How to Prepare for a Healthy Pregnancy
As an integrative functional medicine doctor, and mother of three, I take great joy in helping women nourish and prepare their bodies for pregnancy.
After all, you’re planning to grow a human being—which means your body, mind, and spirit need to be in the best shape possible.
But, if you ask most medical experts what you can do to optimize your preconception nutrition and health, they would likely advise the following:
- Stop drinking alcohol
- Stop using tobacco and any recreational drugs
- And make sure you’re getting enough folic acid
If you’re lucky, they may even recommend:
- Increasing your calcium consumption
- Weaning yourself off coffee
- And taking a prenatal
And this is all sound advice…but (if I may be so bold) it’s basic advice.
Basic, outdated advice that’s been given over and over for decades, with little regard for what we now know about how a mother’s health affects her baby.
And deep down you know you and your future baby deserve more.
You know there must be more you should do than stop smoking and drinking alcohol and coffee to prepare your body to grow a healthy baby.
In my book, Bloom, I liken the process of reclaiming your health to that of growing a beautiful garden.
One of the first steps in this process is nourishing the soil (in this case, your body) before you plant the seed (your baby).
Likewise, if your deepest desire is to grow a healthy, strong, and robust baby, it is wise to take the time and make the extra effort to deeply nourish your body before that life-changing seed takes root.
What Can You Do to Nourish Your Body Before Getting Pregnant?
In addition to the standard advice given above, there are 5 areas I recommend focusing on for optimal preconception health:
#1: Functional lab work—to get an accurate overview of your overall health, hormonal balance, and nutrient levels.
#2: Food—a focus on specific whole, nutrient-dense foods is of paramount importance to your health and the health of your future baby.
#3: Preconception supplements—to help round-out a healthy diet and get ahead of any nutrient insufficiencies or deficiencies.
#4: Sleep—a healthy sleep cycle is the under-appreciated hormonal balancer.
#5: Stress—getting your stress response under control will do wonders for your pregnancy, delivery, and postpartum recovery.
In this article, we’ll look at each of these in-depth, starting with labs.
Which Labs Should Aspiring Mothers Ask For?
Most people (including many doctors) are unaware of how helpful functional lab testing can be in analyzing markers of preconception health, including:
- Inflammatory levels—which can indicate the presence of or trends toward chronic conditions.
- Hormonal health—of the reproductive system and thyroid.
- Digestive/gut health—which affects your entire body.
- Nutrient deficiencies and insufficiencies—which can hinder conception and cause a variety of symptoms.
- Food sensitivities – which can promote inflammation.
These labs are available to everyone and can be ordered by any physician; but in most cases I recommend partnering with an integrative functional medicine doctor.
The reason is, integrative functional medicine physicians have special training in interpreting these particular tests, analyzing how each individual test result relates to other lab markers (and your health concerns/goals), and making lifestyle recommendations to address the root cause of any issues.
Further, most non-integrative medical physicians are trained to only address lab markers which do not fall within “normal” ranges.
However, “normal” can mean many different things (normal-high vs. normal-low for example), and “normal” does not always equate to “optimal”…especially when it comes to preconception health.
For example, I’ve seen countless patients whose Thyroid Stimulating Hormone (TSH) test came back “normal” or “low-normal”, who had very real thyroid health issues—which we discovered by running more in-depth functional lab work.
Without further ado, here are the lab tests I recommend for preconception health:
- Complete Blood Count (CBC)—gives a comprehensive overview of your blood health including: hemoglobin, platelets, white and red blood cells count, etc.
- Comprehensive Metabolic Panel (CMP)—checks your metabolic health, liver and kidney function, electrolyte and fluid balance.
- Thyroid studies—to determine thyroid health. I recommend TSH along with: free T3, free T4, reverse T3, thyroid peroxidase antibodies and thyroglobulin antibodies.
- Vitamin D—tests Vitamin D levels—a vitamin many people are deficient in.
