baby

Value of Postpartum Fitness

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Here are two important facts regarding physical activity following birth:

1. Women who return to vig­or­ous (vig­or­ous, as in jog­ging or aer­o­bic dance) pri­or to six weeks post­par­tum…

  • have less weight to lose
  • expe­ri­ence a more joy­ful state of mind
  • do bet­ter on the Led­er­man Mater­nal Adap­ta­tion scales (how well they adapt to moth­er­hood)

…than women who are seden­tary dur­ing this peri­od (Sampselle, 1999…this is not new infor­ma­tion)

2. Post­par­tum obe­si­ty is a dan­ger­ous short and long term health risk (Led­dy, 2008).

Who should exercise and when, following birth?

Day 1: If you have a vagi­nal birth, begin your “body scan” the first chance you get. With­in the first day, the first chance you get to focus on your­self, take a men­tal trip through your body. See if you can squeeze the kegel mus­cles. Try exhal­ing and suck­ing in your deep abdom­i­nal mus­cles. Note if your shoul­ders need to relax. Take some deep breathes and begin to help your body recov­er.

If you had a cesare­an: Wait a few days to 2 weeks at most to work on this.

After that: As soon as you can, get up and walk around. Start walk­ing in 5 or 10 minute strolls sev­er­al times a day (ask some­one to hold or watch baby so you can allow your body to recov­er a non-preg­nant upright). If you had a cesare­an, hold a pil­low to your abdomen until you have con­trol of your abdom­i­nal mus­cles and stand tall.

How can you get more information on this?

Go to our web­site:

http://dancingthrupregnancy.com/take-a-class/postpartum-exercise/

Find a class. If you had a typ­i­cal birth and your baby has been slow­ly and safe­ly exposed to new peo­ple, by four to six weeks you and baby should be ready for a struc­tured activ­i­ty ses­sion that includes baby. It will also pro­vide focus and adult inter­ac­tion dur­ing the week.

You have to teach your abdomen to be flat.
How do you know if you did too much?

Your lochia, or the bleeding/discharge from the pla­cen­tal site, will increase if you have been too vig­or­ous. If you are healthy and have no ane­mia issues, your lochia will like­ly cease by three to four weeks, six at most.

What are safety issues?

Don’t exer­cise if you have a fever, a warm red spot on your leg that may be painful (or not), or sore nip­ples that need atten­tion. Call your care provider. If you or your baby are sick, it is best not to go into a group set­ting. If your baby is not well or just doesn’t seem right, call your pedi­a­tri­cian.

The most important reason to join a mom-baby fitness program may be that it will help keep you sane.

Pregnancy Pathway, Birth — Labor

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The First Stage of Child­birth is the long, hard labor. It is the slow process that pro­duces dila­tion, or open­ing, of the cervix — the “neck” or out­let at the bot­tom of the uterus. Once the baby’s head can fit through the open cervix, it is time for the Sec­ond Stage, but that is anoth­er top­ic for anoth­er post.

Labor is generally a long, slow process...there is no "enter" button for dilation!

Labor is gen­er­al­ly a long, slow process…there is no “enter” but­ton for dila­tion!

Before the baby can leave the mother’s body, s/he must leave the uterus. The open­ing of the cervix to let the baby out of the uterus gen­er­al­ly takes up the most time. For a first time mom it can be 10 or 12 hours…or, yes, a cou­ple of days. Of course, for some moms, this time is dif­fi­cult and for oth­ers it only becomes dif­fi­cult in the last few hours.

But, you know all this, right? What you want to know is:  Why do I have to go through this? And, if I must, how can I make it the least painful?

Why labor is impor­tant. Let’s go to anoth­er ques­tion:  How impor­tant would your off­spring be if it was no big deal to drop one out? If you were walk­ing along the side­walk and you could sim­ply drop a new­born on the pave­ment, would you even stop to pick it up if you could do it again in a few days, when, of course, it will be much more con­ve­nient?

