessel bringing blood back to your
heart and this can make you feel faint. It is best to avoid lying on your
back if you experience light headedness.
Being active by doing regular moderate
exercise during pregnancy can help lead to a healthy pregnancy and birth. It
can reduce risk of having problems in pregnancy, such as gestational diabetes
Feeling low or anxious can be common during pregnancy.
Staying active can help to boost your mood and lessen stress. If feeling low or anxious
persists, speaking to your midwife or visiting a GP can help to get the right
- If you have always been moderately active, continuing to
exercise at the same level before pregnancy is safe and healthy.
- If you have not been active before, start to build up your
level of activity now. Start by finding ways to build small amounts of physical
activity into your daily routine, for instance by walking to work.
- Before pregnancy, the Chief Medical Officer suggests to aim
for at least 150 minutes or moderate intensity activity per week or at least 75
minutes of vigorous intensity activity per week, or a combination of both. Also
aim to minimise time spent being inactive. This infographic may be helpful.
- Exercise during pregnancy is very beneficial to both yours
and your baby’s health.
- Practicing pelvic floor exercises regularly may help
prevent leaking urine accidentally when you cough or strain, both during your
pregnancy and after your baby is born.
- Find out more information here.
Folic acid (a vitamin) is important as it
reduces the risk of birth defects known as neural tube defects, including spina
bifida (a serious spinal problem).
While folic acid is contained within certain
foods, even a healthy diet does not contain enough folic acid for pregnancy.
Taking folic acid tablets is therefore very important.
Every woman of reproductive age needs enough
folic acid every day to help make new cells, whether planning to get pregnant
It is advised that all women take folic acid tablets
before getting pregnant to offer protection against neural tube defects such as
spina bifida in the early stages of pregnancy.
Some women, including those with diabetes, epilepsy,
rheumatoid arthritis, or who have a BMI over 30, need to take a higher dose of
5mg of folic acid (instead of 400mcg). This is available free of charge through
women are offered an ultrasound scan and to look for conditions such as spina bifida.
- Two to three months before
you plan to stop contraception start taking a daily folic acid tablet of 400mcg
and continue taking up to week 12 of pregnancy. This can be bought from
a supermarket or high street pharmacy.
If you are eligible for Healthy Start vitamins, they
contain 400mcg folic acid. Find out more here.
- For women who have a BMI over 30 or who have long term conditions such as epilepsy,
rheumatoid arthritis, or are taking certain medications, a higher daily dose of
folic acid is needed (5mg daily). Ask your pharmacist or GP if you are unsure
what dose may be suitable for you. The GP will need to write a prescription for
- Find more information about screening for physical abnormalities in
pregnancy here (this information is available in multiple languages).
Vitamin D helps us to absorb the right amount of calcium and phosphate
which are needed to keep bones, teeth and muscles healthy.
We get vitamin D from sunlight and it is also found in some foods. Most of
us don’t get enough vitamin D from our diet and we rely on the summer sunlight
on our skin to make enough vitamin D for the winter months.
Vitamin D is especially important in pregnancy as it helps your baby’s
bones, teeth, kidneys, heart and nervous system to develop. All pregnant women are
advised to take a 10 microgram
supplement of vitamin D each day to give your baby enough vitamin D for the
first few months of life.
Without it, there is a risk that your child will have soft bones, which
can lead to rickets (a disease that affects bone development in children).
Some women are more likely to need vitamin D than others. You may have
an even higher risk of vitamin D deficiency if you; always cover your skin, use
high-factor sun block, have dark skin, spend very little time outside, have a
BMI above 30.
During pregnancy, do not take vitamin A supplements or any supplements
containing vitamin A (retinol), as too much could harm your baby.
If you are pregnant, discuss with your GP or midwife
if you are not sure what dose of vitamin D is right for you and consider buying
a pregnancy appropriate 10 microgram supplement.
If you are buying a multivitamin supplement, ensure
the supplement is specific to pregnancy.
- If you are eligible for Healthy Start vitamins, they
contain vitamin D. Find out more click here.
and during pregnancy
High levels of caffeine before
and during pregnancy can result in babies having a low birth weight. Too much
caffeine can also increase the risk of miscarriage. Advice is to limit caffeine
intake to 200mg a day.
Reduce caffeine intake to under 200mg a day.
Decaffeinated drinks may be a helpful alternative. Be aware that chocolate,
energy drinks and cola, as well as tea and coffee contain caffeine.
These are common sources of caffeine:
- Mug of
instant coffee = 100mg
- Mug of
filter coffee = 140mg
- Mug of
tea = 75mg
- Can of
cola = 40mg
(250ml) of energy drink: up to 80mg
(50g) of plain chocolate = less than 25mg
(50g) of milk chocolate = less than 10mg
This caffeine calculator may be useful to estimate how much caffeine you
for a baby can be a big change in someone's life. It can also lead to worries
about money, family relationships, as well as a range of other things. Being
anxious from time to time is normal, but if it does not go away then it is
important to talk to someone about it.
who experience difficulty in becoming pregnant may experience an impact on
their emotional health and wellbeing too. Partners may become anxious which can
increase risk of sexual dysfunction. The process of treatment to assist conception
too can be a source of stress, anxiety and depression.