- Vitamin B12—tests B12 levels—another common vitamin deficiency in women and men.
- Homocysteine—tests methylation function in the body and can be correlated to Vitamin B12 and folate level.
- Iron studies—provide a comprehensive overview of your iron levels.
- Ferritin—goes a step beyond the standard iron test by analyzing the amount of “stored iron” in the blood. This allows for a far more accurate picture of your overall iron levels.
- hsCRP—measures the inflammatory marker known as: high-sensitivity C-reactive protein in your blood.
- hbA1c—superior to the standard fasting glucose test, the hbA1C gives an average blood sugar range over the course of 8-10 weeks.
- Magnesium, RBC—the most accurate test for magnesium levels (many other tests do not accurately measure magnesium).
- Zinc, RBC—to check zinc levels which can impact immunity, hormones, and libido.
- Serum Coq10—the ultimate in accurate testing for blood levels of Coq10, which impacts egg quality and fertilization rates.
- Food sensitivity testing—this can be done via an elimination diet and/or by using the IgG lab tests.
- Complete stool analysis—to test for any intestinal health issues, including dysbiosis.
- Genetic testing—to check for genetic mutations such as MTHFR, which can greatly impact fertility and nutrient levels.
The Most Powerful Foods You Can Eat to Support Fertility and Preconception Health
A nutrient-dense diet is your best ally in creating the ideal conditions for a healthy pregnancy, baby, and postpartum recovery.
And it need not be complicated or cumbersome to implement.
When it comes to the best foods to support fertility and preconception health, your main focus needs to be on fresh, whole foods.
You will also want to stay away from most processed foods and foods which can disrupt your hormonal and nutrient levels.
Let’s look at what-to-eat first.
#1: Plenty of fresh vegetables
Aim for 7-10 servings a day with a focus on colorful variety.
By “eating the rainbow”, you can ensure you’re getting the nutrients your body needs to thrive.
I also highly recommend including one (or more) servings of dark leafy greens and brassica vegetables (broccoli, kale, cauliflower, brussel sprouts, etc.) per day.
These green powerhouses provide a wealth of vitamins, minerals, and protective nutrients like Vitamin K, Vitamin A (Vitamin-A-rich foods were recommended in traditional cultures for women of childbearing age) iron, calcium, magnesium, folate, and antioxidants.
Plus they help keep your liver clean and reduce toxicity.This matters because the majority of your hormones are conjugated in the liver.
Further, if your liver is congested it can create toxicity and nutrient depletion in the body, which can impact your ability to get pregnant.
If you don’t care for leafy greens or brassica vegetables (I get it!), you can take a greens-based supplement or powder.
Just keep in mind that fresh, whole food is always the ultimate source of nutrition. So be open to trying something new.
#2: Moderate Amounts of Fresh Fruit
Fruits contain an abundance of essential nutrients and fiber which help nourish us and keep our elimination pathways flowing strong.
Fruit also hydrates and gives us a healthy energy boost due to its natural sugar content.
Some of the most nutrient-dense fruits to support preconception health include:
- Mangoes—which are rich in immune-boosting Vitamin C.
- Berries—contain a wealth of egg-protecting nutrients including antioxidants, B-Vitamins, Vitamin C, and trace minerals.
- Papayas—contain powerful enzymes to help ease digestion and reduce inflammation.
- Citrus Fruits—are a wonderful source of Vitamin C, potassium, calcium, and fertility-friendly folate.
- Avocado—is rich in hormone-balancing healthy fats and contains Vitamin K which is essential for proper calcium absorption.
- Bananas—make an awesome snack, plus they’re chock-full of hormonal balancing nutrients like magnesium, potassium, folate, and even a little plant-based protein and fat.
- Figs—an often underappreciated fruit, figs have been used as a folk remedy to increase fertility since ancient times. Plus they’re loaded with essential nutrients like hormone-balancing magnesium, and blood-nourishing iron.