Frankly, preg­nan­cy and labor remind us to pay atten­tion. A new­born can­not sur­vive on its own for at least two years. If we don’t pay atten­tion, it will die.

Okay, now that labor has your atten­tion, what else does it do that is ben­e­fi­cial? It stim­u­lates the baby’s stress response and teach­es the new­born to be alert dur­ing sit­u­a­tions of duress. Each con­trac­tion is pulling the cervix, help­ing it slow­ly open. If you are upright, each con­trac­tion is also alert­ing the baby to the influ­ence of grav­i­ty.

Why is labor painful? So, you need to go through this because it is the bridge from preg­nan­cy to par­ent­hood. Why does it have to be painful?

The first thing to keep in mind about pain is that pain is a com­bi­na­tion of sen­sa­tions and emo­tion, main­ly fear. Fear makes you tense; ten­sion reduces blood flow. Reduced blood flow to the uterus makes the con­trac­tions less effec­tive. In addi­tion, cor­ti­sol is released, mak­ing sen­sa­tions stronger and evok­ing greater fear.

Fear is the emo­tion of fight or flight. Inter­est­ing­ly, the oppo­site response, the relax­ation response, is very effec­tive in pro­mot­ing labor. So, relax. Breathe deeply and slow­ly, focus, move through the cen­ter of your expe­ri­ence. You don’t have to be in fear if you know what is hap­pen­ing and if you are phys­i­cal­ly fit and pre­pared. Both child­birth edu­ca­tion and phys­i­cal fit­ness teach your body to work with dis­com­fort. By includ­ing them in your prepa­ra­tion, you give your­self a tremen­dous advan­tage.

Does this mean you will nev­er feel like you want to stop in the mid­dle of labor? No, but it does mean you can do it. It is finite. The notion that the baby will not do well is also tied to your phys­i­cal fit­ness…babies of fit moth­ers less often expe­ri­ence fetal dis­tress. Your care providers will let you know if there is some fac­tor beyond your con­trol that requires med­ical inter­ven­tion.

Birth is an empow­er­ing event. But, before the baby can be born, it must escape the uterus. It is a clas­sic con­flict and the mother’s body is the venue. Give your­self over; go with it. Only women can do this.

Pregnancy Pathway, Birth

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There is no birth of con­scious­ness with­out pain.

Birth is a process with two major components

Birth is a life process with two major com­po­nents

Okay, be here now:  This is about a real­ly major experience…bringing human con­scious­ness into the world…opening a door to a room of love in your heart that you can only know by giv­ing birth to this person…changing your iden­ti­ty for­ev­er.

Get­ting your mind around the image: If you have not tak­en the time yet to get your mind around this, take a moment. Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sid­er:  Your body has the pow­er to cre­ate a per­son. Your body has the pow­er to expel this per­son when the rent is up.

Your brain, glands and organs are hav­ing a con­ver­sa­tion with the baby’s brains, glands and organs. At some point, this dis­cus­sion reach­es a place where it is time to end this arrange­ment of two peo­ple shar­ing one body. It is true that occa­sion­al­ly the pas­sen­ger doesn’t want to leave, but that is rare. And, we have a rem­e­dy for that. Let’s just focus now on the what hap­pens when it’s time to go.

Labor starts how? Well, it depends. Some­times con­trac­tions start in fits and spurts and take a while to get orga­nized. Some­times they start strong­ly from the get go, and for oth­ers the process of get­ting rolling can take a few days. Some­times it starts ear­ly, and some­times has to be helped to start. Once in a while, the water breaks and labor starts…or not. So, the first les­son of hav­ing a child come to live with you is that you need to be flex­i­ble in your expec­ta­tions.

In the next two posts, we’ll cov­er Labor and then the Birth Mode. Each of these process­es is unique. They involve dif­fer­ent ener­gy sys­tems. They require dif­fer­ent mind-sets from the moth­er and her sup­port team. The out­comes are dif­fer­ent. Going through the cen­ter of these process­es helps you deal with them, helps you recov­er from their stren­u­ous nature and helps you move on to being a par­ent.

