It's really important because we're working upstream. We're trying to optimize our health before we go through some severe hormonal changes, and our body is kind of working in overdrive to create life. And it's really important for us that people feel well not only before pregnancy, but during pregnancy and after pregnancy. In this episode, you are going to learn the uplift for her approach to that time period when you're trying to conceive. You will not wanna miss this because you won't find it in a lot of other places.
We are talking about how to optimize your health before you ever get pregnant to hopefully decrease pregnancy complications to make your pregnancy more enjoyable, prepare for the postpartum transition, and then to be just the healthiest mom you can be. So if you're trying to get pregnant or if you know someone who's trying to get pregnant, if it's your daughter, your granddaughter, be sure you pass this along because it's gonna be great. It's really laying the groundwork for our foundational pillars, working on nourishment, body movement, gut health sleep, nervous dysregulation, and then also detox. This is gonna be fun. Thanks for coming.
Thanks for having me. Always. We are diving into preconception care, so the types of things that we should do for our bodies before we ever get pregnant. Jennifer, you're at the age where you and your friends are having babies and thinking about having babies. Will you tell me, just because you're right in the thick of it, what are your friends doing and how much do they know about preparing their bodies for pregnancy?
I think that my friends that are really interested in their own health are looking for ways to optimize their health and really feel good for their pregnancy and make sure that they're not feeling bogged down and still able to do all the fun things that we're able to do altogether. For my friends that maybe don't have as much agency in their health, I think that this could be really important for them at preconception care to kind of see where they're at before the pregnancy happens and before they conceive. Yeah. I do think it's something we don't talk enough about. I mean, we talk a lot about fertility.
Right? So if you're having trouble getting pregnant, then we'll talk to you. Right? Then we have a list of things that we wanna talk about. But for the average person who's like that, I don't know.
Am I healthy enough for pregnancy? Is my body ready for pregnancy? We really don't have a lot of resources out there that people even know what I should be doing. So we really wanna help women out and say, if you're thinking about getting pregnant or your daughter or your granddaughter or your sister or your friend is thinking about getting pregnant, this is the episode to listen to because we are really gonna dive in and say, this is exactly what you need to know to really boost your health right before you get pregnant. Yeah.
Sounds good? Absolutely. So let's start with what does current preconception care look like? So you decide you and your partner are ready to have a baby. You're on birth control.
What is the typical, situation look like for that woman? The typical situation is they go to their OB GYN or their PCP, and a lot of women have IUDs. They get that IUD out, and they say start taking prenatal vitamin and stop drinking alcohol. Stop smoking if you are a smoker, and, we'll see you when you two get pregnant. Yeah.
Right. Right. Which is not wrong. We agree with all of that advice, but we think we can do a little better than that. Mhmm.
And so before we get into the details that are really gonna help women understand exactly what to do, why is this so important? Like, why not just go get your IUD out and have a baby? It's really important because we're we're working upstream. We're trying to optimize our health before, we go through some some severe hormonal changes, and our body is kind of working in overdrive to create life. And it's really important for us that people feel well, not only before pregnancy, but during pregnancy and after pregnancy.
Yeah. Now surely, there's a bunch of data to guide us on this type of care. Right? There's tons of studies that tell us exactly what women should be doing before they ever get pregnant to really just help us understand how to go about this. Right?
Tons of data. Mhmm. I yes. I really wish that that was the case. I have been scouring for weeks now trying to prepare for this preconception visit and, really, there's not a lot of data.
And it's it's just something that you kinda have to go looking for, which is kind of crazy to sound because a lot of people wanna have babies eventually, and the data shouldn't be hard to find if there is any data. Yeah. So yeah. Yeah. It's a really big deal and a giant gaping hole to say, what could we do to prevent problems from ever coming about in pregnancy?
And I wanna comment on that for a minute because it it's important for us to recognize the current conventional medical model. And I'm I don't wanna be too negative, but I do want to call it out for what it is. The conventional medical model says, if you don't yet have a problem, then we don't have a problem. Right? Like so if someone comes in and they do lab testing and they say, oh, you're prediabetic, a lot of times the the answers for that are like, go do your best.
And the good news is you don't actually have diabetes yet, so call me when you do. And then you you come back for a test, and now, oh, you didn't know what to do to fix it, so now you're diabetic. And then the doctor says, great news. We've got lots of medications that can help fix your blood sugars as long as you stay on this medication for the rest of your life. Now there are many doctors who do a great job at talking more about diet and lifestyle.
But generally speaking, if you look at the insurance model and the conventional medical model and the training of physicians, we really are trained to know how to stop bleeding. Right? Mhmm. How do we stop the problem once it's once it's out of control? And at Uplift for Her and in our model, we really want to avoid all of that.
We want to help women not get to the point. Now this is especially important in pregnancy because in pregnancy, there's only so much we can do to treat things. Right? What is the treatment for preeclampsia? Delivery.
We make you not pregnant. That's our great treatment. What's the treatment for gestational diabetes? Well, we do our best to keep your blood sugars as low as possible, and then we deliver you. What's the treatment if the baby's not growing appropriately because the placenta isn't working very well?
