Before you’re pregnant: seven things worth doing now

01

Take a prenatal that actually works

The standard advice is “start a prenatal.” Most prenatals use folic acid — a synthetic form that up to 40% of women with the MTHFR gene variant can’t efficiently convert into usable folate. The stakes here are real: folate is critical for neural tube development in the first weeks of pregnancy, often before a woman knows she’s pregnant.

Look for methylfolate on the label — listed as 5-MTHF or L-methylfolate. Also check for choline (200mg or more), which most prenatals omit entirely despite being essential for fetal brain development. Adding two eggs a day to your diet is one of the most impactful dietary adjustments you can make. Start at least three months before trying.

Worth looking at: Thorne Basic Prenatal · Needed Prenatal Multi · Nordic Naturals Prenatal DHA

02

Get the one blood test your doctor probably won’t order

Standard pre-pregnancy bloodwork checks haemoglobin. What it misses is ferritin — your stored iron reserve. Functional practitioners want ferritin above 50 ng/mL before pregnancy; many women arrive at their first prenatal appointment severely depleted, and building stores takes months. Six months of runway is not too much.

Vitamin D is the other one. It takes three to four months of consistent supplementation to meaningfully shift levels — which is precisely why checking it now, rather than at your first prenatal visit, changes what you can actually do about it.

03

Filter your water

Tap water in most parts of the US contains PFAS (“forever chemicals”), lead, chlorine byproducts, and trace pharmaceutical residue. None of these appear on the label of your glass. Endocrine disruptors are a particular concern during preconception, when hormonal signalling is doing the most consequential work of its life.

Look for filters carrying NSF/ANSI certification — specifically Standards 42, 53, and 58. A pitcher or countertop reverse osmosis system is sufficient for most households. You don’t need to overhaul your home. You need to address what you drink every day.

Worth looking at: Clearly Filtered Pitcher · AquaTru Countertop RO

04

Swap your three highest-exposure products

Phthalates, parabens, synthetic fragrance, and oxybenzone are endocrine disruptors with relatively short half-lives in the body. The good news: they clear quickly when exposure stops. The practical implication is that swapping your highest-exposure products three to six months before trying makes a meaningful difference.

Start with three: your deodorant, your daily moisturiser, and anything fragranced you apply to your skin every day. Use the EWG Skin Deep database to look up what’s actually in your current products — it takes ten minutes and is rarely reassuring.

If you wouldn’t put it on a newborn, reconsider putting it on yourself right now.

Worth looking at: Primally Pure · Branch Basics · ILIA · Crunchi

05

Switch to 100% cotton underwear

The vaginal microbiome — specifically its Lactobacillus-dominant ecology — is increasingly linked to fertility outcomes, implantation success, and reduced preterm risk. Synthetic fabrics trap heat and moisture, creating an environment that disrupts that balance. There is also a growing concern about PFAS in high-performance athletic fabrics that contact the skin daily.

100% organic cotton as your everyday default is a low-effort, low-cost change with a plausible mechanism behind it. Avoid fragranced soaps near the vaginal area. And if you’ve taken antibiotics recently, a Lactobacillus rhamnosus and reuteri probiotic can help restore what was disrupted.

Worth looking at: Pact Organic · Subset · Jarrow Fem-Dophilus (probiotic)

06

Actually learn your cycle

Most women know their cycle length. Far fewer know their luteal phase length (the time between ovulation and menstruation, ideally 12 to 14 days), whether ovulation is actually occurring, or how consistent their cycle truly is month to month. These details matter — a short luteal phase can affect implantation; anovulatory cycles don’t produce pregnancies.

Basal body temperature (BBT) tracking with an app like Kindara or Read Your Body will surface this data over two to three cycles. An Oura Ring provides more precision with less manual effort. Neither tells you everything — but both tell you far more than a period tracking app built around average assumptions.

07

Give yourself a runway off hormonal birth control

The conventional guidance is “stop the pill and start trying.” The reality is more nuanced. For many women — especially those who have been on hormonal contraception for several years — cycles take time to regularise, and the nutrient depletions that can accompany long-term pill use (B vitamins, zinc, magnesium) take meaningful time to correct.

A reasonable minimum: three months post-pill before actively trying. If your cycles were irregular before you went on hormonal contraception, give yourself six months. Use that window to track your cycle (see section 06), rebuild your nutrient stores, and get a clear baseline on your hormones. The runway is the point.