Julia Getzelman, MD   GetzWell Pediatrics www.getzwell.com

Julia Getzelman, MD   GetzWell Pediatrics www.getzwell.com

Preconception care (PCC) aims to help women make informed and proactive choices to
optimize their health and the health of their future children. But what does that really
mean? Well, what if someone told you that you could have a positive impact on your
unborn child’s lifetime health by some of the choices you make even before you get
pregnant. And, since most women don’t know exactly when they will conceive (>50% of
pregnancies are unplanned and by the time medical care is sought, the fetus has
undergone a great deal of significant primary development (1)), we urge women to
begin thinking with a preconception mindset as early as they start to think about
becoming pregnant.

The idea of preconception care is in its early stages and the field of epigenetics (or the
fetal origins of adult disease) which has informed its development, is just beginning to
be translated into information and recommendations for the average woman.
It’s only the last decade that the science of epigenetics has opened our eyes to the
potential of the 40 weeks of gestation to impact the entire lifespans of our
children. Without a doubt, the 9 months we spend in our mothers’ wombs shapes our
susceptibility to disease, the functioning of our major organs, and may even influence
our temperament and intelligence (2).

Preparing your body and mind for pregnancy is critical to giving your future baby a leg
up to a healthy life.

Why is Preconception Care Important?

Despite all of the medical advancements, research, and cutting-edge science in this
country the incidence of chronic illness is rising every year, even amongst our youngest.
More than 25% of kids in the US have a chronic health issue, and this number has
doubled in just the last 2 decades (3). In that short time we’ve seen an alarming increase
in asthma, diabetes, obesity, autism, cancer, and a host of other health conditions that
were once rare in children. This is the first generation of children that are not expected
to outlive their parents. How is this possible given that our genes haven’t changed in
that short time?

The typical medical explanation for this trend targets our genetic susceptibilities,
lifestyle choices, and environmental exposures after we’re born. But the
aforementioned science of epigenetics provides compelling evidence that modifiable
factors during pregnancy significantly contribute to this pediatric health crisis.
Get Ready for Pregnancy by “Greening Your Womb”

Preconception care means comprehensively preparing your body to provide the
healthiest possible environment for your developing baby. At GetzWell, where we
believe pediatric care should begin before your baby is born, we have named this
process “greening the womb.”

Greening the womb uses a Functional Medicine lens that entails a thorough exploration
of ALL of the many factors that can shape the physical, mental, and even emotional
well-being of your developing baby.

It takes a look at every aspect of you – intestinal health, genetic predispositions,
nutritional needs, toxic exposures in both your home and workplace, sources of stress,
prenatal/perinatal psychology, family health history, exercise, etc.

With the use of cutting-edge testing technologies and a comprehensive health history,
we make nutrition and lifestyle recommendations that are customized to your unique
biology. To put it simply, we help prepare you for a healthy pregnancy AND a healthy
baby by getting the nutrients that are right for you and by doing the most to limit your
exposure to and helping to off-load harmful environmental toxins.

Here are some general womb-greening tips to get you started:

1. Get some vitamin D3. Maternal vitamin D has the potential to regulate over
2,700 different fetal genes involving multiple organ systems and deficiency has
increased markedly in the last 2 decades (4). Low vitamin D levels during
pregnancy have been associated with intrauterine growth retardation,
premature labor, and hypertension (5). Vitamin D deficiency also increases the
incidence of C-sections (6). Ideal vitamin D levels are in the 40-60 ng/dL range.

2. Boost your biome with fermented foods and probiotics. The “bugs of life” that
live in our mouths, intestinal tracts, vaginas, and on our skin protect us and
fortify our digestive and immune health. These bacteria will literally educate
your child’s immune system in the first 3 years of life and will help to prevent
allergies, asthma, constipation, and a whole host of other ills (7). The healthier
your own biome is, the more robust your baby’s gut and immune system will be.

3. Increase omega-3 fatty acids to improve your developing baby’s developing
brain and visual system. These fats also keep your immune system and that of
your developing baby functioning optimally. 

4. Get plenty of choline since it’s a very common deficiency – only 7% of American
women consume the recommended daily amount (8). Choline is critical for brain
development and helps set neural pathways for lifelong learning, memory, and
stress resilience. More choline means less stress reactivity for your child – which is so important (9). Sources include eggs (particularly the yolk and about 4 a day
would be necessary), meat, nuts, cruciferous vegetables, and legumes.

5. Drink filtered water to decrease exposure to heavy metals, pesticides,
pharmaceuticals, plastics, and other common contaminants. We recommend a
Berkey water filter or a multi-stage under-sink mounted carbon filter system.

6. Use green cleaning products that do not contain bleach, petroleum products,
phosphates, phthalates, dyes, fragrance, and other harmful chemicals. The
Environmental Working Group (EWG) has a comprehensive database to guide
your purchases, but we think mild soap and water work just fine.

7. Eat as much organic foods as possible to avoid exposure to pesticides,
antibiotics, and hormones (used to grow animal and plant foods), and bisphenol-
A (from canned foods) – all of which are known to potentially disrupt your baby’s
developing endocrine and immune systems.

8. Supplement smartly. Many of the vitamins and nutrients mentioned here are
available in a safe supplement form. BUT the key is finding the right supplement
and dose for your body and circumstance. Central to the womb-greening
approach is creating a custom plan with vitamins that have been independently
tested for quality and contamination.

Preconception care = lifelong health from the get-go.

If you are on the path to pregnancy, getting your body in tiptop shape is the best way to
ensure that your child greets the world with healthful resilience. And with the right kind
of preconception care tailored to your unique needs, you can greatly improve your
child’s chances of optimal health – for a lifetime.

If you care to learn more about our greening the womb process, please visit our website
or call our offices. We’d be thrilled to hear from you, as we love knowing we’re helping
to support a healthy next generation of kids.
1. National Health Statistics Reports. 2012; 55.
2. Paul, Annie Murphy. “Time” 4 October 2010: 50-55.
3. JAMA 2010; 303: 623-630. Prev Chron Dis 2015; 12: 140397.
4. Ramagopalan S. V., Heger A., Berlanga A. J., et al. A ChIP-seq defined genome-
wide map of vitamin D receptor binding: associations with disease and evolution.
Genome Research. 2010; 20(10): 1352–1360.
5. Early Human Dev. 2009 Apr; 85(4): 231-4; Epidemiology. 2009 Sep; 20(5): 720-6;
J Clin Endocrinol Metab. 2008 Dec 23.

6. J Clin Endocrinol Metab. 2008 Dec 23; J Clin Endocrinol Metab. 2009 Mar; 94 (3):
7. Microbiome. 2014; 2: 38.
8. Clinical Pediatrics. 2006; 45(5): 405-410; Journal of Nutrition. 2005; 51: 1487-
9. Nutr Rev. 2009 Nov; 67(11): 615–623.