We keep you pregnant as long as possible, and then we deliver you. There's just not a lot of treatment options for pregnancy. So when we're looking at this model, especially with pregnant women, it becomes hugely important because there's just nothing we can do except use, I call it, band aids and duct tape. Right? We can just kind of keep you together until you're you're postpartum.
So what we really wanna focus on is, what could we do before the woman ever gets pregnant to decrease those risk of pregnancy complications? Now we don't have guidance of a lot of data. We do have some data that says, maybe, for example, preeclampsia has something to do with something called oxidative stress. Maybe preeclampsia has something to do with magnesium. But when they've done studies to say, if we give women these things, that helps prevent it, those studies haven't really shown to be that helpful with the exception of maybe, like, aspirin.
But what if we could decrease the risk of ever having preeclampsia by ensuring that the woman doesn't have oxidative stress before she gets pregnant, by ensuring she has all of the building blocks necessary so that the body works the best way possible. So do we have data for this kind of care? No. Should we do it anyway? Absolutely.
Like, really, absolutely. It's probably honestly more important. Don't quote me on this, but I think it's probably more important than prenatal care because, again, prenatal care is just catching the okay. It's not more important. It's equally as important.
I can't say that. Yeah. Because I I'm an OB. But I do think that OB care and prenatal care is about catching the problems once they happen. But what if we just prevent those problems before they happen?
So it's huge. Something really interesting too, I think, is is it this is not a new idea. There is preconception care. Yeah. It's just severely underutilized.
Only about twenty percent of women get preconception care. So it's not a new idea that we're that we're proposing. It's just something that's not utilized around in The US or around the world. Yeah. Absolutely.
Absolutely. Now another reason why I think it's so important to provide this kind of care is what if we could make women's lives easier through pregnancy? Mhmm. One of the things I've heard said is that pregnancy is the great stress test for a woman's body. So if you have any sort of, you know, lurking insulin resistance, pregnancy is suddenly brings it to light.
If you have any sort of lurking fatigue issues, pregnancy sure brings that to light. If you have any cardiovascular issues, pregnancy brings that to light. And so, really, we want to see if we can optimize the health before we ever stress the body out, and that's from a medical condition standpoint. But also, what about just from the, like, feeling good standpoint? There's some studies that suggest that hyperemesis or women who have tons of vomiting all through the the first part or the entire part of pregnancy, that that can be related to low blood sugar levels or to dysregulation of blood sugar.
So what if we could fix that? Now is that gonna change pregnancy complications? Maybe, maybe not. Mhmm. But is it gonna help that woman survive the pregnancy from a, you know, from a comfort standpoint?
Yeah. Absolutely. What about women who are not doing any exercise before pregnancy? Are they more likely to have low back pain and have, you know, maybe rectus diastasis or maybe to have shoulder pain from from postural changes that happen if you don't have good core strength? We don't know.
But it sure seems to make a lot of logical sense to me to say, maybe we just help you out a little bit, and probably you'll feel better during pregnancy. So I think that's another big argument for helping women make some changes before they ever try to get pregnant. So a big reason also for the preconception care is kinda is looking forward as well, looking through pregnancy where, you know, we wanna mitigate complications during pregnancy, but also postpartum. We see quite a bit of patients here that are postpartum that that are just kind of feeling bogged down and they're not really sure, like, I don't know if I should be feeling this way. And it's there it's more so I'm confused.
Is this because I had a baby or is there something else going on? You know, I I didn't think that I would feel maybe this poorly after I gave a baby. So really looking forward to also in preparing our bodies for postpartum care and really transitioning back to normal life after having a baby inside you, birthing that baby, and then, you know, going through the the sleep deprivation for a while when you have a newborn baby and not letting little ailments that could have been stopped essentially Yeah. Pre pregnancy to really take hold in postpartum. So important.
If you think about women who are postpartum, right, they've just gone through this major physical stress on their body, which is a beautiful stress, and we love it. But it is it is a lot of strain on the body to have a pregnancy. And then you take that woman and you say, by the way, you won't be sleeping well. You won't be eating well necessarily. You're you're giving tons of calories to this baby as you continue to breastfeed and take care of this baby.
And if you have other children at home, then, by the way, you're also going to be giving of yourself then. We know that that postpartum period is a it it's a very demanding physically, mentally, emotionally, it's very demanding. When would we prepare for that physically demanding period? During pregnancy? Not very well.
Right? The way that I I draw it out for patients is I say, you know, pregnancy is a depleting period, and I draw this line slowly going down. And we know that there's no way to get through pregnancy without depleting something. I mean, you can you can do your best and we are built with resilience. So I'm not trying to freak anyone out and say, like, you're doomed.
But we know that pregnancy is depleting and it's a strain on the body. And then you take that person and you throw them into the postpartum transition. Do we have data that if we do certain things preconception that it will change postpartum outcomes? Not to my knowledge. But it sure makes a lot of sense logically to say, if you're in your best state of health, all of the states of health, your labs, your insulin resistance, your inflammation, your mental health, your physical health, if you're doing a pretty good job with that preconception, do we think that there's a good chance that that will translate to the postpartum transition?
