Preconception Nutrition: What to Know Before Pregnancy
If you're planning a pregnancy, you've probably already discovered just how much information is out there.
Take a prenatal. Choose methylfolate. Avoid folic acid. Eat more protein. Cut out certain foods. Take a handful of fertility supplements. Start three months before pregnancy. Start a year before pregnancy.
It can become overwhelming very quickly.
As a clinical nutritionist working in women's health, I prefer to bring preconception nutrition back to something much more practical: what does your body actually need before pregnancy, and what can we address before those nutritional demands increase?
Preconception nutrition isn't about following a perfect "fertility diet", and no food, supplement or nutrition program can guarantee conception. Fertility is complex and influenced by female and male reproductive health, age, genetics, medical conditions and many other factors.
What we can do is use the months before pregnancy to build a nutritionally adequate diet, identify potential deficiencies where appropriate, establish sustainable habits and make sure you're not waiting until you're already pregnant to start thinking about your nutritional needs.
Research increasingly recognises the preconception period as an important opportunity to improve nutritional and lifestyle factors before pregnancy begins (Stephenson et al., 2018; Stocker et al., 2025).
When should I start preparing my body for pregnancy?
I recommend allowing yourself at least three months to prepare before trying to conceive.
If you know pregnancy is part of your plan further into the future, starting six to 12 months beforehand can give you more time to assess your usual diet, investigate potential nutritional deficiencies where appropriate, establish sustainable habits and make gradual changes.
This can be particularly useful if you're currently on the oral contraceptive pill and know you would like to try for pregnancy within the next year.
That doesn't mean your body needs 12 months to "detox" from the pill or that you need to wait 12 months after stopping it before trying to conceive. Evidence suggests that long-term fertility is not significantly delayed after discontinuing reversible contraception (Girum & Wasie, 2018).
Instead, starting earlier gives you the opportunity to work on your nutrition before you stop contraception. You might review your diet, discuss appropriate pathology with your healthcare team, establish regular meals, assess your current supplements and start building habits that you can realistically maintain. It is also a good time to focus on nutrient-dense foods and make sure key nutrients have not been overlooked, as the pill can affect the levels of some nutrients in some people.
If you're planning pregnancy and would like support putting these pieces together, my 3-Month Preconception Nutrition Program provides personalised nutrition, supplement and lifestyle guidance throughout your preconception preparation.
What nutrients are most important before pregnancy?
There isn't one magic "fertility nutrient".
Instead, preconception nutrition involves looking at your overall diet alongside several nutrients that become particularly important around conception and throughout pregnancy.
Some of the key nutrients to consider include:
folate
iodine
iron
vitamin B12
vitamin D
choline
omega-3 fats, particularly DHA
protein.
Let's look at what each one actually does and where you can get it.
Why is folate important before pregnancy?
Folate is vitamin B9 and plays an essential role in DNA synthesis, cell division and methylation, all processes that become particularly important during periods of rapid growth and development.
One of the strongest evidence-based recommendations in preconception nutrition is adequate folate intake.
The neural tube, which eventually develops into the baby's brain and spinal cord, forms extremely early in pregnancy, often before someone even knows they're pregnant.
There is strong evidence that taking folic acid around conception reduces the risk of neural tube defects (Abate et al., 2024; Toivonen et al., 2023).
Australian pregnancy guidance recommends 500 micrograms of folic acid per day from at least 12 weeks before conception and throughout the first 12 weeks of pregnancy.
This should sit alongside a diet containing naturally folate-rich foods such as:
dark green leafy vegetables
legumes, including chickpeas, lentils and beans
avocado
asparagus
broccoli
citrus
nuts and seeds
Some people require a higher therapeutic dose of folic acid due to specific medical circumstances or an increased risk of neural tube defects.
What is the difference between folate and folic acid?
These terms are often used interchangeably online, but they're not exactly the same.
Folate refers to naturally occurring forms of vitamin B9 found in food.
Folic acid is the synthetic form used extensively in supplements and food fortification.
You may also see 5-MTHF or methylfolate in prenatal supplements. This is a biologically active form of folate and is often marketed as automatically being a better choice than folic acid.
However, folic acid has extensive clinical evidence supporting its role in preventing neural tube defects. While 5-MTHF can contribute to folate status, there is currently less direct clinical evidence demonstrating prevention of neural tube defects compared with folic acid (Samaniego-Vaesken et al., 2024).
This is why I wouldn't choose a prenatal purely because the label says "methylated".
Do I need iodine before trying to conceive?
Iodine is particularly important before and during pregnancy because it's required to produce the thyroid hormones thyroxine (T4) and triiodothyronine (T3).
