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Preconception Planning
by Tera Schreiber

Some call it the biological clock. When I was ready to have a baby, I was ready now. Suddenly, little spit cloths and baby booties became so charming to me! I saw sweet little baby faces and bulging pregnant bellies everywhere I turned: the grocery store, the dry cleaner, the post office, and all of the other places that before simply meant errands to me. When I didn’t get pregnant immediately, feelings of fear, embarrassment and sadness overwhelmed me. The longer we tried to conceive, the worse I felt.

It’s a lonely journey to motherhood when it doesn’t happen as planned. It felt too personal to discuss with my coworkers or in social settings. I feared that if I told too many people, the pressure of them continually checking in with me on my baby-making status would only make matters worse.

Yet, I am a woman of action. However quiet I was about it, I found ways to explore what I could do to improve my chances of conception. Fortunately, the Seattle area is abundant with resources to help women prepare for conception, address fertility concerns, and complement the fertility treatments that are offered by the talented reproductive endocrinologists who practice here. My efforts were rewarded not once, but twice. I am lucky enough to have two children to exhaust and delight me on a regular basis. While my journey to parenthood was personal to me, some of the resources I discovered are too wonderful not to share.

ACUPUNCTURE is what I credit with helping me conceive both times. I worked with Kristi Stoddard, a licensed acupuncturist and certified Chinese herbalist. According to Stoddard, “Chinese medicine can help bring the body into balance to create a home for a pregnancy.” Because each woman has a different “constitution” according to Chinese medicine, there are different treatments for each person. Some of the treatment modalities include acupuncture, Chinese herbs, diet and stress reduction.

“Traditional Chinese Medicine sees difficulties with fertility as imbalances within the body. Taking the time to address these imbalances prepares the body for not only conception, but a full-term pregnancy,” says Lee Hullender, MS, L.Ac., from Abundant Spring Fertility Acupuncture and Chinese Herbal Medicine in Bellevue.

Acupuncture can be appropriate whether a woman is planning to conceive, is just starting to think about preparing her body for pregnancy, has been trying to conceive and is exploring her options for fertility support and enhancement, or is working with a reproductive endocrinologist. According to Stoddard, about half of her patients are working with reproductive endocrinologists, many of whom refer their patients for acupuncture as a way of supporting fertility treatments. A 2002 study found that 42.5 percent of the patients who received an acupuncture treatment both before and after the transfer in in vitro fertilization got pregnant. In contrast, only 26.3 percent of the control group, those who did not receive acupuncture, became pregnant.

It sounds pretty crazy that poking someone with tiny needles can increase her chances at conception. However, studies show that acupuncture affects the body’s ability to regulate hormones that have a real impact on reproductive health. Acupuncture can also increase blood flow to the uterus, helping to create a thicker and more uniform lining, which aids in implantation. Acupuncture is also used to treat factors that affect male fertility.

One of Stoddard’s clients says that her acupuncture sessions were “brief periods of calm and hope in an otherwise challenging time.” And Stoddard confirms that acupuncture can help reduce stress, which is a great benefit for someone struggling quietly with fertility issues or someone who is just beginning to consider making space in her life for a pregnancy. If you plan to use herbs, Stoddard recommends working with a certified Chinese herbalist. “Chinese herbs are very strong and you will want to work with someone qualified to prescribe them,” she says. In addition, a certification is currently being developed for fertility acupuncturists and should be available in 2007.

While I believe acupuncture played a role in helping me conceive, it would not be fair to forget the other factors that helped along the way.

FERTILITY AWARENESS was an important first step toward my understanding the timing of conception and why I wasn’t getting pregnant as I had planned. A great guide to fertility awareness is Toni Weschler’s book, Taking Charge of Your Fertility. This book contains the information a woman needs to determine when she is able to conceive and how to troubleshoot if she is not conceiving as soon as planned. It also contains charts for tracking fertility signs that may help a woman identify any factors that could be obstacles to conception.

Many women may be surprised to learn that they are fertile only during a very brief window of opportunity during their cycle, and that they can forecast their own fertility window by charting their fertility signs. There is power in having this kind of knowledge.

While I found the book very informative, I needed a little help interpreting what was actually at work in my body.

I contacted my naturopathic doctor, Bonnie Nedrow, ND, LM, who appears with her practice partner, Tracy McDaniel, ND, LM on the Seattle Natural Family Medicine Web site. Dr. McDaniel also offers a class on Fertility Awareness at Great Starts Birth & Family Education in Seattle.

PRECONCEPTION HEALTH is something that I thought I had all figured out before I conceived my first baby. However, I have learned from my naturopathic doctors that they can be very instrumental in helping women achieve optimal health for preconception, and even well before.

“It’s exciting when people come to us for preconception care. Most times, people don’t think about seeing a health care provider until they are pregnant. But when they see us before getting pregnant, we can work with them in ways to improve their health and the health of their baby in ways we cannot if they don’t see us until they are pregnant,” says Nedrow. She likens preconception health to farming. “You can throw seeds out your window, and they may or may not grow,” she explains. “But when you take steps to improve the soil, which is the environment for the growth of a plant, you will get a better crop.” Likewise, if you create optimal health in your own body, you are creating the best environment to grow a baby. Nedrow also includes fathers in her preconception counseling. The father’s health will affect the quality of his contribution to the health of a new baby.

Loren Riccio ND, LM, CPM, from Emerald City Naturopathic Clinic, says: “Every couple should address their overall health and wellness in preparation for pregnancy, even if they are not having fertility issues. This will support a healthy and happy pregnancy and ease the transition through postpartum into parenthood.” Riccio explains, “We can only be as healthy as the environment around us.

