It's time to learn all those things they never taught us in health class - periods, pregnancy and pelvic floor!
I'm a women's health educator, a nerd when it comes to learning "all of the things", and my obsession is teaching women how to take control of their health and create a life they love!
We spend the majority of our lives actively avoiding pregnancy, so when the time finally arrives that you actually want to make a baby, it’s important to plan ahead.
If you’re someone who finds herself saying “I’ll get healthy when I’m pregnant”, this episode is for you because you really do need to start making healthy lifestyle changes before you get pregnant – 3 months to be exact.
Why 3 months? It takes 90 days for an egg to mature inside the follicles in the ovary before it is released at ovulation. For the boys, it takes 3 months for sperm cells to fully mature. By making lifestyle changes in the 3 months before actively trying to conceive, you’re making sure that your man has a stock of healthy, high quality mature sperm and that you’re creating the healthiest possible environment that encourages a fertilised egg to implant and develop into your baby.
Hello, and welcome to episode 29 of The Mana Women’s Wellness Podcast. I’m your host, Rachel and today we’re talking about the 5 health checks you need to do before getting pregnant. And if you’re listening to this because you’ve decided it’s time to start a family, or grow your family then congratulations! I am so excited for the journey that you’re about to embark on and I hope that this episode will give you some guidance about how to get started.
So you’re getting a sneak peek here about one of the things on my list here, but if you want to learn more about how to get the timing right and when is the right time of the month to actually make a baby, then you might want to check out my Free Fertility Roadmap, which is my simple 3 step system to understanding your body’s natural fertile signs so that you can identify when during your menstrual cycle you are fertile, so you can confirm ovulation and actually know how to maximise your chances of conceiving. And the research says when you know this stuff, when you use fertility awareness to help you conceive, on average you’ll be successful in half the time compared to a couple that crosses their fingers and hopes for the best. And when you’re on a timeline, that knowledge is a game changer.
Most of us spend the majority of our lives actively avoiding pregnancy, so when the time finally arrives that you actually want to make a baby, it can feel a bit weird because it’s this huge momentous thing that is finally happening to you. It’s not a decision to make on a whim and like all good things in life, it certainly does take a little bit of thought and planning ahead. In this case, planning ahead at least 3 months. And if you’re someone who finds herself saying I’ll get healthy when I’m pregnant, I’ll cut out that bad habit when I’m pregnant…well this episode is especially for you because you really do need to start making healthy lifestyle changes before you get pregnant – 3 months to be exact – because giving yourself a 3 month window allows you to improve the quality of your eggs and for your man to improve the quality of his sperm.
So, why 3 months? No, this isn’t just an arbitrary number I plucked from the sky, there is a reason why 3 months is the minimum, magical timeframe. It takes 90 days for an egg to mature inside the follicles in the ovary before it is released at ovulation. This means that you can significantly improve the quality of your eggs within this 3 month window. This time frame also allows you to balance hormones, regulate menstrual cycle and any other potential issues that could be going on to get you in the best possible position for pregnancy. For the boys, this 3 month window is just as important. Most men produce millions of new sperm every single day, but it takes 74 days, or about 2 ½ -3 months for these new sperm cells to fully mature. By making lifestyle changes in the 3 months before actively trying to conceive, you’re making sure that your man has a stock of healthy, high quality mature sperm and that you’re creating the healthiest possible environment that encourages a fertilised egg to implant and develop into your beautiful growing baby.
And so, once you and your partner make that decision, or maybe you’re deciding to go it alone with reproductive technology, it’s time to make a doctor’s appointment. Tell your doctor your plans and you’ll likely be sent off for a blood test. You’ll have the levels of your essential nutrients checked, iron, iodine, folate, thyroid hormone levels to make sure you’re in the best possible position not just to conceive, but to stay healthy throughout your pregnancy and not develop any nutritional deficiencies. Your immunity to different diseases will be screened by checking if you need a booster for any vaccines that you might have had in the past. In Australia, most girls are vaccinated against Rubella, or German measles, as teenagers. It is recommended that you check your immunity before falling pregnant, as your antibody levels can reduce over time. If you have been in contact with anyone who has Rubella, you should consult your doctor immediately. During the first trimester, Rubella can cause serious birth defects including deafness, blindness and heart disease. This is also because there are particular immunisations with live viruses that you can’t have while pregnant, like measles, mumps and yellow fever and you’ll need to check if you need these vaccinations before getting pregnant. Your doctor will likely also recommend a high quality prenatal vitamin, again to make sure you’re getting all the required nutrients.