These thyroid hormones are involved in metabolism, growth and neurological development.
Iodine requirements increase during pregnancy. The recommended dietary intake at 220 micrograms per day during pregnancy, compared with 150 micrograms per day for non-pregnant adult women.
It is recommended that women who are considering pregnancy, pregnant or breastfeeding take a daily supplement containing 150 micrograms of iodine.
Food sources of iodine can include:
iodised salt
seafood, such as mussels and prawns
dairy products, such as parmesan and goats cheese
eggs
miso paste
If you have an existing thyroid condition, speak with your medical practitioner about iodine supplementation because your requirements may need more careful consideration.
Why should I check my iron before pregnancy?
Iron is one nutrient I particularly like to think about before pregnancy rather than waiting until pregnancy demands have already increased.
Iron is required for haemoglobin production and oxygen transport, and requirements rise substantially during pregnancy to support maternal blood volume, the placenta and the developing baby.
The recommended dietary intake for iron increases to 27 mg per day during pregnancy.
Iron requirements and utilisation also change throughout pregnancy, with substantial fetal iron accumulation occurring later in gestation (Fisher & Nemeth, 2017).
If your iron stores are already low before conception, you're beginning pregnancy with less of a reserve available as those requirements increase.
The goal before pregnancy isn't to automatically start a high-dose iron supplement. It's to make sure iron hasn't been forgotten.
Iron-rich foods include:
red meat
poultry
eggs
legumes
tofu and tempeh
nuts and seeds
leafy green vegetables.
Pairing plant-based iron sources with a vitamin C-rich food, such as capsicum, kiwi fruit, citrus or berries, can also improve non-haem iron absorption.
Why does vitamin B12 matter before pregnancy?
Vitamin B12 works closely with folate and is involved in DNA synthesis, red blood cell formation and neurological function.
Australian recommendations increase slightly during pregnancy to 2.6 micrograms per day.
B12 deserves particular attention for women following vegetarian or vegan diets because reliable dietary B12 is predominantly found in animal-derived and fortified foods.
Sources include:
meat
poultry
fish
eggs
dairy products
B12-fortified foods.
Low maternal B12 status has been associated with outcomes including low birth weight and preterm birth, although the relationship between B12 status, supplementation and pregnancy outcomes is complex (Rogne et al., 2017).
If your diet contains little or no B12, preconception is a useful time to make sure this nutrient is being adequately addressed.
Should I check vitamin D before trying for pregnancy?
Vitamin D is involved in calcium metabolism, bone health, immune function and numerous other physiological processes.
Vitamin D status can be influenced by factors including sun exposure, skin pigmentation, clothing, dietary intake and lifestyle.
Food sources are relatively limited but include:
oily fish
eggs
fortified foods
UV-exposed mushrooms.
Vitamin D supplementation is one area where more isn't automatically better. Rather than assuming every woman planning pregnancy needs a high-dose supplement, your individual risk factors and, where appropriate, pathology can help guide whether supplementation is necessary.
Why is choline important before and during pregnancy?
Choline doesn't receive anywhere near as much attention as folate, but it is an important nutrient during pregnancy.
It contributes to cell membrane structure, methylation, neurotransmitter production and fetal growth and development.
Australian Nutrient Reference Values set an adequate intake of 440 mg of choline per day during pregnancy.
Good food sources include:
egg yolks
meat
poultry
fish
dairy products
soy foods
legumes
some nuts and vegetables.
Eggs can be particularly useful in a preconception diet because they provide choline alongside protein, iodine, B12 and several other nutrients.
Research into choline during pregnancy continues to develop, particularly in relation to fetal brain and neurological development. For practical preconception nutrition, the important point is simply to make sure choline isn't overlooked when assessing your overall diet.
Do I need omega-3 or DHA before pregnancy?
Omega-3 fats include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
DHA is particularly relevant during pregnancy because it is an important structural component of the developing brain and retina.
Food sources include:
salmon
sardines
trout
other oily fish
DHA-enriched eggs
algae-derived DHA supplements.
Plant foods such as walnuts, chia seeds and flaxseeds provide ALA, but conversion of ALA into DHA in the body is limited.
If you eat little or no seafood, your DHA intake is therefore worth considering separately.
Maternal DHA status and requirements change throughout pregnancy as maternal metabolism and placental transfer adapt to support fetal development (Wilson et al., 2019).
How much protein do I need before pregnancy?
You don't need to start eating enormous quantities of protein because you're planning a pregnancy.
Instead, focus on including a quality protein source regularly throughout the day.
