implantation

What is Fetal Programming?

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What is fetal pro­gram­ming? Every per­son liv­ing on earth was first exposed to a uter­ine envi­ron­ment that helped deter­mine their life­time health and devel­op­ment. The term for this phe­nom­e­non is fetal pro­gram­ming. It is a hot top­ic and deserves atten­tion.

Accept­ing the impor­tance of fetal pro­gram­ming places respon­si­bil­i­ty on the moth­er-to-be to do all she can to insure her body pro­vides nutri­ents and oxy­gen to her grow­ing infant while avoid­ing pos­si­ble risks and tox­ins. At the same time, genet­ic and envi­ron­men­tal fac­tors con­tribute great­ly to the poten­tial for some dis­or­ders and prob­lems that arise. Thus, we must be care­ful in assign­ing guide­lines for accept­able behav­ior or blame for poor out­comes to preg­nant women.

On the one hand, we can all see the neg­a­tive con­se­quences of some­thing like fetal alco­hol syndrome…clearly the result of mater­nal behav­ior. Is a preg­nant woman whose baby has been dam­aged in this way guilty of abuse?

But, what if a moth­er is obese, eats poor­ly and ends up with an infant with a dis­turbed metab­o­lism. Is this abuse? What if the moth­er has an infec­tion that results in cere­bral pal­sy? Or what if she lives near a high­way and invol­un­tar­i­ly inhales fumes that neg­a­tive­ly affect the pla­cen­ta?

How do you get a healthy baby? Of course, there are no guar­an­tees. There remain many unknown fac­tors that can affect the course and out­come of a preg­nan­cy. Some fac­tors we are aware of, such as avoid­ing cer­tain fumes or chem­i­cals.  There are some behav­iors we know can max­i­mize the poten­tial for a good out­come, such as eat­ing ade­quate pro­tein, aer­o­bic con­di­tion­ing and strength train­ing. [Note for new readers…lots of these fac­tors have been cov­ered in our pre­vi­ous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cau­tion­ary tale:  There is a species of goat that, if they eat a cer­tain type of skunk grass on day 14 (and only day 14) of preg­nan­cy, will not go into labor. Why? Plant tox­ins in this grass inter­fere with the devel­op­ment of a small por­tion of fetal brain, the par­aven­tric­u­lar nucle­us. This nucle­us is involved in the sig­nal­ing cycle of labor. With­out it, the moth­er will not go into labor!

What are the take-home mes­sages here?

  • Prob­a­bly no one is ever a per­fect fetus…too many pos­si­ble threats.
  • There are some threats we can avoid…being lazy, over-eat­ing, smok­ing.
  • There are some threats we can­not avoid, so we do the best we can.

Do the best you can by your baby…aerobic fit­ness, good nour­ish­ment, sleep, good hygiene and de-stress­ing your life.

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 — Maternal Immunological Response

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Today: Mater­nal Immuno­log­i­cal Response…or…the Mother/Fetus Dance!

Maternal Immune Response During Pregnancy

Mater­nal Immune Response Dur­ing Preg­nan­cy

Back to work! Thank you for your fore­bear­ance while we wrote a chap­ter for a nurs­ing text­book!

Dur­ing the course of preg­nan­cy, the mother/fetus dance is ongo­ing. The mater­nal immune sys­tem and the tro­phoblast cells con­tin­ue to influ­ence each oth­er even beyond the implan­ta­tion.

Because the mother’s immune response mod­u­lates near the start of each trimester, the fetus is affect­ed to some degree and mounts a response, as well. For a long time it was thought that mater­nal and fetal DNA mate­r­i­al was not exchanged across the pla­cen­tal mem­brane, how­ev­er recent find­ings indi­cate that there is some exchange of mate­r­i­al. Thus, we all car­ry some por­tion of our mother’s DNA and our moth­er car­ries some of ours.

What is the impact of this chimeric effect? It depends on how well our DNA gets along!

How does this affect the fetus in utero? The fetus may be affect­ed by clot­ting issues. Depend­ing on mater­nal health sta­tus s/he may be sub­ject to a stronger or weak­er immune sys­tem.

How does this affect the moth­er? Women are more like­ly than men to devel­op autoim­mune dis­or­ders (preg­nan­cy play­ing a role here), and those who bear male off­spring are more like­ly than those who only have girls to have these dis­or­ders.

The maternal/fetal dance goes on.…

Be Prepared for Birth!

