Preparing for Parenthood: Strategies for Optimal Health Before and During Pregnancy

Introduction to Preconception Health 0:00

This is Doctor Talks, real talk from real doctors on the issues that matter to you most. Welcome back to the Raising Healthier Kids Summit. I am here with the phenomenal Dr. Felice Gersh, who is an integrative OB-GYN and the perfect person to chat about preconception and healthy delivery and having a healthy baby. So I'm really excited to chat with you about that today. Well, I'm thrilled to be here. I love that we're talking about really young childhood and like we were chatting before coming on that the health of the child begins long before the child is even conceived and, and actually can go back to other generations, but we can't, we can't modify other generations.

So we'll start with the mom, right? Because at least she can make certain choices that can have dramatic impacts on the complete life, everything that's going to happen with her child from the moment that it comes into the world. Right. And that's one of the big reasons why I even wanted to write the book. And we were talking about that as well, because our health is so important. Our health is going in the wrong direction. We're seeing chronic disease like we've never seen before. And I feel like as a society, we're not recognizing how important our health is today and the actual things that we can do for ourselves.

And then to our kids as well. If we're going to get pregnant, if we're going to get pregnant again, if we're thinking about getting pregnant or even if we are pregnant, all the things that we're doing matter. And so it's not to scare people. It's just to, I think, make people recognize that their choices make a difference and we can improve our health and our kids' health. So maybe we can just start there. And what are some of your thoughts about optimizing health before conception? Well, it's really great if you have a minimum.

I mean, I like more, but a minimum of say a three month lead time before you start even trying to conceive. And so like, what's the point of that? Well, it turns out that when you can, first of all, to optimize your fertility, that's a big deal. So It turns out that egg quality matters. It's not just having a bunch of them or even having ovulation. We want to have optimal egg quality. Now, an egg comes from an ovary. They've actually had studies where they'll take fluid from the follicle that contains the egg, which we call the oocyte, and if you have inflammation in the mom, and there's a whole bunch of things that can cause that we can touch on, but if you have inflammation in the mom,

Why Health Before Conception Matters 2:25

it's actually going to create inflammation in the ovary and in the fluid surrounding the egg, and it can damage that egg so that it won't properly ovulate, or if you create an embryo, The embryo is not high quality. And then as well in terms of implantation, it's a very unbelievably amazing but complex process how an embryo actually implants. It doesn't have like a little drill, just like drills in and then it jumps into the hole. It's almost like the parting of the Red Sea. When you look at what happens in the uterus itself, the muscle cells, the myocytes, they actually move apart.

And it's all involving the immune system, these specialized killer cells. I mean, it's amazing. And that involves the hormones having proper progesterone production and also having the endocannabinoid system just right in the uterus where you have the spot of implantation. We don't even know how that gets chosen. But it actually is where the endocannabinoids, these lipid signaling agents, are the lowest in that area of the uterine lining that allows this whole process to occur. And you desperately need to have an adequate amount of progesterone.

And it turns out that systemic or body-wide inflammation in the mom and hopefully to be the future mom, that inflammation actually can dampen down her ability to make progesterone so that you won't have a proper implantation and then you'll end up with a miscarriage. So these are like really important things. So you talk about you need to have a state of like homeostasis, calmness, not having like a lot of like stress, not having a lot of inflammation. They've even had studies, you know, where women go on vacation and they're happier and calmer.

And then suddenly they conceive when they've been trying and trying and trying for many months. So we should talk about what can you do to lower inflammation? So you won't have inflammation in your ovaries. You won't have inflammation in your overall body. So you'll make proper progesterone. The endocannabinoid system will work properly. You'll have a healthy egg, a healthy embryo. And then we have to take it from there, because that's just the beginning, right? Yeah. I mean, it's, of course, a very complicated, complex dance.

We often forget that, you know, and all these things make a difference and sure. You eat one piece of cake, it's not the end of the world. But if you add in all of the inflammatory triggers for you and you keep piling on, then it just gets worse and worse and worse. And eventually that leads to chronic disease, autoimmune condition, more difficulty with fertility, all of these things. And so especially with fertility, like you mentioned, it's such a complex pathway that we need a lot of things to go perfectly right in the best of circumstances.

