Preconception Care: Preparing for pregnancy with a naturopath

Photo by Garrett Jackson

Preparing for pregnancy can be a challenging yet exciting time and working with a naturopath on this journey is a fantastic way to promote the health and wellbeing of yourself and your future family.

Firstly, let’s acknowledge some of the many forms of family and paths of getting there. Same sex couples, heterosexual couples, multi-parent or co-parenting dynamics, gender non-binary families, conception through sexual intercourse, artificial insemination, and assisted reproductive treatment (ART) including donated eggs, embryos or sperm, and in-vitro fertilization (IVF). Regardless of who's in your family or the method of conception, the physical and mental health of prospective parents is important during both pregnancy preparation and parenthood.

In this article you will find out how naturopathic care can help you plan for pregnancy and information on optimizing the reproductive health of both egg and sperm.

What is pre-conception?

This is the time period in which those intending to have children actively engage with improving their health and wellbeing before conceiving (becoming pregnant): Before conception i.e. pre-conception. Preconception care aims to reduce the risk of unwanted reproductive outcomes such as infertility or subfertility, miscarriage, unwanted pregnancy, as well as complications during pregnancy such as gestational diabetes or pre-eclampsia. It is essential to focus on both egg and sperm not just the health of the mother or person who will be pregnant.

Timing is important.

Spermatogenesis (development of sperm) takes around 74 days and oocyte development (egg development) around 100 days. Therefore, ideal preconception care is around 3-4 months as what a person has done 3-4 months ago will affects the health of reproductive cells today.

What does a naturopath do?

A clinical naturopath uses both traditional and evidence-based medicine to promote health and wellbeing, and prevent illness.

A pre-conception care treatment plan aims to promote healthy egg and sperm by reducing inflammation, optimising general health and mental wellbeing, as well as reproductive health. Tools that may be used include nutritional guidance, herbal medicine, lifestyle advice, and screening if required. Herbal medicine is prescribed on an individual basis. It is important to remember that herbal medicines can be powerful and may interact with certain drugs. It is essential to share all of your medical history and current medications uses with your practitioner. Screening for nutrient deficiencies, hormonal imbalance, or genetic changes are commonly used in setting up a thorough and individualised plan for preconception care.

What may be involved in a Naturopathic preconception care plan:

Physical activity

Moderate physical exercise is not only great for general health and wellbeing but has been shown to reduce inflammation in the body. And positively impacts our genetic health, as well as quality of sperm and egg. Daily exercise of around 30 minutes that is within your ability is recommended and refers to moderate exercise and and not overexercising as this can put stress on the body, particularly those with a menstrual cycle.

Body composition and weight management

Healthy body weight of both egg and sperm donor is important for fertility and pregnancy outcomes. Sperm parameters in people who are overweight have been shown to be lower i.e. lower semen volume, sperm count and quality such as normal morphology. Men or sperm donors within a healthy weight range are more likely to have healthy sperm parameters and fertility potential.

While BMI is still used as an assessment tool for weight and health in many medical settings it is important to remember that overall health and distribution of body fat are important and that BMI does not reflect health.

Underweight can be a driver of anovulation (not ovulating) and menstrual cycle concerns that impact conception.

Stress management

Reducing stress can have a very impressive impact on fertility and many couples will understand the impact of stress on intimacy.

How can stress impact fertility? Stress is associated with the following (Hechtman 2012).

- Poor semen quality

- Increased risk of miscarriage

- Reduced conception rates

Within this category of stress management I believe it is hugely important to include ‘open communication’. Communication between the couple about fears, doubts, emotional and physical needs is essential.

Reducing exposure to chemicals and environmental toxins

Bisphenol-A (BPA), phthalates, heavy metals (copper, aluminium, lead, mercury, cadmium) and xeno-estrogens are common endocrine disruptors in our environment and food sources.

Through pastics, dental fillings, exposure to environmental chemicals such as pesticides, workplace chemicals, cleaning products, and cosmetics are some of the ways our toxic load builds up. While we all have the capacity to detoxify our bodies increased exposure can impact fertility and infant health. Reducing exposure through small changes can make a huge difference as explained here in this article.

Alcohol, smoking, and drugs

Lifestyle behaviors and habits like consumption of alcohol, cigarette smoking and use of recreational drugs should be addressed during this time. All of these factors will impact overall health and wellbeing, inflammation and general organ function in the body including the hormonal systems.

Research has shown that cigarette smoking (including passive smoking) is associated with:

- decreased semen quality and sperm motility

- overall reduced fertility

- increased risk of complications in pregnancy and birth

- Increase risk of miscarriage (this includes in female partners of smokers)

- Increased risk of long-term health impacts on the child due to DNA damage

Nutrition

Nutritional status is essential for both mum and dad / egg and sperm donors and has been shown to impact fertility and pregnancy outcomes. Increasing nutrient dense foods such as fresh vegetables and fruits, wholegrains, nuts and seeds, healthy fats and oils, and reducing the intake of processed foods are keys to health during this time. Over or under consumption of certain food can lead to deficiencies and a carefully constructed care plan will be created by your naturopath for your needs.

Below are some nutrients and foods known to positively impact fertility

Iodine – seafood and sea products such as seaweed including kelp, spirulina, dulse flakes

Essential fatty acids (EPA/DHA) – seafood such as herring, sardines, mackerel, spirulina, nuts and seeds, avocado

Zinc – pumpkin seeds, cashews, chickpeas, oatmeal, crab, oysters, pork, chicken, eggs

Calcium – green leafy vegetables, organic dairy, almonds, sesame seeds, figs, quinoa, buckwheat, sardines, seaweed, egg yolk, alfalfa

Iron – lean meat particularly red meat .e.g kangaroo, liver leafy green vegetables, blackstrap molassas, beets, legumes, eggs

Vitamin D - sunshine, wild-caught fish, egg yolk, mushrooms, full cream milk, fortified nut milk

CoQ10 – talk to your practitioner about finding a high quality practitioner supplement.

Lycopene - guava, cooked tomato, watermelon, grapefruit, asparagus, cabbage

Folate and B12 - leafy green vegetables, broccoli, oranges, animal products

Selenium - brazil nuts, seafood, lean meats, root vegetables, eggs, oatmeal

An important factor to remember about preconception care is that everybody is unique. Three months minimum preparation time is often used as a guide for preconception care duration and potentially more time if a detoxification program, certain screening for conditions or deficiencies that may impact pregnancy, development of a baby, or the postpartum period are considered.