This is just a short-list of nutrient-dense fruits, the point is to enjoy a variety of whole fruit every day—up to 3 servings.
One exception: if you have blood sugar issues, check with your doctor or practitioner about the appropriate amount of fruit for you.
#3: Lots of Healthy Fats
Fats provide the building blocks for hormones and play a massive role in our ability to conceive.
If you’ve been told to fear fats or have been following a low-fat diet, now is the time to re-embrace the following healthy fats:
- Coconut oil
- Nuts and seeds—while all nuts and seeds provide healthy fats, walnuts, hemp seeds and chia seeds boast a healthy dose of omega-3s, while pumpkin seeds provide a rich-source of immune-boosting zinc
- Fish oil
- Butter and Ghee from pasture-raised cows
That said, you do want to avoid highly processed vegetable and seed oils including:
- Canola oil
- Cottonseed oil (does anyone eat cotton seeds?!)
- Corn oil
- Grapeseed oil
- Hydrogenated or partially-hydrogenated oils (they’re still out there so read labels)
- Safflower oil
- Soy oil
- Sunflower oil
- Peanut oil
While they may seem harmless, or even “heart-healthy”, the truth is these oils are bad news—especially for your hormonal health.
The reason is, they contain a high-level of pro-inflammatory omega 6 fatty acids.
This may not be a big deal if you eat a diet rich in anti-inflammatory omega-3 fatty acids from fatty fish, walnuts, etc.
Unfortunately, most of us don’t consume near-enough anti-inflammatory omega-3s to balance our omega-6 consumption, which means regular use of these oils can quickly degrade your health.
Further, seed and vegetable oils are typically highly processed using heat and other chemical solvents, which you don’t want in your body…especially with so many better options available.
How Much Fat do you Need?
This varies person to person.
Some people thrive on a high-fat diet, while others do better with moderate amounts of good fats.
Based on the current research out there, I tend to take a moderate approach when it comes to fats: don’t go low-fat, but don’t go crazy-high-fat either.
You’ll want to experiment and listen to your body to determine what makes you feel energetic and satiated vs. bogged down and lethargic (and this goes for all types of foods, not just fats).
Here are some strategies you can follow to get the right amount of healthy fat for optimal hormonal health:
For starters, stop counting fat grams. Unless you’ve been advised to do so for other health reasons, stop counting and instead adjust the way you eat.
- Begin by swapping out healthier fats for unhealthier fats when cooking, on salads, etc.
- Try out a handful of healthy nuts and seeds as a snack in place of a low-fat option.
- If you eat dairy, ditch low-fat dairy products in favor of full-fat, preferably organic (if you can get essential-fatty-acid-rich dairy from pasture-raised cows, even better).
- Don’t pass on butter—unless you’re sensitive to dairy products.
- And talk to your doctor or practitioner about a high-quality fish oil or plant-based essential fatty acid supplement. These are usually tasteless and can be added to your favorite smoothie recipe.
#4: Make Room for More Protein
Protein provides the building blocks for tissue repair, regeneration, and growth. It also plays a key role in keeping your blood sugar stable and energy levels even.
While protein needs vary person to person, my general guideline for women’s preconception health is to aim for 0.5 grams of protein per pound of body weight.
So, if you’re 140 pounds, you’d want to eat about 70 grams (more or less) of protein per day. Which isn’t a lot if you plan your meals right.
To get enough protein, try including a little at every meal and snack.
This could be in the form of meat, nuts and seeds, protein powders, eggs, collagen powder, beans, legumes, full-fat dairy, and whole grains like quinoa and millet.
I do not recommend soy-based foods for most women at this stage in life, due to the naturally-occurring phytoestrogens found in soybeans.
Since so many women struggle with excess estrogen these days (due to environmental factors), it’s best not to add fuel to the fire.
If you’re a vegetarian, I’d recommend getting your protein from non-soy-based sources like hemp, beans, legumes, protein powders (pea protein is great), nuts and seeds, and cultured dairy products (if you’re not vegan and don’t have a dairy sensitivity).
