Pregnancy Reference Card

(You can complete this at your first appointment.)

Planning for a healthy pregnancy means understanding your health risks, how they can affect your pregnancy, and ways to reduce or address them.

Healthcare providers will use a range of information to create a health pregnancy plan that is just right for you. This can include your body mass index (BMI), health history, current health, medicines and supplements you take, lifestyle, and other factors.

Use this card as starting point for you and your provider to create a healthy pregnancy plan that meets your health needs.

BMI: Be More Informed

Check out these resources about health, nutrition, and physical activity during pregnancy. They may help you come up with questions to ask your provider.

My Information

  • Current Weight: [Fill in blank].
  • Height: [Fill in blank].
  • Starting BMI: [Fill in blank].
  • Recommended Weight Gain: [Fill in blank].
  • Estimated Due Date: [Fill in blank].


Tests and Procedures

[Fill in blank]

Healthy Eating

[Fill in blank]

Physical Activity

[Fill in blank]

Things to Avoid

  • Alcohol, smoking/vaping, marijuana, drugs (ask your provider about taking prescription/over-the-counter medications)
  • Raw fish, undercooked meat, unpasteurized cheese (such as feta)
  • Too much caffeine (limit to 200 milligrams, the amount in a 12-ounce cup of coffee, per day)
  • Exposure to hazardous substances, such as lead

Additional Notes

[Fill in blank]

Visit for more information and resources.

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