I sure think so. I sure think so. And there's not it once you're pregnant, it's not to say there's nothing you can do, but it's sure not the best time to say like, do you know what? I'm pregnant now. I'm gonna overhaul my diet.
I'm gonna make sure I'm not stressed. I'm gonna make sure that I'm exercising regularly. You should do that during pregnancy. But, also, if we can get some of those habits in place preconception, then I really think we have the opportunity to change the postpartum transition. And not only that, but the rest I don't wanna be too too dramatic here, but how about the rest of the woman's life?
Right? Yeah. I think a lot of times, we want to change our habits, and it's a better idea to try to change those habits before we get pregnant rather than during pregnancy, rather than when you have a newborn, rather than when you're trying to get pregnant for your second baby, and so on. So can we really optimize this before we ever start getting pregnant? Another point that I've also seen is women will use exercises as stress reduction for them, but with their bodies can't do the same things they could do two weeks postpartum.
So maybe they lost their way to reduce stress because they can't exercise the way they used to and things can kind of just compound. So we're finding ways, I think, to cope with stress and being a new mother and then also moving our bodies in a way that feels good for us. It's all kind of it's all intertwined and we all need to prep for that. I also think it's worth mentioning that you and I both see women who come to us after they've had one, two, three, four babies and say, I don't know what happened to my body. Like, I am not the same person as I was before I had babies.
And, you know, in this context, it's like, well, right. You just had two or three or four babies. Right? But I think these poor women are like, I I don't know what else to do. Like, I've got two kids or three kids or four kids, and and, like, I'm exhausted.
My hair won't grow back. I'm you know, my hormones are imbalanced. And what I like to point out to them when it's appropriate is that oftentimes, we get depleted during the first pregnancy, and then we don't really recover all the way between pregnancies. Then we get more depleted the the second pregnancy. Then maybe we recover twenty percent or thirty percent, then we get depleted again.
And so when are we going to catch up? Mhmm. Well, we will. We can help people with that, and we do help people with that. But what if we don't get that depleted to begin with?
And so this preconception care is not just for first time moms, but it's really for especially for women who may have gotten through the first pregnancy and are feeling like, I feel like I did that pretty well. Let's see you before the second one. Because I think a lot of people just assume, well, I did great with my first, so I'll do great with my second. And we see this all the time, women who are like, my first two pregnancies were great. I had no problems.
But that third one Mhmm. I don't know what happened, but I was not the same after that. Well, I don't know what happened for sure. But could we do something about that by checking in between pregnancies and saying, how did your body do with that stress test, and can we boost it back up? Can we make sure you've recovered everything that you need to before going through that stress test again?
Yeah. Absolutely. I think you'd there's some things that you kind of just don't know unless you were to go digging. Yes. And that's kind of what we're doing is we're as we're going digging looking for things that could be off that we could optimize.
Yeah. Pretty basic things. Yeah. Yeah. The other part of this equation is male health and making sure There's another part of the equation?
It's not just about women? No. Also, bringing up male health and kind of making sure that they're also in their optimal health because, you know, there it takes two people to have a baby and making sure that the male partners are also finding a way to optimize their health, making sure they're nourishing their body in a way that feels good for them, moving their body in a way that feels good. Optimizing their gut health, making sure everyone is getting deep restorative sleep because along a lot of times with the mother that's not getting enough sleep, a lot of times the male partner is right there with them and not getting as much sleep either. Yeah.
So and then also making sure that in this acutely stressful period of bringing home a new baby and things have changed a little bit, making sure that everyone has ways to cope with their stress and, allow their nervous system to regulate to a new being in their home. Gosh. I'm so glad you bring that up because it is so important. And, you know, from a physical or biological standpoint, there are components of the the man that contribute to the health of the sperm. So we know insulin resistance, thyroid health, some nutrient deficiencies, inflammation, all of those things contribute to sperm health.
But after that, the man is sort of like not part of the equation anymore. It's just like, well, we got the sperm, so now we're good. But it turns out that in most situations, it's the couple that's going to be taking care of that baby. And so that comes into play in several different components. One is he can be there and supporting her as she's trying to be super healthy and take care of her body and exercise and not have high levels of stress and make healthy food choices.
He gets to be there with her and doing it with her. Does that have a direct outcome on the biology of the pregnancy? Maybe not. Mhmm. But, man, that's really great moral support, and this is a family, and it's creating a culture, and it's creating, like, hey.
We both wanna be healthy together. We both want to create these routines that are going to last us throughout the pregnancy and postpartum. Again, because it's sure difficult to come up with those routines in the middle of a stressful exhausting pregnancy or postpartum when you've got a new baby and you're like, hey, partner. How about we come up with some new, you know, systems around our house to have healthy routines? Yes.
You can do it then, and, yes, we should do it then. But you can also do it before, and that's so great. And then also, just like you mentioned, this is going to be a big strain on the male partner as well as he's trying to support her physically and also through stress levels. We know that pregnancy is a very stress can be a very stressful time on on a relationship or on a marriage. And so having him utilize and learn some nervous system coping strategies, if his stress levels are through the roof before they ever get pregnant, is there anything he's interested in doing to decrease his stress levels and as a couple learn some coping skills so that they can get through the stresses of pregnancy and, you know, potentially complications or or stressful things that come up when you're having a baby and growing your family?