#5: Eat Enough of the Right Carbs (starches, grains, sugars)
Here’s a refreshing bit of commonsense advice: carbs should not be avoided if pregnancy is the goal!
What kinds of carbs and how many carbs? Let’s keep this super-simple:
Unless you have diabetes or another blood sugar issue, you can enjoy enough healthy, whole-foods-based, nutrient-dense unprocessed, non-artificial carbs to feel satisfied.
That doesn’t mean you should go nuts and enjoy a whole gluten-free cake or mixing-bowl full of whole grain pasta, but use your common sense; enjoy your starches as side-dishes, and keep sweets to a dull roar (even all-natural ones).
If you’re eating enough of the vegetables, fruits, fats, and proteins recommended above, the amount of carbs you can fit in your stomach will be a no-brainer.
The Healthiest Most Nutrient-Dense Carbs Include:
- Whole grains (preferably gluten-free to support optimal digestion) including:
- Brown Rice
- Starchy vegetables, including:
- Sweet potatoes
- Moderate amounts of organic corn (if you’re not sensitive to corn, and yes, it should be organic)
- Whole Fruits—up to 3 servings a day
- Natural Sugars and Sweeteners—enjoy sparingly, a few teaspoons per day
- Stevia—appropriate for diabetics and non-diabetics
- Raw honey
- Maple syrup
- Coconut palm sugar
- Blackstrap molasses
- Brown rice syrup
- Date sugar
A Shortlist of Preconception Supplements for Moms-to-be
While supplements cannot replace the nutrients found in whole, fresh foods, they can help quickly boost nutrient levels and protect against any insufficiences or deficiencies.
For example, if your lab work shows that you’re deficient in iron, B12, or Vitamin D you can boost your levels much faster by taking supplements in addition to eating more nutrient-dense foods.
This is where a comprehensive lab workup can really help target your nutrients needs. Without it, you’ll be left guessing which supplements to take.
Depending upon a patient’s lab results, I often recommend the following supplements:
- Vitamin B12—many, many women (and men) are deficient in B12…even if they eat plenty of meat. The reasons usually have to do with genetics, prescription drugs, diet, or digestive health issues. Due to the prevalence of genetic mutations which affect absorption, I recommend the methylcobalamin form of B12.
- Iron—iron deficiencies often show up on women’s lab work. Our monthly cycles and diet are usually the reasons for this; and if you don’t eat a lot of red meat and/or have heavier periods you’re at greater risk. Always talk to your practitioner before beginning an iron supplement regime, as too much can be toxic. If you’re unsure, turn to iron-rich foods like red meat, liver, and leafy greens, and up your Vitamin C intake.
- Folate—folic acid levels must be optimized to create the healthiest conditions for pregnancy. Unfortunately, folic acid is another one of those Vitamins in which absorption may be hindered by genetic mutations like MTHFR. For that reason, it’s important to check with your doctor or practitioner about the right form of folate for you.
- Vitamin D—while most of us think of Vitamin D as a vitamin, it’s actually a hormone—and it’s essential to preconception health, a healthy pregnancy, and postpartum recovery. Due to our indoor-based lifestyles, supplementation is nearly always beneficial. But you’ll want to have your levels checked to see what amount is appropriate for you.
- If you do ANY of the lab tests listed in this article, Vitamin D would be my #1 recommendation; it’s that important!
- Magnesium—crucial for maintaining over 500 biochemical processes, and often difficult to get enough from foods, magnesium is a supplement nearly everyone can benefit from taking. Magnesium glycinate is my recommendation due its superior absorption and gentleness on the stomach. Or you may opt for topical magnesium products, which are also highly effective.
- Choline—crucial for baby brain development, healthy methylation, liver health, and beyond.
Don’t Wait Until You’re Pregnant to Catch More Zzzzs
Sleep is an area of preconception health that is often overlooked.
