Your Top Pregnancy Questions—Answered By Parsley Providers

For people who are trying to conceive, are pregnant, or are newly postpartum, Googling health topics in the middle of the night is standard operating procedure. There are so many questions that come up along this journey. We asked our Instagram followers for their top fertility,motherhood, and pregnancy questions and turned to our Parsley Health experts for their best advice, so you can stop the late night web browsing and get answers you can trust.

Q: Should you get pregnant if you’re not at optimal health? For example, if you are overweight, or have IBS or a thyroid condition, etc., should you work on getting healthier before trying for a baby?

Joanne Pizzino, MD:

There are so many factors that go into the decision to have a child, and only you know what is right for you. However, bringing a healthy baby into the world requires a lot from your body. So it makes sense to ensure you are healthy enough to nurture a fetus and ultimately care for the baby and yourself after birth. Ideally, if you have the time to optimize your health at the cellular level before trying to conceive, you could potentially increase your chances of fertility and enjoying your pregnancy while safeguarding the new life you are creating. Parsley’s holistic medicine gets to the root causes of things like unexplained weight gain, gastrointestinal conditions, hormone dysfunctions, and thyroid and adrenal issues to promote optimal health. Your provider can best advise you on timing, but in general, you’d want to give yourself two to six months of addressing any condition using a holistic approach before attempting to conceive, as even some treatments including herbs and nutraceuticals are not recommended during pregnancy. That said, it’s never too late to work on your own health, even if you are already pregnant. Although some treatments are not advised during pregnancy, Parsley Health providers can help you use lifestyle changes and other natural methods to support your growing baby safely.

Q: Can I reduce my risk of fertility issues or having a miscarriage?

Stephanie Wallman, DO:

Yes! At Parsley, we do a comprehensive evaluation of different lifestyle aspects that affect fertility. This includes:

• Your stress levels: Stress affects your adrenal glands, and redirects resources away from your ovaries to produce stress hormones instead. When your body thinks you’re running away from a lion, it doesn’t think it’s a good time to try to have a baby. In some cases, we even see stress cause women to lose their periods completely. No periods = no babies.
• Your exercise habits: If you are doing too much high-intensity exercise, this can cause too much stress on the body, again affecting your hormones. A good amount of low to moderate-intensity exercise, on the other hand, can improve insulin levels (which is important in women with PCOS), and normalize ovulation, making it easier to get pregnant.
• The toxins you’re exposed to: Many women are consistently exposed to what we call “endocrine disruptors.” These chemicals, which include things like BPA, phthalates, lead, mercury, pesticides, and PFCs, are everywhere in our environment and can affect the timing of your menstrual cycle, including ovulation, making it more difficult to conceive. You can go to ewg.org and enter your commonly used shampoo and conditioner, makeup, lotions, etc. to make sure you are not inadvertently exposing yourself to these toxins. We also recommend switching to a stainless steel or glass water bottle and avoiding plastics, especially during mealtime.
• Your diet: Certain nutrients, like zinc, magnesium, and selenium, are important for hormone regulation and can be easily added to the diet through foods. It’s also good to incorporate cruciferous vegetables like broccoli because when you digest them, a byproduct called DIM is formed that may help balance estrogen levels.

We also do a comprehensive and accurately timed hormone panel. Once we get an understanding of where we are starting from and the timing you have in mind for getting pregnant, we develop a plan.

As for miscarriage risk, we estimate that about 30-40 percent of pregnancies end in miscarriages. (Frequently they are not even noticed because they occur so early in the pregnancy.) Of those miscarriages, about 70 percent of them occur because of a genetic or chromosomal abnormality. We use things like CoQ10 to help produce the healthiest egg for fertilizing. Reducing toxin exposure also helps us to create a healthy mature egg that can be fertilized and reduce the chances of chromosomal abnormalities. But ultimately, while it can be devastating emotionally, a miscarriage is no one’s fault and not necessarily preventable. It is a very natural process and one that we have to trust our bodies with.

Q: What’s the best diet for fertility?

Christina Kang, health coach:

A good diet for getting pregnant looks a lot like a healthy diet in general. Maintaining a whole-foods based, nutrient-dense diet in the months before you try to conceive can impact egg quality. Think about eating the colors of the rainbow through an abundance of vegetables and low-glycemic fruits so you get a wide range of nutrients. Choosing organic if possible can help reduce your exposure to toxins from pesticides as well as GMOs. Include plenty of healthy fats, like coconut oil, ghee, olive oil, avocados, nuts, and seeds. You’ll also want to eat eggs, which are a rich source of choline, a nutrient key in fetal brain development, as well as fat and protein. Include fatty fish, too, like sardines and salmon, that are low in mercury. And organ meats, such as liver from grass-fed sources, contain fat-soluble vitamins as well as CoQ10, iron, zinc, copper, and protein.

