offspring

DTP Offspring – Renee Crichlow: REAC Fitness

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In Part 4 of our con­tin­u­ing series on DTP’s off­spring, meet Renee Crichlow, ACSM Cer­ti­fied Per­son­al Train­er from Bar­ba­dos, whose REAC Fit­ness busi­ness includes Mum-me 2 B Fit­ness Series (pre­na­tal), After Baby Fit­ness Series (post­na­tal) and 6 week Jump­start Body Trans­for­ma­tion Pro­gram (gen­er­al female pop­u­la­tion).

See pho­tos and read more about Renee’s busi­ness on the DTP Blog here. The adven­tures of one of her stu­dents is fea­tured in a recent series of arti­cles in Bar­ba­dos Today.

Renee is a women’s fit­ness spe­cial­ist, tar­get­ing all stages of a woman’s life cycle from ado­les­cent, child bear­ing years, pre­na­tal, post­na­tal to menopause. I design var­i­ous exer­cise pro­grammes to help women get into shape. As a train­er, friend and coach, I am com­mit­ted to guid­ing, moti­vat­ing and edu­cat­ing women to exceed their fit­ness goals and to per­ma­nent­ly adopt healthy lifestyles. She start­ed study­ing with DTP in March 2012 and com­plet­ed the practicum in May 2012.

I most enjoy the good feel­ing asso­ci­at­ed with know­ing that I am help­ing women to pos­i­tive­ly change their lives through exer­cise. I have learned that we are con­nect­ed and not sep­a­rate from each oth­er. Shar­ing our chal­lenges and tri­umphs enable each of us to grow and have a sense of belong­ing like a sis­ter­hood. The baby and preg­nan­cy sto­ries always amaze me and I learn a lot con­sid­er­ing I don’t have chil­dren of my own.  I am also fas­ci­nat­ed by the fact that as the preg­nant mum­mies bel­lies grow, they are still mov­ing with lots of ener­gy and I feed off of that ener­gy.  I just love work­ing with preg­nant ladies and moth­ers.

Pregnancy Exercise — The Evolutionary Imperative for Vigorous Activity

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This arti­cle is from my blog, Danc­ingTh­ruPreg­nan­cy on Word­Press.

I have long want­ed to write this post. Recent­ly two arti­cles appeared in the NY Times prompt­ing me to move for­ward. One arti­cle dealt with how it is that ongo­ing vig­or­ous exer­cise pro­duces brain enhance­ments. The sec­ond arti­cle dealt with how run­ning cre­ates its “high” and explained why the result­ing addic­tion is an evo­lu­tion­ary ben­e­fit for human sur­vival.

Every day in Africa a gazelle wakes up.

It knows it must run faster than the fastest lion or it will be killed.

Every morn­ing a lion wakes up.

It knows that it must out­run the slow­est gazelle or it will starve to death.

It doesn’t mat­ter whether you are a lion or a gazelle.

When the sun comes up, you bet­ter be run­ning.

Abe Gubegna
Ethiopia, circa 1974

The preg­nant mom who exer­cis­es vig­or­ous­ly and reg­u­lar­ly — the one who runs or swims or does aer­o­bic danc­ing — is not the one at risk, or whose infant is at risk, of a lack of tol­er­ance for the rig­ors of labor or for lifestyle health prob­lems. It is the seden­tary or low activ­i­ty moth­er and her off­spring who are at risk. I have writ­ten at length on this real­i­ty in my chap­ter on Women and Exer­cise in Varney’s Mid­wifery.

This real­iza­tion has plagued me for ages, and the two arti­cles in the Times con­vinced me to make this state­ment, explain why it is true and exhort women of child­bear­ing age to become aer­o­bic ani­mals.