It’s really important not to skip this in the planning phase because you want to allow yourself time to have a really thorough health check and to follow up and address anything that might come up before you are already pregnant. You will be growing a human from the tissues and nutrients in your own body, so you want to make sure you have everything you need to grow that tiny human without depleting your own levels so that you feel exhausted and unwell for the next 9 months.
The next step is to reduce, or eliminate where possible, your exposure to toxins in your environment. We’ve got the obvious ones like cigarette smoke and alcohol, and some less obvious ones too.
Alcohol can create significant hormonal imbalance and the build-up of toxins it creates increases your oestrogen levels while reducing your progesterone levels. High levels of oestrogen can lead to a very wonky menstrual cycle and lowered progesterone can make it more difficult for your fertilised egg to implant in your uterus, and can also increase your risk of miscarriage. Consumption of one or more standard drinks a day can reduce your chances of conceiving. It is recommended that any woman planning a pregnancy should avoid drinking alcohol due to the potential impact it can have on a foetus when she does not yet know she is pregnant.
Male sperm can also be affected by alcohol consumption. Alcohol disrupts blood glucose levels, which in turn can damage sperm cells and destroy folate. Fathers that drink heavily during the month prior to conception have lower birth weight babies, which may affect the infants growth and development throughout their life.
I talked about the effects of caffeine on your fertility and your partner’s sperm quality in Episode 25, but in a nutshell, caffeine, found in coffee, chocolate, tea and cola drinks affects your absorption of iron. It’s a diuretic that can flush calcium and other key nutrients out of your system before they can be properly absorbed. Many women have low iron levels anyway during pregnancy due to changes in blood volume and the cardiovascular system, so it is recommended that caffeine is avoided where possible.
Next, we have the hormone disruptors, or xenoestrogens that I covered in an alarming amount of detail in Episode 24. Xenoestrogens, also known as exogenous oestrogens, are natural or synthetic substances in the environment that imitate oestrogen when they enter the body. Their effects block the function of the body’s oestrogen and lead to hormonal imbalance that may disrupt the menstrual cycle and ovulation. These hormone disruptors are found in many household cleaning products and most products that contain an added fragrance. You can also find them in skincare, makeup, food storage and plastics. If you want to learn more about them and how to reduce your exposure, then give Episode 24 a listen. I’ll include a link to this one, as well as the episode I did about caffeine, in the shownotes at fertilityco.com.au/29.
The growth of the placenta and foetus are most vulnerable to maternal nutrition during the time of implantation, so a pre-conception diet is essential to prepare the body. The first two weeks of conception is a phase of rapid development, and tends to be before a woman knows she is pregnant. If I talked about the essentials of human nutrition before we even factor in pregnancy, we would be here all day, so there are four nutrients in particular that I want to cover in this episode.
Folate is an essential nutrient in the first couple of weeks of foetal growth and it is one of the most important nutrients to take before getting pregnant. Folate assists in the development of foetal tissues into organs as well as formation of DNA. The supplement form of folate is folic acid and you need to be taking at least 400mg at least one month before conception and during the first trimester of pregnancy. But again, I say a minimum of three months is best.
Folate can’t be stored in the body so you need to get it from your diet every day from foods like leafy green vegetables, fortified cereals, oranges, strawberries, beans and nuts.
Folate is especially important in the first 25 days after conception, when the neural tube that will later form the brain and spinal cord begins to develop. The spine forms inside the tube, however in cases such as Spina Bifida, the tube does not properly enclose the spine, which can cause paralysis. This is why pre-conception health is so important, because in those first 6 weeks when the neural tube is developing, most women don’t even know they’re pregnant. So by the time you take a positive pregnancy test and decide to boost your intake of folate or take a folic acid supplement, the window for neural tube development has already been and gone.
The thyroid gland needs iodine to produce hormones essential for body thermoregulation, breakdown of macronutrients, production of growth hormones and development of the central nervous system. Iodine deficiency at critical periods of development can lead to irreversible neurological impairment of an infant. The World Health Organisation suggests that iodine deficiency is the greatest cause of preventable brain damage in childhood. If you are trying to conceive, you should aim to consume 150ug of iodine per day. It is found in dairy products and iodised salt.
