Meet Dr. Amy Luu and Her Passion for Health Before Pregnancy
What if the most important part of pregnancy care actually happens before you're even pregnant?
Most people start thinking about their health after that positive test, but the time leading up to conception—the preconception period—is just as important, and honestly, often overlooked. It’s a powerful window to support long-term health, not just for the parent and baby, but for future generations too.
In this episode, I’m joined by Dr. Amy Luu, a board-certified family medicine physician and obesity medicine specialist. I have the privilege of working with her at Green Mountain Partners for Health, my home clinic in Colorado. Her approach to whole-person care is truly something special. She supports patients of all ages but is especially passionate about helping women through the changes that come before, during, and after pregnancy.
We covered everything from lifestyle shifts and supplements to vaccines, medications, and the role of sleep. Dr. Luu also breaks down epigenetics in a way that shows how today’s choices can impact not just your future child—but your child’s future children.
Whether you’re actively planning a pregnancy or just curious about how to take better care of your body, this episode is packed with insight and encouragement.
Let’s get into it.
Planning for a Baby? Start with Your Health First
When planning to have a baby, it’s really important to start paying attention to your health even before pregnancy begins. This time gives you a great opportunity to take care of yourself and create the healthiest environment for both you and your future child.
Even though most of the attention usually goes to pregnancy and postpartum care, the time before conception matters just as much. It’s when you can make simple but meaningful changes—like improving your habits, checking in with your doctor, and getting your body ready for what’s ahead.
Another component that’s super interesting is epigenetics. It shows that our lifestyle and environment can influence how our genes work. So instead of thinking your genes are just fixed, it’s more about how your choices can affect which ones are active. This can impact your child’s health and possibly even future generations, which is both fascinating and kind of a big deal.
For example, women who enter pregnancy with uncontrolled diabetes or obesity have a higher chance of facing complications like gestational diabetes, preeclampsia, and birth defects. But the encouraging part is that even small improvements like eating better, managing blood sugar, or losing a little weight—can make a real difference for a healthier pregnancy and baby.
In the United States, almost half of all pregnancies are unplanned, which makes it harder to prepare ahead of time. But if you’re planning to conceive, this is your moment to focus on things like balanced nutrition, weight management, and any health conditions that need attention. It really can set the stage for a smoother experience and better outcomes.
Your Weight Isn’t Everything, But It Can Shape the Journey to Parenthood
Maintaining a healthy body weight and composition (ie. how much muscle and type of fat you carry) plays an important role in both fertility and pregnancy. When your weight is higher than what’s ideal for your body, it can raise the risk of several complications like miscarriage, birth defects, preterm delivery, gestational diabetes, and high blood pressure during pregnancy. It can also influence your baby’s birth weight and lead to other challenges.
Finding your healthiest weight is a personal process. Remember, the lowest weight on the scale is not always your healthiest weight, so it’s best to work with your healthcare provider to figure out what’s right for you based on your unique health situation. But the good news is that even a small amount of weight loss can make a real difference. For instance, losing just 10 percent of your body weight has been shown to lower the risk of preeclampsia, gestational diabetes, preterm birth, and stillbirth. Losing a bit more around 20-30% has been linked to lower chances of needing a C-section and complications like shoulder dystocia, when the baby’s shoulder gets stuck during delivery.
And while these examples focus on pregnancy, it’s also worth noting how weight can affect your ability to get pregnant. Obesity can interfere with fertility, but that doesn’t mean weight loss should be your only focus. If you’re having trouble conceiving, it’s important to get a full evaluation from a fertility specialist. There might be other factors involved, and putting everything on weight alone can delay helpful treatment or even cause more harm than good.
The main takeaway is that improving your weight and overall health can lower risks, but fertility is complex and affected by many things beyond just the number on the scale. You don’t need to chase a perfect BMI or ideal weight to move in a healthier direction. Even a 10% change can lead to better outcomes, and setting overly strict goals can sometimes do more harm than good.
Your care plan should be based on what your body truly needs, with a focus on creating a strong, nourishing foundation for both conception and pregnancy. Extreme dieting or recent weight loss surgeries might not be the best path when trying to conceive, since your body needs to feel safe and supported to welcome a new life.
What to Consider About Weight Meds Before and During Pregnancy
Trying to get pregnant while also using or thinking about using anti-obesity medications definitely brings up some important considerations. These medications have really changed the way we think about weight; it's not about “eat less, move more;” it’s about addressing metabolic processes and hormones that impact weight. For a lot of people, they’ve been a total game-changer in finally making progress toward their health goals.