In the con­tem­po­rary world, we are not as active as pre­vi­ous gen­er­a­tions. Few women exer­cise to the extent required to devel­op the capac­i­ty to with­stand the rig­ors of birth. It is lit­tle won­der that so often health care providers hear that women are afraid to exer­cise, and child­birth edu­ca­tors hear that preg­nant moms are afraid of birth and don’t have con­fi­dence in their abil­i­ty to do it. There are solu­tions for these issues…

The biggest bang for the buck is aer­o­bics. This gets almost every­thing that helps you in labor. It increas­es endurance, strength and range of motion. It improves breath­ing capac­i­ty (you get more oxy­gen + less fatigue). It reduces your need to tap your car­diac reserve (your body works hard in labor but not to the degree it must if you are not fit). Plus, reg­u­lar par­tic­i­pa­tion in a good car­dio or aer­o­bic work­out gives you the men­tal tough­ness and con­fi­dence you need to know that your body is capa­ble of the work and the recov­ery — what we call body trust. Fit Preg­nan­cy has dis­cussed the myths sur­round­ing how hard a preg­nant woman can work out.

Learn­ing use­ful posi­tions and move­ments is extreme­ly help­ful. Be sure that your work­out also includes strength and coor­di­na­tion move­ments — such things as squat­ting, core move­ments for pelvis and spine, and oth­er motions that aid your progress in labor. Being upright and mov­ing are keys to a healthy labor. These require strength and coor­di­na­tion.

Men­tal focus and being present teach you to work with your body. Activ­i­ties such as relax­ation train­ing, yoga, pilates for preg­nan­cy and dance help you devel­op the men­tal skills (mind­ful­ness and deep breath­ing) that accom­pa­ny your move­ment. Learn to rec­og­nize your body’s sig­nals so you know when it’s time to push.

A tru­ly effec­tive use of your time is a one hour class a cou­ple times a week that com­bines all these ele­ments. We have known this for decades. The evi­dence is clear that it works. Keep moving…right into labor and birth!

Find a safe and effec­tive class or train­er.

Active Pregnancy — the rationale

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Moving into Motherhood

It’s time to hit the main theme again:  Aer­o­bi­cal­ly fit women are at reduced risk for things that go wrong in preg­nan­cy, improve their tol­er­ance for labor and birth, and recov­er more rapid­ly in the post­par­tum peri­od.

Mov­ing into Moth­er­hood

The arrival of the hol­i­days pro­vides a good rea­son to bring this up, yet again! Preg­nan­cy is a gate­way time in women’s lives…we become more aware of our bod­ies, our sen­sa­tions, our feel­ings, our needs, and how ver­sa­tile and amaz­ing our bod­ies are. We can make peo­ple with our bod­ies! Dur­ing preg­nan­cy, we often take precautions…we eat more care­ful­ly, avoid tox­ins, try to avoid stress. When the hol­i­days arrive, we see indul­gent behav­ior in a dif­fer­ent light.

Yet, even with all this focus on behav­ior, we some­times miss the biggest aid to a healthy preg­nan­cy:  phys­i­cal fit­ness. Research clear­ly demon­strates that fit women do bet­ter, are health­i­er and hap­pi­er. More and more in the U.S. we see dis­or­ders of nor­mal organ func­tion that accom­pa­ny seden­tary preg­nan­cy.

Let’s look at this a lit­tle clos­er (yes, I am going to repeat myself some more, but it is an impor­tant con­cept to spread). We live in a body mod­el that rewards an active lifestyle.

Being sedentary causes things to go wrong

Not mov­ing cre­ates bio­chem­i­cal imbal­ances because the car­dio­vas­cu­lar sys­tem atro­phies and mol­e­cules cre­at­ed in the brain or brought in through the diges­tion may not get where they need to go for a healthy metab­o­lism.

Your car­dio­vas­cu­la­ture is the high­way that brings usable sub­stances to the place they are used. You have to help it grow and devel­op, use it to pump things around and give it a chance to be healthy. Aer­o­bic fit­ness does all these things.