If he can have some of those tools and learn some of those tools before, then he will be better equipped to have a healthy pregnancy, support his partner through a healthy pregnancy, and then also that postpartum transition. And I would say not just him, but, you know, all of this would apply to a female partner too. Can she support her partner? Even if she's not the one biologically giving birth, can she create these healthy routines and habits with her partner as well. So we've convinced ourselves.
We think this is a really good idea, which is why we do it. But let's talk in a little more detail about the difference between standard preconception care and really what we think preconception care should look like for couples. Starting off, we agree with standard preconception care, you know, get making sure you're getting your birth control out and then, you know, starting a prenatal vitamin. That's absolutely something that we agree with. Decreasing alcohol intake, smoking cessation, if that's that's applicable.
But also looking at what your nutrients and looking at things like anemia or iron levels and seeing if there's there's things that we could that we could optimize before you get pregnant. Yeah. Let's pause there for a second because I think you are painting such a great picture, and I wanna make sure we kind of go through the details of that. So you mentioned earlier, in conventional preconception care, we're saying, okay. So stop drinking alcohol.
Make sure that you are not smoking. Add your prenatal vitamin. Add a fish oil, the omega threes. Right? That's typically something that we get from conventional care.
Do you wanna say anything about types of prenatal vitamins? Are they all created equally? No. Unfortunately, all prenatal vitamins aren't created equally. We have a couple that we recommend here and really just making sure that they have enough nutrients that we're looking for.
So plenty of folate or folic acid, plenty of iron, and especially if you maybe lean towards an iron deficiency previously in your life, iron is definitely something that you should prioritize in a prenatal vitamin. Not all of them include everything that you could need. Let me add to that a little bit because I totally agree with that. So it's worth talking about supplements for a minute because you and I use a lot of supplements, and they're not all created equally. You do wanna have a reputable brand.
I think also as much as we want to buy from, like, big box stores that are inexpensive, just a caution there is a lot of those may be stored in hot warehouses or out in the sun or or various temperatures. And a lot of those nutrients can oxidize. They can go bad if they're in light or uncontrolled heat temperatures. And the supplement companies, when you're ordering directly from some of the higher end supplement companies, we've used ones like Pure or Thorne is one of my favorite prenatal vitamins. Needed is another great prenatal vitamin.
When you order directly from those companies, most of them will will have standards of storage that say we're not going to store our supplements so that they get oxidized. So it's worth maybe not buying off of Amazon in that case, not because it's bad, but you don't know. And then I also think there's a lot we don't know about prenatal vitamins, about exactly how much that we need. I mean, there are there are plenty of studies that say, like, the recommended daily amount and different things like that. But I do think with our standard American diet, if you are eating, like, the perfect diet, you are just every bite you take is packed full of nutrients and you're getting all of it in, then probably you can get by with a less a lower quality prenatal vitamin.
If you're working on it, but you're not quite there yet, maybe a lot of your meals are not quite as nutrient packed as they could be, then you probably want to on the side of a higher nutrient level in your prenatal vitamin. And some of that we test for, so we'll get into that for a minute. One of those is iron and really seeing, like, do you need extra iron? Do you need just the one included in a prenatal vitamin? Do you need a lot more, little more?
So that comes into our more custom approach to prenatal care. But but do think about I think as annoying as it is that they can be a little bit pricey for these these prenatal vitamins, I would think about getting those higher quality ones that are higher in nutrients than ones you might get at a big box store. So just a note on that. And then also to make sure that you're getting the omega threes, a lot of prenatals will have it with the prenatal vitamin or separately, and I don't have a strong opinion on that. Mostly, it'll be separate.
Even if it comes in the same box, it'll be separate. But do make sure that you're getting an omega three. That has good data. That's recommended by by every you know, by the entire prenatal care world. Yeah.
So make sure that you're getting the fish oil. And then before we move into what specifically we're adding to that prenatal care, will you talk a little bit about the timeline? Like, when should women seek out this prenatal care? When should they start making changes? How long does this take to kind of go through this process?
In a perfect world, I would like twelve months. Two six to twelve months, I think, would be a great timeline. But we also know that a lot of pregnancies are unplanned. Almost half of pregnancies are unplanned. So, it's perfectly okay to to not do the have the full twelve months to make these changes.
But, really, at any point, before you decide that you wanna try to conceive would be a great time to come in and identify these these things that we can work on. Yeah. Yeah. I love that. I think there's lots that can be done ahead of time.
And, really, I mean, of the if you're in the age where you may have a baby at some point, you can always get started. This isn't like it's not helpful if you're gonna have a baby in eighteen months. You know? Like, those we're looking for nutrient deficiencies. We're looking for patterns of, like, really high stress levels or looking for signs of inflammation.
Chances are if if you're eighteen months out from thinking about having a baby, those symptoms are gonna be there then. You know, it's not like you you fix everything and then six months, you're like, oh, shoot. I, you know, I have more problems. Just some point in your childbearing years, this would be a good time to start thinking through these things. But, yeah, I agree with you at least three months.
