Women should take stock of their health before trying to get pregnant, and improve it if necessary, say new government recommendations on "pre-conception care."

That means quitting smoking, avoiding alcohol, making sure chronic conditions such as high blood pressure are under control, and dropping excess pounds, among other steps.

"We want couples to consciously think about being ready for pregnancy before pregnancy happens. We want them to know there are many things they can do to improve their health or their baby's health," said Dr. Hani Atrash, associate director for program development at the U.S. Centers for Disease Control and Prevention's National Center on Birth Defects and Developmental Disabilities.

Atrash co-authored the report, which was published this month in the CDC journal Morbidity and Mortality Weekly Report.

The new recommendations were compiled by experts at the CDC and more than 35 government, public and private partners. They are aimed at reducing infant deaths and improving the health of both newborns and their moms.

The recommendations themselves are not new, Atrash said. "We have known these things for many years, but they have really not been part of the health-care system."

Even women who are not actively planning to get pregnant should heed the recommendations, he added. "About 49 percent of pregnancies in the United States are unplanned," Atrash noted.

One of the best steps a woman can take is to schedule a pre-pregnancy visit to her doctor to assess her health status (the CDC team urged that health insurance providers cover the cost of this visit).

Other key recommendations for women of childbearing age:

• Take 400 micrograms of folic acid a day to reduce the risk of neural tube birth defects.
• If a smoker, quit.
• Reach and/or maintain a healthy weight.
• Avoid alcohol.
• Inform doctors of all medications, both over-the-counter and prescription.
• Avoid exposure to toxic substances both at work and at home.
• Along with your partner, craft a "reproductive life plan" that includes a discussion of how many children you want and when.

The recommendations came about after two years of exhaustive data review involving all the various agencies. The experts looked at studies focusing on interventions that improved maternal health and pregnancy outcomes.

According to CDC statistics for 2000, there were about 62 million U.S. women of childbearing age aged 18 to 44 years old. By age 44, 85 percent of U.S. women have given birth, according to the CDC.

Two physicians in clinical practice welcomed the new recommendations.

"Putting it all in one statement is always helpful," said Dr. Denise Sur, a family medicine physician at Santa Monica-UCLA Medical Center and an associate clinical professor of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles. "This provides an organized approach for giving advice to women."

"A lot can be done before pregnancy to be sure the baby is healthy," she said.

"None of this is anything new," agreed Dr. Richard Frieder, an obstetrician-gynecologist at Santa Monica-UCLA Medical Center and a clinical instructor of ob-gyn at the David Geffen School of Medicine at UCLA. "This is a formal statement, the same as what the American College of Obstetricians and Gynecologists has been recommending for a long time."

"It's a strategy to try to improve the quality of care to women before pregnancy and during pregnancy, so the end result is improving newborn outcomes," Frieder said.

Frieder urged women to follow the recommendations and also to alert their physician about their plans to try to get pregnant. "Women don't always tell their doctor they are planning to get pregnant," he said. But, he said, they should, and the doctor should remember to ask about it at routine visits, so that planning can be done and the woman's health status evaluated.

The recommendations are being widely distributed, said Atrash, with many of the partner organizations providing links to them on their Web sites.