Remem­ber: Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sid­er:  Your body has the pow­er to cre­ate a per­son. Your body has the pow­er to expel this per­son when the rent is up.

Twins & Triplets — Exercise & Nutrition Tips

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A detour: We received a ques­tion about nutri­tion and exer­cise for mul­ti­ples. So, here is some infor­ma­tion for those with twins and triplets. Add a com­ment if you have a ques­tion or expe­ri­ence to share on this top­ic! Next comes birth, we promise!!

If one is a girl and one is a boy, they're fraternal!

If one is a girl and one is a boy, they’re fra­ter­nal!

Nutri­tion for Mul­ti­ples:

The pri­ma­ry thing we tell peo­ple with twins or more is that the pro­tein needs rise about 30 grams/baby/day above the 70 — 90 grams/day need­ed for a sin­gle­ton. Water intake also needs to rise. Avoid thirst and as much as pos­si­ble, drink until urine runs clear rather than yel­low (as best as you can).

Mul­ti­ples is con­sid­ered a risk fac­tor, and for each risk fac­tor (mul­ti­ples, under­weight, teenage mom, inter-preg­nan­cy peri­od less than a year) an addi­tion­al 200 calo­ries is often rec­om­mend­ed, with 400 extra calo­ries the upper lim­it.

Exer­cise with Mul­ti­ples:

A crit­i­cal fac­tor in suc­cess­ful implan­ta­tion and growth of the pla­cen­ta appears to be aer­o­bic fit­ness in the six months pri­or to and the first half of preg­nan­cy. Once bio­me­chan­ics become dif­fi­cult in mid-preg­nan­cy, women with mul­ti­ples can con­tin­ue activ­i­ty safe­ly as long as mon­i­tor­ing show the babies are grow­ing appro­pri­ate­ly. A bel­ly sup­port can be extreme­ly help­ful when exer­cis­ing.

Con­traindi­ca­tions for exer­cise include the dis­cov­ery that one fetus is grow­ing at a sig­nif­i­cant­ly slow­er rate than the other(s), that both/all are too small, that the placenta(s) is/are mal­func­tion­ing, or some oth­er con­di­tion occurs, such as an incom­pe­tent cervix or pla­cen­ta pre­via, that would be a fac­tor in any case.

Absolute size dif­fer­ence does not nec­es­sar­i­ly mean that one baby is grow­ing more slow­ly, as some fetus­es may be a cou­ple weeks younger than their uterus-mate(s) if the moth­er ovu­lat­ed twice in the fer­til­i­ty cycle. Or, s/he might be small­er if genet­i­cal­ly des­tined to be a small­er infant at birth. Thus, growth rate is the mea­sur­able fac­tor that helps deter­mine if a fetus is at risk of not receiv­ing ade­quate ener­gy. This can hap­pen when there are two pla­cen­tas and one pla­cen­ta is work­ing more poor­ly than the oth­er, or for some rea­son there is a flaw in the umbil­i­cal cord of an iden­ti­cal. The com­pe­ti­tion for ener­gy places a slow­er grow­ing baby at risk.

Pro­tect­ing Mom and Baby:

The pla­cen­ta is designed to nour­ish the baby and will do so at a cost to the moth­er first if there is inad­e­quate nutri­tion. Thus, activ­i­ty to the lev­el the moth­er can tol­er­ate and fol­low­ing nutri­tion­al guide­lines above — in the absence of med­ical com­pli­ca­tions — pro­duces healthy off­spring. Mul­ti­ples will gar­ner all the same ben­e­fits a sin­gle­ton does.

Note about images:  we strive to use images we own or that are adver­tised as free on the inter­net. We want to thank google, bing and yahoo for mak­ing free images avail­able.

