Women’s Health
Prepare for a Healthy Pregnancy: 7 essential Guide for Malaysian Couples
Starting a family is an exciting journey, but a healthy pregnancy begins even before conception. Many couples only…
Screening Guide
Pre-Pregnancy Health Checks
How a pre-pregnancy check helps you and your baby, which checks guidelines suggest, and what to sort out before you start trying.
Overview
Planning a baby is a special time. Seeing a doctor a few months before you start trying gives you the best chance of a healthy pregnancy.
Many things that matter most for a baby happen in the first weeks – often before you even know you're pregnant. So some steps, like taking folic acid and checking your vaccines, work best when started early.
WHO describes care before pregnancy as a way to improve the health of both mothers and babies. It covers nutrition, vaccines, infections, long-term conditions, lifestyle and emotional wellbeing.
Who may want to understand this screening
This check is for anyone planning a pregnancy in the coming months, and ideally for their partner too. It's especially helpful if you have a long-term condition such as diabetes, high blood pressure, a thyroid problem or epilepsy, take regular medicines, or had problems in a previous pregnancy.
WHO recommends a daily folic acid supplement from the moment you start trying to conceive until 12 weeks of pregnancy, to help prevent neural tube defects (problems with the baby's brain and spine). The US Preventive Services Task Force (USPSTF) similarly advises starting at least one month before conception.
WHO recommends one dose of rubella vaccine for non-pregnant women who are not already protected, and advises avoiding pregnancy for one month afterwards. Rubella in early pregnancy can seriously harm the baby.
If you have symptoms, don't wait for a check-up. See a doctor for things like missed periods with pain or bleeding, very heavy periods, extreme thirst or tiredness, or low mood that won't lift.
What screening may involve
We start with a chat about your health, periods, past pregnancies, family history, medicines and supplements, smoking, alcohol, diet, exercise and how you're feeling emotionally. The doctor checks your blood pressure, weight and BMI.
Blood tests often considered include a full blood examination for anaemia, blood group, blood sugar or HbA1c, rubella immunity, and screening for HIV, syphilis and hepatitis B. Thyroid function may be checked if you have symptoms or a thyroid history. Your doctor tailors tests to your age, risk and history.
If you already have diabetes, the American Diabetes Association (ADA) advises aiming for an HbA1c below 6.5% before conception, if this can be reached safely, to lower the risk of birth defects and other complications.
What screening can — and cannot — tell you
A pre-pregnancy check can show whether you need a rubella vaccine, whether you have anaemia or an infection to treat, and whether a condition like diabetes or high blood pressure needs better control first.
It's also a chance to review your medicines. Some – for example certain blood pressure tablets – are not suitable in pregnancy. Please don't stop any medicine on your own; the doctor will help you switch safely.
Normal results can't guarantee a problem-free pregnancy. You'll still need regular antenatal care once you're pregnant.
If it's taking longer than expected to get pregnant, WHO suggests couples are assessed after 6–12 months of trying. Tests such as semen analysis or hormone levels may be considered then.
Practical considerations
Most tests don't need fasting. If a fasting blood sugar test is planned, the doctor will let you know beforehand.
Please bring your vaccination records, previous blood results, details of past pregnancies and all your medicines and supplements (the boxes are fine). If you have a long-term condition, bring your latest specialist letters too.
After your results are ready, the doctor will go through a simple plan with you – such as starting folic acid, arranging a vaccine, adjusting medicines and when it's a good time to start trying.
Sources
1. Preconception care: Maximizing the gains for maternal and child health – Policy brief (WHO/FWC/MCA/13.02) — World Health Organization, 2013
2. Periconceptional folic acid supplementation to prevent neural tube defects (e-Library of Evidence for Nutrition Actions) — World Health Organization, 2023
3. Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication — US Preventive Services Task Force, 2023
4. Rubella vaccines: WHO position paper – July 2020 (summary of key points) — World Health Organization, 2020
5. Section 15: Management of Diabetes in Pregnancy (Standards of Care in Diabetes—2025, abridged for primary care) — American Diabetes Association, 2025
Common questions
When should I start taking folic acid?
As soon as you start trying for a baby. WHO recommends continuing it until 12 weeks of pregnancy; the doctor can advise on the right supplement for you.
How long should I wait to get pregnant after the rubella vaccine?
WHO advises avoiding pregnancy for one month after rubella vaccination. If you become pregnant sooner by accident, talk to your doctor – it is not a reason to end the pregnancy.
I have diabetes. Can I still have a healthy pregnancy?
Yes, many people do. Planning ahead with good blood sugar control and a medicine review makes a real difference.
Should my partner come too?
It helps. Your partner's health, infections, smoking and family history all matter when planning a baby.
Should I stop my regular medicines before trying?
Don't stop anything on your own. Bring your medicines to the check, and the doctor will advise which are safe and which may need changing.