Be Pre­pared for Birth!

Pregnancy Pathway, Conception — Prior Sperm Exposure

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Today:  Sperm!!!

For com­plete graph­ic, see Feb. 5 or 23 post.

The mother's prior sperm exposure can affect her pregnancy.

The mother’s pri­or sperm expo­sure can affect her preg­nan­cy.

Not every sperm is your friend! Sperm expo­sure — like so many expo­sures — affects our immune sys­tem. Women who have babies with more than one father may be at risk for dis­or­ders of preg­nan­cy because the chal­lenges to their immune sys­tem have been exten­sive. And, very young women who become preg­nant are at increased risk of some dis­or­ders because they have had very lit­tle expo­sure to sperm.

In addi­tion, women who have pri­mar­i­ly and exten­sive­ly used bar­ri­er meth­ods of con­tra­cep­tion may be at risk for dis­or­ders for rea­sons sim­i­lar to young women with lit­tle expo­sure. Unlike women whose immune sys­tem has had too much chal­lenge due to preg­nan­cies by sev­er­al men, women with lit­tle expo­sure may not have a strong defense against for­eign DNA. Please do not take this as a rea­son to not use a con­dom — one of the bar­ri­er meth­ods along with a diaphragm and cer­vi­cal cap. Rather, if you use a bar­ri­er method of con­tra­cep­tion, keep in mind that your body’s adjust­ment to preg­nan­cy may take time.

For more infor­ma­tion on bar­ri­er meth­ods, to go the Amer­i­can Col­lege of Obste­tri­cians and Gyne­col­o­gists’ online pam­phlet: ACOG Pam­phlet on Bar­ri­er Con­tracetp­tion.

Anoth­er way sperm can affect the preg­nan­cy is that the com­bi­na­tion of the mother’s and father’s nat­ur­al immune respons­es may be strong against the tro­phoblast implan­ta­tion. This is not some­thing  you can know ahead of time. Also, women are eight times more like­ly than men to devel­op autoim­mune dis­or­ders. One rea­son may be the pre­na­tal expo­sure to for­eign DNA encoun­tered in preg­nan­cy.

Keep in mind that by get­ting good pre­na­tal care, exer­cise, suf­fi­cient rest, stress man­ag­ment and healthy nutri­tion, you do all with­in your pow­er to have a healthy preg­nan­cy. Your health care provider will deter­mine your risk fac­tors that may affect preg­nan­cy out­come and treat you in an appro­pri­ate man­ner.

Moms and babies enjoy exercise together!

Moms and babies enjoy exer­cise togeth­er!

Once your baby comes, there will be time to max­i­mize health for both of you. Exer­cis­ing togeth­er is great fun!

Get­ting there may require some patience, but the reward is well worth it.

When you are look­ing around for sperm, use your head. The same behav­ior that pro­tects you from infec­tions you nev­er want to get, pro­tects you from sperm you don’t real­ly want to meet. When the time comes to adopt some sperm, find out about it’s cre­den­tials!

Pregnancy Pathway, Conception — Health Status

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Today: How the mother’s health sta­tus at the time of con­cep­tion affects the preg­nan­cy.

For com­plete graph­ic, see Feb. 5 or 23 post.

The Impact of Health Status at the time of conception.

The Impact of Health Sta­tus at the time of con­cep­tion.

When a woman becomes preg­nant, her health can be a major fac­tor how her preg­nan­cy will pro­ceed. If she has been exposed to a vir­u­lent infec­tion, it may have an impact on how well the implan­ta­tion goes. If she has meta­bol­ic syn­drome, she is at risk for com­pli­ca­tions such as ges­ta­tion­al dia­betes.

On the oth­er hand, if she has tak­en care of her­self, is phys­i­cal­ly fit and well nour­ished, is well rest­ed and has not been exposed to ill­ness­es that induce dra­mat­ic changes in her immune sys­tem, she has done her best to cre­ate a sit­u­a­tion in which her body is best pre­pared for the rig­ors of preg­nan­cy.

There are still genet­ic and envi­ron­men­tal fac­tors that can affect the course of the preg­nan­cy, but behav­ior is the one fac­tor that women have con­trol over. At Danc­ing Thru Preg­nan­cy we are fond of the notion that if you know a cer­tain behav­ior is the best for a sit­u­a­tion, it is smart to chose that behav­ior; if you do not, you are sab­o­tag­ing your­self.