And then another important component is thinking about medications if you're on medications. That you really do wanna personalize with your OB care provider because it needs to be done with caution. You don't ever wanna just stop a medication. But some of the medications that come up the most are blood pressure medications, cholesterol medications, and antidepressants, SSRIs. Yeah.
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Now let's get back to the episode. So for the cholesterol medications, number one, we undertreat women before they're pregnant for high cholesterol, so there's not as many people who who have who are on cholesterol medications for better or for worse. But if you are, then you should not conceive on those medications. You need to talk to your doctor about when's the right time to get off of that. And then I also think the blood pressure medications, some of them are safe and some of them are not, but the key is you should have controlled blood pressure.
Yeah. Yeah. So this is, we'll get into kind of what do we do to help those medical problems. But if you currently have high blood pressure, don't just stop your blood pressure medication. Make sure you're talking to your doctor.
Same thing with SSRIs. If someone's like, I'd really like to get off of my medication before pregnancy, that's definitely something we can help with, and the longer, the better with that. But if you are actively trying to get pregnant, then don't just stop it and hope for the best. Like, you'd be better off to talk to your doctor and probably stay on it while you're while you're trying to conceive in that case. I think supplements too are also something that, you know, not all supplements are safe to turn to take during pregnancy too.
So Yeah. Make sure you consult with your provider on that Yeah. As well. Yeah. And generally speaking, stop all supplements unless you know they're safe once you do get pregnant.
Exactly. Okay. So we agree with all of that, and that is something that we go through with our patients. What are the next steps that we would take with our preconception patients? Then the next steps with these preconception visits, it's really laying the groundwork and for our foundational pillars, working on nourishment, body movement, gut health sleep, nervous demregulation, and then also detox.
So you just went through those super fast. Yeah. Because this if anyone's come to see us, they know that we talk about these pillars all the time, but it's worth kind of breaking it down and saying, we are looking at foundations. We're saying the body works when it has all of these pieces in place. I always talk about, like, a recipe.
If you're gonna make chocolate chip cookies, you need all of the ingredients. If you don't have chocolate chips, you're not making chocolate chip cookies. It won't work. And that's the same thing here. If we want a healthy body that's ready for pregnancy, then we have to make sure we have all of the ingredients, all of those components, and we've divided those up into six different pillars.
But go through those one more time just a little more slowly. So first, we start off with usually with nourishment because it's the only way that we can really fuel our bodies besides sleep and sunlight. You know, fueling our bodies is very important throughout all time and especially during pregnancy when you're pregnant. That is food. Yes.
You can take supplements, but, really, if you're running off something, like, if your body needs to complete a process, it's going based on food. So if your diet is crap and you're not getting a lot of nutrients in, then that's gonna be a problem. So, yeah, we've we always start with food and say, can we get all the the things that we need to help your body run? And it I feel like it also it it seems overwhelming at first talking about food, but really finding foods that that nourish you and that make you feel good are things you wanna keep eating. And I think that it's it's, not as difficult maybe as as it seems to let other things that don't serve you fall away.
And, man, it's worth doing. Right? I mean, you're in your twenties. You're just having babies. Like, this is a good time.
I we see a lot of women who are in their forties whose health is really starting to struggle that that I think would have benefited from having decades of nutrients, you know, full, full nutrients. So it is it is difficult and we can help. We have we have lots of resources available, but, man, it's so worth it to figure it out. Absolutely. And the next kind of moving into sleep, and that's mostly focusing restorative sleep.
It's our time for our body to heal and repair and really give our, our nervous system a time to relax as well. Yeah. And pregnancy can cause insomnia for sure, which is super frustrating because you're absolutely and utterly exhausted and laying awake. Yeah. And there's far fewer things we can do to support sleep in pregnancy than we can before pregnancy.
So helping patients if they have a long history of a messed up circadian rhythm or a long history of insomnia. Let's at least get some steps in place and some plans in place before you get pregnant. Yeah. Absolutely. Next, moving into body movement.
And, really, it's physical activity that feels good to you and that you wanna continue to do, and it's your fitness level and continuing that through pregnancy. We don't we're not picky about movement in women before they're trying to get pregnant. Just movement. Just any kind of movement. I do think, you know, looking at core and and your core strength is helpful in pregnancy because as that belly gets bigger, it starts to put some strain on the lower back and our posture.
And if you already have poor posture, then it hurts more. Yeah. It just gets worse during pregnancy. So we don't necessarily do assessment, but definitely looking at how can we optimize movement in doing some some core work or doing some, you know, maybe a physical therapy evaluation if someone's already having a bunch of hip pain or back pain to help get them the help they need before pregnancy instead of getting second trimester and saying, like, I can't even walk because I'm so out of alignment or I'm in so much pain, and then they're trying to fix it with a big pregnant belly. It's, it's worthwhile.
Yeah. Alright. Another really important pillar is gut health. Yeah. And I'll let you mostly talk about gut health, but I can I can start us off?
Really in it can start a lot with in the mouth and oral health, and there there are, pregnancy complications links to poor oral health. So that's something I think that we will talk discuss during our visit and then, the importance of maternal gut health. Yeah. Both. I think are are are a really good thing to point out.
