Holistic OB-GYN Dr. Anna Cabeca on Natural Fertility, Pregnancy, Menopause, and More

In a woman’s life, most of her most important and transformative moments revolve around her reproductive life cycle: getting her period, getting pregnant, delivering a baby, going through menopause. Yet many women have very little understanding of how these processes work, and most doctors aren’t interested in helping women optimize them to live their healthiest, fullest lives. Holistic OB/GYN Dr. Anna Cabeca wants to change that. Dr. Cabeca is a triple board-certified doctor, bestselling author of Keto Green 16 and The Hormone Fix, an expert on women’s health and functional medicine, and a mother who has her own powerful story to share. Read on to learn about the best natural fertility practices (including how she learned the connection between stress and fertility), how to have a natural pregnancy in a hospital setting, and much more.

*This is a short clip from our interview with Dr. Anna Cabeca. Click here to watch the whole thing.*

You can also listen to this interview as an episode of The WellBe Podcast.

How A Personal Experience Revealed the Link Between Stress and Fertility  

At age 39, after practicing as a holistic OB-GYN for over a decade, Dr. Anna Cabeca was diagnosed with early infertility and early menopause while trying to get pregnant. After failing to respond to the highest doses of infertility treatments, she was told that she would never be able to have another child. 

“I was grief-stricken with that information,” she remembers. She was a specialist in fertility treatments, had helped thousands of women and couples conceive healthy pregnancies, and had been able to take care of her patients’ needs for years — yet here she was. “It really devastated me,” she says. “And it took me on a journey around the world for healing. That’s one of the reasons why there’s many different tools in my doctor’s bag than in many of my colleagues’. It was this firsthand experience.”

That journey showed her clearly the root cause of her infertility: stress. There had recently been a major tragedy in her family, and the trauma from the tragedy resulted in PTSD, chronic fear, and chronic stress. She’d learned in medical school and as a resident that there was a link between stress and fertility, but it had always been downplayed. “They were like, ‘Oh, yeah, there are stress issues, get a massage, whatever,’” she says.

But on her personal journey, she began to see more clearly just how much stress undermines fertility. To understand the link between stress and fertility, it’s important to first understand the role of the hormone progesterone in pregnancy. Dr. Cabeca refers to progesterone as “our mother hormone,” and explains that the word itself comes from the phrase “to support fertility” (pro meaning supporting and gestation referring to the process of conception, pregnancy, and birth). Progesterone is one of the key reproductive hormones, and it is predominant in the second half of a woman’s menstrual cycle, after ovulation. “So it’s the hormone that makes the bed, essentially, in the uterus for the embryo to implant,” Dr. Cabeca says. 

In women with minimal levels of stress, progesterone levels are optimal for conception. But when people are experiencing extreme stress, whether it’s traumatic, acute stress or the chronic stress of everyday life, things change. Stress causes the body to pump out the stress hormone cortisol, which is manufactured from the same components used to make progesterone. 

“Essentially, cortisol is made downstream from progesterone. So when we’re having to make cortisol, progesterone goes down, and with that, all of the other downstream hormones, and that includes estrogen, DHEA and testosterone,” Dr. Cabeca explains. “These are reproductive hormones, hormones of sexual desire, fertility, and pregnancy. All of those get depleted to sacrifice to make this life-saving hormone, cortisol. When that goes on for too long, you get this significant depletion — and in my case, it became infertility.” 

After coming to understand the link between stress and fertility, Dr. Cabeca was able to become pregnant naturally at age 41 after making lifestyle changes that reduced her stress levels. Today, a huge part of her practice is optimizing major hormones like cortisol, estrogen, and progesterone to help her patients address issues like infertility and early menopause naturally. She also makes it a point to educate residents and other physicians about just how significant of a factor stress can be in conception. “The eyes don’t see what the mind don’t know,” she says. “So once I knew this — wow. I could see it everywhere. Understanding how your body responds to stress, it’s really powerful information.”

How to Address Root Causes with Natural Fertility Strategies 

When people think of fertility treatments, they often think of things like IVF, IUI, or egg freezing. As a holistic OB/GYN, Dr. Cabeca uses all of these strategies with patients, but she prefers to look for a root cause and try natural fertility strategies first. In many cases, there are clear signs and symptoms that indicate an underlying issue that root cause can be fixed with simple lifestyle changes.