But here’s the thing: using these meds during pregnancy is kind of a gray area. Most of them haven’t been studied enough in pregnant individuals, and some are linked to birth defects. That’s why if you’re on these medications and planning to conceive, it’s super important to have a real conversation with your doctor. You’ll want to figure out the safest time to stop taking them before pregnancy, and also when or if it makes sense to go back on them afterward.
It’s also a good reminder that medication is just one piece of the puzzle. What you eat, how you move, how well you sleep, and how you’re feeling mentally all matter too. Even if you pause the meds during pregnancy, sticking with healthy habits is still really important.
And don’t skip those check-ins with your doctor. Ongoing support during pregnancy helps you manage weight gain in a way that’s healthy and safe. Say you lost 10% of your weight before getting pregnant– that's amazing! But remember that gaining weight during pregnancy is normal and expected. The goal is just to keep it in a range that lowers risks for both you and the baby.
From Prep to Pregnancy: Navigating the Unexpected with Care
What does optimizing health before pregnancy actually look like in real life? Take one of our patients, for example. She had a history of bariatric surgery and was managing her weight with medication. By the time she conceived, she had already spent a good amount of time working with our team to build a strong, healthy foundation. That kind of proactive approach whether it’s through medication, surgery, or both can make such a difference in setting someone up for a healthier pregnancy.
She had great habits in place when she got pregnant, so we safely paused her medication at that point. But pregnancy doesn’t always go as planned. During her first and second trimesters, she dealt with really intense nausea and vomiting. It was the kind of morning sickness that completely threw off her ability to stick to her usual nutrition and movement routines. All those pre-pregnancy goals suddenly felt totally out of reach.
That’s where ongoing, personalized care became so important. Instead of trying to force her to stay on track with the original plan, we adapted. We checked in regularly, adjusted things based on how she was feeling, and just took it one day at a time. Some days were harder than others, and that flexibility helped her focus on what was actually possible in the moment.
Without that consistent support, it would’ve been incredibly tough for her to manage. She told us more than once how grateful she was because trying to figure out nutrition and health on her own while feeling that sickness would have been overwhelming. Thankfully, she’s now in her third trimester and doing so much better.
This whole experience is such a good reminder that even with the best prep, pregnancy can still be unpredictable. And that’s exactly why having a team that can adjust with you day by day matters so much.
Before the Bump: How Both Partners Can Prep for Pregnancy
When someone says, "I want to get pregnant," or "My partner and I are planning to have a baby soon," many wonder what steps they should take and what a preconception visit looks like. The good news is that it’s never too early to start thinking about your health before pregnancy. The healthier you are prior to conception, the better the chances for a healthy pregnancy and baby.
A key point is that preconception care is not only for the person who will carry the pregnancy but also for their partner. Both egg and sperm contribute DNA to create a baby, so optimizing health and lifestyle for both partners is important.
During a preconception appointment, the healthcare provider will typically review medical histories for both partners. This includes any chronic conditions like diabetes, high blood pressure, thyroid disease, asthma, or mental health concerns. Managing these conditions early helps create the healthiest environment for fertility and pregnancy.
Another important topic is genetic screening. Tests can identify risks for inherited conditions such as cystic fibrosis, sickle cell disease, or Fragile X syndrome. Knowing this information beforehand empowers couples to make informed decisions and prepare accordingly.
Lifestyle factors are also addressed, including substance use like alcohol, smoking, vaping, recreational drugs, and even caffeine. These can affect fertility by impacting egg and sperm quality and influence the environment needed for a healthy pregnancy. For caffeine, recommendations suggest limiting intake to less than 200 milligrams per day, roughly one to two cups of coffee.
Protecting Baby Starts with Protection for You
Vaccines are a really important part of staying healthy during pregnancy for both the parent and the baby. Some of the key ones to have up to date are Tdap, MMR, Hepatitis B, varicella, the flu shot, and COVID-19.
This matters even more because the immune system naturally slows down a bit during pregnancy. That’s actually on purpose the body does this to avoid rejecting the baby, since the baby carries DNA from another person. But while that helps keep the pregnancy safe, it also means the body isn’t as strong at fighting off infections.
That’s why vaccines are such a big deal during this time. They help protect the pregnant person and the baby from serious illnesses. And it’s not just about the pregnant person, partners and close family members should be up to date on their vaccines too. That way, you’re creating a little protective bubble around the baby.