With oral health, we don't necessarily do a ton for that. But if, for example, you have terrible gingivitis, your gums bleed every time you floss, or if you've had eight cavities over the past year, it's worth seeking out a a dentist or a, oral health specialist to see if we can get that taken care of before pregnancy because dental health or oral health rather can get worse during pregnancy, and, again, not much to do about it. So if you're wondering if you might be developing a cavity or if you're wondering if you have, you know, an infected root canal or anything like that, like, before pregnancy is much better than during pregnancy. And then for gut health, really, we see gut health affect fertility a fair bit, but also gut health is related to mental health, and there's not a ton we can do about it once you're pregnant. There are some things like eating fermented foods that you can absolutely do during pregnancy, eating plenty of prebiotic fiber you can do during pregnancy.
But if you have chronic constipation, chronic bloating, chronic diarrhea, if you have stomachaches, any of those things that you're having before, it's so much easier. We we beg of you. Let us help you before because during pregnancy, we want so badly to help you, but we're like, well, we can't quite do it that way. Maybe we could try it this way. Like, if we can help you feel really good before you ever get pregnant, it just bodes well for the pregnancy.
Now there are lots of questions that come up about, SIBO and dysbiosis and imbalance microbiome and maybe effects on the pregnancy. We don't know. Yeah. We don't have that clear data at this point to say much of anything. So I really rely on the logic of if you're healthy before pregnancy, you're probably gonna do better during the pregnancy.
And that doesn't mean that we go crazy with it, but can we take some basic steps to make sure that you have a really healthy gut? And some of those things are super simple, like eating enough fiber, eating a variety of vegetables, eating sauerkraut. It's it's not super, super fancy things we're doing, but we get the opportunity to sit down with a woman who's thinking about it and say, how do we what could we do that's easy to add to your routine that would help you in your pregnancy? So, yeah, plays a big role in in certainly comfort levels during pregnancy, constipation and bloating and other things, gas, get worse during pregnancy. But, also, there is a likely connection between some pregnancy complications and gut health.
We just don't have that super spelled out. And once you're pregnant, there's just not much to do about it. Yeah. I think it makes sense. We know that, hormones can influence our gut microbiome.
We see that with menopause and, with low estrogen states, our our gut microbiome can can, can be can get changed. I think that the the vaginal microbiome, we don't talk a lot about. Yeah. But it's an area of ongoing study and looking at the number of bacteria and the balance between lactobacillus and yeast and and other things like that in the vagina, and then how that affects maybe this new this new area of study is any sort of microbiome inside the uterus that may be affecting fertility. So it's not necessarily once you're pregnant may not be an issue, but infertility and in preparing your body for pregnancy, there will be data coming up in the future that says, hey.
By the way, if if your vaginal microbiome is as healthy as possible, good things will happen, you know, in fertility and pregnancy. We'll have that data. I almost guarantee it that we will have that data. And so what we do is say, let's just do what makes the most sense. If you're having chronic yeast infections, let's do something about it before you get pregnant.
Will that change your pregnancy outcome? I don't honestly know. Are you less likely then to get terrible yeast infections during pregnancy? Probably. I don't know.
So let's just use some common sense and say, let's help you be as healthy as possible just because it makes sense. And someday, we'll have these exact connections of, if you have this problem, then it will create this problem during pregnancy, but we don't have to wait till we have that data to help you to be healthy. Yeah. You know? Let's just help you to be healthy.
Absolutely. Next, kinda moving into nervous system regulation or other another pillar, and that's really focusing on things that can help you with anxiety, maybe experiencing postpartum or, some depression and postpartum blues and really finding a way for you to feel good and enjoy this time that you have while you're pregnant and also postpartum. Yeah. Exactly. So if you're already struggling with a bunch of anxiety or I hear people say, like, I'm a type a personality.
I'm a perfectionist. Those are fine, but they can really be difficult to manage once you get into pregnancy. One of the things that we learn very quickly in pregnancy, it really is sort of the things that we have to learn for being a mother, is that we have no control. We have no control over our children. We have no control.
We have so little control over our bodies once we're pregnant. And on the the health of our baby, you know, we can't control whether there are certain things once we're already pregnant. And that if we come into pregnancy with a perfectionistic mindset or with a, like, type a mindset and we're already super revved up, especially if we've had struggles with infertility, and now we're we're super revved up and stressed about this pregnancy, and now we're pregnant, that nervous system is just gonna go even higher, more dysregulated. So the more that we can sit down and say, okay. Let's figure out what your triggers are.
Let's figure out how to help retrain the nervous system. Let's figure out how to keep you at a nice revved down state. Then going into the pregnancy, we can help support you through the pregnancy to kind of learn how to stay in that revved down state when things are feeling a little bit more out of our control, and then that carries through to postpartum When things feel even more out of our control as these babies are doing whatever they want and we can't control it. So that's a really great time to start learning those lessons and also to just get an idea of where your barometer is set. I call it the the, like, nervous system barometer.
Are you, like, already maxed out? Are you way down low? Where are you now, and what can we do to support that now? Yeah. Absolutely.
Partner like we said earlier. Absolutely. And I think also just bringing up, there's often more time just one person in, in this relationship. So screening for things like intimate partner violence and, domestic violence is also really important for, pregnant mothers and also just for, our women's in general. Yeah.