So we got to give our body the best chance to be successful, I think. Absolutely. So it basically is lifestyle. Okay. So now sometimes in order to facilitate lifestyle, there are some pharmaceuticals and the big ones that are now talked about are the,

Nutrition and Micronutrients for Fertility 5:55

what are called the GLP-1 agonists and associates we'll say, but we'll put that on the back burner for now and just like focus on lifestyle. So if you Like, think about all these things. One would be, of course, number one, the nutritional status of the mom to be. So it's so critical to think about not only what you eat, but what you don't eat, because it all is going to be contributing to overall health. you need to have optimized nutrition. That includes the macronutrients, so the proteins, the carbs, the healthy fats, and so on.

And then you need to have the micronutrients. So I encourage all of my moms to get a simple micronutrient test, which you can get from major laboratories like Quest. And it's amazing. It'll show you all your basic minerals, vitamins, and where you stand. Because one of the things that's not appreciated is that, for example, many women decide they want to get pregnant and they go off of oral contraceptives. Well, It turns out that oral contraceptives, among other pharmaceuticals, can actually lower your micronutrient status.

It's associated with some deficiencies of some B vitamins, some minerals. So like see where you stand. That's why we want to have that little lead time of at least say three months so that we can replete or make sure that you have all the proper micronutrients in your body. So you want to get on a healthy anti-inflammatory diet like you were alluding to. So it's going to be heavily plant based because plants are like magic because they have all kinds of phytonutrients. I call it the magic sauce.

And of course, lots of fiber that nourish your gut microbiome. And now we know the microbiome is like critical. And that's like a big thing for little kids when they're born is like, that's why I try, by the way, trying to optimize your health during pregnancy is going to give you your best chance of not ending up with like an emergency cesarean section, which isn't the end of the world. You know, if you have to have a C-section or your baby was born by C-section, it's not the end of the world, but it is best, you know, if you can talk about best to have a normal vaginal delivery, because we now know that that helps set the stage for the microbiome, the entire microbiome, all the collectives of these microbial life forms of the new baby.

And by having a healthy pregnancy, it doesn't mean you can't end up with a C-section, but it improves your statistical chances of not having to have a C-section. So in terms of the nutrients, I suggest what actually the Harvard School of Public Health termed a sustainability diet, which means that you eat mostly plants and a little animal protein. That when you're pregnant, you need to increase your protein intake, but it doesn't have to be all animal protein. So, you know, that some of the amazing sources of protein from plants can be things like the legumes, the beans and the lentils and the whole grains.

I call them the ancient whole grains that are organic. Things like quinoa, buckwheat, amaranth, millet. You may never even have heard of these things, but they're out there and you can order them online too, but get organic. You cook them like rice. They're really full of lots of fiber, B vitamins, And they're very filling and you can add in nuts and berries and seeds and things like that, which have also, you know, all kinds of things like lignans, which are really healthy phytonutrients and so on.

So you want to have also make sure you don't skip breakfast. That's really important. It helps with glucose regulation. And so many women now are getting gestational diabetes. which is not good for the mom or for the baby. And then sometimes you end up with this like 10 pound baby, that will definitely increase your risk of a C-section. And then after birth, the baby tends to have more glucose regulation problems, may get hypoglycemic, and we don't want to go there. So we want to make sure that you have a normal sized baby if possible, and that there aren't these pregnancy related complications.

And I don't recommend being vegan when you're pregnant. In fact, one of the sources of choline, now choline is not talked about enough. Choline is like part of the building blocks of acetylcholine, the neurotransmitter that makes you smart. So you definitely want to have that into your diet. And the egg yolks of, now we're talking about like, if you can get it, you know, pasture-raised organic eggs, And they have wonderful choline, vitamin E in those egg yolks. So don't just think you eat the egg whites and toss the egg yolks, okay?