One vaccine to really plan ahead for is the MMR. Unlike Tdap, flu, and COVID-19 vaccines which are safe to get during pregnancy MMR has to be given before pregnancy. It contains a live virus, so it’s not safe once you're already pregnant. If someone hasn’t had the MMR vaccine and finds out they’re pregnant, they’ll need to wait until after delivery to get it. That’s why it’s extra important for everyone around them to be vaccinated too to help reduce the risk of exposure.
What to Eat (and Take) Before You’re Pregnant
During a preconception visit, nutrition and supplementation are essential topics to cover. While individual dietary preferences and needs vary, a whole-food, unprocessed, plant-forward diet is generally the best choice. This kind of diet helps reduce inflammation and promotes overall health for both parent and baby.
However, it’s challenging to get all the necessary vitamins and minerals from diet alone. That’s why starting a prenatal vitamin at least three months before pregnancy is highly recommended. Many people know to take prenatal vitamins during pregnancy, but beginning earlier ensures your body has adequate stores of crucial nutrients needed for early fetal development. Some vital organs begin forming very early in pregnancy, often before many people realize they are pregnant.
For special populations, such as those who have had bariatric surgery, supplementation is even more critical. These individuals are at higher risk of vitamin and mineral deficiencies due to altered nutrient absorption and should maintain lifelong multivitamin use, especially if planning pregnancy.
At a minimum, prenatal vitamins should contain folic acid, which supports brain and spine development during the first month of pregnancy. Vitamin D is also important, as it supports fertility by helping maintain the uterine lining and contributes to healthy bone development and live birth rates. Other key nutrients to look for include calcium, iron, vitamin A, vitamin B12, vitamin C, omega-3 fatty acids, and choline. While formulations vary, a product labeled “prenatal” generally contains the necessary nutrients, especially the recommended extra folic acid.
Physical activity is another crucial component of preconception health. The general recommendation is 150 minutes per week of moderate cardiovascular exercise, plus one to two days of resistance training to strengthen muscles and bones. This level of activity supports overall health, and prepares the body for pregnancy and even delivery.
It’s important to emphasize that exercise doesn’t need to be intense or exhausting. Overly vigorous workouts can stress the body, triggering a fight-or-flight response that may hinder conception. Instead, consistent, moderate movement that allows for recovery is the best approach. The goal is to create a safe, supportive environment for your body to conceive and carry a healthy pregnancy.
If you have questions about the best prenatal vitamin or exercise routine for you, discussing them with your healthcare provider can provide personalized guidance tailored to your needs.
Additional Important Topics in a Preconception Appointment: Sleep and Recovery
Sleep is one of those things that’s easy to overlook, especially when life gets busy, but it’s actually a big deal when you’re thinking about getting pregnant. Good sleep quality helps reduce inflammation, balance hormones, and support recovery. All of that really matters when your body’s getting ready to support a pregnancy. For most people, aiming for seven to eight hours of quality sleep each night helps keep everything running smoothly, both physically and mentally.
In addition to an energy boost, solid sleep also helps regulate your cycle and supports hormone health, both of which are super important for fertility. Basically, good sleep now puts your body in a stronger place to conceive and handle the changes ahead more smoothly.
Once you are pregnant, you’ll likely need even more rest. A lot of people feel extra tired in the first trimester, and it’s not always something you can just power through. If your current routine doesn’t allow much room for rest, now’s a great time to work on small, consistent changes to help support a healthy sleep environment and prepare you for trimesters to come.
So don’t wait until you’re completely wiped out to make sleep a priority. Start building those habits early so you’re already giving your body what it needs for a healthier, less stressful pregnancy.
Taking care of your health before pregnancy isn’t just a nice-to-have, it's a powerful way to support your future baby, your own wellbeing, and even generations to come.
From nutrition, sleep, and supplements to weight, medications, and vaccines, there’s so much you can do during the preconception period to set yourself up for a smoother, healthier pregnancy.
Whether you’re actively planning or just starting to think about it, this stage is about tuning in, asking questions, and building habits that make your body feel safe, supported, and ready. And the best part? You don’t have to figure it all out alone. With the right care team, it’s absolutely possible to navigate the ups and downs with flexibility, confidence, and compassion.
Thanks for reading, and seriously, your health before pregnancy really does matter.
Curious to hear more?
Check out the full episode with Dr. Amy Luu. We talk through all the things — supplements, sleep, weight, medications, and more. It's a good one and definitely worth a listen if you're thinking about pregnancy or just want to feel more in tune with your health.
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