A Preconception Appointment with a Midwife

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A Preconception Appointment with a Midwife

Picture you sitting across from me in my home. It feels safe and cozy and we probably both have something to drink and some healthy snacks on the coffee table in front of us. We are snuggled back in comfortable chairs and I begin the conversation with, “So you are thinking about getting pregnant?” Comfortable pause as you acknowledge that is true and you want to know what to do to have a healthy baby. I smile and laughingly say you are at the right place and that I am proud of you for taking the first step.  Which is true. I am proud of couples who want to do what it takes to have healthy pregnancies. I believe preconception care is the key. True preconception care is about so much more than a physical and recommending some vitamins. It’s creating a healthy environment for the child to be conceived and raised in. 

We will cover 4 areas that impact your conception journey.

•       Pursuing a healthy lifestyle through diet, sleep, and exercise.  

•       Assessing Health: We look at your health at the present time and see how we can improve it.

•       Creating a healthy environment in your home. We look at the environment you live and work in and discuss how to reduce toxins that affect fertility and fetal development and health.

•       Creating a healthy inner ecosystem in your body. We discuss how to prepare your body through detoxing and focus on a healthy gut, the foundation of health. 

Starting place: Pursing a Healthy Lifestyle

The everyday life choices we make about what we consume, without a doubt, have the biggest impact on our health. By choosing to eliminate processed foods, sugars, and allergenic and inflammatory foods you have chosen energy and vitality, but those choices are some of the hardest to make in our world of fast food and confusion about what health looks like. Seriously, a good diet is the number one most important choice to set you and your family up for success in health and for preconception period. A Dutch Study done between 2007 and 2010 used the Preconception Dietary Risk Score to assess the relation of diet and conception and showed that even small adaptions towards a fertility diet increase the chance of conception.(1) So next time you want to eat McDonalds or a donut remember it does make a difference towards getting pregnant. By choosing to be consistent in exercise you are building a legacy of energy for life. At least that’s what I tell myself when I don’t want to do it. Third by focusing on good sleep I am allowing by body to heal and regenerate.  J Diet, exercise, sleep, ----- so simple, yet so powerful.

Assessing Health

There are 5 functional tests I would recommend everyone take before conception, optimally a year before so they can address any issues.

A complete thyroid panel. Thyroid issues are rampant in the U.S. Isabel Welch, a thyroid expert, believes that 1 in 8 women have hypothyroidism. Subclinical hypothyroidism, a very small decline in thyroid activity, can hugely affect egg production. Women treated for thyroid issues reduced the chances of miscarriage by more then 50%. (2)

Vitamin D levels “Vitamin D has been said to be a better predictor of pregnancy success following in vitro fertilization than any other conventionally used prognostic parameter.” It is thought that vitamin D’s role in fertility is to assist cell division prior to ovulation. (3)

Hemoglobin, which is consists of iron and heme, transports oxygen throughout the body. Low hemoglobin levels in the first half of pregnancy are associated with preeclampsia.  Low levels in the second have are associated with preterm rupture of membranes and premature birth. Anemia, low iron levels, determined through hemoglobin levels, is associated with reduced conception levels. (4,5)

Hemoglobin A1C is a test used to determine blood sugar levels over the last three months. High Hemoglobin A1c is connected to lower conception rates. Blood sugar levels are extremely important in pregnancy on every level. (6)

Pathogen Test. This may surprise you but for a healthy pregnancy and newborn this is the number one test I would recommend. I strongly believe that gut health is the root of a person’s health and the foundation of the health you pass on to your children. Your bacteria is the foundation of your babies immune system. Studies show that as many as 85 percent of women have a vaginal infection when they give birth and pass on dangerous pathogens to their newborn babies instead of the beneficial bacteria that creates a foundation for wellness. This is also the test which can most impact the quality of your pregnancy by eliminating stress in your body which can cause other issues. (7,8)

Creating A Healthy Environment

One of the most compelling areas in preconception care is the affect toxins have on our bodies. Toxins can cause infertility, lessen fertility, and increase miscarriage and birth defects. Affect our overall health, specifically hormonal and thyroid health, and affect a baby’s development pre and post birth. Phthalates and BPA are categories of toxins that specifically affect conception by harming eggs and sperm.

Creating a Healthy Inner Ecosystem.

This is one of my favorite topics because it is so tied to epigenetics (Epigenetics: Rewriting Your Genetic Code) and functional health. It is also super connected to the other three areas: Lifestyle, assessing health, and creating a healthy environment. I believe this is a huge missing piece for many people for thriving in pregnancy and having a healthy family. The health of a woman’s, the large and small intestine, has one of the greatest impacts on the health of her new baby. Famously, Hippocrates, the Father of Medicine, credited the gut with being the beginning of all disease. It is also the foundation of all health. The mother’s gut is key to her children’s health especially in the realm of learning disorders, pervasive developmental disorders, and autoimmune disorders. By having a healthy gut the mother holds the future of your child’s health in her hands. Dramatic yes, but still very true. (See blog Gut Health.)

1.     The preconception diet is associated with the chance of ongoing pregnancy in women undergoing IVF/ICSI treatment. https://www.ncbi.nlm.nih.gov/pubmed/22593431
2.   It Starts with the Egg by Rebecca Fett pg. 19
3.   Journal of fertility and sterility. 2010 study lead by Dr. Lubna Pal from Yale University
4.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696966/
5.       https://www.ncbi.nlm.nih.gov/pubmed/24134949
6.       https://www.ncbi.nlm.nih.gov/pubmed/10357963
7.      http://bodyecology.com/articles/woman_needs_to_know_have_a_baby.php
8.      https://www.nichd.nih.gov/health/topics/vaginitis/conditioninfo/Pages/risk.aspx
9.      https://www.nichd.nih.gov/health/topics/vaginitis/conditioninfo/Pages/risk.aspx

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