Yet sleep deprivation has become epidemic, with the CDC reporting 1 in 3 adults don’t get the recommended minimum 7 hours of sleep per night.
What does this have to do with preconception health?
You see, chronic sleep deprivation has been proven to have a significant impact on hormone levels.
And since hormonal balance is the holy grail of conception and healthy pregnancy, you’d better believe sleep plays a significant role in your preconception health efforts.
To give one example, lack of sleep has been proven beyond a shadow of a doubt to negatively affect your insulin levels.
And it’s not just from chronic sleep deprivation.
Research has shown even a single night of sleep deprivation can have a major consequences for your insulin sensitivity—so imagine what chronic lack-of-sleep can do.
Since insulin is a hormone, and all hormones are connected, this can interfere with your fertility and overall health.
And that’s just one example.
Further, insomnia has also been shown to affect production of the following hormones,:
- Luteinizing hormone (LH)—is important because if rises too sharply or is elevated, it can impact fertility. Sleep deprivation can cause a rise in this hormone.
- Follicle stimulating hormone (FSH)—is responsible for healthy eggs and ovulation. FSH has been shown to decrease 20% in women who are short-sleepers vs. long sleepers.
- Prolactin—plays a crucial role in the formation of breast milk, and also in overall reproductive health.
- Testerone—while mostly discussed in the context of men’s health, it is also believed to be a follicular regulator in women.
- Estradiol—plays an essential role in ovulation by regulating FSH and LH levels.
- Thyroid Stimulating Hormone (TSH)—which is absolutely crucial to fertility, healthy metabolism, sleep cycles, and a variety of other bodily functions.
- Cortisol—cortisol is your master stress hormone, and imbalances can cause a cascade of hormonal-related symptoms which could impact fertility.
- Leptin—is an appetite-regulating hormone. An imbalance can also result in intense food cravings. Leptin balance is nearly impossible to maintain without adequate sleep.
How Much Sleep Should You Aim For?
It depends whether you’ve been sleep deprived (sleeping less than 7 hours per night) to this point.
If you haven’t been getting enough sleep, I’d recommend committing to as much sleep as possible—10-12 hours a night would do wonders.
If you’re already a good sleeper, then 8-9 hours a night is ideal. Listen to your body and sleep when you’re tired.
What If You Have Insomnia or Just Can’t Sleep?
First off, don’t beat yourself up.
Despite all the research to the contrary, sleep-deprived mothers get pregnant all the time (believe me, as a mother of three I know!).
However, if you’re serious about preconception health you’ll want to address sleep issues now.
This will benefit you during preconception, pregnancy, and during those first few taxing months as a new parent.
Since the root causes of sleep issues are highly individual, the best way to address them is with guidance from your integrative doctor or practitioner.
Yes, I could recommend some general over-the-counter sleep meds and supplements to help…but in this case I won’t.
The reason is: you don’t want to take a band-aid approach to this, even with natural remedies, because those sleep-aids may not be safe to use during pregnancy.
So why not address the root cause now using an individual approach?
The good news is, often the causal factors behind sleep issues will reveal themselves within your lab work.
From there, your doctor or practitioner can make individual lifestyle and supplement recommendations to safely reset your sleep cycle.
And keep in mind, I’ve had patients eliminate or greatly reduce their insomnia or other sleep ailments simply through cleaning up their diet, getting regular exercise, and/or practicing stress management.
Which leads me to my next point…
The Role Stress Plays in Prenatal Health (and how to make it work for you)
Chronic stress—the kind that makes us anxious, unhappy, and tired—can be a massive roadblock to optimizing preconception health, getting pregnant, and maintaining a healthy pregnancy.
Here’s why: when we’re stress out all the time, it forces our body into a chronic state of fight-or-flight. This elevates our stress hormones, cortisol and adrenaline, which throw off our hormonal balance and fertility.
Fight-or-flight is a completely normal and appropriate response to a dangerous situation. However, if it’s sustained for more than a few minutes at a time without any burst of movement to burn up that adrenaline and cortisol (think sprinting as fast as you can to escape from a wild animal), its effects are draining and damaging.
