Midwife-Led Preconception Care: A Holistic Approach to Fertility Health

November 26, 2025•5 min read

Most women are taught how to prevent pregnancy, not how to prepare for it. That gap leaves many entering preconception confused and unsupported.

From years of birth control masking irregular cycles, to conditions like PCOS or endometriosis that go undiagnosed, to everyday stressors that quietly disrupt hormones, these hidden factors shape fertility health long before conception.

This week at Health University, we’re joined by Abigail Prushansky, certified nurse midwife and functional medicine nurse practitioner, to explore how midwife-led preconception care helps close that gap and build a stronger foundation for fertility. Midwife-led preconception care isn’t about quick fixes; it’s about understanding your body and preparing for pregnancy with knowledge and support.

Why Preconception Care Matters

Too often, attention to reproductive health begins when a person or couple decides it’s “go time” to have a baby. But waiting until conception can mean missing the chance to prepare the body and mind for a healthy embryo, baby and family.

Preconception care is the season to nourish physically, to reduce stress, and to recognize the emotional weight of fertility struggles or loss. With this groundwork, fertility becomes easier to navigate, pregnancies are healthier, and the process feels less overwhelming.

Midwife’s Role in Preconception Health

The holistic care approach offered by midwives, as well as board-certified fertility acupuncturists and other specialists, views preconception differently. Instead of focusing solely on whether pregnancy occurs, the care is whole-person and patient-centered — looking at health history, lifestyle, emotional well-being, and long-term goals. It’s not a checklist; it’s a partnership.

Fertility literacy is a cornerstone. Many people were taught only how to avoid pregnancy and are completely uneducated on the monthly rhythms of their own bodies . Holistic providers, including preconception midwives, can fill that gap. This is how kowledge becomes empowerment.

And unlike the conventional “get pregnant, stay pregnant” model, midwife-led care doesn’t stop at conception. It spans the entire continuum — before pregnancy, throughout it, into postpartum, and beyond. The goal isn’t just a successful pregnancy, but lifelong reproductive health.

Key Fertility Factors Before Conception

Fertility is influenced long before conception. Considerations such as age, the health of eggs, and other health conditions such as auto-immune disorders can go unseen. Yet these factors can either support or complicate the journey to pregnancy. Understanding them early allows you to act with foresight rather than in reaction.

Age & Fertility Planning: While motherhood in later years is more common, our reproductive lifespan remains as it always easy. This means that fertility declines with age. As follicle counts drop, the chances of natural conception decrease, and options become limited. Freezing eggs or embryos between ages 28-34 can help assure opportunities for future pregnancies.
Egg Quality vs. Egg Quantity: Egg quantity is fixed at birth, but quality is affected by time, lifestyle, stress, and overall health. While there is a correlation between egg quantity and quality, it’s not a fixed equation, and much can be done to improve your whole health and your fertility.
Hidden Diagnoses & Contraception: Menstrual conditions such as PCOS and endometriosis often remain undiagnosed for years, as hormonal birth control is often prescribed to young women to help alleviate symptoms. Yet this allows for years, sometimes decades, to progress without interventions that can rebalance hormonal health.

Preparation before conception doesn’t have to be complicated. The following checklist outlines simple practices to implement before attempting to conceive.

Track Cycles & Symptoms: Charting your cycle and noting symptoms can highlight irregularities or unusual changes that point to patterns which can lead to an infertility diagnosis.
Keep Food & Lifestyle Journals: Taking notes of your nutrition and lifestyle habits can uncover connections and reveal how your body is either supporting or straining fertility. These journals make it easier to see where change may be needed.
Gather Medical History & Labs: Getting a baseline as early as age 28 can identify potential future fertility challenges..
Clarify Your Fertility Timeline: Knowing when you want to get pregnant and how many children you’d like to have informs your decisions now.

Holistic Midwife-Led Care

Full Circle Premium Health, founded by Abigail Prushansky, CNM, FNP-BC, in Torrance, California, offers compassionate, continuous care for women from their first menstrual cycle through menopause. Their approach focuses on nurturing physical, emotional, and relational well-being, creating a foundation for long-term reproductive health.

Full Circle Premium Health’s Approach to Preconception Care

At Full Circle Premium Health, preconception care takes a whole-person approach, addressing physical, emotional, and relational health. The following areas are the focus of care:

Comprehensive Health Review: A one-hour deep dive, including labs and partner health history to understand the full picture of reproductive wellness.
Cycle and Fertility Literacy: Guidance on tracking cycles and understanding ovulation versus withdrawal bleeds, empowering women to know their bodies better.
Lifestyle & Environmental Wellness: Practical support for nutrition, exercise, and reducing environmental exposures that affect long-term fertility health.
Emotional & Relational Care: Validating reproductive grief, involving partners in the process, and offering therapy referrals when needed.

Check out all of our episodes on the following platforms:

https://susanfox1.easywebinar.live/gentle-detox

Know the status of your fertility health. Take our FREE Fertility Quiz now: http://yourfertilityquiz.com/

Fulfill your dream of a family. Know your best options for a healthy pregnancy: https://www.healthyouniversity.co/programs

Boost Employee Productivity by Investing in their Fertility Health. Check out our Corporate Wellness program and know the benefits it can bring to your company: https://www.healthyouniversity.co/corporate-wellness

Abigail Prushensky is a women’s health provider and midwife with extensive experience supporting women through fertility, pregnancy, and hormonal transitions. As a mother and founder of Full Circle Premium Health, she empowers patients with compassionate, whole-person care, education, and guidance for every stage of reproductive life.

Website: www.fullcirclepremiumhealth.com

Email: [email protected]

Instagram: @askabigailnpcnm

Medical Disclaimer:

By listening to the Health Youniversity podcast, you agree not to use this podcast as medical advice to treat any medical condition for yourself or others. Consult your healthcare provider for any medical issues you may have. This entire disclaimer also pertains to any guests or contributors to any Health Youniversity podcast.

Dr. Susan Fox

I am a women’s health expert with a specialty in working with women and couples navigating fertility challenges for more than 20 years. I look forward to helping you realize your dream of family. I’m also a mother, a sister, a friend. I live in beautiful Northern California, where the nature of Mt. Tamalpais, the Pacific Ocean and San Francisco Bay are my backyard. Traditional Chinese Medicine discovered me in 1978, when I was struggling with digestive complaints that flummoxed medical doctors. It wasn’t until I received my first acupuncture treatment and herbal prescription that I connected my medical condition to grief over loss of a loved one; that the stress of holding in such huge emotions was literally tying me up in knots, and I was finally able to heal. Discovering the powerful links between the physical, the mental, the emotional, the spiritual, and the environmental shifted my understanding of health and wellness forever. For more than 20 years, I’ve had the privilege of learning and implementing Whole Systems Traditional Chinese Medicine to understand the root causes of health conditions and realize optimal health and well-being. I am a strong believer in the importance of health education, for knowledge is power when you have the tools for effective self care.

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