It's a great time for us to offer that support and offer the help that you need. Good. Wonderful. Another big, topic is also detox. And this, I think, can feel really overwhelming in just my patient population and not let alone people that aren't, interested in getting pregnant yet.
But really making sure that we're we're living in a nontoxic household and and clearing our body and allowing our body to detox the toxins that are in our water, in our air, in our on our food, and we're putting on our body with fragrances. And I I will say the biggest thing is that we don't know. There's so many questions around this, and I think a lot of people in the holistic health community talk about detox and toxins like we have it all figured out. We do not have it figured out. There are so many things we don't know about how these toxins enter our body and what our bodies do about them.
Now on one side, I will echo the argument that you'll hear from a lot of conventional doctors, which is our bodies are meant to detoxify. Like, we are meant to get rid of stuff that's not meant to be in our body, and that is true. And it does that through the liver. It does it through the stool, through the urine, through our breath, through our skin, through sweating, through lymphatics. We are beautifully built to take things in that that maybe don't belong there and get rid of them.
But the part that I will emphasize is we can absolutely outrun that. Right? If you take someone who drinks one glass of wine one time ever, you wouldn't be like, oh my gosh. Your liver, it's gonna die. Right?
You'd be like, well, your liver will take care of it. Yeah. But if you have someone who's drinking excessively, then you know that it's gonna harm the liver. So we know that there is a sweet spot of how our bodies can tolerate toxins. And when the body can't tolerate toxins, except we don't know that tipping point.
So in any woman, we're looking at detoxifying our environment through, there are many sources out there who speak about this in way more detail than I will, but looking at getting rid of parabens and phthalates and fragrances and, PFAS and, you know, all of these different elements, glyphosate that can really affect our bodies in ways that we don't fully understand, but know but we know that they bog down our system. Now these toxins can affect our hormones and can certainly contribute to fertility. But how do they contribute to pregnancy and pregnancy complications? I don't know. No.
I don't think anyone knows. But it makes a lot of sense that we should not do a bunch of that right before we get pregnant. And I think there's this question of should we detoxify then? Should we, like, give ourselves a detoxification boost before we ever try to conceive? We know that some of these toxins travel through the placenta.
Many of them travel through the placenta. The placenta is there to be a filter in a lot of ways, but it's not a great filter because the baby needs a bunch of stuff from mom. So it's a super leaky filter, and it's really based on size. So the smaller the molecule, the the more likely it is to go through the placenta. So we really we know it's an issue, but we don't have a lot of other guidance around that.
So if someone comes to me preconception and says, you know, I think I'd like to do a detox. I'd I'd like to support my detoxification pathways. That is something we can advise them on and say, listen. I don't have the data to say should you or what might be the benefit, but if we just wanna use common sense and say, like, yeah. That that sounds good.
That this feels like a good idea. Then we can do it in a safe way, and we can we can help give that guidance. The other ways that we can do it are just like drink water and sweat and move your body and eat lots and lots of broccoli and, you know, use the ways that our body is equipped, so decreasing exposure to toxins and then supporting our body's natural detoxification pathways. That just makes so much sense to me. Do I have data?
No. We don't. We don't have this data for pregnancy, and we should. And maybe someday we will. But pregnant women are really difficult to study.
It's a difficult area of study. So for now, can we just use some common sense with health and help women with that? I think you said that really beautifully. It's we don't know what the tipping point is, but we do know that over time, these things can can be burdensome. So it's important to do what we can and take it step by step.
I think it's the approach that I always take with my patients, like, little swaps here and there. Exactly. It's kind of where we start. Exactly. I love that.
Well, so we've described kind of our approach to this preconception care, maybe somewhere a year or so, six months, three months even before pregnancy. We go through a survey of sort of what is happening in your lifestyle and what are some little changes that are very doable that create the healthiest body possible before pregnancy, that you'll be able to keep those changes with you through pregnancy and then into postpartum, and we can kind of support you every step of the way. And then tell them a little bit about the lab review also and why we do that. Yeah. So the lab review gives us a pretty good idea of of what your cells are doing and what nutrients you have in your body because sometimes, you can't always tell.
You can't always tell if you're iron deficient or you can't always tell if you're vitamin d deficient. I would say most people don't know they're vitamin d deficient because most patients that I see are vitamin d deficient. Especially in Utah. Yeah. Yeah.
So it's really looking at these these nutrients that you we wouldn't we wouldn't be able to tell if necessarily if we were deficient in. So we're looking at, anemia. We're looking at iron levels. We're looking at, vitamin b, vitamin d, looking at folate levels. Really things that are critical to the fetal development that could put you, at risk for things like high blood pressure, diabetes, insulin resistance.
Yeah. Absolutely. And you mentioned important for fetal development, and I will say supporting mom's health so that her body tolerates this better, whether it's through pregnancy complications or just feeling better. One example of that is, you know, I took care of pregnant women for over a decade, and so many of them would say, I'm just so tired. And most of us, including me in my earlier training, would say, like, yeah.
I'm so sorry. Pregnancy is exhausting. And after some functional training, I started to say, well, let's check your thyroid. Let's check your iron. Let's check your ferritin.