Advice for young women of childbearing age

If you are think­ing of preg­nan­cy, have recent­ly become preg­nant, or work with women of child­bear­ing age, we encour­age you to open avenues of activ­i­ty for your­self or oth­ers in this pop­u­la­tion. You can learn more from our blog dancingthrupregnancy.wordpress.com. You can seek out local pre/postnatal fit­ness experts on this site. Yoga is nice…we use some of it in our work, along oth­er spe­cif­ic exer­cis­es for which there is a direct health ben­e­fit. But, we also see yoga con­verts who come into our pro­gram in mid preg­nan­cy unable to breathe after walk­ing up a flight of stairs. How will they do in labor? Not as well as those who have been doing aer­o­bic dance or an ellip­ti­cal machine 2 or 3 times a week.

The AHA/ACSM guide­lines for the amount of aer­o­bic exer­cise need­ed to improve car­dio­vas­cu­lar sta­tus hold true for preg­nant women just as they do for the rest of the pop­u­la­tion – a min­i­mum of 150 min­utes of mod­er­ate, or 75 min­utes of vig­or­ous, or a com­bi­na­tion of these lev­els of inten­si­ty, per week. If you are not get­ting this lev­el of activ­i­ty, you are putting your health – and that of your off­spring – at risk.

High Birth Weight: The New Adverse Outcome

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While pub­lic aware­ness of low birth weight and pre­ma­ture infants is becom­ing — at long last — inter­est­ing to the main­stream cul­ture and media, anoth­er phe­nom­e­non is begin­ning to shake the pro­fes­sion­al birthing world:  high birth weight. Because it is occur­ring in a more afflu­ent ele­ment of soci­ety, it is alarm­ing. This tells us that you can­not buy your way out of preg­nan­cy risks that are cre­at­ed by a seden­tary, tox­ic food life-style.

Here is the dilem­ma:

Nor­mal weight and some over­weight women who eat too much in preg­nan­cy tend to have babies who are, basi­cal­ly, already obese at birth. There­fore, these infants already have meta­bol­ic and car­dio­vas­cu­lar dys­func­tion. Babies born over 8 lbs. 14 oz. are at increased risk for Type 2 Dia­betes and heart dis­ease.

Inter­est­ing­ly, the Insti­tute of Med­i­cine  recent­ly issued new guide­lines on preg­nan­cy weight gain. After near­ly 20 years of adher­ing to the “nor­mal” weight gain being 25 to 35 pounds, the Insti­tute rec­og­nized that pre­na­tal BMI plays a role in how much weight gain is nec­es­sary for a healthy preg­nan­cy.

The evi­dence that under­lies this change demon­strates that gains greater than 22 pounds — for all clas­si­fi­ca­tions of pre­na­tal BMI — is the demarka­tion point for increased health prob­lems.  More infor­ma­tion on this is avail­able at:  New IOM Guide­lines.

We have known for a while now that obe­si­ty in preg­nan­cy puts moth­er and infant at risk for a num­ber of prob­lems from car­dio­vas­cu­lar, meta­bol­ic and immune dis­or­ders to pre­ma­tu­ri­ty, low birth weight, increased need for cesare­an birth and slow recov­ery. Add anoth­er one:  Obese new­borns with increased risk for heart and metab­o­lism prob­lems.

Ref­er­ence on weight gain and high birth weight:

Lud­wig DS, Cur­rie J. The asso­ci­a­tion between preg­nan­cy weight gain and birth­weight: a with­in-fam­i­ly com­par­i­son. Lancet. 2010 Sep 18;376(9745):984–90. Epub 2010 Aug 4.

A good ref­er­ence for issues sur­round­ing obese preg­nan­cy:

Led­dy MA et al. The Impact of Mater­nal Obe­si­ty on Mater­nal and Fetal Health. Rev Obstet Gynecol 2008;1(4):170–178.

Fitness Starts Early!

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Preg­nan­cy fit­ness is not only impor­tant for moms, but for the fetus as well. Evi­dence is clear that aer­o­bic fit­ness improves brain, heart, immune and meta­bol­ic function…at all ages, includ­ing in utero. If con­tin­ued ear­ly in life, healthy phys­i­cal adap­ta­tions that occur in the uterus become rein­forced behav­ior, prepar­ing a good foun­da­tion for a healthy lifestyle. Babies are acute observers of move­ment and activ­i­ty, and learn from each oth­er. A key com­po­nent of a good mom-baby pro­gram is the inter­ac­tion of the babies them­selves. A good teacher will facil­i­tate healthy activ­i­ty among our small­est class mem­bers!

