How to prepare your body for pregnancy: a preconception checklist

If you’re working out how to prepare your body for pregnancy, the steps Canadian guidelines put first are simple and inexpensive. Important development happens in the first weeks after conception, often before a pregnancy test turns positive, which is why the Public Health Agency of Canada and the Society of Obstetricians and Gynaecologists of Canada (SOGC) focus on the months before trying.

Preconception health is also a two-person project when a partner is providing sperm. Sperm take a few months to develop, so habits in the months before trying count for both of you. Use the checklist below as a starting point, and bring it to your next appointment.

How to prepare your body for pregnancy: a checklist for the months before

1. Start taking folate. The Public Health Agency of Canada recommends a daily multivitamin with at least 0.4 mg (400 mcg) of folic acid for anyone who could become pregnant, ideally starting at least three months before pregnancy. It notes that food alone doesn’t provide enough. Dr. Esau, ND recommends folate or 5-MTHF as the form to look for on the label.
2. Book a preconception visit. Bring a list of any long-term health conditions and every prescription, over-the-counter medicine, vitamin and herbal product you use, so they can be reviewed before you start trying.
3. Stop alcohol, smoking, vaping and cannabis. There is no known safe amount of alcohol or nicotine in pregnancy, and cannabis may affect fertility and fetal development. If quitting is hard, ask your provider about support options; cutting down still counts.
4. Keep caffeine moderate. The SOGC suggests about two small cups of coffee a day at most.
5. Eat for the long haul. Vegetables and fruit, whole grains, protein foods such as beans, eggs, fish, tofu or lean meat, and water as your main drink. Choose fish that are low in mercury.
6. Move most days. Walking, swimming, cycling and strength training all count. Choose something you can keep doing once you’re pregnant.
7. Look after sleep and mental health. Stress, sleep and support shape how pregnancy and the months after birth feel. If you’ve been meaning to start counselling, now is a reasonable time.
8. Talk about family history. If conditions run in either family, your provider may suggest genetic carrier screening.

How much folate should I take before pregnancy?

For most people, the Public Health Agency of Canada recommends a daily multivitamin containing 0.4 mg of folic acid, one form of folate. Its guidance links folic acid with a lower risk of neural tube defects, serious conditions affecting the baby’s brain and spine. The neural tube closes in the very early weeks of pregnancy, which is why the recommendation starts before you conceive.

Some people are advised to take more. The Public Health Agency of Canada lists a family history of neural tube defects, conditions that affect how folate is absorbed (such as celiac disease, Crohn’s disease or gastric bypass surgery), some genetic factors, certain medications and smoking among the reasons a higher dose may be advised. It also advises not going above 1 mg a day without talking to your health care provider.

How long should we try before getting a fertility assessment?

Most couples conceive within a year: younger people with regular cycles have about an 80% chance of pregnancy after one year of trying. The highest pregnancy rates come from having sex every one to two days during the fertile window, the six days or so leading up to ovulation. Some lubricants slow sperm, so choose a fertility-friendly one if you use lubricant.

Seeing a naturopathic doctor at Natura before pregnancy

Dr. Erin Esau, ND has a focus on fertility. A first visit at Natura Integrative Care Clinic in Steinbach runs 60 to 90 minutes and can be booked as an accelerated two-part visit: up to 60 minutes with a registered nurse, who takes your case (asks you the questions about your health), and then 30 minutes with Dr. Esau, ND, which usually means you can get in sooner. The visit goes through your cycle history, health conditions, medications and supplements, and both partners’ habits. Dr. Esau, ND may do a physical exam related to your concerns and order testing, and you then discuss options and make a plan together.

Lab testing ordered by a naturopathic doctor isn’t covered by Manitoba Health, so you pay the lab directly. Prices vary widely depending on what’s tested, but generally start around $75. Naturopathic doctors in Manitoba can’t order imaging such as ultrasound or prescribe medications such as hormones; during fertility care, those usually come through your fertility clinic. Natura doesn’t bill insurers directly; see fees and insurance for visit prices and how receipts work.

Natura also offers acupuncture with Dr. Esau, ND, exercise physiology with Lindsay Porter, and pelvic floor therapy with Taryn Bloodworth, RNBN, whose areas of focus include pregnancy preparation. Read more about fertility visits at Natura.