Pregnancy places unique demands on the body, but the foundations for a healthy pregnancy need to be established before conception. Research shows that a woman’s health before pregnancy and in the time between pregnancies strongly influences the health of both mother and baby, during pregnancy and in the future (1, 2).

Every pregnancy is demanding on a woman’s health, challenging her metabolic, physical and mental fitness.  We need to be aware it is not a stand-alone nine-month event that ends at the six week post-delivery check-up (4). Each pregnancy changes a woman’s overall physical condition and has impacts that are not necessarily obvious.  This means that every pregnancy, regardless of outcome, is an opportunity to improve the health of both mothers and children.

Pre-pregnancy and inter-pregnancy health optimisation means taking time to look after ones physical and emotional health, manage medical conditions, and rebuild strength and metabolic stability after childbirth. It is not about achieving perfection, but about reducing avoidable risks and supporting long-term wellbeing.

The Relationship Between Health and Pregnancy

Pregnancy can be viewed as a “stress test” for the body. The cardiovascular and metabolic demands of pregnancy can unmask problems such as gestational high blood pressure or diabetes. While these often resolve after delivery, studies show these conditions can signal a higher risk of developing high blood pressure, diabetes, or heart disease later in life, or in future pregnancies (1, 2).

Addressing health factors before, between, and after pregnancies – such as weight, blood pressure, nutrition, mental health, and physical fitness – can reduce the chance of complications (1, 3). These steps also improve energy levels, mood, and long-term health.

What This Means for Babies

Babies are affected by maternal health well before birth. Poor nutrition, untreated medical conditions, or a short time intervals between pregnancies are linked with higher risks of preterm birth, low birth weight, and breathing or feeding difficulties after delivery (3, 4).

There is also growing evidence that a child’s future health – such as the risk of obesity, diabetes, and cardiovascular disease – can be influenced by the in-utero environment (1, 2, 5). Supporting maternal health before pregnancy is therefore one of the earliest ways to protect a child’s lifelong health.

Why It Matters to Optimise Health Between Pregnancies

After childbirth, attention naturally focuses on the newborn. However, the immediate months after delivery are also a critical time for mothers. This period allows the body to recover, pregnancy experiences to be reviewed, and future health needs to be addressed (4).

For example, population-based studies showed that even mildly raised blood pressure before pregnancy is associated with a higher risk of miscarriage, preterm birth, smaller babies, and other complications (6). Entering pregnancy with well-controlled blood pressure is therefore beneficial for both mother and baby.

Similarly, among women who have been affected by gestational diabetes, large studies showed that those who improved their diet and physical activity, and entered a subsequent pregnancy at a healthier weight have significantly lower recurrence rates (7).

Supporting Health Through a Team Approach

There is currently no standardised postnatal or pre-pregnancy programme. Optimising health works best when care is coordinated, personalised, and practical.

General practitioners can review medical history, manage ongoing conditions, support recovery after pregnancy, and provide preventive care such as vaccinations and screening. Dietitians offer clear, realistic guidance on nutrition, helping women feel confident about food choices without unnecessary restriction. Physiotherapists support recovery after childbirth, including pelvic floor health, back and joint strength, and a safe return to physical activity.

Obstetricians help women understand any previous pregnancy complications and how future risks may be reduced. Psychiatrists and psychologists can provide timely support if there are mental health needs.

A team approach allows sharing of information, continuity of care and clear communication between patients and clinicians.

Common Misconceptions

Many believe they only need to focus on health once they are already pregnant. In reality, many pregnancies occurs before someone may realise they are pregnant, which makes pre-pregnancy health especially important.

Another common misconception is that feeling exhausted, sore, or emotionally low after childbirth is something to simply “push through.” While these experiences are common, they are not something women need to endure without support.

Finally, some believe that health optimisation is only relevant after complicated pregnancies. In fact, every pregnancy – including those that sadly end in early miscarriage or those that were uncomplicated – can be an opportunity to reflect on health and discuss ways to reduce future risks.

Turning Evidence into Action

Research matters most when it leads to practical change. Positive actions may include   improving your own knowledge and those supporting you about these issues, allowing enough time between pregnancies, gradually rebuilding physical activity in a structured, safe way, prioritising sleep and stress consciously, and addressing nutritional needs such as iron and folate levels (3, 4). These changes do not need to be dramatic. Sustainable habits, guided by healthcare professionals and tailored to individuals, are far more effective than short-term fixes.

Conclusion

Looking after your health before and between pregnancies is an investment in both present and future wellbeing. By supporting women during these often-overlooked life stages, healthcare can reduce pregnancy risks, improve recovery after childbirth, and promote long-term health for mothers and their children. Small, evidence-based steps taken early can have benefits that last a lifetime.

References

1. Adam S, McIntyre HD, Tsoi KY, et al. Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO best practice advice. Int J Gynaecol Obstet. 2023;160(Suppl 1):56–67. doi:10.1002/ijgo.14563.
2. Poon LC, Nguyen-Hoang L, Smith GN, et al. Hypertensive disorders of pregnancy and long-term cardiovascular health: FIGO best practice advice. Int J Gynaecol Obstet. 2023;160(Suppl 1):22–34. doi:10.1002/ijgo.14561.
3. Killeen SL, Donnellan N, O’Reilly SL, et al. Using the FIGO nutrition checklist for counselling in pregnancy: a review to support healthcare professionals. Int J Gynaecol Obstet. 2023;160(Suppl 1):10–21. doi:10.1002/ijgo.14560.
4. American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. ACOG Committee Opinion No. 736: Optimizing postpartum care. Obstet Gynecol. 2018;131(5):e140–e150. doi:10.1097/AOG.0000000000002633.
5. Mai TDT, Katsuragawa S, McDougall A, Nguyen PY, Romero L, Vogel JP, Makama M. Self-care interventions for preventing cardiovascular diseases after hypertensive pregnancy disorders: a systematic review and meta-analysis. BJOG. 2025;132(10):1350–1361. doi:10.1111/1471-0528.18152.
6. Xiong W, Han L, Tang X, Wang Q, Chen W, Li R, et al. Preconception blood pressure and adverse pregnancy outcomes: a population-based cohort study. Hypertension. 2024;81(4):e31–e40. doi:10.1161/HYPERTENSIONAHA.123.22296.
7. Mussa J, Rahme E, Dahhou M, Nakhla M, Dasgupta K. Incident diabetes in women with patterns of gestational diabetes occurrences across two pregnancies. JAMA Netw Open. 2024;7(5):e2410279. doi:10.1001/jamanetworkopen.2024.10279.