I Would Rather Pull My Front Teeth Out Than Hear "Trimester Zero" Ever Again, Thanks
Social media, it seems, will never run out of new buzzy health trends that make me, as a health reporter for over a decade, want to rip my hair out. But none have made me grit my teeth harder lately than the term “trimester zero.” The term refers to the three months preceding pregnancy in which women should be thinking about optimizing their own physical and mental health to increase their fertility and the likelihood of a healthy pregnancy. From vague advice like using this time to balance your hormones and flush toxins out of your body, to wildly specific regimens of wearing socks at all times and eating more stew, the internet is awash in posts from influencers and women’s health mags about how they’re preparing their bodies for a healthy pregnancy — and therefore how you should too.
Just a general word of advice: if someone says you need to rid your body of toxins, stop listening. That’s literally what your kidneys are for.
Secondly, anytime there’s a buzzy new health phrase floating around the internet, it behooves us all to give it a Google. The term trimester zero likely originated with author Miranda Waggoner’s The Zero Trimester: Pre-Pregnancy Care and the Politics of Reproductive Risk, published in 2017. In her book, Waggoner presents the case that “in the medical and cultural quest for perfect pregnancies and perfect babies, we have arrived at a place wherein all females are considered future pregnant women who are advised to reside within a medical-behavioral regime in order to protect fetuses and babies that do not yet exist and may not exist for years or decades to come,” according to a review by fellow author Kristin K. Barker.
In short, the person who coined the term thinks trimester zero is a trap. It begs too much control over women’s lives, preying on their mom guilt before they’ve even become mothers. I happen to agree with her, because I fell into that trap myself.
When my husband and I decided we were ready to have a baby, the first thing I did was make an appointment with my psychiatrist. I’d been on an anti-anxiety medication, an SSRI, and a sleep aid for years, and I wanted to know if I should stop them before becoming pregnant. My doctor told me the average pregnancy has a 3% to 5% chance of yielding a baby with a birth defect. While my sleep aid had to go, the other two medications I took weren’t associated with a significant increase in that risk. Still, the only way for there to be no risk was to take no medication, so I chose to wean off.
I was right to go and talk to my provider about the medications I was on; this is part of the American College of Obstetricians and Gynecologists’ (ACOG) pregnancy planning advice. Where I went wrong was assuming that no risk of birth defects would be worth the risks of untreated mental illness.
Even following my psychiatrist’s weaning schedule perfectly, my old depression and anxiety symptoms returned in a rush. They weren’t just my old baseline; they were my old crisis-level symptoms. On a weekend when my husband was out of town, I loaded up my two dogs and went to visit my sister and nieces for a couple days. But once there, I was overcome with anxiety and a visceral urge to get home. It made no sense, but I bailed. On the drive home I sobbed and didn’t know why. My brain started making a plan about which knife in my kitchen block I could try cutting my arms with first. I say my brain did it because I wasn’t in control of my thoughts anymore, and each new suggestion it made horrified me. I called my husband who called my mom, and she came to stay with me so I wouldn’t be alone. The only reason I didn’t pull over and dial 911 was because I was afraid of where my dogs, clueless in the backseat, might end up once they took me away.
Back in my psychiatrist’s office the following week, terrified husband in tow, my psychiatrist said I should absolutely restart my medications. His message: my medications were among the safest I could possibly take during pregnancy. While one of them might increase my baby’s risk of congenital heart defect a percentage point or two, at worst, it could be repaired. What could not be fixed would be me hurting myself or ending up hospitalized because I denied myself the chemical compounds my brain needs to function. The risks of untreated mental illness have not been well-defined by research, but it has established that they exist, from preterm birth and low birth weight to sleep disturbances.
That appointment was my first lesson in one of the many truths of motherhood: that taking care of yourself is taking care of your baby, that what is best for you personally is also often in the best interest of your family. And I wasn’t even pregnant yet. I had risked so much, and for what? Just to be “a good mom” — to do the noble thing I thought a good mom would do and quit her meds, have a perfect “trimester zero,” and become the clean slate my still-hypothetical baby deserved.
If you are trying to conceive and want to know what to do to prepare, you should visit an OB-GYN. Some people with conditions that increase the risk of birth defects, like epilepsy, may actually benefit from taking folic acid for a few months before attempting to get pregnant. In fact, most doctors say that’s a good idea for the general population — it can only help. In general, medical experts recommend you eat a healthy diet, get your daily movement in, stop using substances (like drugs and alcohol), and make sure your environment is safe.
That’s right; a doctor who knows you want to get pregnant will ask you if you’re at risk of domestic violence long before they ask if you’re drinking hot lemon water every morning or religiously doing prenatal yoga. They will want to know about your job, your relationship status, your access to quality foods and care — the true social determinants of health. They’ll recommend a prenatal vitamin with folic acid because it has been proven in studies to reduce the risk of birth defects, and because it’s a low-cost, easy intervention pretty much everyone is capable of. No expensive yoga studio membership fees here, thanks.
The fact of the matter is, trimester zero is likely much longer than 90 days for most women. It also assumes we have any say over when we get pregnant. Personally, it took me an entire year to get pregnant in which I already had to track my ovulation and keep intense tabs on my body. Then you’re pregnant, which comes with quite a few rules and regulations on its own (particularly if you’re high-risk, like I was). And I highly doubt the trimester zero believers think you should hop off the Perfect Wellness Wagon before you’re done breastfeeding. So when, exactly, are we supposed to live as normal people who aren’t focused on personal optimization at all times?
The idea that we can perfectly prime our bodies to have the healthiest possible baby is, unfortunately, just us trying to optimize our way into control. But that control has never really been in our reach. The hardest thing to accept about pregnancy, parenting, and our health is that all three of these things are never truly ours to dictate. Of course it’s anxiety-inducing to think about struggling to get pregnant, or having a baby with a birth defect; it’s natural to want to prevent bad things. The reality that you may not be able to is both heartbreaking and freeing. Then, random naturopaths on the internet can’t use your fears to sell you a trimester zero wellness retreat when all you needed was some folic acid and a fucking break. The wellness industry generated nearly $7 trillion in revenue in 2024 precisely because they know what anxieties of ours to capitalize on.
Letting women live and generally leaving them alone is the healthiest thing we can do for them. If you want to perfectly optimize your health and wellness routine, more power to you. Personally I have had enough of regimes, and don’t suggest we willingly submit ourselves to another based purely on vibes and the infuriating idea that eating enough stew will warm our wombs.
source https://www.scarymommy.com/pregnancy/i-would-rather-pull-my-front-teeth-out-than-hear-trimester-zero-ever-again-thanks
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