Meeting with your doctor or midwife ahead of time can help you start pregnancy in the best possible shape, prepare you for what’s to come, and allow you to prevent some potential problems. If you don’t make a pre-conception appointment, most of these issues will be addressed during your first prenatal visit, but by then you may have missed some opportunities for prevention.

Your health: if you have any medical problems, like diabetes, asthma, connective tissue disease, congenital heart disease, or anemia, you should be in your best possible health before getting pregnant. Diabetes, for instance, causes birth defects if the blood sugars are not well controlled during the first few weeks after conception—a time when many women don’t even know they are pregnant. Your practitioner will ask you about your health, to screen for conditions that can affect pregnancy.

Your reproductive history: some causes of pregnancy complications are best evaluated before pregnancy. If you have had a prior preemie, for example, you should talk to your doctor to see if there is anything you can do to prevent your next baby from coming early. Your doctor or midwife will ask you about any previous pregnancies, abortions and infections, and will do a physical examination including a pelvic and Pap test if you are due.

Genetics: some couples carry recessive genes that don’t combine well. For example, if your ancestors are from Europe, you have about a 4% chance of carrying the gene that causes cystic fibrosis (CF). If both you and your partner have this gene, your baby could develop CF. a serious lung disease. Knowing about the gene ahead of time expands your options. In vitro fertilization (IVF) techniques provide new ways to prevent some genetic diseases before you get pregnant, but only if you know that your baby is at risk. Not knowing about these genes means you miss this opportunity. Your practitioner will ask about your ancestry, and then offer genetic testing based on family history and ethnicity.

Folic acid reminder: a preconception appointment will also give your practitioner a chance to remind you to take a multivitamin or supplement with at least 400 micrograms of folic acid, which has been shown to prevent about 50% of the cases of the serious spinal defect, spina bifida.

Don’t worry if you are already pregnant. These issues will be addressed at your first prenatal appointment. Recommendations for a pre-conception appointment are fairly new, and most families do fine with screening early in the first trimester.