Pregnancy Pathway, Pregnancy — Behavior: Avoiding Risks

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Some­times it seems like preg­nan­cy is a time of restric­tions. Avoid­ing risks can be one thing that makes it seem that way. But, bear with us here in an inter­est­ing trip through dan­ger and find­ing you find ways of enhanc­ing your preg­nan­cy!

Risk Fac­tor #1:

Lack of pre­na­tal care. More than any­thing else, be sure you have care. Hav­ing some­one mon­i­tor your health and that of your baby dur­ing preg­nan­cy is vital to a good out­come.

Risk Fac­tor #2:

Not exer­cis­ing. Seden­tary behav­ior increas­es the risk for meta­bol­ic, car­dio­vas­cu­lar and immune dis­or­ders.

I know, I know, you don’t have time to exer­cise. Well, pay now or pay lat­er, as they say. Make time to go to a class (make sure it includes 20 -30 min­utes of aer­o­bics) a cou­ple times a week. A class will also pro­vide social sup­port, anoth­er fac­tor that enhances your preg­nan­cy. Take a walk at lunch time. Prac­tice relax­ation tech­niques.

Risk Fac­tor #3:

Breath­ing dan­ger­ous fumes. Yes, this includes smok­ing and sec­ond-hand smoke. But, it also means avoid­ing envi­ron­ments where there is a lot smog (near high­ways), liv­ing with mold or dust, and fan­cy cleansers that may have dan­ger­ous chem­i­cals in them. Stick with vine­gar, ammo­nia or bleach as cleansers.

Smog can endanger your fetus!

Smog can endan­ger your fetus!

We are learn­ing that com­bus­tion exhaust from cars and trucks can neg­a­tive­ly affect birth weight and pre­ma­tu­ri­ty. If you live or work near a high­way or in an area where smog is preva­lent, what are your options? Can you trans­fer or move? Can you wear a mask? Talk to your care provider and fig­ure out the best pro­tec­tion for you and your fetus.

Risk Fac­tor #4:

Poor Nutri­tion. Yup, just go back one entry and find out how food affects preg­nan­cy. If you don’t eat enough pro­tein and drink enough water, you don’t make suf­fi­cient blood vol­ume to nour­ish your pla­cen­ta and thus your fetus.

Read labels!

Read labels!

Eat whole foods and learn to read labels when you buy processed foods. What is a “processed” food? Any­thing with more than one ingre­di­ent!

Some pro­cess­ing (ex: home­made soup) takes lit­tle nutri­tion away, but some pro­cess­ing (ex: pota­to chips) takes every­thing good away and replaces it with unsafe sub­stances. Look for low sodi­um, low sug­ar, high vit­a­min and min­er­al con­tent items with no sat­u­rat­ed or trans fats.

Read the ingre­di­ents; if you don’t know what the words mean, maybe you want to pass it up.

Risk Fac­tor #5:

Alco­hol and Drugs. Com­mon items can be as dan­ger­ous as street drugs, which

There is plenty of time in life for a glass of wine...later.

There is plen­ty of time in life for a glass of wine…later.

No. No. No. Only meds from your prenatal care provider are okay.

No. No. No. Only meds from your pre­na­tal care provider are okay.

Caffeine? Only one cup & only if you must.

Caf­feine? Only one cup & only if you must.

can severe­ly com­pro­mise you baby’s future. If you have a drug or alco­hol habit, get help.

Risk Fac­tor #6:

Genet­ics. You can have genet­ic pre­dis­po­si­tions for many preg­nan­cy issues. How­ev­er, that does not nec­es­sar­i­ly mean you will devel­op a giv­en dis­or­der. For exam­ple, nutri­tion and exer­cise great­ly reduce the risk and sever­i­ty of meta­bol­ic issues. Some genet­ic issues are unavoid­able how­ev­er, and your care provider will alert you to these, if they are rel­e­vant.

Risk Fac­tor #7:

Social issues — iso­la­tion, lack of sup­port, abuse, pover­ty. All of these fac­tors can have neg­a­tive effects.