You need that healthy fat. You need all the ingredients, the magical ingredients like choline, vitamin E, and the healthy fats. And actually they've shown that a little bit of saturated fat actually makes people feel happier and improves fertility. So you don't want to go on a completely devoid of saturated fat type of diet. You want to have that in there. And so you want to have definitely some animal protein, the best source that you can get, but you don't have to like go on a massive high animal protein diet because then sometimes you get other things in there that you don't want.

And we all know about what happens with confined feedlot animals, right? We don't, you know, like those are horror stories. So you want to get the best animal protein that you can.

Avoiding Endocrine Disruptors and Toxins 11:30

And eggs really are a very good source. And a lot of people malign soy. Well, it turns out that organic, unprocessed soy is a great source of protein and phytonutrients. So don't think soy is evil. If it's GMO, if it's organic, if it's fake food. I don't even know why people eat faux food anyway, but definitely this is not the time to eat faux food. You know, like soy pretending to be cheese, soy pretending to be a hot dog. You know, that's not the kind of soy we mean. I'm talking about like the bean, the edamame or tofu miso or tempeh.

That's about it. But you know, soy and also other foods, you know, eat them the way the nature put them on the planet, you know, so don't eat like fake for vegan types of burgers either. That's processed food. Stay far away from ultra processed food. So the only processed food I suggest that people eat would be, I call it minimally processed, right? Like say you buy pickles. Well, who's making their own pickles these days? Maybe there are some of you out there, but I know I buy, but organic pickles and the ingredients are like vinegar, And cucumbers, you know, so when you read the label and it's hopefully in a glass glass jar, you know, because that brings up the next thing, you know, which is chemical avoidance, you know, poison in our environment.

Not good, not good. But yeah, I was going to ask you about that next, because I mean, you mentioned a great list of things to kind of consider things that we want to do. And I want to talk next about some of the things we should avoid, especially because it really is in the news and the media, I feel like a lot more in terms of reproduction, fertility rates going down, concern about endocrine disruption, reproductive disruption, especially around, you know, some of the chemicals we see in plastics and some of the bigger categories, you know, BPA, Ballets, PFAS, all of these, you know, kind of categories that you hear more more commonly these days.

So I guess I wanted to talk to you a little bit about some of the things that you feel like are most important to avoid, or at least to be conscious of. So when you're making purchases, you're trying to avoid these things to give yourself the best chance for fertility success. Absolutely. So these are the things you definitely want to avoid after your little one is here, right? Because this is like horrible. In fact, they've had studies showing that just switching kids from conventional foods to organic foods has dramatic benefits, like really huge benefits in so many ways.

And poor little kids are getting so much ultra processed food in their diets and artificial sweeteners. But this starts in utero and preconception to make the mom super healthy. So much of the data involves a few different types of chemicals, but of course, everything that is unnatural, whether it's stain retardants or flame resistant things, they put them in kids' pajamas. Now they took them out of kids' pajamas when they realized how terrible these chemicals were and that it was more dangerous to be in those pajamas and to risk a fire.

So we don't want to put those things in our lives, but the things that have had the most research are the bisphenols, like bisphenol A, but now plastic. So there is no such thing as safe plastic. So when it says on the label BPA-free and it's plastic, it means it's BPA or BPF. It's a different substitute, bad thing, which may even be worse. than the original. But it makes you think, oh, this is a great substitute. No, it isn't. Stay away from plastic. And so in hard plastics are the things like BPA.

And they are huge endocrine disruptors. Now, they're considered xenoestrogens, so like fake estrogens. they are terrible for developing estrogen receptor dysfunction. So they've actually done studies that women who are pregnant who are exposed to the BPA, and it's kind of ubiquitous, like everybody has it to some degree, but if the women who have the most exposures, they can actually end up with babies who are programmed wrong in terms of their endocrine system. Like you get one chance to make a good brain.

You get one chance to make an endocrine system. And part of the endocrine system involves the receptors for the hormones. And they've done studies showing that BPA in the in the baby will actually disrupt the function when the kid becomes a child and then a puberty, it becomes explosive. And that's part of the explosion of this condition called PCOS, polycystic ovary syndrome, is exposures in utero to these terrible endocrine disruptors that change the developmental function of the receptors for estrogen.