Let's check your b twelve. Let's check your vitamin d. And guess what I found? A whole bunch of deficiencies that when we treated it, they got better. They felt better.
So I just think that doing some lab evaluation just makes so much sense. I I'm baffled by the the fighting back against that that so much of the medical community says don't do that. Like, these tests are not expensive. They're covered by insurance for things like fatigue. They should be done.
They should be tested. For preconception, they're not usually paid for, unless you have symptoms that justify them. So we are usually doing a cash price. So, just so women know if they go to their doctor and say, I want these labs, it will be likely difficult to get them done, unfortunately. But, if you can find someone who can do it for you, I do think there are some really simple lab tests that can be really beneficial.
And I will add to that. Sometimes when we have these conversations, then women will hear it and say, got it. Take vitamin d. Take iron. Take these things.
Oh, yeah. And you can take too much too. So sometimes I'll have patients come in on vitamin d, and we'll test it in this way too high. Yeah. And so we'll say, okay.
Well, great. But you you can pull back. Like, you don't need to take that much. So this isn't just a plea for, like, take all the vitamins and all the nutrients ever. This is a plea to say, like, what does your body need?
Are you is your body showing signs of not methylating well that we need to add actually methylated b vitamins? Do you need a prenatal with methylfolate instead of folic acid? These are things that we can look at and test for easily and then help your body have the support that you need instead of the generic, like, make sure you eat healthy before you get pregnant. You know? We can actually say, like, this is what your body is asking us for and give those recommendations for that.
I am just so passionate about this. I just think that there's so much good that we can do that's pretty easy stuff. This isn't really fancy stuff. One thing we didn't quite dive into that is actually worth covering really briefly is, just more specifically, some of these pregnancy complications that come up are pretty easy to reverse before you ever get pregnant. Will you talk just about a couple of those that come up in pregnancy that we can address before?
Yeah. I think the main ones that we that we could address before pregnancy is insulin resistance that could lead to gestational diabetes or, high blood pressure, and then also inflammation. Inflammation is something we both see quite frequently, and we know how to reduce inflammation in our body, and there's ways that we can support you. Even if you supplements don't feel right for you, there's other ways that we can do that. And then also making sure that we support your immune system Yeah.
And fight off infections that maybe you you currently have that we don't know about and kind of optimizing our health. Yeah. Absolutely. Doing all of those things before you ever get pregnant. So improving insulin resistance, you wouldn't you may not know that you have insulin resistance.
You wouldn't feel it. So how do you know if you're, like, teetering on the edge of insulin resistance and then you're that person who gets gestational diabetes? Well, you can. We can do that. Like, that's not rocket science.
Like, we can do that if we just get you in the right time. And so really helping women to know where their bodies are at and help them understand what they can do to take steps to keep themselves as healthy as possible. I know there's a lot that we've covered here, and I certainly don't want women to feel hopeless that, like, they're they're doomed. This is just an opportunity to do a little bit more and to do to help women feel a little better, to have that healthy transition through pregnancy to the postpartum, to motherhood, really, to the rest of their lives where they're really hoping to feel their best and have their bodies work the best, to have healthy pay babies, healthy pregnancies, not be too uncomfortable during pregnancies. I I am so thrilled to be able to help women with that, and that is something that we offer at our clinic that that we're just launching is this preconception care.
But I also don't don't want to if someone's listening to this that doesn't live in Utah and can't come see us, I don't want them to feel desperate. Really go back through the basics of those six pillars, and you'll be there. I mean, the labs are really nice. But if you can't get the lab work done, by far, the lifestyle changes are more important. So if this resonates with you, if this sounds like something that you want to do, certainly, we can do that for you.
We have health coaches that can, take care of patients from every state so the licensure isn't an issue for them. You can work with the health coaches who can perfect these six pillars with you. This is what they're trained in. This is what they do. So we have two health coaches on our team that can help women with this.
If they're feeling like, I really love what she's talking about, but I don't know where to get that, you can get it from all over with us. If you are in the state of Utah, we can certainly do the whole thing. But aside from just, like, come see us, really, I just want women to feel empowered to emphasize the importance of this time period and to say, like, there are good things that you can do before you get pregnant to prepare your body and your mind and your your relationship for the difficulties and the stress and strain that come from a pregnancy and the postpartum transition. And I just I we really wanna help them with that. We wanna support them through that.
So I hope to our listeners, I hope that you'll find this helpful. I hope you'll find some things that you can can do and think about that will improve your health and improve your pregnancy. Yeah. Absolutely. I also think one more thing is just if you are already pregnant, there's not nothing that we can do to help you.
Yes. You know, we don't want to exclude you if you are pregnant. We do focus a lot on lifestyle factors here, and it really would be diving into those foundations. So don't feel like, oh, I'm already ten weeks pregnant. What I I can't do anything anymore.
We absolutely can still, find a way to to, help you and optimize your health completely. Completely. I'm so glad you brought that up. Thanks. K.
Well, thanks for being here. This is a really good conversation. Thanks for having me. Thank you so much for tuning in to today's episode. A huge thank you to our guest for sharing their insights and time with us.
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