For individuals with an existing mental
health condition, sometimes becoming pregnancy can trigger this condition to
become worse, in other cases there will be no change - everyone is different. Mental
health conditions are often managed with medications. Doctors and specialists
can help with decisions about how mental health conditions can be managed
during pregnancy. This may include ensuring that conditions are as stable as
possible before pregnancy and checking suitability of medications for mother
and baby. It may be helpful for mental health conditions to be monitored
closely during pregnancy.
For information on
mental health during pregnancy, click here.
- Take care of your emotional
health as you try to become pregnant, including through being active, eating
well, finding ways to relax and avoiding drugs and alcohol.
notice of your emotional health. Try to talk to someone you
trust if you are feeling stressed, anxious or are experiencing symptoms of your
mental health condition, whether that be your partner, a friend or family
member or your doctor who may be able to help you access support. Remember that changes to
emotional wellbeing at this time are not unusual.
- For individuals who are
taking medication for mental health conditions and who are planning to become
pregnant, talk to a doctor or specialist letting them know your plans, ideally before
- Do not stop taking medication before speaking to a doctor
or specialist as it could be dangerous. They will work with you to find the most suitable medication for
managing your mental health condition in pregnancy.
- Meet other expectant and new parents by downloading the MUSH app.
- Remember, pregnant women, or women who have had a baby in
the past 12 months are entitled to free prescriptions (you'll need a Maternity
Close management of diabetes (type 1 or type
2 diabetes) before pregnancy can help reduce risks of pregnancy loss or birth
defects. Suitability of some medications which are part of diabetes management
may need to be reviewed ahead of pregnancy and therefore it is important to
speak to your doctor before trying to become pregnant.
who have diabetes (either type 1 or type 2) can experience diabetes related
complications unlinked to pregnancy (known as microvascular and macrovascular
complications). However, the combination of diabetes and pregnancy can increase
the risk of developing these problems, or making existing problems worse.
Due to hormonal changes, pregnancy can sometimes cause rapid
progression of diabetic retinopathy (a microvascular complication), which
affects the small blood vessels in the retina of the eye. Checks to identify diabetic
retinopathy therefore need to be undertaken more frequently during pregnancy.
In addition, women who have not previously
had diabetes can experience gestational diabetes, a condition characterised by high
blood sugar during pregnancy. Gestational
diabetes resolves after pregnancy, but increases a woman’s chance of developing
Type 2 diabetes subsequently.
- It is important to speak to your diabetes specialist as soon as you
start thinking about stopping your contraception. The earlier the better, 6–12
months before thinking about having a baby is ideal. There are important steps which
your specialist can help with to make sure you are ready before you conceive.
This includes reviewing how your blood glucose levels are controlled, reviewing
suitability of medication for pregnancy, and prescribing a higher dose of folic
acid (5mg daily) to take while you are
trying to get pregnant.
- Aim to keep good control of your diabetes and blood pressure during
pregnancy, as well as not smoking, as this will reduce the chance of
complications associated with diabetes developing or progressing.
- Ensure you know how frequently to attend diabetic eye screening during
pregnancy. This is usually every 3 months, starting within the first 6 weeks of
- Find more information about diabetic retinopathy screening in pregnancy by clicking here
(this information is available in multiple languages).
Many people take medications prescribed by
their GP Suitability of some medications may need to be reviewed for use during
pregnancy. For other medications, the health condition may need to be carefully
monitored. This will depend on the specific health condition and therefore it
is important to talk about plans for pregnancy with your doctor, only taking
your medications with their advice. Over the counter medicines, complementary
medicines or other supplements also need to be considered, talk to your
pharmacist for more information.
Depending on the health condition, sometimes
a higher dose of folic acid may need to be prescribed (5mg daily rather than
400mcg) to take while trying to get pregnant and for during pregnancy,
according to your doctor's advice.
Find more information on some pre existing
medical conditions here.
Management of health conditions can change
during pregnancy. You may be regularly reviewed during pregnancy so that your
condition can be closely monitored.
- Speak to a doctor or pharmacist?
about plans to try for a baby so that your treatment can be checked for safety
- Your doctor will talk to
Prescribing a higher dose
of folic acid (5mg daily) to take while you are trying to get pregnant
Any medications you are
taking so their suitability can be reviewed
How your condition may
affect pregnancy and vice versa
How you will be cared for
Sexually transmitted infections (STIs) are conditions that are passed from one person to
another through sexual contact. Many STIs have no or only mild symptoms. This
means that there is a group of people who are living with STIs that they do not
know they have, increasing their risk of passing their infection on to other
Many STIs can affect chances of getting
pregnant. For instance, chlamydia and gonorrhoea are two of the most common
STIs. Either can lead to infertility in men and women
if not treated.
Syphilis, another STI, can be
treated but if a woman becomes pregnant when she already has syphilis, (or
becomes infected while pregnant), it can be very dangerous for the baby. Click here for more information about syphilis.