If iso­la­tion is a sim­ple mat­ter of need­ing to meet oth­er moms-to-be, join an exer­cise pro­gram. That way, you get both sup­port and exer­cise; just be sure it includes aer­o­bics, along with cen­ter­ing, relax­ation and appro­pri­ate strength.

If your sit­u­a­tion is more dire, seek the help of a care provider or social work­er at your local hos­pi­tal or clin­ic. Safe­ty and sup­port are crit­i­cal for you at this time. Get the help you need. There are peo­ple who care. And, if you know of some­one who needs help, help them.

If you have oth­er risk fac­tors to offer, please post them in the com­ments. Thanks!

What’s next?  BIRTH!!

Pregnancy Pathway — Exercise cont’d

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MORE?!! You didn’t think that was it? Only a few com­ments on evi­dence as to WHY mov­ing around, burn­ing calo­ries, being strong and learn­ing to relax while preg­nant is ben­e­fi­cial? No, of course not. You know there is more to it, like WHAT move­ment is safe and effec­tive dur­ing preg­nan­cy?

So, what is safe? Well, first, unless you have a very few con­di­tions that your health care provider con­sid­ers unsafe, every woman — fit, cur­rent­ly seden­tary, young or a lit­tle old­er — can exer­cise safe­ly in preg­nan­cy. How much of what kind depends on your fit­ness lev­el and exer­cise his­to­ry. Get med­ical screen­ing first.

If you are fit, you can do vigorous exercise

If you are fit, you can do vig­or­ous exer­cise

If you are fit, you just need to learn how to mod­i­fy some move­ments to accom­mo­date your bio­me­chan­ics. As your body changes, stress on the joints and tis­sues means a lit­tle less jump­ing or bal­lis­tic motion will be more com­fort­able and safer. If you are fit, you can con­tin­ue with vig­or­ous exer­cise and it will be of ben­e­fit to you and your baby.

If you are not so fit or are seden­tary, find a cer­ti­fied pre/postnatal instruc­tor and join a group where you will have fun, get some guid­ance and be mon­i­tored for safe­ty. How do you find such a per­son? Try our Find A Class or Train­er page.

What is effec­tive? Don’t spend your time on things that may be nice to do but don’t help you focus and pre­pare for birth, relieve dis­com­forts or have the sta­mi­na for birth and par­ent­ing. There is sub­stan­tial sci­en­tif­ic evi­dence and infor­ma­tion from large sur­veys that these things are help­ful.

Car­dio­vas­cu­lar or aer­o­bic activ­i­ty is the most impor­tant activ­i­ty you can do. Already fit? Keep work­ing out; join a class if you want sup­port or new friends. If you are seden­tary or some­what active, you can improve your fit­ness by doing at least 20 — 30 min­utes of aer­o­bic activ­i­ty 3 times a week. Work at a mod­er­ate pace — some­what hard to hard — so that you can talk, but not sing an aria! If you are more than 26 weeks and have not been doing car­dio, you can walk at a com­fort­able pace. Aer­o­bics is key because it gives you endurance to tol­er­ate labor and pro­motes recov­ery.

Strength and flex­i­bil­i­ty exer­cis­es that do not hurt and are done cor­rect­ly are also safe. There are some spe­cial preg­nan­cy exer­cis­es that actu­al­ly help you pre­pare for birth. Essen­tial exer­cis­es that aid your com­fort, align­ment and birth prepa­ra­tion include:

Kegels (squeez­ing and relax­ing pelvic floor mus­cles) — squeez­ing strength­ens them and thus sup­ports the con­tents of the abdomen, and learn­ing to release these mus­cles is nec­es­sary for push­ing and birth.

Abdom­i­nal hiss/compress and C-Curve® - con­tract­ing the trans­verse abdom­i­nal mus­cles reduces low back dis­com­fort and strength­ens the mus­cle used to push and lat­er to recov­er abdom­i­nal integri­ty after birth.