Of course, as she learned firsthand, stress is a major player here, so she’ll always try to address that head-on when working with patients on natural fertility improvements. Another huge factor, she explains, is optimizing a woman’s menstrual cycle. “When I see women that are struggling with PMS and irregular cycles or painful periods, that’s a big red flag,” Dr. Cabeca says. As a holistic OB-GYN, she tries to address period issues holistically, using diet, lifestyle, and supplementation to bring a woman’s hormones back in sync and restore healthy, normal periods.

She explains that in order for a woman who has been taking hormonal birth control to optimize her period, she needs to get off the pill and familiarize herself with her period without these synthetic hormones. “If you’ve been on birth control, you really don’t know your period,” she says. “The birth control pill can be a good reset for a time, but when we’re on it long-term, that can disrupt our own connection with our natural hormonal flow. Understanding your period, knowing when you ovulate, knowing your cervical mucus, how you can tell the changes to your cervical mucus to show that you have ovulated, you won’t see that [when you’re] on the birth control pill.”

Another big root cause of infertility is male factor infertility, which she says accounts for 40% of infertility cases. This could mean inadequate sperm production, poor sperm motility, or other issues on the male’s side. On the female side, besides stress and period optimization, ovarian resistance — meaning the ovaries are not producing eggs as they should — is another issue Dr. Cabeca frequently sees. This often happens as a woman gets older.

While many of Dr. Cabeca’s patients have success with natural fertility strategies alone, more conventional fertility treatments like IVF or egg freezing are sometimes needed. In these cases, however, Dr. Cabeca can still bring her background as a holistic OB-GYN into play in order to improve patients’ odds of success and minimize any negative impact on their bodies. 

She advises women to prepare their bodies as much as possible beforehand by optimizing their diet and nutrition. This means avoiding sugar, hydrating between meals, practicing intermittent fasting, and eating a largely keto-based, green diet, and taking supplements as needed (more on that below!). Using other natural fertility strategies like stress reduction and acupuncture can also greatly improve the outcome of conventional fertility treatments. Dr. Cabeca also explains that the extra hormones used in conventional fertility treatments will generally be flushed out of a woman’s body by her next menstrual cycle, but that there are things she can do to expedite this process, like taking detoxifying herbs. 

Above all, she counsels women to take the time to get clear about their decision to undergo any of these fertility interventions. “I always tell clients: listen to your intuition, that small voice inside of you. What are you visualizing? What’s in your future? What do you want for yourself?” she says.

How to Have The Most Natural Pregnancy Possible 

Once a woman becomes pregnant, she faces more decision points and challenges, and many women feel overwhelmed by the pressures of the conventional medical system. As a holistic OB-GYN, Dr. Cabeca understands the importance of both trained medical support and also avoiding unnecessary interventions. To that end, she provides strategies for having the most natural pregnancy possible — strategies that most doctors never mention to patients because they aren’t part of conventional training and practice. 

In order for women and their babies to have the best possible outcome from pregnancy and delivery, Dr. Cabeca emphasizes the importance of these five practices:

• Maintain your nutrition. For Dr. Cabeca, this specifically means avoiding sugar and dairy and eating mostly organic greens, good quality fats, and healthy proteins. She explains the hormones in dairy aren’t good for babies in utero, because pregnant women really should be relying on their own hormones during this time, and that sugary starches can cause blood sugar spikes more easily in pregnant women. “We really want to keep our blood sugar stable in pregnancy as much as possible, so that we have a healthy baby who’s metabolically strong,” she says. “Because we know insulin resistance, diabetes, creates a metabolically challenged baby, and we don’t want that.”
• Supplement wisely. Dr. Cabeca advises her patients to take a high-quality multivitamin that contains methylated B vitamins, as well as several other supplements that are important for supporting the baby’s development. She recommends a vitamin D supplement, a clean omega-3 fish oil supplement that has been tested for heavy metal content, as well as the amino acid carnitine, which studies show is good for brain development. Iodine, which is essential for every hormone receptor, is also important if you’re not getting enough iodine through diet alone. For a list of fully vetted practitioner-grade supplements, plus 1,500+ other WellBe-approved products, check out our Non-toxic Product Database. 
• Do pelvic floor exercises. She advises that women do pelvic floor and Kegel exercises regularly throughout their pregnancy, as well as other forms of physical exercise, like certain yoga poses, that help prepare your body for birth and recovery. She underscores the importance of flexibility as well as strength in both your core and pelvic floor muscles in order to support a natural pregnancy and successful, trauma-free childbirth and recovery. She also recommends pelvic massage, which can increase blood flow and flexibility in the muscles around the vagina, making recovery easier and reducing the odds of a tear. 
• Know what you want childbirth to be like. While much of labor and delivery is unpredictable, and the best-intentioned birth plans need to get thrown out the window, Dr. Cabeca explains that it’s still important to have an idea of what you do and don’t want when it comes to certain decision points. For instance, knowing whether or not you want to have an episiotomy (a small cut made in the perineum during childbirth as a way to prevent tearing), or whether you want to be able to walk around during labor. She also recommends having a birth advocate or doula who can help make your choices known in the often chaotic environment of a hospital birth. These small choices alone can go far toward promoting a natural pregnancy and labor without unnecessary interventions or injury. 
• Trust your body. Conventional OB-GYNs can often pressure women to make choices that might move the labor along more quickly or conveniently — things like induction, or a scheduled C-section, or breaking the water. As a holistic OB-GYN, Dr. Cabeca believes deeply in “trusting the process of your body’s own natural wisdom when it comes to delivering your baby.” To ensure that you’re given the opportunity to truly trust and listen to your body, she says, it’s important to find a holistic OB-GYN, or at least one with an open mind and a low C-section rate. 