HIV and Hepatitis B can also be
passed on by sexual contact (as well as by other routes of transmission). For
those living with HIV or Hepatitis B, it is important to talk to your
specialist doctor or nurse. They can advise about conceiving safely, minimising
the risk of passing the infection on to the baby and planning specialist care which may be needed
during pregnancy and birth. Click here for more information about HIV and
Most STIs can be treated with antibiotics,
special creams or shampoos. But some treatments are not suitable if you are
pregnant and therefore it’s a good idea to get checked before trying for a
information on how sexually transmitted infections may affect your pregnancy. click here.
You will be screened for HIV, Hepatitis B and syphilis as
part of the Infectious Diseases in Pregnancy Screening programme. This is part
of routine antenatal screening and is offered, and recommended, for all
pregnant women in England in every pregnancy.
- Before trying for a baby,
if you have any reason to believe you or your partner may have an STI, contact
your local Sexual Health service about getting a sexual health screen.
For many services, you will be able to access a sexual health screening test that
will be posted to your home. In some areas you may need to go to your
local sexual health clinic for a check-up.
- For people living with
HIV or Hepatitis B, talk to your specialist doctor or nurse as they can advise
about conceiving safely and it will be necessary to plan specialist care needed
during pregnancy and birth.
- Find more information
about infectious disease screening in pregnancy here (this information is
available in multiple languages).
If you're planning a pregnancy, it’s a good
idea to check if you are up to date with your cervical screening and if necessary, have the test before
getting pregnant. Cervical screening aims to identify abnormal cells which can
sometimes lead to cervical cancer. Having this test before becoming pregnant
means that any further tests or treatment can be arranged around pregnancy.
All women aged 25 to 49 who are registered with a GP get a
letter inviting them for cervical screening every three years. If you’re
planning a pregnancy there’s no need to wait for a letter.
screening is not advised during pregnancy as it makes the results of the test harder to
- Contact your GP practice
to find out if your cervical screening test is due, telling them about your
pregnancy plans. If you have not had a cervical screening test in the last
three years (if you are between 25 and 49 years) make an appointment before you
begin trying to get pregnant.
Rubella (also known
as German measles) is rare but it can be dangerous to the unborn baby if you
catch it while you’re pregnant. It can cause hearing loss, eye conditions,
heart defects, brain damage or pregnancy loss. This can be prevented by making sure you have had two doses of
the MMR vaccination, which includes rubella, before you start trying for a
baby. Click here for more information about Rubella and the MMR vaccination.
There has also been a significant rise in measles in the UK in the past few years. By ensuring that you have had two doses of the MMR vaccine before you become pregnant, you will reduce the chance of you baby caching measles in the 1st year of their life (before they are given the MMR vaccine at a year of age). Although extremely rare, measles in early childhood can result in a progressive brain condition called SSPE. Watch this mother's story of SSPE in her daughter following measles as a baby.
The MMR vaccine is a
live vaccine (it contains a weak form of the virus to make your body develop immunity) and therefore it is not
given during pregnancy.
- If you have not had two MMR vaccinations, or you have no way of being
certain that you were vaccinated, ask your GP for these doses one month apart
and with the second dose at least a month before pregnancy.
cell disease and thalassaemia affect haemoglobin, a part of the blood that
carries oxygen around the body. Individuals living with sickle cell disease or
thalassaemia need specialist care throughout their lives.
For women living with thalassaemia who are
having regular blood transfusions and iron chelation it may take several years
for women to become physically fit enough to have a successful pregnancy.
Suitability of some medications which are
part of thalassaemia and sickle cell disease management and those used for pain
relief during sickle cell crises (painful episodes) may need to be reviewed before
pregnancy and therefore it is important to speak to your specialist doctor
before trying to become pregnant.
It may also be possible to be referred for
specialist genetic counselling before pregnancy to understand the chances
of genetic conditions being passed on.
Sickle cell disease
in pregnancy affects each woman differently but woman may experience more
frequent painful episodes.
Sickle cell disease
can make some pregnancy related
complications more common, including pregnancy loss, blood clots and high blood
pressure. Thalassaemia can also
increase the risk of blood clots during pregnancy.
-If you or your baby’s
father have someone in your family with sickle cell disease or thalassaemia
talk to your specialist or GP about the chance of passing the condition onto
your baby and treatment during pregnancy.
Your doctor will talk to
How your condition may
How you will be cared for
- All pregnant women in
England are offered a blood test to find out if they carry a gene for
-Those at high risk of
being a sickle cell carrier are offered a test for sickle cell. If the mother
is found to be a carrier, screening is also offered to the father. Both parents
need to carry a gene for these conditions for it to be passed on to the baby.
If one parent carries a gene, the baby may also be a carrier of the condition.
-If the result shows your
baby has sickle cell disease or thalassaemia, you'll be offered an appointment
with a health professional to understand more about it and to talk through
- Find more information
about sickle cell and thalassemia screening in pregnancy here (this information
is available in multiple languages).