Why Are Some Women Training for Pregnancy Like It’s a Marathon?

Three years ago, Esther Rohr and her husband decided to start thinking about pregnancy. The 26-year-old Oregon-based wedding photographer made small but intentional lifestyle changes—going to bed earlier, drinking more water and less alcohol, dialing in her fitness, loading up on protein, and taking supplements like beef organ capsules and Vitamin D3. They started charging their phones in the kitchen for better sleep and unplugging their Wi-Fi at night, because her research suggested it might affect cellular health. Concerned about their exposure to reproductive toxins, Rohr began the slow, painstaking task of swapping out all their synthetic workout clothes, nonstick pans, and scented personal care products that might contain phthalates or other endocrine-disrupting chemicals. She bought an air purifier and hopes to eventually replace their LED bulbs with incandescents, because she worries they might be affecting her circadian rhythm.

Rohr has never tried to conceive before. To her knowledge, she doesn’t have any health problems that would make it difficult. But nonetheless, she’s dedicated to optimizing her health to give their baby the “best chance at a healthy start in life.” Learning from accounts like @vitallymelanie, and @innate_fertility, what began as a curious interest in “crunchy, healthy, fitness, baby mama” content turned into a timeline filled with guidance for easy, breezy, positive pregnancies—and the tools she should use to get there.

One of the accounts recommended reading 9 Months Is Not Enough, a book premised around the idea that women are plagued by a “fertility gap,” but not to worry because “you can do something about it.” That resonated with Rohr. After changing her house and her habits, Rohr also decided to go through extra hormone testing and a controversial OligoScan, which measures minerals and heavy metals in your body through a light-frequency-based hand scan. For the next year, she tried to lower the levels of mercury that showed up. Rohr and her husband completed two rounds of Dr. Daniel Pompa’s “cellular healing diet,” essentially a keto diet, and taking six to eight supplements each day.

“It was a brutal, brutal year,” Rohr says. But it was all for a greater purpose. “I need to be focused on giving my body building blocks. Because right now, it's a huge, pivotal time to be giving it what it needs.” In late December of last year, after three years of preparation, Rohr finally feels like she’s on the precipice of being “ready.”

The cultural obsession with wellness and optimization, which is currently driven and designed by male biohackers like Bryan Johnson and Peter Attia, has come for this murky preconception period, coined “the zero trimester” by sociologist Miranda Waggoner in her 2017 book by the same name. Women have started training for pregnancy “like it’s a marathon,” as influencer Kaylie Stewart announced to her 1 million TikTok followers last fall. After all, if you spend months planning a wedding, some influencers point out, why wouldn’t you do the same for a baby?

A growing group of influencers and holistic women’s health experts, doctors, life coaches, and nutritionists are posting content that speaks to the “Trying to Conceive” (TTC) demographic—including women who are struggling to conceive and those who haven’t started yet. The concept is simple: If you follow this wellness formula, you will set yourself up for the quickest conception, the easiest pregnancy, and the healthiest child. Pregnancy, these accounts argue, doesn’t have to be traumatic. You get to be in the driver’s seat. And what mom-to-be wouldn’t want that?

These days, #preconception appears in 106,000 Instagram posts and #pregnancyprep in 36,000. Singular TikTok “prep” videos rack up tens of thousands—sometimes millions—of views and likes. “Pregnancy Prep” influencers post curated lists, aesthetic vlogs, and GRWM TikToks filled with glowing, happy women. They suggest a litany of lifestyle changes, niche products, books, courses, and “quick” tips and tricks to follow in the 6 to 12 months before getting pregnant. “Healthy pregnancy isn’t chance—it’s choice,” is a favorite line of Alexandra Radway, 29, a functional nutritional therapy practitioner who has been posting pregnancy prep content on her Instagram account, @alexandraradway, since 2021.

Unsurprisingly, much of this content asks women to buy products and programs. From brazil nuts for “egg health” and grass-fed butter, to prenatal vitamins, pelvic floor Pilates, and nontoxic pans, the prepregnancy changeups and swap-outs offered up on social media seem never-ending. Some are basic, and others, more unconventional. One of Radway’s favorite tips is to watch the sun rise. “It's the equivalent of, like, 2,500 Brazil nuts of antioxidants,” she says. “Everyone's focusing on super foods. I'm like, ‘No, super sunrise.’”

Radway’s advice may sound woo-woo, but preconception health has been around since the beginning of time. Ancient cultures, like the Spartans, encouraged “maidens” to “exercise themselves with wrestling, running, throwing the quoit, and casting the dart” so that “the fruit they conceived might … take firmer root and find better growth.” For millennia, traditional Chinese medicine and Ayurveda have sought to boost fertility through diet, panchakarma, and acupuncture. There are even Biblical passages encouraging sobriety before conception.

In Western medicine, several governing medical bodies, including the American College of Obstetricians and Gynecologists, published the first guidelines for perinatal care in 1983, stating that “preparation for parenthood should begin prior to conception.” It wasn’t until the early ’90s that doctors started recommending folic acid use before and during pregnancy to prevent neural tube defects.

