Preparing for pregnancy starts BEFORE the baby: what the research says (Part 1 of 3)
A QUESTION WORTH ASKING EARLIER
When I was pregnant with my first son, 26 years ago, the first thing my midwife said was: stop highlighting your hair. That advice was pure caution: the NHS now says most research shows hair dye is safe in pregnancy. But someone thought about it, and someone told me.
This week, Tanyka Davson, co-founder of Cubbi, published a brilliant blog on pregnancy-safe skincare: what to avoid and what to use instead. It's practical, clear advice, and it sparked the idea for this series, so thank you, Tanyka. It got me thinking about preparing for pregnancy in the months before. That's when parents-to-be are creating the environment a baby will begin in, and it's when they get the least guidance. A good friend of mine says we must assume nothing and validate everything. So I did my research, and this is what I found.
THE BIGGER PICTURE
Around 1 in 7 couples in the UK have difficulty conceiving. The number of people having IVF has almost tripled in 30 years, and more than 3% of UK babies are now born through IVF. Birth rates in England and Wales hit a record low in 2025, mostly because people are choosing to have children later and fewer of them. But not only for that reason.
And this is not just a women's issue. A major 2022 review of 57,000 men across 53 countries found average sperm counts fell by more than half between 1973 and 2018, and the decline is speeding up. In the UK, a problem on the man's side is the main cause in around 30% of cases, and in around 40% both partners are affected. Preparing for a baby is a shared responsibility.
WHAT GOES INTO YOUR BODY
For a long time, the conversation about preparing for a baby has been about food and folic acid, and rightly so. But there are newer things that young women and men are putting into their bodies, from weight-loss jabs to injectables, that I don't think enough people are talking about. In some cases there is clear guidance, and it needs to be shared far more often. In others, we simply don't know the impact yet, and that needs more study. I want to shine a spotlight on both.
Food. Whatever you eat becomes the building blocks for your baby, and for the egg and sperm before that. The NHS recommends women take 400 micrograms of folic acid a day from before conception until 12 weeks of pregnancy. Many only start once they find out they're pregnant. A varied diet built on fresh food matters for both partners.
Weight-loss jabs and tablets. Clear guidance exists. In June 2025 the MHRA, the UK's medicines regulator, advised against Mounjaro, Wegovy or Ozempic while pregnant, trying to conceive or breastfeeding. Stop Mounjaro at least one month, and Wegovy or Ozempic at least two months, before trying for a baby. Mounjaro can also make the contraceptive pill less reliable, so the MHRA advises adding a non-oral method, such as condoms or a coil, for four weeks after starting or increasing the dose. With weight-loss tablets now approved in the UK, more people need to hear this.
Botox. More reassuring than I expected. At cosmetic doses Botox stays almost entirely where it's injected and does not appear to cross the placenta. Nearly 30 years of reports from its maker show birth defect rates in line with the general population, though the key figures come from just 152 live births. The NHS still advises avoiding it in pregnancy and breastfeeding, because it hasn't been properly studied.
Fillers: we simply don't know. Most fillers are designed to break down over 6 to 18 months, but MRI studies have found filler still in place years later, in one case 15 years after injection, and researchers say the breakdown products need more study. Some fillers are permanent. There is no recommended gap between your last filler and trying for a baby. Weight-loss medicines have a stop-before-conception window. Fillers have nothing. The answer can be worked out, without involving a single pregnant woman. It just hasn't been yet.
WHAT YOU CAN DO TODAY: LESS PLASTIC
Here is the good news. Chemicals in everyday plastics, such as BPA and phthalates, leave the body quickly, usually within hours to days. So cutting your exposure works fast. In one US study, families who switched to fresh food without plastic packaging for just three days saw BPA levels fall by around two thirds. In another, teenage girls who swapped their make-up and toiletries saw phthalate and paraben levels drop by up to almost half in three days.
Why it matters: large studies of couples having IVF have linked higher phthalate levels with poorer fertility outcomes, in women and in men. That doesn't prove a plastic detox will help you conceive. But it's a low-cost, low-risk change you can make together. The Royal College of Obstetricians and Gynaecologists has suggested mothers-to-be choose fresh food over cans and plastic packaging. Simple swaps: fresh over packaged, glass or steel over plastic, never heating food in plastic, and checking toiletry labels.
WHAT I'D LOVE TO SEE NEXT
I'm not a clinician, and this isn't medical advice. But the path seems clear. First, research into how long fillers, and what they break down into, stay in the body. Second, clear advice for both parents-to-be: one trusted place to find out what to stop, when, and what to start, from injectables to food and plastics. Third, the right question at every consultation: consent forms ask "Are you pregnant or breastfeeding?" They should also ask "Are you planning a pregnancy?" And fourth, accountability, once that guidance exists. England is preparing a licensing scheme for Botox and fillers, and that's where it belongs.
What this means for you: if you make anything designed to help people prepare for pregnancy, from fertility and preconception supplements to food, drinks and skincare, make it as natural as you can, avoid unnecessary chemicals, and keep plastic out of the product and its packaging wherever possible. Your customers are trying to create the healthiest possible start, and your product should help them do it. And even if your products are for after the baby arrives, remember that many parents start researching long before they conceive. The trust you build with them starts here.
And if you prescribe weight-loss medicines, or offer Botox and fillers, you are in the best position of all to help. For weight-loss jabs and tablets, the MHRA guidance already exists, so make sure every patient hears it. For Botox and fillers there are no rules yet, but asking one simple question, "Are you planning a pregnancy?", and talking through what we do and don't know, is simply good practice. It costs nothing, and it helps someone make an informed choice.
And if you're hoping to conceive soon, don't just take my word for any of this. Do your own research, find out what the current advice is from trusted sources such as the NHS, the MHRA, your GP, pharmacist or midwife, and make the decision that's right for you, with all the facts in front of you.
So I'll put the question to you, and to every clinician, midwife and practitioner reading this: should the people who give these injections be regulated, and held accountable, for making sure young women understand what we still don't know?
I'd love to hear from you, especially if you're qualified to answer some of my questions. Any information that sheds light, and facts, on this topic matters. If we have that knowledge, we all share a responsibility to help young people make informed decisions. Over the next few weeks I'll be exploring this in more detail: Part 2 looks at what goes on your body during pregnancy, from skincare to the clothes you wear, and Part 3 at life after the birth, from breastfeeding to the products that touch your newborn. Every child deserves the cleanest, healthiest start we can give them, and that start begins before they are even conceived.
FREQUENTLY ASKED QUESTIONS
How long before trying for a baby should I stop Mounjaro or Wegovy?
The MHRA advises at least one month for Mounjaro and two months for Wegovy or Ozempic, using effective contraception throughout. Check with your prescriber.
Is it safe to have Botox or fillers while preparing for pregnancy?
There's no official UK guidance on how long to wait. Very little Botox appears to enter the bloodstream at cosmetic doses, while fillers can last for years. The NHS advises avoiding both in pregnancy and breastfeeding. Speak to your GP or midwife.
Does reducing plastic help fertility?
Cutting plastic lowers BPA and phthalate levels within days, and higher levels have been linked with poorer fertility in both women and men. It isn't proven to improve fertility, but it's a simple, low-risk step for both partners.
If you're a brand that supports parents-to-be and want to talk about how you guide them through this, or you're a clinician who'd like to add your voice to the series, just get in touch with The Nest.
The Nest News lands every Tuesday: three insights shaping maternity, baby and children's products, and the actions you can take. Sign up at https://www.thenest.uk.com/the-nest-news-signup
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