This week, let’s talk about an often overlooked step in the fertility journey, which is the preconception phase.  Of course many pregnancies happen by accident or through happy surprise, but if you have the opportunity, preconception care can make a world of difference for your pregnancy. We’ll carry this preconception idea over into the next few weeks as well and talk about health parameters to normalize, supplements, seed-cycling, and cycle charting.

If you have the privilege of safety and available resources of money/finances and time for  family planning, that is a gift.  I want all people with the capacity for pregnancy to have access to affordable incredible health care from licensed practitioners.  I’d also like to reiterate that these episode is for all people with capacity for pregnancy:  cis women, non-binary people, and trans men.

Preconception CareTimeline: 

4-6 months preconception window

Preparing for preconception:   If you are otherwise healthy as far as you know.  I would recommend making sure this checklist is completed starting at 6 months to 4 months prior to starting to try to conceive. Of course, many of you will be dealing already with infertility so your list might include some parameters specific to your situation.

1. PCP visit
   1. If you haven’t seen a PCP in the past year, see them now during the preconception phase.  Otherwise, establish care with a primary care physician. In licensed states, such as Oregon, this can be your ND.
   2. Confirm all your prescription meds are safe in pregnancy, or make a plan with your doctor to switch to those that are safe.
   3. Be sure your doctor tests specifically for iron deficiency anemia, which is a barrier to pregnancy, and also for thyroid levels. If there are any problems, now is the time to address them.
   4. Run all routine blood work to check the basics, as well as blood pressure check, accurate weight, etc…
2. Get your “well woman” exam.  
   1. If you haven’t seen an OB/GYN or midwife in the past year, see them now for your “well woman” exam during the preconception phase. You might need a PAP smear, pelvic exam, or some blood work depending on what’s going on.   Otherwise Establish care with an OB/GYN or midwife and get your well woman exam.  
3. Quit birth control pills, birth control patches, birth control injections, or remove your IUD.
   1. If you are on birth control this would be the time to quit with guidance of your prescribing doctor (ob/gyn, pcp, midwife, planned parenthood, etc).
   2. Be sure to use barrier contraceptions like condoms (male or female) or a diaphragm for the next few months to allow your own hormones to normalize and the birth control to be completely eliminated before trying to conceive.
4. Visit your dentist
   1. Teeth cleaning and X-rays as oral health affects the health of your whole body, and untreated gum infections can be an issue during pregnancy.
5. Have some hard conversations with your partner.
   1. It is difficult to imagine having a baby before you have a baby because there is no way you can predict how drastically and completely everything will change. And I do mean EVERYTHING. Values, energy level, relationship, time, money, sex drive, sex itself, looks, self-care, focus, memory, all the priorities, etc…
   2. Have you talked about who will get up in the night to feed? 
   3. How you will sleep? (cosleeping, same room, same bed, different rooms, etc…)
   4. Are one or both parents taking maternity or paternity leave? What happens after that?
   5. Don’t forget about lifestyle
   6. What do you really like to do? How are you going to feel when doing that thing becomes more complicated because of a baby? Can you make a plan now to be able to maintain that thing in a way that works for you?
6. If you have a known MTHFR or other polymorphism.
   1. MTHFR is linked to recurrent pregnancy loss and repeat miscarriage. This is thought to be due to micro clotting and there are some effective steps to take to counteract this, but it is a good idea to begin working with a good practitioner now who can help to prepare your body in the best way for pregnancy.
   2. MTHFR is consequential for pregnancy, but so are GST, GPC, VDR, PEMT, and others. This would be a great time to schedule a consult with Dr. Amy, or find a local practitioner who can help you to optimize your genetics.

Babies Change Everything

Babies really do change everything, and if you’re anything like I was, you’ll say “no – that’s just for other people. It won’t change everything for me.” All I have to say to that is May the Force Be With You. Over the next few weeks we’ll take a look at a good preconception supplement routine and a gentle technique called Seed Cycling to get your hormones balanced before you start trying.