There is grow­ing evi­dence that at all ages, aer­o­bic fit­ness pro­duces the great­est num­ber of ben­e­fits. Recent­ly, researchers deter­mined that aer­o­bic fit­ness in 9 and 10 year olds pro­duced ben­e­fits in the devel­op­ment of two impor­tant brain regions — the basal gan­glia and the hip­pocam­pus — that are sig­nif­i­cant fac­tors in prob­lem-solv­ing intel­li­gence. This is just one of the lat­est reports that tells us the capac­i­ty to absorb and use oxy­gen (which improves with aer­o­bic fit­ness) is a key to health, qual­i­ty and length of life…beginning in the womb!

The 51% Factor: Pregnancy, Power & Health

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In the U.S. and most of the devel­oped world, approx­i­mate­ly 51% of the pop­u­la­tion is female. Most females give birth at some point in their lives, although, in any year, only about 2% of the pop­u­la­tion gives birth.

No one liv­ing on earth got here any oth­er way than ges­ta­tion, so there ought to be some pow­er attached to being part of that 51%. His­tor­i­cal­ly, it might be said that the pow­er has been mere­ly for survival…the good breed­ers sur­vived long enough to pro­duce heirs and those who lived on knew where the roots and fruit grew.

Only women can make more peo­ple with their bod­ies.

Here are some things to con­sid­er:

  • Women make peo­ple
  • Women’s health and fit­ness before preg­nan­cy affects whether the preg­nan­cy is healthy
  • Women’s health and fit­ness dur­ing preg­nan­cy affects her life­time health and that of her off­spring
  • Mater­nal sur­vival is impor­tant to off­spring well-being
  • Mater­nal health and fit­ness affects mater­nal adap­ta­tion and there­by off­spring well-being

Thus, is it not a san­guine notion that the health and sur­vival of women is crit­i­cal to the health of every­one? After all, the health of nations is asso­ci­at­ed with this slight major­i­ty of females, and the wealth of nations is asso­ci­at­ed with its health.

The good news is that peo­ple work­ing from this under­stand­ing are mak­ing some head­way around the globe. Recent­ly, the World Health Orga­ni­za­tion not­ed that mater­nal death among preg­nant and birthing women world-wide has been dra­mat­i­cal­ly reduced from the 1980’s to recent­ly. This is very good news!

Here is the inter­est­ing foot­note:  Mater­nal death in the U.S. has risen 42% in the same peri­od. While the absolute num­bers remain small, this is a dis­turb­ing pic­ture. What could be caus­ing this?

Time will tell if we can fig­ure it out and fix it. I ven­ture to sug­gest some direc­tions for con­sid­er­a­tion:

  • The ele­vat­ed cesare­an birth rate with its sequel­lae of car­dio­vas­cu­lar and immune sys­tem dis­or­ders
  • Obe­si­ty
  • Meta­bol­ic syn­dromes
  • Dia­betes
  • Heart dis­ease

Why am I hope­ful, then? I see among our cur­rent edu­cat­ed gen­er­a­tion of new moms and moms-to-be a will­ing­ness to exert their influ­ence – as breed­ers – over the health care scene. They want less tech­no­log­i­cal birth. They want sup­port. They want more infor­ma­tion. They want to be healthy. These are won­der­ful things. I salute these young women…they also make my job eas­i­er in the process.

In addi­tion, I see among young health care prac­ti­tion­ers an under­stand­ing of the val­ue of these things. Among prac­ti­tion­ers work­ing in pub­lic health clin­ics there is a sense of des­per­a­tion on the one hand that the poor and indi­gent have no capac­i­ty or will to take care of them­selves. On the oth­er hand, the first step is always edu­ca­tion and there are a lot of peo­ple work­ing on this issue.