Squatting

Squat­ting

Squat­ting — get­ting into this posi­tion strength­ens the entire leg in a deeply flexed posi­tion; start seat­ed and use arms for sup­port, sta­bil­i­ty and safe­ty. Leg strength improves mobil­i­ty and com­fort in preg­nan­cy and post­par­tum; plus, deep flex­ion is a com­po­nent of push­ing in almost all posi­tions.

Strength­en­ing for bio­me­chan­i­cal safe­ty — strength­en­ing some parts of the body helps pre­vent injury to bone sur­faces, nerves and blood ves­sels with­in joints re-aligned in preg­nan­cy. This can be done using resis­tance rep­e­ti­tions (weights, bands, cal­is­then­tics or pilates) or iso­met­rics (yoga or bal­let). A respon­si­ble class will focus on upper back (row­ing), push-ups, abdom­i­nals, gluteals, ham­strings, and mus­cles of the low­er leg.

Stretch­ing of areas that tend to get tight — reliev­ing some dis­com­forts through flex­i­bil­i­ty helps you main­tain a full range of motion. Sta­t­ic stretch­es, used in com­bi­na­tion with strength exer­cis­es or fol­low­ing aer­o­bics, is most effec­tive. Stretch­ing pri­or to exer­cise tends to pro­duce more injuries than not stretch­ing. Areas need­ing stretch­ing include the chest, low back, ham­strings and hip flex­ors (psoas).

Mind/Body skills are very impor­tant. There are two activ­i­ties that exer­cis­ers con­stant­ly tell us are a big help in preg­nan­cy, birth and par­ent­ing.

• Cen­ter­ing employs a bal­anced or neu­tral pos­ture, deep breath­ing and mind­ful­ness to help you work in a relaxed way. Ath­letes and dancers call this “the zone.” Start­ing your work­out in asso­ci­a­tion with your body estab­lish­es econ­o­my of motion, some­thing very use­ful in birth and par­ent­ing, and reduces risk of injury.

• Relax­ation is anoth­er key activ­i­ty; it relieves stress, pro­motes labor in the ear­ly stages and helps you enter the zone!

Remem­ber: Birth is a Motor Skill™

Pregnancy Pathway, Pregnancy – Exposure to Toxins and Infection

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Hot top­ic for today: Tox­ins and infec­tions in preg­nan­cy.

Pregnancy Exposure to Toxins and Infections

Preg­nan­cy Expo­sure to Tox­ins and Infec­tions

A moth­er-to-be needs to be aware of items that can have adverse effects on the health and devel­op­ment of her fetus, as well as her own health. Two of these fac­tors are tox­ins and infec­tions.

1. Tox­ins can be food, envi­ron­men­tal fac­tors, and med­ica­tions, alco­hol or drugs. Let’s start with food. Inter­est­ing­ly, many plants have slight tox­ins in them that can have a small neg­a­tive impact dur­ing ear­ly fetal devel­op­ment. One the­o­ry of nau­sea and vom­it­ing in ear­ly preg­nan­cy is that this helps the mother’s body pre­vent these tox­ins from inter­fer­ing with nor­mal devel­op­ment. Pica — espe­cial­ly eat­ing dirt that is large­ly clay — may be anoth­er man­i­fes­ta­tion of how the body strives to counter plant tox­ins, as clay can coun­ter­act some of the effects of these tox­ins. So, plant tox­ins can be one food source in ear­ly preg­nan­cy.

Anoth­er source is food addi­tives (things you can­not pro­nounce, so read the ingre­di­ents!). We have no idea how many chem­i­cals and hor­mones added to foods affect fetal devel­op­ment.

NIH illustration of reading food label

NIH illus­tra­tion of read­ing food label

Risk-aver­sion involves avoid­ing items that are risky. If you are not sure, don’t eat it. For up to date infor­ma­tion, look at the FDA site on food safe­ty or the NIH site on read­ing food labels.