This could include eggs or Greek yoghurt at breakfast, chicken, tofu or legumes with lunch, nuts or seeds with a snack, and meat, poultry, tofu, tempeh or legumes with dinner.
Protein requirements increase during pregnancy as maternal and fetal tissues grow (Elango & Ball, 2016), so establishing a habit of including protein across your meals beforehand can make those changing requirements easier to meet.
What should I eat when preparing for pregnancy?
One of the biggest problems with "fertility nutrition" online is the intense focus on individual superfoods and supplements while the foundations of the diet get forgotten.
Your preconception diet doesn't need to be exotic.
Start with the basics.
Aim for regular, adequate meals rather than regularly skipping meals or relying on snacks to get through the day.
Include two serves of fruit each day alongside plenty of colourful vegetables. Different colours provide different combinations of vitamins, minerals and phytochemicals, so variety matters more than finding the perfect "fertility food".
Choose quality carbohydrate foods such as:
oats
wholegrain bread
brown or basmati rice
quinoa
barley
wholegrain pasta
potatoes and sweet potatoes
legumes
fruit.
Include protein throughout the day and regularly incorporate iron-rich foods.
Add healthy fats from foods such as extra virgin olive oil, avocado, nuts and seeds, alongside appropriate omega-3 sources.
Prioritise fibre from vegetables, fruit, legumes, wholegrains, nuts and seeds, and make sure you're drinking enough fluid to maintain good hydration.
And importantly, eat enough.
The months before pregnancy are generally not the time for crash diets, aggressive calorie restriction or unnecessarily cutting out entire food groups.
Research examining preconception dietary patterns generally supports focusing on overall dietary quality rather than searching for one specific "fertility diet". Diets containing plenty of plant foods, wholegrains and unsaturated fats have been associated with some favourable fertility and pregnancy outcomes, although no particular dietary pattern can guarantee conception (Cui et al., 2022; Grieger, 2020; Winter et al., 2023).
Want a simple food-first place to start?
Download my free Preconception Nutrition Starter Plan for practical meal foundations, key nutrients to have on your radar and easy ideas for the months before trying to conceive.
Do I need a prenatal vitamin before pregnancy?
For most women, a better question is:
What does my prenatal actually contain?
Two prenatal supplements sitting beside each other on a pharmacy shelf can contain very different amounts and forms of folate, iodine, iron, B12, vitamin D, choline, DHA and other nutrients.
And a prenatal doesn't automatically cover everything you need.
This is where I recommend looking at supplementation in the context of your diet, health history, medications, existing supplements and relevant pathology, rather than choosing whichever prenatal has the longest ingredient list.
At minimum, Australian preconception recommendations around folic acid and iodine need to be considered, alongside any additional requirements identified for you.
Your supplements should complement a good preconception diet, not replace one.
What if I'm coming off the pill before trying to conceive?
If you know you'd like to start trying for pregnancy within the next year, you don't have to wait until you stop the pill to start preparing.
You can begin beforehand.
Depending on your individual situation, your preconception preparation might involve:
assessing your current diet
establishing regular meals
improving dietary variety
reviewing folate and iodine
discussing relevant pathology with your GP
reviewing existing medications and supplements with the appropriate healthcare professionals
building sustainable sleep, movement and lifestyle habits
creating a plan for tracking your natural menstrual cycle after stopping hormonal contraception.
You don't need a "post-pill detox".
Starting earlier simply gives you breathing room to put these foundations in place before trying to conceive and, once you stop hormonal contraception, begin getting to know your natural cycle again.
Should I get blood tests before trying for pregnancy?
There isn't one universal blood panel that every woman needs simply because she's planning a pregnancy.
However, depending on your symptoms, health history, diet and individual risk factors, it may be useful to discuss appropriate investigations with your GP.
These may include iron studies, vitamin B12, vitamin D, thyroid investigations or other pathology relevant to your circumstances.
The aim isn't to test everything possible. It's to identify areas where testing could meaningfully change your preconception nutrition or medical care.
Want help preparing nutritionally for pregnancy?
Preconception nutrition can quickly become overwhelming when you're trying to work out whether you're eating enough of the right foods, which prenatal to choose, whether you need additional supplements and what you should actually be doing in the months before trying to conceive.
My 3-Month Preconception Nutrition Program is designed to take the guesswork out of that preparation.
We'll look at your current diet, health history, menstrual cycle, symptoms, supplements, lifestyle and relevant pathology to identify your priorities and develop a practical preconception plan specific to you.
Whether you're preparing to come off the pill, already tracking your natural cycle or simply know that pregnancy is part of your plans in the near future, the aim is to give you a clear, evidence-informed nutrition strategy for the months ahead.