But it's even more than just estrogen. They've shown that BPA can affect the development of the function of the endocrine system involving testosterone and melatonin. These are like not optional for good health. So it becomes then a huge problem for the offspring. And phthalates, phthalates have been shown in males to alter the genitalia. And this is terrible stuff. So we want to avoid phthalates. Phthalates are found in things called fragrance. So if you get like a shampoo or a hair conditioner or perfume or cologne, and on it, it says fragrance, that word fragrance, that's like red flag, like think of skull and crossbones, that is a phthalate.

And phthalates are toxic endocrine disruptors. So the only sense that you should have would be from nature, like a rose petal. But even in pregnancy, we don't use essential oils because they can even be endocrine disruptors, even though they're natural. So avoid sense of any kind. That doesn't mean that you can't smell the roses and the flowers from your garden. I'm talking about concentrates that you're going to put in your body or on your body that get absorbed. Avoid anything that says fragrance and soft plastics, like the lids on takeout containers.

If you go to the airport or you go to Starbucks and you buy a coffee or something and then you put the lid on it. That's in the family of phthalates. Cause you know, it's, you can bend it. Okay. Like tubing and that kind of things. All those are phthalates. And when you get a hot drink in those containers, it actually will dissolve some of the phthalates into your drink. You're drinking and you're drinking through it. So if you have to buy one of those drinks and you have to get the cup, then take off the lid, just take off the lid.

Okay. As fast as possible. And if you can manage it, bring your own container. You know that people do that. They bring their own little glass or stainless steel container. And the takeout places for coffee and tea, they'll put it in your container. They even sell them, a lot of them, and then say, here's your container. So try to avoid this, especially when you're preconception and when you're pregnant, as much as you can. and try not to use chemical cleaners in your home because they are really toxic too.

And you look, oh, wow, you know, so simple things like vinegar and water, lemon oil. I mean, there's, and you know what? It's clean enough. I'm telling you, it's really good. It's like getting off the bad bacteria, you know, and soap and water is amazing. Just ordinary good quality, like simple soap. and not antibacterial soap. They're not even supposed to sell that anymore because we don't want to get rid of the good bacteria. We can't just go on a killing spree and kill all the good bacteria along with the bad ones.

So yes, chemical avoidance and get an air purifier. We've had a lot in California. We've had so many fires, but not just California. I mean, all of Canada was on fire and the fires came down into the mountain states, the Rocky Mountain states, and central, even US. So get air purifiers and get a water purifier. Find out from your water supplier what's in your water. They actually do tests now. I mean, but they'll tell you like your arsenic. And now they're going to have to test for like the forever chemicals, like the PFAS that you mentioned.

So talk to your water department, find out, well, what's in my water and get a water purifier that will get out the bad stuff. You know, like get out the lead, you know, get it out, you know, and check your home. Make sure if you have an older home, there's no like lead paint hiding under the current paint or something like that, that can actually chip off.

Healthy Pregnancy Habits and Stress Reduction 20:15

because lead is super toxic. I'm sure you all heard about what happened like in Flint, Michigan with the water with full of lead from the old pipes. So check your water. And also when you're pregnant, don't eat ocean fish. Don't do it. In fact, very limited if any fish, which is so sad. It should be so healthy, but it isn't because you have all these forever chemicals that are in our lakes and rivers. And not only that, pharmaceuticals get, that just end up like, you know, you can get, you know, oh, here's my dose of Prozac.

I'm drinking water or I'm eating fish. Like what the heck, you know? So this is really for real. And the pharmaceuticals are in our water forever chemicals because they call them forever because they won't go away. It takes like a thousand years to break them down. And in the oceans, unfortunately, they're full of mercury. And the mercury gets into the fish, and especially the larger fish, but even salmon. People think, oh, I'm eating salmon. Salmon has mercury, less than swordfish, but it still has mercury.

And you don't want that when you're pregnant. You don't want it ever. So it's so sad. You have to limit it. You know, you can eat the smaller fish like sardines, but I can't get most of my patients even like sardines. But if you grew up with sardines or you're from Scandinavia, you probably like them, you know, or herring. Those are smaller fish and they don't have mercury. Now, depending, they could have other stuff, but they're not going to have mercury. So yes. Be cognizant of everything on your body.

