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The "trimester" before pregnancy

So you have decided you would like to have a baby! How exciting! But where to start?

The time leading up to pregnancy is just as important as when you are carrying the baby or the postpartum period for both you and bub. This means that ideally, you want to be consciously working on your health before actively trying to conceive. It’s important that, if possible, this work is done not only by the woman carrying the baby but also by the man because you cannot make a baby without healthy sperm!

For women, it takes around 100 days for eggs to mature and for men it takes around 75 days for their sperm to mature, therefore a minimum of three months of preconception work should be undertaken by both to prepare for a successful and healthy conception. This also applies for those undertaking assisted reproductive therapies who might have fast-tracked egg maturation, the longest time possible to prepare is only going to benefit you and the baby.

Everyone has a different fertility journey, health history and home environment so it is important that your plan is individualised to you, however, alongside your specific recommendations there are a number of general points that everyone can consider:

Macronutrients: All three (protein, fat and carbohydrate) are very important as they are the building blocks of our nutrition and energy. Healthy fats are especially important for healthy hormone balance and the plumpness of eggs. Protein will supply us with long-term energy and as your requirements increase during pregnancy, it is a good idea to get started beforehand to build healthy habits. Carbohydrates are needed for our body to ovulate, however, sticking to wholegrains, starchy vegetables and some fresh fruit rather than processed or sugar-containing products is recommended.

Micronutrients: To be honest, all nutrients are important for preconception and overall health but a special mention should be made for folate and choline for their role in foetal development and placenta growth. Other important nutrients include iron so your body can make enough haemoglobin for your baby, iodine for thyroid and ovulation health, and Vitamin D for healthy sperm and implantation. Supplements can be a good way to ensure you are reaching your nutrient requirements, however, off-the-shelf products are usually not the best option so it is best to ask a qualified naturopath or nutritionist for their recommendation.

Variety: Eating a plethora of different foods is going to ensure you get a variety of nutrients but also support a healthy microbiome which in turn supports a healthy immune system, hormone balance, detoxification of waste, and digestive function. Fibre which is only found in plant foods (fruit, vegetables, grains, nuts and seeds) feeds these good bugs in our gut, meaning the more plant foods you eat, the healthier your microbiome. Having a healthy microbiome also improves your baby’s microbiome with research showing these impacts begin during the preconception stage all the way through to breastfeeding and into their second year of life.

Fluids: Adult women are suggested to consume at least 2 litres and men 2.5 litres of water every day, with those amounts increasing with high-intensity exercise. Consuming enough good quality water every day is vital for ensuring you have well-hydrated reproductive cells, ripe for conception, as well as ensuring adequate digestion and detoxification of waste from the body.

Weight: Achieving a healthy weight before conception not only reduces your risk of complications when pregnant but also improves chances of conceiving from both a male and female perspective. A simple way to understand if you are close to a healthy weight is to calculate your BMI (Body Mass Index) which assesses your weight to height ratio. The flaws of this formula is that it does not take into account differences in the builds of certain ethnicities, high muscle mass or body proportions, so is better used as a general guide. Crash or fad dieting to decrease weight is also not advised during the preconception stage as this often involves restricted calories and nutrients and can lead to undesirable side effects such as headaches, digestion changes and fatigue.

Stress: There is a correlation between high levels of stress and increased time for conception. When stressed, the body in a way perceives danger, reducing the function of all non-essential functions for survival which includes reproduction. Some of the best ways to reduce stress include meditation and mindfulness practices, spending time in nature, gentle exercise (frequent high-intensity can actually increase stress), and starting to think about your values and goals for the way you want to balance your professional, personal and/or study life components to best suit your needs. Herbal medicine can be an additional support for some people as well as talk therapies with professionals such as counsellors, psychologists or life coaches.

Sleep: Irregular sleep which includes those who go to bed and wake up at different times every day, are waking during the night or are just not receiving the optimal 7-9 hours every night, may be associated with irregular periods and ovulation. Having a baby means there will be a lot of lost sleep so why not concentrate on cultivating healthy sleep patterns now to set yourself up for later. Prioritising a regular sleep pattern can also reduce stress levels and risk of carrying excess weight which will further improve your overall health and fertility. Setting regular bed and wake up times (this can be hard to achieve for shift workers but try to be strict with yourself), turning down the lights in the evening and reducing screen time, hot showers before bed, and creating a bedroom environment that is dark, cool and clean will help to contribute to better quality sleep.

Toxins: I’m not a huge fan of focusing too much on what things need to be avoided but as a general rule with preconception it is recommended that smoking, alcohol and more than 1 shot of coffee per day are put on hold during this time for both the male and female. When sperm reaches the egg, the mitochondria (energy centre of the cell) within the egg have to sort through the unwanted parts of the sperm (eg: the tail) and essentially give the remaining parts a good sprucing before allowing fertilisation to take place. If there is too much to "clean up" inside the egg then the mitochondria do not have enough energy left to initiate a healthy fertilisation or properly clean up the sperm. A history of smoking or heavy drinking, under-nutrition, chronic health struggles, infections or exposure to workplace chemicals can contribute to this.

Age: As women we are born with millions of follicles (eggs) in our ovaries, most of which are lost before we even hit puberty. Once we begin menstruating we start to lose around 20-30 with each cycle which is where the pressure to conceive before a certain age has stemmed from. According to medical standards, women over the age of 35 are considered geriatric which is to be frank, an awful name. Of course women certainly have an ideal timeline for conception but that doesn’t mean that someone past the age of 35 can’t conceive (unless they’ve hit menopause). However, with age comes ageing and that means that attention directed towards reducing inflammation and toxic load, and improving antioxidant status will help to support ‘youthful’ reproductive cells.

Testing: As a starting point, going to your GP and getting a few general things tested at the start of your preconception journey will give you a nice starting point for what, if anything, may need some extra attention. There are many different speciality tests available that can give a lot more specific information down the track, however, these are a nice general starting point for most people:

  • Full Blood Count

  • Iron Studies

  • B12 and Folate

  • Thyroid Panel

  • Blood Glucose and Insulin

  • Liver Function Test

As mentioned earlier everyone has their own preconception journey, if you are using a donor sperm or egg, going through IVF or other assisted reproductive technologies, using a surrogate or any other format of pregnancy, these tips can be used as general recommendations where possible. They apply not only to the three months prior to conception, they are applicable to everyone at all times.

If you feel you would like some more individualised advice or are called to work with me, drop me a line.

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