I was very excited to be invited to share with a bit about the work I do as a physician to help women have healthier pregnancies and healthier babies. My particular focus of work is called “preconception care” (PCC), which means that I generally work with women before they conceive. The idea is that there are certain things couples can do before conception and in early pregnancy (often before they’ve seen a doctor or midwife!), that can make a big difference in the health of their children.

It’s interesting looking at traditional cultures where the idea that you would prepare your body for pregnancy was quite common. The amount of time and methods used varied depending on the culture, but the idea that a woman would prepare herself for pregnancy was not unusual.

Today nearly 50% of pregnancies are unplanned so there certainly is no preparation done in those cases. But even for couples who are intentionally trying to conceive, there is often very little information made available to them about how they should approach this monumental time in their family’s life. At a fundamental level, healthy children require two things (1) That they have what they need for proper growth and development (nutritional sufficiency). (2) An intentional avoidance of things known to be toxic or dangerous to healthy development (avoidance of toxicity).

This framework is generally applied to some basic degree once women have conceived and are seen by a healthcare worker. For example, women are told to take prenatal vitamins and folate to ensure they have the proper nutrients for their baby’s development. Women are also advised to avoid certain kinds of food (i.e. high mercury seafood) and substances (smoking, alcohol, etc.) that are known to be dangerous for the developing child. These are all good and important things.

Preconception care seeks to go deeper. Over the last few decades, there has been a significant rise in the rates of numerous health conditions affecting pregnancy and children’s health. These include rises in the rates of Cesarean sections, preterm birth, allergies, eczema, autism, developmental delays and certain birth defects. Some of these may be addressed by the general advice noted above, but the list of things that have been repeatedly correlated with poorer outcomes is growing.

New medical research is suggesting that (a) nutritional deficiencies are more common than previously thought and (b) the list of substances that should be avoided in pregnancy is longer. I ask the patients I see to fill out a questionnaire, which helps to identify where their children’s health may be at risk based on the above 2 categories. Then, together, we work to find strategies to eliminate deficiencies and toxicities so that the environment in which the child will grow (the mother’s body), is optimized for the 9 months they will spend within it. (NB: Husbands aren’t entirely off the hook either!)

I believe that all women of reproductive age stand to benefit from receiving PCC prior to conceiving a child, whether it’s their first or their fifth. In women I have worked with who already had children, they’ve often told me that the children they had after receiving PCC has been their healthiest and happiest child to date.

For more information about the kind of work I do, please feel free to visit my website (soon to be updated) at preconceptioncare.ca or check out the most recent articles I’ve published on the subject at Hindwi and Public Health.

Dr. Rebecca Genuis is a family doctor with a special interest in environmental medicine and preconception care. She works in Edmonton, AB and can be contacted through her website www.preconceptioncare.ca