You’ve probably heard of infertile couples going on a vacation and coming back pregnant. That’s because they took a chill pill and relaxed!
Their stress hormones stopped sounding the alarm and their body knew it was safe to get pregnant.
Your body is infinitely wise, and if it senses a state of danger (which triggers that fight-or-flight response) it will do everything in its power to keep you from getting pregnant.
How to Reset Your Stress Response for a Healthier Body, Mind, and Spirit
There are so many things you can do to beat stress, here are some ideas to get you started:
- Have sex with your spouse or partner—that’s a given.
- Exercise—20-30 minutes per day for best stress-relief.
- Spend time in nature—walking outdoors, gardening, hiking, sunbathing, camping, etc.
- Drink tea—any kind of tea works, but chamomile, lavender, and lemon balm are awesome stress-tamers.
- Listen to music.
- Get grounded by gardening, walking on the beach, walking outside barefoot, or using a grounding mat.
- Meditate—you can use an App like Headspace, journal, do yoga, practice deep breathing, etc.
- Get a massage or facial.
- Nurture your spiritual side—this could mean going to church, praying, meditating, volunteering, or spending time in gratitude.
- Spend 20-30 minutes every day doing something you ENJOY.
And the following is a list of some stressful habits/activities to minimize (within reason):
- Spending time on a device or screen—shut them off after work, and at least 2 hours before bed.
- Watching television late into the night—remember, you’re supposed to be going to bed early.
- Over-exercising—which can tax your adrenals.
- Eating junk food—which depletes nutrient levels and energy reserves.
- Spending time with negative people—also known as: energy vampires.
- Working too much—this is tricky, because many women will increase their workload to compensate for unpaid maternity leave (at least in the United States and/or if you’re an entrepreneur). If you must work more, then you must also relax more—at least 40-60 minutes a day.
- Spending too much time indoors—natural light, fresh air, and greenspace go a long way in reducing stress.
- Using social media as a substitute for real social time—you may have suspected, but studies have now proven the more time you spend on social media the less happy you become. Conversely, spending time with friends and loved ones has incredible mood-lifting, health-enhancing and stress-busting benefits.
While the suggestions above may seem simple, choosing to heal from chronic stress is one of the most powerful things you can do for preconception health of body, mind, and spirit.
- Getting the right lab work now can save you tons of time, money and stress later on. Use the list above to start a conversation with your doctor about getting tested.
- Focus on eating plenty of nutrient-dense foods including:
- 7-10 servings of fresh vegetables a day (at least 2-3 of those should be leafy greens or brassicas).
- 3 servings of fresh fruit.
- Moderate amounts of healthy fats in place of unhealthy, refined vegetable oils.
- Plenty of protein from either organic, grass-fed meats and/or plants (but pass on the soy please).
- Enjoy just enough carbs (preferably gluten-free, unrefined grains and small amounts of natural sweeteners) to feel satisfied—but don’t go crazy.
- Supplement based on your lab work and practitioner’s recommendations
- Though nearly everyone will benefit from Vitamin D and Magnesium
- Don’t skimp on sleep
- If you’re already sleeping well, then aim for 8-9 hours a night. If you’ve been sleeping less than 7 hours a night, aim for 10-12 hours.
- If you have a sleep issue, seek assistance from an integrative practitioner NOW. Do not rely on supplements or OTC sleeping pills, as they may not be indicated during pregnancy. Get to the root cause instead.
- Heal from chronic stress
- It’s the most powerful thing you can do to care for your body and protect your health and fertility.
Remember, taking care of your health and happiness now—whether you plan to get pregnant next month or next year—is the best gift you can give your future child, your family, and yourself.
Enjoy it, and know in your heart of hearts that you deserve to be nurtured, nourished, and cared for—during preconception and every season of your life.
Blessings on your exciting journey to parenthood!