Envi­ron­men­tal fac­tors that may affect fetal devel­op­ment can include air pol­lu­tion, house­hold cleansers, mold and oth­er items encoun­tered any­where one goes. Things we breathe can be par­tic­u­lar­ly dan­ger­ous, so be sure to keep cleanser use to sim­ple items such as vine­gar, ammo­nia or chlo­rine bleach. Wear­ing a mask while clean­ing is also a good idea.

Med­ica­tions, drugs or alco­hol that might nor­mal­ly be con­sid­ered safe for a non-preg­nant per­son — some­thing as sim­ple as aspirin — can be dan­ger­ous as they affect blood clot­ting fac­tors and threat­en the pla­cen­ta. Or, because they cross the pla­cen­tal bar­ri­er but can­not be metab­o­lized by the imma­ture fetal liv­er, they are tox­ic and induce dam­age to the fetus.

2. Infec­tions are of con­cern, as well. It is pos­si­ble that an active infec­tion at the time of fer­til­iza­tion and implan­ta­tion can con­tribute to dys­func­tion in preg­nan­cy because it inter­feres with the nor­mal immune respons­es of ear­ly preg­nan­cy. Hyper­ten­sion in preg­nan­cy may be relat­ed to infec­tion in the ear­ly days of preg­nan­cy. Some infec­tions — par­tic­u­lary sex­u­al­ly trans­mit­ted infec­tions — are known to have detri­men­tal effects on the baby’s health. Preterm pre­ma­ture rup­ture of mem­branes (P-PROM) almost always reflects active infec­tion.

Tak­ing Pre­cau­tions: First, be sure to let your health care provider know about any ill­ness or infec­tion. Sec­ond, take care of your­self. Fol­low rec­om­men­da­tions for fre­quent hand­wash­ing and car­ry ster­ile hand gel in your purse or back­pack. Avoid places where hygiene might be com­pro­mised. Prac­tice safe sex.

Rant: Health Care Reform/Pregnancy

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Since Health Care Reform is a hot top­ic, let’s look at it from the per­spec­tive of preg­nan­cy and birth.

What revi­sions would most ben­e­fit preg­nant women, their off­spring, fam­i­lies and com­mu­ni­ties?

1. Reward healthy behav­iors. A sys­tem that pro­vides reduced pre­mi­ums for health care for women who exer­cise, eat well, do not smoke and are in a nor­mal weight range is evi­dence-based.

Yes! We could pro­vide finan­cial incen­tives for being healthy dur­ing preg­nan­cy. Why? Healthy moms have healthy babies; healthy babies cost the pay­er less mon­ey.

2. Review best prac­tices. Is a 40 or 50% cesare­an rate the best prac­tice?  Accom­pa­ny­ing the rise in cesare­an births is grow­ing infor­ma­tion that babies born by cesare­an are at increased risk for a num­ber of immune dis­or­ders. But the busi­ness mod­el of med­i­cine rewards cesare­an because it both pays the provider more and is defen­sive med­ical prac­tice.

Fetal mon­i­tor­ing to deter­mine if a cesare­an may be nec­es­sary, is wrong 3/4 of the time. In an effort to change this, guide­lines are chang­ing for the use of mon­i­tors dur­ing labor. What is the evi­dence that this change of prac­tice is ben­e­fi­cial? Will it lead to more or less mon­i­tor­ing, which may itself be an inter­ven­tion that can dis­rupt nor­mal labor?

3. Change the busi­ness mod­el for health care. When we make finan­cial incen­tives for care providers, base them on best prac­tice, not on enrich­ing the mid­dle man. Cur­rent­ly the pay­ers (insur­ance com­pa­nies) are mid­dle men, mak­ing mon­ey (i.e., con­duct­ing busi­ness) by charg­ing fees. They ration pay­ments for ser­vices in order to pay their own salaries and over­head. They do not actu­al­ly do any­thing pro­duc­tive. This is why sin­gle pay­er, gov­ern­ment, and health care coop options have been pro­posed. They elim­i­nate most of the cum­ber­some mid­dle lay­er.

