Pregnancy can lend itself to a host of issues, from health ones like gestational diabetes to emotional ones like depression. But if a mom-to-be takes a proactive attitude toward her pregnancy, she can decrease her risk of some conditions.

The best thing a mom-to-be can do is plan her pregnancy, says Janis Biermann, senior vice president of Education and Health Promotion for the March of Dimes. "When the mom-to-be is thinking of becoming pregnant, she should see her health care provider for a preconception checkup," she says. "At this checkup, the mom-to-be should talk about her family history, any medicines, including herbals and over-the-counter drugs, vaccinations, medical conditions such as diabetes, weight, stress, alcohol and smoking."

Biermann also recommends the following:

• Use a reliable form of birth control until ready to get pregnant.
• Take a multivitamin pill that contains 400 micrograms of folic acid daily.
• Stop smoking, drinking alcohol and taking illegal drugs.
• Eat healthy and get to one's optimal weight.
• Avoid fish in high mercury content, such as tile, shark, swordfish and king mackerel. Limit tuna intake.
• Do something active every day.
• Avoid exposure to chemicals and other harmful substances.
• Learn to lower stress.

It is important to eliminate these behaviors as they can increase the risks of pregnancy complications, problems with the baby developing properly, premature birth, small birth size and SIDS. With unsafe behaviors, Mom is also at risk for developing diabetes and high blood pressure.

"Too many women gain too much weight during pregnancy," says Dr. Teresa Hiller, an endocrinologist and senior investigator at the Kaiser Permanente Center for Health Research in Oregon and Hawaii. She was the lead author of a study involving more than 40,000 women and their babies published in the November issue of Obstetrics & Gynecology. "This extra weight puts them at higher risk for having heavy babies, and these babies are programmed to become overweight or obese later in life," she says. "A big baby also poses serious risks for both Mom and Baby at birth – for mothers, vaginal tearing, bleeding and often C-sections, and for the babies, stuck shoulders and broken collar bones."

This message is especially important for women with high-risk factors like gestational diabetes, says Dr. Hiller.

To help combat this, "truly, exercise is probably the best thing a mom can do to be proactive during her pregnancy," says Lisa Druxman, pre- and postnatal health expert, author of Lean Mommy (Center Street, 2007) and founder of Stroller Strides. "Exercise alleviates or lessens virtually every ache and discomfort of pregnancy. Exercise is now recommended by the American College of Obstetricians and Gynecologists (ACOG) throughout pregnancy."

Prenatal physical therapy, which is sometimes covered by insurance, targets specific pregnancy issues, rather than traditional exercise at the gym or running. It can help a woman prepare for labor and delivery by increasing core muscle strength and stamina.

"Generally, as a physical therapist, I see mothers (pre- and postnatal) that already experience pain or functional limitations due to pain," says Martina March, co-founder of Bebe PT, a specialized rehabilitation clinic for pregnant and postnatal women in Los Angeles, Calif. "In my opinion, every pregnant woman should be seen by a physical therapist before she experiences pain and discomfort, implementing physical therapy as a proactive approach. I am a strong advocate for such a proactive approach becoming a standard practice during every woman's pregnancy."

Elsa Marie Collins, a client of March's, says that, "Going into pregnancy was intimidating for me because I am such an active person and avid runner." She spoke with her OB about wanting to be active and run, and she fully supported her. "I wanted to be as healthy and active as possible," Collins says. "I did not want to gain too much weight or kind of give in to the mentality of, 'I'm pregnant, I can be as lazy as I want and eat whatever for nine months.'"

Depressed pregnant women have twice the risk of preterm delivery than pregnant women with no symptoms of depression, according to a new study by the Kaiser Permanente Division of Research. "Realistic expectations about motherhood – discarding the myths and fantasies – is one of the most important keys to preventing mood disorders both during pregnancy and postpartum," says Dr. Shoshana Bennett, clinical psychologist and author of Pregnant on Prozac (GPP Life, 2008). "'This should be the happiest time in my life,' 'My needs shouldn't matter anymore,' 'I should be able to handle this all by myself' and 'Mothering is instinctual' are a few of the damaging beliefs that set pregnant women up for feeling like failures."

A comprehensive plan of wellness even before conception, including a nighttime sleep, nutrition, emotional support and physical health, are crucial components, says Dr. Bennett. "If she is depressed or knows she's high risk, she needs to speak with a therapist who specializes in prenatal depression so she receives professional treatment as well, if needed," she says. "Natural and alternative treatment options can be reviewed before or during pregnancy, so she is reassured she'll be well taken care of in case depression or anxiety hits."

Dr. Bennett says it's extremely important that the couple communicate about the division of labor with house and child. "Couples who do not discuss these topics before the baby comes home often find themselves shocked, disappointed, frustrated and angry when it becomes clear that they were on different pages," she says. "As a therapist, I'll always make sure that the couple has discussed who will be on duty when at night and they have a schedule between them."

If the mother-to-be suffers from depression or another mood disorder, is on a psychiatric medication or she knows she's high risk, "She ideally should have a pre-pregnancy appointment with her prescribing doctor," says Dr. Bennett. "She should know what her treatment options are before pregnancy is upon her and make sure she's monitored appropriately once she is pregnant."

To proactively ward off depression and anxiety, Dr. Deborah Roth Ledley, a licensed psychologist, mom and author of Becoming a Calm Mom: How to Manage Stress and Enjoy the First Year of Motherhood (American Psychological Association, 2008), recommends working on your marriage and relationship. Discuss differences on religion, financial matters and childrearing style. Look into new mom resources in the area, such as breastfeeding support groups and new mom classes. Do it now while there is time. Make some plans for childcare. All of these things will help ease worries later on.

6 Things to Do to Have a Proactive Pregnancy Have a preconception checkup. Take folic acid supplements. Get healthy – no alcohol, smoking or drugs. Exercise! Consider physical therapy. Prepare yourself emotionally.

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