Unfortunately, our physical environment has become more and more polluted. On a daily basis we consume and accumulate harmful substances which affect our health. With the trend toward women choosing to have babies later in life, the total accumulation of harmful substances increases.” For this reason, naturopaths generally recommend a detoxification program or metabolic cleanse prior to conception. People should work with a naturopath to provide guidance and support for a metabolic cleanse if they choose this route. Unguided metabolic cleanses can sometimes be too aggressive, causing damage to organs and making a person very sick.

“Ideally, people should slow down to have kids. Preconception preparation brings the family together and helps to prepare them for parenting through preparing them for conception. It validates to the father that his contribution is important, and helps him to embark upon parenting in a more involved way,” says Nedrow.

“The side effects of preconception optimal health,” she explains, “include being really healthy. So, ultimately I would encourage it for everyone.” Yet, realizing that not every couple will be willing or able to take on a four-month preconception plan, naturopaths can work with clients to help them do what they can to improve their health and their chances for conception. In addition to offering preconception health care, Nedrow teaches an “Optimal Health for Preconception” class, which can help people learn more about how they can influence their own health, and increase their chances for conceiving a healthy baby. She explains that often the hormonal issues people try to treat with more hormones are reflective of underlying health issues. Optimal health during preconception can often help women avoid having to move on to more aggressive fertility treatments.

For women who have known fertility issues that are otherwise not addressed through preconception health planning, naturopathic medicine can offer additional support in collaboration with fertility specialists. Naturopathic treatments work to balance excesses and deficiencies in a person’s body. Excesses are generally signs of toxicity and can cause headaches, acne, rashes, aches, pains, fatigue, and elevated cholesterol and blood sugar. Deficiencies are just that – a lack of something that is needed in the body. Signs of deficiencies include infertility, poor memory, fatigue, low libido, and skin problems. A naturopathic doctor can help diagnose and treat excesses and deficiencies through things like herbs, diet, exercise, cleanses, stress-reduction techniques, hydrotherapy, and nutritional supplements.

There are other resources available in our area that can help people prepare for pregnancy, or help complement already existing plans for conception.

THE MIND AND BODY CONNECTION to fertility is something that everyone who is trying to conceive could benefit from understanding. The premise is that struggling with fertility issues has an impact on your mood, and that mood has an impact on your body and health. It becomes a vicious cycle that actually harms your ability to conceive. I felt anxious and sad after just a couple months of trying to conceive without success, and certainly those feelings intensified as the months wore on. Research shows that women going through fertility treatments are as depressed as women who are suffering from life-threatening diseases such as cancer, heart disease and HIV-positive status. Depression in women who are undergoing fertility treatments generally peaks at two years of treatment.

This mind and body connection is explored in counseling and groups. It is also explored in classes, such as the “Mind and Body Fertility Program,” taught by Carol Knoph, M.Ed. at Pacific Northwest Fertility in Seattle and at the Northwest Center for Reproductive Sciences in Kirkland. Research at Beth Israel Deaconess Medical Center in Boston found that participants in a mind and body fertility program had a significant decrease in depression and anxiety after six months.

The same researchers found that those who participated in a 10-week mind and body program had, after one year, an ongoing pregnancy rate (meaning they were beyond the first trimester or had already given birth) of 55 percent, compared to 20 percent of those who did not participate in such a program. Knoph says that the results from her classes are very similar to the Boston study, and that many of her clients remain friends, to meet and lend support to one another beyond the end of class. Recalling the isolation I felt trying to conceive, I can only imagine what a great benefit this type of community must be for women.

YOGA FOR FERTILITY classes and workshops, taught by Lynn Jensen, are designed for women or couples trying to conceive. About half of her students are working with assisted reproduction and the other half are not. Yoga for fertility includes poses that are specific to the different phases of a woman’s monthly cycle and is intended to stimulate and tone the reproductive system, as well as regulate the body’s hormone levels.

In addition, yoga is considered a stress-reducer. We know from the mind and body research that trying to conceive without success for many months can increase stress, which adversely affects fertility. Therefore, finding a way to deal with stress is critical. In a recent Harvard-based study, women participating in a yoga and relaxation program tripled their chances of pregnancy.

RESOLVE of Washington State offers support groups, one-on-one support opportunities, referrals and recommendations, and a network of help in dealing with fertility issues. Research shows that support groups are very valuable for women who are trying to conceive. The mind and body research from Boston found an ongoing pregnancy rate of 54 percent among women who were in fertility support groups.

And the women who participate in the Resolve groups would agree that there is value. One woman who participated in a group said, “I find it hard to believe that it’s been over two years since I joined my Resolve peer support group. I cannot praise those beautiful women enough. I’m not sure that I can even explain it ... I can only say that I was able to leave our meetings feeling clean and whole, free of my infertility, even if for just a short while. I credit them with saving my sanity and my marriage.”

There are certainly days when I look back on my anxiety about trying to conceive, and feel incredibly lucky that I had success. I now have the privilege of changing diapers, wiping up spilled applesauce, and reading fairy tales to my girls, and I can’t think of a happier ending for my story. While I will never forget the agony of waiting for a pregnancy to happen, I do feel that taking charge of the process by exploring the alternatives helped me stay sane, and helped me eventually have my babies.

We are lucky to live in a place with so many great resources for preconception planning and fertility enhancement. The Seattle area boasts many fine reproductive endocrinologists who can help couples hoping to become parents. Just as valuable, though, are the alternative and supportive resources available, which can give couples even more help on their journey.

Tera Schreiber is mother to two delightfully busy children and the Executive Director of Great Starts Birth & Family Education.

©2006 Caliope Publishing Company