The WellBe Takeaway on Integrative Reproductive Health

Women’s reproductive health is the basis of their overall health, and reproductive milestones like periods, pregnancy, and menopause are some of the biggest moments in a woman’s life. Dr. Anna Cabeca is an illustration of how using an integrative approach in obstetrics and gynecology can lead to the best results for both women and babies. Here’s what to remember about holistic female health:

• A woman’s fertility is a reflection of her overall health. While conventional fertility treatments like IVF are often necessary, there are many natural fertility strategies that work by simply optimizing a woman’s overall health.
• One of the main root causes of infertility is an irregular period. Dr. Cabeca advises that women get off any sort of hormonal birth control and get to know the rhythms of their menstrual cycle. If anything seems off, they need to take steps to bring their hormones back in balance and optimize their cycle.
• Stress is another major root cause of infertility. There’s a close relationship between stress and fertility, because the stress hormone cortisol is essentially made from the reproductive hormone progesterone. When stress levels are up, it negatively impacts progesterone levels, leading to fertility problems.
• As a holistic OB-GYN, Dr. Cabeca also works with women undergoing conventional infertility treatments, and helps them support their treatment cycles with lifestyle-based changes. This involves optimizing nutrition by avoiding sugar and eating green, keto-based meals, as well as other integrative practices like acupuncture and taking detoxifying herbs.
• To have as natural a pregnancy as possible and avoid unnecessary interventions both during pregnancy and during labor and delivery, Dr. Cabeca advises women to optimize their nutrition (avoiding sugar and dairy, eating organic greens, high-quality proteins, and healthy fats), take appropriate supplements (including a multivitamin with methylated B-vitamins, an omega-3 fish oil, vitamin D, and carnitine), do pelvic floor exercises and pelvic massage to prepare the body, have a vision of how the birth will go, and to listen to their body rather than agreeing to procedures intended to speed things along. 

Have you ever worked with a holistic OB-GYN? If so, what was your experience? Tell us about it in the comments below!

Watch our whole interview with Dr. Anna Cabeca to learn her thoughts on egg freezing, why she advises her clients to use prayer and fasting when making big reproductive decisions, how to choose a holistic OB-GYN, why breastfeeding is so important, how to best support babies who were born via C-section, the best practices for postpartum recovery, and much more!

You can also listen to this interview as an episode of The WellBe Podcast.

Citations:

1. Roney, J.R., Simmons, Z.L. Elevated Psychological Stress Predicts Reduced Estradiol Concentrations in Young Women. Adaptive Human Behavior and Physiology 1, 30–40 (2015).
2. Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015 Oct-Dec;8(4):191-6.
3. Goran MI, Plows JF, Ventura EE. Effects of consuming sugars and alternative sweeteners during pregnancy on maternal and child health: evidence for a secondhand sugar effect. Proc Nutr Soc. 2019 Aug;78(3):262-271. 
4. Ferreira, Gustavo C, and Mary C McKenna. “L-Carnitine and Acetyl-L-carnitine Roles and Neuroprotection in Developing Brain.” Neurochemical research vol. 42,6 (2017): 1661-1675. 

The information contained in this article comes from our interview with Dr. Anna Cabeca, a triple-board certified physician in gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine, as well as an expert in functional medicine and women’s health. Dr. Cabeca earned her medical degree from Nova-Southeastern University of the Health Sciences in Florida, and completed her residency at Emory University. She is the author of Keto Green 16 and The Hormone Fix. You can learn more about Dr. Anna Cabeca here.