Women with low iron have more difficulty getting pregnant than women with adequate iron stores. Iron carries oxygen in the blood to body cells via the protein haemoglobin and so will be essential for transporting oxygen to baby during pregnancy. It also forms part of the protein myoglobin, which is the protein within muscles that provides oxygen for muscle contraction. Iron is involved in energy production, respiration, immune response, skin and nail growth and bone development. Large amounts of iron within the body have been linked to cardiovascular disease, often through high consumption of red meat.
Pregnant women, infants and young children may need iron supplementation to maintain adequate levels. Newborns obtain the iron supply required for their first 6 months of life from their mother during pregnancy. They will not gain iron through breastfeeding and so iron stores must last until around six months of age where they begin to eat solid foods. Iron from supplements is not as well absorbed as that from foods, but can be improved when taken between meals. Constipation is a common side effect from iron supplements.
Dietary iron is found in two forms, depending on its source. Animal sources provide heme iron, while non-heme iron is found in both plant and animal sources. Heme iron makes up around 10% of our daily intake, but is more readily absorbed by the body than non-heme iron. This is why vegetarians often have iron deficiencies. Iron absorption from plant sources such as cereals or green leafy vegetables is significantly lower than from animal sources. Around 80% more iron is required in vegetarian diets to get the same amount absorbed from meat.
Females need about 12-16mg of iron per day due to loss of iron through blood during menstruation. Get your iron levels checked as part of a pre-conception medical check because iron deficiency during pregnancy can increase your baby’s risk of being underweight or premature.
Selenium is an essential nutrient for male fertility due to its role in testicular function and sperm synthesis, motility and function. Selenium is an antioxidant and works with Vitamin E to protect the lipids in cell membranes from damage by free radicals and may reduce the risks of some cancers.
For women, selenium may reduce the risk of pre-eclampsia by protecting the lipids in cell membranes from damage by free radicals. It may also reduce the risks of some cancers. The recommended daily intake of selenium for pregnant women is 65ug. Lactating women require 75ug, and all other women require 60ug. Men require 70ug per day.
Food sources of selenium include seafood, Brazil nuts, wheat germ, cashews, barley, wholegrains and oats. 2or 3 Brazil nuts a day are enough to provide your daily selenium intake so I always add a couple to my morning smoothie so I know I’ve got that one covered.
Like I said, I could talk for hours about nutrition for pre-conception and pregnancy. If you want to know more, you can check out Episode 4 of the podcast, where I list my all-time favourite fertility superfoods and they’re all really easy foods to source and add in to your diet – nothing overly unusual or complicated. You can also check out The Mana Guide to Pregnancy Nutrition over at my online store where I cover in detail the basics of nutrition as well as pre-conception nutrition and nutrition throughout the whole 9 months of pregnancy too.
Ok, so remember ladies that I am a physio after all, so now let’s talk about exercise and why creating a regular exercise habit now will serve you and your baby through your pregnancy and beyond. Regular, moderate intensity exercise is essential for maintaining a healthy lifestyle. 75% of pregnant women do not get enough exercise, so creating new habits before your pregnancy will increase the likelihood you will maintain them during your pregnancy.
20-30 minutes of moderate intensity exercise most days of the week has enormous benefits in helping your body cope with the increased demands on your muscles, joints, heart and lungs. Women that exercise often feel better about themselves and their changing body during pregnancy. Try to get into a routine before falling pregnant. Starting a new exercise program when you’re already pregnant, or only working out occasionally may increase your risk of injury or reduce the benefits that regular exercise provides.
Over-exercising is not recommended for women planning to conceive. Excessive exercise or high-intensity exercise can disrupt hormone balance and so may interfere with the menstrual cycle and ovulation. In the event that you fall pregnant, excessive exercise can lead to overheating which may impact foetal development. Excessive exercise is considered running the equivalent of around 15km (10 miles) per week.
You should of course consult your doctor before starting a new program or if you are new to exercise. If you do want to start a new workout program, then make sure it’s designed to be continued during early stages of a healthy pregnancy with no complications. When you do fall pregnant, talk to your doctor and get medical clearance before continuing with exercise to make sure the exercises are right for your needs.
Once that morning sickness kicks in, you are highly unlikely to be motivated to start a new exercise habit, so set yourself up now while you’re feeling good and you will be far more likely to stick to it during your pregnancy.
Here are just some of the benefits of exercising during pregnancy.