So, if preg­nan­cy is in your head­lights, eat right, exer­cise, and be cau­tious about expo­sure to ill­ness and infec­tion. Wash your hands, use one of the hand cleansers, prac­tice safe sex (okay, so if you are try­ing to get pg, this may change, but in the mean­time!).

We wel­come com­ments on what you are doing to be healthy for preg­nan­cy!

Curl-up! Strong abs are part of physical fitness!

Curl-up! Strong abs are part of phys­i­cal fit­ness!

Pregnancy Pathway, Preconditions — Behavior

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Please refer to Feb­ru­ary 5 entry for entire graph­ic. Today:  Behav­ioral Pre­con­di­tions to Preg­nan­cy.
bubblus_preconditions-behavior

Why do you sup­pose the Amer­i­can Col­lege of Nurse Mid­wives and the Amer­i­can Col­lege of Obste­tri­cians and Gyne­col­o­gists rec­om­mend the min­i­mum time between preg­nan­cies to be two years? Why is it crit­i­cal to eat foods high in B vit­a­mins (includ­ing folic acid) and cal­ci­um dur­ing the child­bear­ing years? How does your exer­cise reg­i­men in the six months pri­or to con­cep­tion affect your risk for some dis­or­ders of preg­nan­cy, such as preeclamp­sia?

Answer:  Your pre­con­cep­tion or inter­con­cep­tion behav­ior affects the course and out­come of your preg­nan­cy. As it turns out, it takes about two years for a mother’s body to replen­ish her stores between preg­nan­cies. Pri­or to a first preg­nan­cy, behav­ior in the six months lead­ing up to con­cep­tion has been shown to affect out­come.

Dur­ing preg­nan­cy, nutri­tion­al and func­tion­al resources must sup­port two beings in one body, one of whom is grow­ing at a very fast speed by bio­log­i­cal stan­dards (think cell time NOT com­put­er time). Essen­tial vit­a­mins and min­er­als (such as B vit­a­mins and cal­ci­um) are tak­en from the mother’s body — already in meta­bol­ic stress due to demands on the kid­neys and liv­er to clear tox­ins and fil­ter meta­bol­ic waste from the fetus as well as the moth­er.

Insur­ing that mater­nal stores of valu­able nutri­ents are ade­quate to pro­vide for both fetus and moth­er is a job that only the poten­tial moth­er can do. By eat­ing a bal­anced and col­or­ful diet of pro­teins, fruits and veg­eta­bles, whole grains and essen­tial fat­ty acids (omega 3’s and 6’s — fish, wal­nuts, olive oil, ava­ca­do, eggs), as well as ade­quate aer­o­bic exer­cise lead­ing up to and dur­ing preg­nan­cy, a woman improves her odds for a healthy infant. Smart behav­ior reduces her risk for con­di­tions that cause immune sys­tem and car­dio­vas­cu­lar dis­or­ders that dis­turb implan­ta­tion, blood pres­sure and blood flow to essen­tial organs.

Fur­ther, avoid­ing risky behav­iors that may lead to sys­temic infec­tions, meta­bol­ic syn­dromes or mal­nu­tri­tion lead­ing up to con­cep­tion is an aspect of behav­ior known as “risk-aver­sion” —  the abil­i­ty to avoid behav­iors that have neg­a­tive con­se­quences. Infec­tion at the time of con­cep­tion (to be dis­cussed in a future post), an extreme lifestyle (either seden­tary or anorex­ic), tox­ic food choic­es, drugs, tobac­co and alco­hol are all behav­iors that incur risk for poor preg­nan­cy out­comes, includ­ing pre­ma­tu­ri­ty and low birth weight — out­comes  on the rise in the U.S.

dtp_mover22As dis­cussed in the pre­vi­ous two posts, behav­ior is inter­twined with genet­ics and envi­ron­men­tal influ­ences. Hav­ing a cer­tain gene muta­tion or an envi­ron­men­tal risk may pre­dis­pose a woman to pos­si­ble prob­lems in preg­nan­cy or the devel­op­ment of cer­tain can­cers, but some behav­iors — espe­cial­ly exer­cise — may mit­i­gate this poten­tial or reduce the sever­i­ty or course of dis­ease. Behav­ior is the area in which we have the great­est con­trol. Exer­cise, healthy nutri­tion and risk aver­sion are the three areas in which women can exert con­trol over their des­tiny as moms-to-be. It’s a dif­fi­cult set-up. We live in a time of instant grat­i­fi­ca­tion of per­son­al acts. But, moth­er­hood is a long-term com­mit­ment to the bio­log­i­cal and psy­chic well­be­ing of a new human who is — and is not — us.

