Midwife Tips for Preconception Planning
I wanted to share my thought process around helping folks plan for a pregnancy, what I’ve done with my own clients, and some of the tools I recommend to get a sense of one’s overall wellness. To a certain extent, this varies depending on whether someone has been trying to get pregnant (and for how long), if they have a history of miscarriage, whether they have any specific health challenges that can impact fertility (like PCOS or endometriosis, for example), how recently they were on hormonal contraception, etc, but the basic approach is similar.
Also, I don’t really work with men all that much but there are some great recommendations for male (and female!) fertility and preconception planning in Fertility, Cycles and Nutrition by Marilyn Shannon.
Nutrition
I’ve gotten into permaculture over the past year and have learned a ton about soil. Preparing soil, feeding soil, composting, and so on. To grow a nice, fat, healthy tomato with tasty flavor and tons of nutrients, you need good soil. Babies are similar - they draw from what’s ready for them. And if you want to grow a baby that’s delicious enough to nibble on (this is a real thing), it’s good to start off from a healthy and nourished place.
I like to have all clients (pregnant or not) provide a three-day food journal, tracking everything they eat and drink, and whatever supplements and medications they take. This helps us identify what nutrients might be missing and give insight into where we can plug the gaps.
It’s helpful to begin taking a food-based prenatal vitamin 6-12 months before you intend to conceive (for example). I’m a big fan of cod liver oil as well, and here’s a guest post from midwife Shannon Staloch on how cod liver oil can assist fertility (she sent me a big bottle when I was pregnant!). To better understand the nutritional needs of pregnancy, listen to this excellent podcast from Taking Back Birth, and for a good read that will change the way you think about nutrition, fertility, and pregnancy, check out Nina Planck’s Real Food for Mother and Baby.
Fertility Cycle Tracking
I love when people come to me having already learned to chart their cycles (which is more than just noting when someone gets their period on an app). If they don’t already know how to do it, then it’s useful to go through what happens during a normal cycle, what the various signs of increasing fertility are, how to track them, and how to interpret them. It’s a fantastic way to tune in to our bodies, and can be very helpful in identifying fertility challenges (even before they manifest in other ways).
Labwork
Here are some of the labs I recommend checking, and why.
Complete blood count: Basically, this provides information about iron levels in the body, and whether someone might be anemic. If so, focus on blood building, including a diet rich in supportive foods and possibly supplements (like this one).
Vitamin D3: Because low D levels are implicated in various issues in pregnancy, including preterm labor and high blood pressure. Additionally, low vitamin D levels are a factor in certain thyroid disorders which can make it harder to get pregnant. Vitamin D levels tend to be lower in people when they come off of estrogen-based contraceptives.
Thyroid Panel: This is a comprehensive look at what’s happening with the thyroid, which is one of the regulatory mechanisms for our bodies and which impacts fertility, pregnancy, and the postpartum. One in eight women will have a diagnosed thyroid disorder (typically Hashimoto’s Disease) in their lifetimes, and many, many more go undiagnosed. This is especially relevant if someone has had one or more miscarriages, preterm labors, difficulty making breastmilk or losing pregnancy weight, or postpartum depression. This podcast and blog post from Aviva Romm is an excellent introduction to why thyroid screening is important, which labs to request, and how to interpret the results. She has many other articles to explore about thyroid health.
Other possible labs to check would be blood sugar, to get a snapshot on possible blood sugar dysregulation, screening for sexually transmitted infections, screening for rubella immunity (folks who are not immune to rubella aka German measles have certain risks to their baby in pregnancy), folate and vitamin B12 levels (which can determine why someone’s iron is low if they’ve been getting plenty in their diet already), and anything else it might be helpful to know.
Emotions
People come to this process from all sorts of different places. Some are in high-stress life situations. Some people have never been pregnant before. Some have experienced losses. Some have had a challenging birth, maybe they’re now planning a VBAC. Some people have trauma or unresolved emotions that they want to move from their bodies to clear the way. So, preconception planning in a safe space is one way to explore how these feelings and experiences are present in the process, and to find out about helpful resources.
So that’s it! I’m sure there are all sorts of other cool things out there that people do to help prepare for pregnancy, like bodywork, journaling, spiritual practices, exercise, and so on.