Social media, it seems, has turbo-charged preconception health from a quick pharmacy stop for prenatals to a full blown industry. In 2019, a study from Harvard went viral because it suggested that, metabolically, carrying a baby was the equivalent to running more than a dozen marathons. Cut to 2025, and “pregnancy prep” accounts have their own vibrant ecosystem. Women seemed to recognize, “Hey, I have to sign up to run a marathon every single day, maybe I want to train for that,” says Radway. “I would want to be in shape and be well nourished and maybe have a coach and be prepared.”

Radway started posting on Instagram after a difficult first pregnancy led her to get a degree in functional nutritional therapy, which emphasizes holistic dietary and lifestyle changes to address root causes of health issues. As a result, she says that her second pregnancy was a complete 180 from her first. And she felt a “divine calling” to share what she learned with other women. “To me that was the most pressing problem in the world, and I felt like I was uniquely positioned to solve it.”

The current fixation on optimizing this fragile, sensitive zero trimester arrives at a moment when the average woman is having children three years later than their mothers did—if they have them at all. Though there is an emerging discussion around declining sperm counts thanks to a pivotal study in 2017—spawning a sperm-obsessed optimization movement—the latest stats suggest one in five women will experience infertility. And the burden of infertility, historically, has always fallen on women, even though this new data reveals a more complex reality.

Unsurprisingly, one recent report suggests nearly three-quarters of Gen Z have fertility anxiety. The generation grew up with unlimited access to information about the ups and downs of conception and pregnancy, including infertility tell-alls and Girl Boss “Why I froze my eggs” articles; wearables that track macros, movement, and menstrual cycles; and a MAHA movement that has stoked fears about environmental toxins and falsely promotes the idea that moms taking Tylenol might give their babies autism and ADHD. Pair all of this with the extreme rollback of America’s reproductive rights since Roe’s fall in 2022 (17 states either have a total abortion ban or make it illegal after six weeks, making it difficult to get life-saving care) and you have fertile soil for a pregnancy prep fixation to take root.

In response, younger generations are saying: “I ought to be able to have a pregnancy which is healthy and safe and happy, and I ought to get the support I need to be able to do that,” explains Lara Freidenfelds, a historian and author of The Myth of the Perfect Pregnancy: A History of Miscarriage in America.

“We're just a bit tired of it,” says UK-based Sophie Payne, 33, of women not getting helpful answers about their health issues. At 27, Payne was diagnosed with premature ovarian failure and struggled to conceive. In 2022, she suffered multiple miscarriages. While there’s no “one thing” that helped her conceive in 2023, she believes that working with functional health professionals to change up her diet and lifestyle helped. Payne started a holistic pregnancy prep Instagram account called Curious_Clementine with her sister in early 2024. “Sadly, when it comes to getting pregnant, we're not really told what to do, how to do that, and how to go into it in the best possible health for us, but also for our future children.”

In the not-so-distant past, moms-to-be would have been taught about pregnancy and childbirth from elders and other women in their community. These days, they live in an increasingly isolated world, often far from grandparents and mothers. They try their best to figure things out as they go—and often social media is their greatest mentor. From the Paynes’ view, more women want to take control of their health, which is one big element driving this trend. “They want to do their own research and do what they can to feel their best,” Payne says. The sisters estimate about half of the women who reach out to them have struggled to get pregnant or had a miscarriage and are looking for simple lifestyle tweaks that could help. After all, a few nutritional swaps and supplements cost a lot less than IUI or IVF.

Rohr, as one of 10 children with 29 nieces and nephews, has watched countless family members and friends navigate hard pregnancies. In response, she’s determined to have a positive, empowering one. “I always thought having a baby was, like, the least casual thing ever,” she says. “It just seems like this life-changing thing that I wanted to be super, super sure about.”

Doctors say that, in general, all this new attention surrounding the “zero trimester” is a very positive, exciting development. Healthy moms usually spell better outcomes for mom and baby. Currently, the American College of Obstetricians and Gynecologists recommend doctors ask patients of reproductive age if they plan to get pregnant within the year during checkups. “There's so many things that we can do to optimize underlying health in that preconception year that will make outcomes in pregnancy better,” says Natalie Clark Stentz, an ob-gyn and reproductive endocrinologist and infertility specialist at Michigan Medicine. This is especially true if you have a chronic health condition, like diabetes, hypertension, depression, or a thyroid disease, that needs to be managed and monitored during pregnancy.

At the same time, that “prep” should be expert-vetted and backed by science, and it usually doesn’t involve the TikTok Shop. A doctor’s preconception toolbox is much simpler than what you might see online, and really hasn’t changed much in decades: ensure vaccinations are up to date, avoid alcohol, stop smoking and taking drugs, start a prenatal vitamin with folic acid to prevent neural tube defects at least a month before getting pregnant, and go through any prescription medications and supplements with your doctor. Only 5 percent of the preconception nutritional claims on social media reviewed in a 2025 study were referred to in current international preconception guidelines, and 54 percent were considered to have “no evidence for the health outcome.” TikTok and Instagram had a higher percentage of “no evidence” claims than other platforms.

