Topeka (WIBW) - Traci Leadstrom and her husband made some changes before they even knew 15-month old Liam, three-year old Kayleigh or their 10-year old son were on the way.

Traci says she had a prenatal visit with her doctor, started taking vitamins, eating healthy and treating her body as though she already was pregnant.

Certified nurse midwife Leslie Arnold says prenatal care begins just as Traci treated it - before pregnancy.

Arnold says a big issue for women of child bearing age is folic acid. In our diets, it comes from green, leafy vegetables.

The March of Dimes recommends at least 400 micrograms a day, at least three months before conception to ensure proper development of the neural tube and spinal cord.

Arnold says those systems are developed in the first weeks of pregnancy, so if a woman doesn't start taking folic acid until she finds out she's pregnant five or six weeks in, she may have missed the opportunity to help proper development.

Other issues:
*Stop smoking. It impacts birth weight.
*If you are on medications, see if they might interfere with fetal development.
*Check immunizations - are you up to date on measles, mumps, rubella? and if you never had chicken pox, get the vaccine.
*Maintain a healthy weight. Obesity puts a woman at higher risk for two conditions that should be under control before conception, high blood pressure and diabetes.

Arnold says, when blood sugars are high, it crosses the placenta and goes to the baby and he might grow faster than is appropriate, have heart problems, or have problems controlling their own blood sugar.

Establishing a relationship with a doctor before conception is also a good idea. He or she can be familiar with your medical history and know any risks you might face.