Why does insur­ance pay for cesare­ans? Well, they will do it once. After all, the care providers have to prac­tice defen­sive med­i­cine. But, once you have a cesare­an, you become a risk for the insur­ance com­pa­ny (they know what the research says about cesare­ans and off­spring health prob­lems) and may be denied insur­ance. They can no longer afford you.

Because care providers are paid fee for ser­vice and must prac­tice defen­sive med­i­cine, preg­nan­cy and birth have become increas­ing­ly bur­dened with inter­ven­ing pro­ce­dures that do not nec­es­sar­i­ly pro­mote a healthy preg­nan­cy or birth process. How is this play­ing out? Increas­ing­ly, we see women giv­ing birth in what they per­ceive as a more sup­port­ive and health-induc­ing set­ting:  their own homes. Think of it this way:  many women now believe that it is safer to stay home than go to a hos­pi­tal to give birth.

Unless health care becomes about best prac­tices and healthy out­comes — not price, size, and get­ting paid for pass­ing mon­ey back and forth — the U.S. will con­tin­ue to have some of the worst maternal/infant out­comes in the devel­oped world.

Pregnancy Pathway, Pregnancy

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Time for an entre: Preg­nan­cy!!

Up for dis­cus­sion…

Health Influences in Pregnancy

Health Influ­ences in Preg­nan­cy

Let’s start at the begin­ning…in the first trimester you feel sick and tired, right? Three things:

1) your immune sys­tem is pro-inflam­ma­to­ry (caus­ing nau­sea and fatigue), 2) your body is pro­tect­ing your fetus from some tox­ins (if you eat some­thing not so great for the fetus, you throw up), and 3) you have extreme swings in blood sug­ar lev­els so that after you eat, the lev­el soars and you feel sick.

Num­ber 3 can be fixed with behav­ior, but you may have to wait out 1 & 2. To fix num­ber 3 eat very small meals fre­quent­ly (6 or 8 times a day) and be sure to eat pro­tein, that is, eggs, meat, fish, fowl, cheese, nuts, rice & beans, soy, etc. with each small meal. This sta­bi­lizes blood sug­ar and pre­vents dra­mat­ic ele­va­tions that can cause nau­sea.

In most healthy preg­nan­cies, the immune sys­tem will rebound in the sec­ond trimester so that you feel good; it is pro­tect­ing you again!  But, those wicked tox­ins and infec­tions are still out there in the envi­ron­ment, so the mes­sage is beware bad air (smog, smok­ing, indus­tri­al air pol­lu­tion), high­ly processed foods (lunch­meats, things with names you can’t pro­nounce), any drugs or meds not pre­scribed or okayed by your ob or mid­wife, alco­hol, and dan­ger­ous bac­te­ria, virus­es and oth­er microbes!

Exer­cise wisely…no sky-div­ing or scu­ba div­ing! Eat healthy food and get enough sleep. De-stress through relax­ation and med­i­ta­tive tech­niques. Don’t take risks with your health, but do stay active and start to pre­pare for birth and bring­ing home a baby (or two?).

Third trimester & the immune sys­tem goes on the fritz again — can’t keep this baby in here for­ev­er; must expel! You may feel sick and tired again. BUT, keep your pre­na­tal care appoint­ments, keep mov­ing, get good nutri­tion, rest and stay focused. Before you know it the real work begins, not to men­tion the 18 years of sleep depri­va­tion.

Get­ting from here…

Being Fully Present in Your Pregnancy...

Being Ful­ly Present in Your Preg­nan­cy…

…to here..

Being Fully Present as Mom

Being Ful­ly Present as Mom.

…is a jour­ney like no oth­er. The adap­ta­tions of your body to the demands of preg­nan­cy are amaz­ing. If you pay atten­tion, you will learn more about the mean­ing of exis­tence from this than from any­thing else.

BE HERE NOW!!

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