For instance, raw milk is a darling of self-proclaimed “crunchy moms,” yet unpasteurized milk can introduce harmful germs like listeria, which can cause a miscarriage or harm a fetus. Extreme diets and exercise can work against your fertility, too, by affecting the hormones that are necessary for conception, says Kara Goldman, an ob-gyn and associate professor of reproductive endocrinology and infertility and director of fertility preservation at Northwestern University. Recently, a patient with a history of estrogen-receptor-positive breast cancer told her she’d been taking beef organ supplements, not realizing until Goldman dug into the ingredients that the capsules included “ovary” and “uterus.” This meant she was inadvertently taking supplemental estrogen after years of avoiding unnecessary estrogen exposure. Additionally, organ meats like liver can be rich in Vitamin A, which Stentz says can be “very toxic” for pregnancy.

“Any buzzy individual thing is likely sensational, whether that's Brazil nuts, organ meats, or whatnot,” Stentz adds. “The evidence-based things, they're not sexy. Maintain a normal BMI, stop smoking, pick a boring prenatal vitamin.”

Pregnancy prep regimens can get pricey fast. A month’s supply of Perelel’s “conception support pack,” which includes a prenatal, omega DHA + EPA, and CoQ12 + folate, costs $58.77. A full swap-out of all kitchen Tupperwares, cooking utensils, and pans can run you hundreds. Add on “soft movement” like Pilates, organic produce, a whole new set of makeup and skin-care products, and it becomes all the more expensive.

In a recent post, Radway explicitly calls out to “the woman looking for a sign to start preparing her body for pregnancy in 2026,” promoting her January Jumpstart, a “7-day winter reset to prepare your body, mind, and soul for pregnancy and birth.” For $97 you can get her Baby Ready Body Book Bundle, and in December for for $1,770, she offered her “Baby Ready Body LIVE” courses that promise to “balance your hormones, boost your energy, calm your nervous system, and prepare your body for a healthy pregnancy.” The courses promise to not only optimize hormone health and cook nutrient-dense meals, but also “prepare your body to give your baby the best possible start.”

“You're taking a very vulnerable, very highly motivated population of patients and targeting them with information that is kind of driven by financial incentives,” says Goldman.

The marketing can disguise the fact that even going into pregnancy in peak health is not a guarantee. For starters, we have “so little control over whether or not we're able to become pregnant or how easily we're able to become pregnant,” says Stentz. Early pregnancy loss is “very, very common and unpreventable for the most part,” adds Freidenfelds. “It is hard for people to manage the idea that you will try very hard to reduce risk, and yet you will not be able to completely forestall all bad outcomes.”

This hyper-focus on women’s health can also subtly shift the burden of infertility, miscarriage, and fetal health onto their shoulders. In reality, men’s biology plays a role in between 30 to 40 infertility cases. Under an Instagram post announcing a new book called, 9 Months That Count Forever: How your pregnancy diet shapes your baby’s future, by French biochemist Jessie Inchauspé, “the Glucose Goddess,” one commenter wrote, “I feel so much guilt for not eating well during pregnancy. Definitely a bit triggered by this …” Another typed, “Well I threw up sometimes 10X a day until she was born so … Prayers.”

“It really can make women feel guilty or blame-worthy if their outcome isn't ‘perfect,’ however they're defining perfect,” says Waggoner, an associate professor of sociology at Rice University. This trend promotes the idea that there’s a “causal and deterministic link between preconception care behaviors and birth outcomes, and that's where I think it can be problematic for both individuals and at a policy level.”

Perhaps most importantly, Goldman wants to set the record straight: Infertility is a disease, and most causes can't be prevented or treated by lifestyle modifications. Over the past 25 years, Freidenfelds has watched fertility get reframed as something less biologically focused, and instead, something you can plan or try to “do well.” When she started researching her book in the early aughts, the term “trying to conceive,” or “TTC,” was reserved for specialty internet forums for women with infertility. By 2018, women started to throw the term around when they were simply referring to stopping birth control the next month to try to get pregnant. “That's a very, very different scenario,” she says.

Rohr doesn’t yet know if she will have a hard time getting pregnant, but that hasn’t stopped her from sharing her preparation with the world. In May of 2025, she began posting behind the scenes of her own journey on TikTok, including one video titled “POV me and my husband decided to lock tf in and get fit before trying to get pregnant so I can have a healthy (& easier) pregnancy and our baby can have the best chance at a healthy start.” The post went viral, racking up over 13.5 million views and 2.5 million likes.

Rohr knows that some of her “hacks” might seem bizarre or controversial. In fact, she started posting an entire series called “unhinged things we’re doing to prep for conception,” because her friends were fascinated by it. She even recently read a book called Hunt, Gather, Parent, geared towards parenting young children.

“The energy [in our home] is just like, all pointed in one direction,” Rohr says. “Not knowing things is very uncomfortable for me.” If all goes well, she hopes to have a baby by this Christmas.

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