Not sure whether the program is right for you? Book a free discovery call and we can have a quick chat about where you're at and the type of support you're looking for.
References
Abate, B. B., Kumsa, H., Kibret, G. A., Wodaynew, T., Habtie, T. E., Kassa, M., Munie, M. A., Temesgen, D., Tilahun, B. D., Merchaw, A., et al. (2024). Preconception folic acid and multivitamin supplementation for the prevention of neural tube defect: An umbrella review of systematic review and meta-analysis. Annals of Nutrition and Metabolism. https://doi.org/10.1159/000539803
Clarke, L., et al. (2025). Iron optimisation in pregnancy: A Haematology in Obstetric and Women's Health Collaborative consensus statement. Internal Medicine Journal. https://doi.org/10.1111/imj.16694
Cui, Y., Liao, M., Xu, A., Chen, G., Liu, J., Yu, X., Li, S., Ke, X., Tan, S., Luo, Z., Wang, Q., Liu, Y., Wang, D., & Zeng, F. (2022). Association of maternal pre-pregnancy dietary intake with adverse maternal and neonatal outcomes: A systematic review and meta-analysis of prospective studies. Critical Reviews in Food Science and Nutrition. https://doi.org/10.1080/10408398.2021.1993781
Elango, R., & Ball, R. O. (2016). Protein and amino acid requirements during pregnancy. Advances in Nutrition, 7(4), 839S-844S. https://doi.org/10.3945/an.115.011817
Fisher, A. L., & Nemeth, E. (2017). Iron homeostasis during pregnancy. The American Journal of Clinical Nutrition, 106(Suppl 6), 1567S-1574S. https://doi.org/10.3945/ajcn.117.155812
Girum, T., & Wasie, A. (2018). Return of fertility after discontinuation of contraception: A systematic review and meta-analysis. Contraception and Reproductive Medicine, 3, 9. https://doi.org/10.1186/s40834-018-0064-y
Grieger, J. A. (2020). Preconception diet, fertility, and later health in pregnancy. Current Opinion in Obstetrics and Gynecology, 32(3), 227-232. https://doi.org/10.1097/GCO.0000000000000629
Rogne, T., Tielemans, M. J., Chong, M. F. F., et al. (2017). Associations of maternal vitamin B12 concentration in pregnancy with the risks of preterm birth and low birth weight: A systematic review and meta-analysis of individual participant data. American Journal of Epidemiology, 185(3), 212-223. https://doi.org/10.1093/aje/kww212
Samaniego-Vaesken, M. L., Morais-Moreno, C., Carretero-Krug, A., Puga, A. M., Montero-Bravo, A. M., Partearroyo, T., & Varela-Moreiras, G. (2024). Supplementation with folic acid or 5-methyltetrahydrofolate and prevention of neural tube defects: An evidence-based narrative review. Nutrients, 16(18), 3154. https://doi.org/10.3390/nu16183154
Stephenson, J., Heslehurst, N., Hall, J., Schoenaker, D. A. J. M., Hutchinson, J., Cade, J. E., Poston, L., Barrett, G., Crozier, S. R., Barker, M., Kumaran, K., Yajnik, C. S., Baird, J., & Mishra, G. D. (2018). Before the beginning: Nutrition and lifestyle in the preconception period and its importance for future health. The Lancet, 391(10132), 1830-1841. https://doi.org/10.1016/S0140-6736(18)30311-8
Stocker, L., Kermack, A., & Godfrey, K. (2025). Nutrition for preconception health and fertility. Annals of Nutrition and Metabolism, 81(Suppl. 3), 9-18. https://doi.org/10.1159/000543616
Toivonen, K. I., et al. (2023). Folic acid supplementation to prevent neural tube defects: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 330(5), 460-466. https://doi.org/10.1001/jama.2023.9864
Wilson, N. A., Mantzioris, E., Middleton, P. F., & Muhlhausler, B. S. (2019). Gestational age and maternal status of DHA and other polyunsaturated fatty acids in pregnancy: A systematic review and meta-analysis. Prostaglandins, Leukotrienes and Essential Fatty Acids, 144, 16-31.
Winter, H. G., Rolnik, D. L., Mol, B. W. J., Torkel, S., Alesi, S., Mousa, A., Habibi, N., Silva, T. R., Cheung, T. O., Tay, C. T., Quinteros, A., Grieger, J. A., & Moran, L. J. (2023). Can dietary patterns impact fertility outcomes? A systematic review and meta-analysis. Nutrients, 15(11), 2589. https://doi.org/10.3390/nu15112589