Why all clinicians caring for women of childbearing age need lifestyle medicine training 

With more than one-third of U.S. pregnancies unintended, missed opportunities to address lifestyle behaviors before conception can have lasting consequences for maternal and child health. Embedding lifestyle guidance into every clinical specialty can help fundamentally shift the health trajectory of families.

By John McHugh, MD, FACOG, DipABLM, FACLM 
ACLM Women’s Health Member Interest Group Founder 

August 21, 2025

As an obstetrician, I see firsthand the impact of lifestyle behaviors on maternal and fetal health. Nutrition, physical activity, sleep, stress management, connectedness, and avoidance of risky substances not only influence fertility, they shape the trajectory of pregnancy outcomes and the lifelong health of the child. 

However, more than one-third of U.S. pregnancies are unintended. There are a significant number of women who don’t even realize they’re pregnant until several weeks into gestation—well after key lifestyle behaviors may have already impacted the developing fetus. In the year prior to conception, they’ve likely interacted with multiple clinicians across specialties who may have overlooked important conversations about lifestyle and reproductive health. These missed opportunities represent a gap in care. 

What is preconception care, and why does it matter? 

Preconception care is “a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to the woman’s health or pregnancy outcome through prevention and management.” Preconception health is associated with avoiding outcomes such as miscarriage, birth defects, gestational diabetes, hypertensive disorders, preterm birth, and low birth weight. 

Lifestyle-related conditions like obesity, insulin resistance, and hypertension can directly impact ovulation, hormone regulation, implantation, placental health, and fetal development. Meanwhile, habits such as poor nutrition, physical inactivity, use of risky substances, and unaddressed mental health issues compound those risks. A growing body of evidence shows that interventions during the preconception period—particularly those targeting healthy lifestyle behaviors—can improve reproductive outcomes. 

Why preconception care is everyone’s business 

Every clinician who interacts with women of childbearing age—whether in primary care, dermatology, endocrinology, or psychiatry, for instance—has an opportunity to contribute to healthier pregnancies and families, even if pregnancy isn’t top of mind for the patient. Because the window of influence begins before conception, we should normalize routine discussions of lifestyle and preconception health within all points of care. 

A primary care physician can start a conversation about nutritious eating habits. A mental health provider may be the first to address chronic stress or sleep hygiene. A gastroenterologist could be well-positioned to talk about anti-inflammatory diets and fertility. A dermatologist managing acne might have a unique opportunity to address a medication risk or hormonal imbalances. Every interaction is a potential turning point, and the cumulative effect can be powerful. 

Clinician barriers: real, but addressable 

I understand the barriers. The time during appointments is short. Reproductive planning can feel awkward if the visit is for an unrelated concern. And too many clinicians—through no fault of their own—haven’t been trained to address lifestyle in a meaningful or evidence-based way. 

But these challenges are not insurmountable. In California, I’ve had the privilege of working on statewide initiatives to improve preconception health, and one lesson stands out: clinicians need accessible tools that make these conversations easier. For example, something as simple as a “preconception wellness quiz” modeled in the accessible style of a Cosmopolitan Magazine quiz can open the door to deeper conversations about goals, risks, and actionable steps. 

The education gap in lifestyle medicine 

The historical lack of lifestyle medicine education in medical training is another challenge. According to the National Institutes of Health, U.S. medical schools provide an average of only 21 hours of nutrition education over the course of four years, with a wide range of three to 56 hours, and more than half offering fewer than 20 hours  

This gap leaves clinicians unprepared to offer practical, evidence-based lifestyle guidance, despite the fact that poor diet is the leading risk factor for mortality in the U.S.  

To help bridge this gap, the American College of Lifestyle Medicine (ACLM) offers targeted, accredited continuing education to equip a wide-range of health professionals with practical, evidence-based information. Its three-hour CME/CE course, “Food as Medicine: Preconception, Pregnancy and Postpartum,” is designed to equip clinicians with the knowledge and confidence to support patients in optimizing nutritional status before conception, throughout pregnancy, and in the postpartum period. ACLM also offers a complimentary 5.5-hour course, “Lifestyle Medicine and Food as Medicine Essentials,” which introduces core lifestyle interventions in clinical care, until Sept. 14. 

A call to action 

As clinicians, we wield tremendous influence. If we begin to embed lifestyle guidance into every clinical specialty—especially for those caring for women of childbearing age—we can fundamentally shift the health trajectory of entire families. Let’s empower ourselves and each other to embrace that opportunity. 

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