Like sun, we're getting towards summer. Oh my goodness. And in summer, that's when we're doing this, but you'll probably be watching this in summer, right? So don't, don't put that poisonous sunblock on your skin. Get something with minerals, like a mineral-based sunblock. Or put on sun repellent types of clothing. They're lightweight, but the rays don't go through. And a little sunlight is good. It's really important. It's like magic medicine. You get antioxidants made in your skin. It makes your brain make serotonin.

And from serotonin comes melatonin, so you have good sleep and you feel happy. But you don't want to get burned. in a few years get skin cancers. So you only want to get a little bit just to get slightly pink tone in your skin if you're a person that turns pink, but not burn. And so wear a big hat, stay in the shade and so on. But don't put the... They've been in the news too a lot. What's in those sunblocks, they really get into your body and they're not good for you or your baby. or your kids.

Don't put it all over your kids. And the ones that they spray, it's like, don't spray that near me. It's like, oh, it's an aerosol. I'm not breathing it. And don't put hairspray on either. What a great list. I mean, that was just absolutely fantastic. Basically, 100% of everything you said, I say all the same thing. So I mean, really just a great, fantastic list, kind of a, review of I would say that really the big things to think about I think that's fantastic and I always you know we talked about some of the things we don't want to do one I like to finish on the positive, so maybe we can just finish up by talking about you know if you are.

thinking about getting pregnant, you're thinking about having another child, you are pregnant right now. What are the first things that you would want somebody to think about or do? If they were going to do something this week, they're going to make a change this week. What would be the big takeaway for you to kind of leave them with if they want to start on this journey or kind of modify things to help have a resilient child? Well, from the dietary point of view is eat real food. I mean, that's like the takeaway.

If it came through a factory, be very cautious about consuming it. Look at the label. If it has anything other than one organic or two organic foods and it's in glass, maybe that's okay. But other than that, if it came from a factory, don't go there. If you can buy from direct from the grower, like a farmer's market or go to and spend your money on food. I don't care if you shop thrift stores for your shoes or some other gadget or something, but try to spend your money on food for the highest quality.

Believe me, that is bang for your buck when you get good food. The other thing is to have joy. I mean, this is your family. This is such a happy time of life, never to be regained. This is like you're living in the moment. So seize the moment and And have joy and have fun every day stress and we know that the stress of the mom and even the mom to be like during gestation

Closing Thoughts and Where to Find Dr. Gersh 24:55

also it affects fertility, but also when you have a family when you have young kids. the stress of the mom, the stress of the parents, it's like the energy in the room. If it's a negative energy, the fetus feels it, the children feel it. So work on stress control. I'm telling you, we didn't talk about that much, but that's my takeaway. It's like have joy in your life, work on relationships, love and purpose, and have joyous energy surrounding you because the kids will absorb it, the fetus will absorb it, and everyone will lead a better quality life.

Love it. That's, I mean, a beautiful way to finish and really, really fantastic actionable tips. So really, you know, a big thank you to you for everything. That you mentioned and kind of going through that before we go, can you just tell people a little bit more about where to find you in case they want to? Sure. Well, I'm a practicing OBGYN and board certified as well in integrative medicine. I have a practice in Southern California in Irvine, the integrative medical group of Irvine. And I have a few books out and I have a fertility book out for women trying to get pregnant fast.

And I have Instagram live. So sure, I would love for you to follow me. And if you're interested in being a patient, I see patients every day. I'll see another patient in about 10 minutes. Amazing. Well, thank you so much for being here. Thank you for everything that you do for patients, for families out there and for helping create my patients, I guess. Thank you so much and thanks everyone for listening. We'll see you in the next episode. Thank you for tuning into Dr. Talks. We hope today's episode has enlightened and inspired you on your path to optimal health.

Each day is a new opportunity to make choices that empower your well-being. For more insights and strategies, subscribe to our podcast and visit our website, www.DrTalks.com. Stay connected. Stay healthy and join us next time on Doctor Talks, real talks from real doctors on the issues that matter to you most.