As for foods to avoid when pregnant, stay away from trans fats, high-sugar foods, and processed foods in general, which commonly contain inflammatory ingredients and are low in nutrients but calorie-dense. You may also want to avoid gluten, even if you haven’t been diagnosed with celiac disease or don’t have a known gluten intolerance. It’s speculated that many people don’t know that they are gluten intolerant, and research shows that a component of gluten may affect even healthy people. Plus, thyroid dysfunction is very common during pregnancy and postpartum, and gluten is a trigger for autoimmune thyroid disease. If you are confident that gluten doesn’t bother you, opt for organic, gluten-containing products that are sprouted if possible.

Q: I have no energy and have bad nausea—what can I do?

Stephanie Wallman, DO:

If you are in your first trimester, this is a pretty common issue. The first thing I recommend is to listen to your body. Rest when you can and get to bed early. You’re building a human—it takes a lot out of you! That said, exercise is important and you should definitely try to keep up some kind of routine, even if it’s low intensity, like yoga, light weights, or walking. The energy loss that happens during the first trimester is real, but keeping up even a low level of exercise can help give you back some energy rather than take it away.

For nausea, you have a lot of options. First off, try to keep your meal schedule pretty regular, eating every 3-4 hours throughout the day including breakfast, lunch, dinner and 2 snacks between meals as needed. Make sure you’re drinking enough water—at least 2 to 3 liters per day—as dehydration can aggravate nausea. Sucking on ice cubes made from filtered water is effective, as are pregnancy-safe teas such as ginger, peppermint, raspberry leaf, or peach leaf, which promote movement through the GI tract. Chewable ginger tablets can help, as can supplementing with vitamin B6. A Parsley Health doctor can recommend the correct brand and dosing for you. Complementary healing modalities such as acupuncture can also help to reduce nausea during pregnancy.

Q: I don’t have gestational diabetes, but I’m experiencing big swings in energy. How can I better manage blood sugar during pregnancy?

Christina Kang, health coach:

Let’s start with a healthy pregnancy diet. You’ll want to opt for complex carbs, like starchy vegetables, instead of simple ones like crackers and white flour, and avoid sugary and processed foods. When you eat carbohydrates, pair them with protein and fats, which help slow the absorption of glucose into the bloodstream, tempering blood sugar spikes. A balanced meal with carbs includes a quality protein (legumes, nuts/seeds, fish, grass-fed meat, eggs), fat (avocado, olive oil, ghee), lots of veggies, and side of complex carbs (sweet potato, yams, quinoa, oatmeal). Starting your day with a low-glycemic meal, like an egg scramble, is a good idea, as your breakfast can impact the way your body responds to food later in the day. And adding cinnamon to your meals whenever possible can be helpful as research shows that it helps with blood sugar control.

Staying active, prioritizing quality sleep, and managing stress with tools like meditation, deep breathing, therapy, and even laughter can also affect your blood sugar control. Cortisol, a key stress hormone, stimulates gluconeogenesis (glucose production from non-carb sources), reduces insulin sensitivity, and affects other hormones that increase blood glucose such as adrenaline and glucagon. All this leads to an increase in blood sugar. Paying attention to the ingredients in your household, hygiene, and skincare products is also important, as is filtering your water and using a HEPA filter for your air, since toxin load is associated with blood sugar dysregulation.

Q: How can I help readjust my hormones postpartum?

Joanne Pizzino, MD:

After delivery, you experience a drop in estrogen and progesterone and you’ll see changes to your thyroid hormones and cortisol as well. Your body will take care of this adjustment on its own—you just need to avoid getting in the way. Sleep is hard to come by when you have a newborn, but it’s so important to the parasympathetic nervous system, which helps us rest, digest, and repair. Get help with the baby if you can, so you can sleep, and don’t hesitate to take naps when your little one does. Even just taking a short break for yoga or mindfulness can help recharge your system when you’re running on less sleep. Mindfulness and meditation have been shown to have profound effects on the parasympathetic nervous system. Also, most hormones in the body, including reproductive and thyroid hormones, cortisol, and insulin are very sensitive to blood sugar. Working with a health coach to optimize the right proportions of carbohydrates, proteins, and fats at each meal personalized for you to maintain steady blood sugar, can be crucial for managing postpartum hormones.

Thinking about getting pregnant, trying, newly pregnant, or postpartum? Parsley Health helps members from their fertility journey through the fourth trimester using a personalized and holistic approach to medicine. Members have unlimited messaging access to their doctor and health coach, so you never have to Google your pregnancy questions again.