So now we’ve arrived at the final item of your pre-conception checklist, and it’s kind of an obvious one. I touched on this at the start of the episode but if you want to get pregnant, you need to know when to have sex! Like I said, it sounds obvious, but there are so many couples out there who are blissfully unaware that not every woman ovulates on day 14, that you can’t get pregnant on any old day of your cycle. In fact, 50% of couples who are referred on for infertility treatment have nothing wrong with them at all, they just have the timing wrong!
So if you’re brand new to the podcast, welcome, but if you’ve been listening for a while then I hope you would know that your body gives you clear signs every menstrual cycle when you are fertile and when pregnancy is possible. The most important sign is your cervical mucus which changes throughout your menstrual cycle and becomes wet, slippery and more obvious in your undies as you approach ovulation. When you see this mucus, sometimes it looks like raw egg white, sometimes it doesn’t, but when you see this mucus, have sex! And have sex as often as you can, as close to ovulation as you can to maximise your chances of one lucky sperm reaching and fertilising the egg. If you have no idea what I’m talking about, or you want to know more, have a listen to Episodes 1 and 2 where I cover the fundamentals of the menstrual cycle and what happens through each of the phases beyond just bleeding, and I also cover in detail the main fertile signs and what they mean for your fertility.
If you’re curious, I also have something pretty incredible coming out soon that will teach you all about your body’s fertile signs, so make sure you subscribe to the podcast and follow me over @manawomenswellness on Instagram so you’ll know when it’s ready for you to devour. If you want early access, VIP prices, all of that good stuff, grab your copy of the Fertility Roadmap so you can start receiving my weekly emails and you will be the very first to know when this brand new awesome thing goes live!
Ok, I’ve already said too much, so let’s quickly recap what we covered in this lesson. First we talked about the key areas to address with your doctor to make sure everything has been addressed before getting pregnant. We talked about how to reduce your exposure to potential nasties, from smoking and alcohol to common household items that could be impacting your hormones. We talked about nutrition and the essential nutrients you and your baby need for pre-conception and early pregnancy, focusing on folate, iodine, iron and for the boys in particular, selenium. And finally we talked about exercise and spending the next 3 months setting up sustainable and enjoyable exercise habits that you can continue with throughout your pregnancy.
You may now have identified areas of your lifestyle that need some improving or tweaking before trying to conceive. Try not to feel stressed or overwhelmed about these changes, because they all relate to a healthy lifestyle whether you’re trying for a baby or not. They can all be sustained throughout your life to maintain health. Start out small and set some goals for the areas you want to improve. Don’t take on everything at once – you will only set yourself up for failure and extra stress. Involve your partner, family and friends to keep yourself motivated, and most importantly remember why you are doing this – you are hoping to give your future child the best possible start to life!
I really hope you found this episode helpful. If you’re on your pre-conception or fertility journey right now, I’d love to hear from you. DM me on Instagram and let me know the changes you’re making, or have made, to prepare yourself for pregnancy. And if there’s anything you want to know about preparing for pregnancy, let me know and I’d love to answer your questions in an upcoming episode.
I will see you in next week’s episode, for those women who do not want to get pregnant right now. We are talking about your options for non-hormonal birth control for that window of time between coming off hormonal contraception and when you’re officially ready to start trying – maybe even during your 3 month pre-conception window, as well as after having a baby and beyond.
Ok, bye for now and don’t forget that knowledge is power!
When you truly understand your body, you are empowered to make informed decisions and take control of your health!
Until next time.
Want to say goodbye to hormonal contraceptives and their weird and unpleasant side effects?
Want to improve your chances of conceiving quickly and naturally?
You need my Fertility Roadmap – My simple 3-step system to understanding your body’s natural fertile signs and pinpointing ovulation day so that you can use this knowledge to achieve (or avoid) pregnancy.
Episode 24 – Household Items That May Be Affecting Your Fertility
Does your pelvic floor need a little extra TLC? Take the Pelvic Floor Quiz and find out how to start strengthening your pelvic floor today!
Want to make sure you’re exercising safely during your pregnancy? Get your Free Guide: 10 Exercises to Avoid During Pregnancy.
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I'm obsessed with all things periods, pregnancy, pelvic floor and helping women just like you to navigate all of life's major milestones!
I'm a physiotherapist and natural fertility educator and my passion is teaching women how to take control of their health.