Pregnancy Pathway, Preconditions — Environment

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Please refer to Feb­ru­ary 5 entry for entire graph­ic. Today: Envi­ron­men­tal Pre­con­di­tions to Preg­nan­cy.
bubblus_preconditions-environment
Our envi­ron­ment is with us all the time. Even if we think we are pre­vent­ing or con­trol­ling envi­ron­men­tal fac­tors that impinge on our bod­ies and minds, they are lurk­ing here, there, every­where, and they are myr­i­ad. Our envi­ron­men­tal influ­ences are every­thing from the air we breathe to the per­sons who raise or teach us, from the food avail­able to our hous­ing, from our job stress­es to cul­tur­al forces or even the weath­er in our part of the world. These things help shape who we are phys­i­cal­ly and men­tal­ly, over the long term and from moment to moment.

08-4Are you pre­pared to become a par­ent? One way to tell is to look at your environment…is it healthy? Are you liv­ing in a sit­u­a­tion that you can count on? What about clean air, safe paint or safe food? What about water? What about peo­ple around you? Are they sup­port­ive? Does your envi­ron­ment help you stay healthy?

What about your body? Fac­tors in the envi­ron­ment that affect fer­til­i­ty (or lack of it) may deter­mine if  you can even become preg­nant, or when you can become preg­nant. Think about this:  Women who work togeth­er often cycle togeth­er. What if you work alone, say at home…does this affect your ovu­la­tion? One fac­tor iden­ti­fied in the low­er­ing age of men­stru­a­tion in girls is the increas­ing num­ber of hor­mones in var­i­ous meats. Anoth­er fac­tor is the pres­ence of non-bio­log­i­cal­ly relat­ed old­er males in the house­hold. If these things are known, imag­ine what is not known about sit­u­a­tions, chem­i­cals or peo­ple in our envi­ron­ment that affect our repro­duc­tion!

There is not an absolute sep­a­ra­tion of genet­ics, envi­ron­ment and behav­ior. If we are genet­i­cal­ly pre­dis­posed to cer­tain dis­or­ders, for exam­ple, we may or may not devel­op them, depend­ing on envi­ron­ment. Some per­sons are inclined toward autoim­mune dis­or­ders, but they may do well or poor­ly depend­ing on the air pol­lu­tion where they live. Some indi­vid­u­als may devel­op immune dis­or­ders. And, this sit­u­a­tion may adverse­ly impact inflam­ma­to­ry respons­es dur­ing implan­ta­tion.

Peo­ple who strive to take care of them­selves even if they live in hor­ri­ble con­di­tions can use their behav­ior to improve their chances for suc­cess in every­thing from a healthy preg­nan­cy to a mean­ing­ful exis­tence. Even if genet­ics and the envi­ron­ment are against the process, behav­ior can some­times over­come the odds. Grant­ed, it’s not like­ly you can pro­duce 6′5″ off­spring (see last post on genet­ics!) if the egg per­son is 5′2″ and the sperm per­son is 5′7″, but much is pos­si­ble beyond that.

So, what do you do about your envi­ron­ment if you are think­ing about becom­ing preg­nant? Take stock. Ask your­self what, if any­thing, might have to change. Ask what you can or can’t accept for your off­spring, if you know there are envi­ron­men­tal fac­tors that aren’t per­fect. Fetus­es are amaz­ing crea­tures; the pla­cen­tas that sup­ply and defend them are ruth­less and will pro­tect a fetus at all costs. But, you can give your body and poten­tial baby a good chance to do well by pro­vid­ing a six month span of a healthy envi­ron­ment lead­ing up to con­cep­tion. And, healthy for mind as well as body.

When your baby comes into the world, a door opens in your heart to a room you didn’t even know was there. In that room is a cer­tain kind of love and car­ing that can­not be described. It is love for this being who is and isn’t you. As a moth­er, you have been her/his envi­ron­ment for nine months or how­ev­er long you have shared. The womb is a small, pro­tect­ed, orga­nized envi­ron­ment, one that reflects your larg­er envi­ron­ment. So, take stock now, ahead of time.