Which brings me to the clos­ing point:  How do we bring more resources and intel­li­gence to help­ing women be healthy, pre­pare for preg­nan­cy, have healthy babies, reduce preg­nan­cy com­pli­ca­tions, and improve infant and mater­nal death rates? I, for one, will keep blog­ging on this issue. You, I hope, will vote for peo­ple who under­stand this issue. The polit­i­cal pow­er and will is in our hands.

51% of us are women…some day 51% of us can set pri­or­i­ties

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…Important Notes from Wonderrobyn

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The fol­low­ing are notes from co-author Robyn Bran­ca­to, CNM (cer­ti­fied nurse mid­wife) who prac­tices in New York City, or, as she is know here: Won­der­robyn! You can read about both authors in the About tab above. Here they are on the beach in San Diego, when they gave a talk at con­fer­ence there a cou­ple years ago. Robyn on the left, Ann on the right.

Robyn and Ann, Pathway authors

Robyn and Ann, Path­way authors

1. Addi­tion to Small Rant: “Resist the temp­ta­tion to watch A Baby Sto­ry on TLC! It does not por­tray birth accu­rate­ly, as they con­dense 15 hours of labor into 30 min­utes and play up the dra­ma so that you will be on the edge of your seat! In the major­i­ty of women, birth is not that dan­ger­ous.”

2. Regard­ing: When does con­cep­tion occur? “This is a real­ly inter­est­ing post… I love the dis­cus­sion about at what point con­cep­tion occurs! Per­son­al­ly, I like the Bib­li­cal notion of quick­en­ing. Even though this varies from woman to woman and can range any­where from 16 to 22 weeks ges­ta­tion, it seems like the most nat­ur­al the­o­ry.”

Dear Read­er:  What do YOU think? Did you read the con­cep­tion post on March 23, ’09?

3. About sperm & preeclamp­sia. “Is the con­nec­tion between bar­ri­er meth­ods and preeclamp­sia actu­al­ly estab­lished? I have read stud­ies stat­ing the con­trary — that bar­ri­er meth­ods have no effect on preeclamp­sia rates.”

HURRAY! THIS REQUIRES FURTHER CONSIDERATION.

More infor­ma­tion: The immune mal­adap­ta­tion the­o­ry sug­gests that tol­er­ance to pater­nal anti­gens, result­ing from pro­longed expo­sure to sperm, pro­tects against the devel­op­ment of preeclamp­sia. Thus, bar­ri­er meth­ods and being young may pre­dis­pose women to this major dis­or­der of preg­nan­cy.

Evi­dence exists on both sides of this the­o­ry. Here are two recent stud­ies (one of each) that read­ers may find help­ful in under­stand­ing this idea. Keep in mind that oth­er fac­tors than just sperm expo­sure may be affect­ing research find­ings. But, it does seem that under some con­di­tions, bar­ri­er meth­ods and amount of expo­sure to sperm can affect the preg­nan­cy itself.

Ness RB,  Markovic N, Harg­er G, Day R. Bar­ri­er meth­ods, length of pre­con­cep­tion inter­course and preeclamp­sia, Jour­nal: Hyper­ten­sion in Preg­nan­cy 23(3):227–235. 2005.  Results did not sup­port the immune mal­adap­tion the­o­ry.

Youse­fi Z, Jafarnezhad F, Nas­rol­lai S, Esmaeeli H. Assess­ment of cor­re­la­tion between unpro­tect­ed coitus and preeclamp­sia, Jour­nal of Research in Med­ical Sci­ences 11(6):370–374. 2006. In a matched con­trols study, women with <4 months cohab­i­ta­tion or who used bar­ri­er meth­ods had high­er risks of devel­op­ing preeclamp­sia than those with >4 months cohab­i­ta­tion. Oral con­tra­cep­tion users had a low­er preeclamp­sia rate than those who used no oral con­tra­cep­tion.

In a com­men­tary arti­cle in OB/GYN News ‚  July 1, 2002, the fol­low­ing note was made by Dr. Jon Einars­son: With insuf­fi­cient expo­sure, preg­nan­cy may induce an immune response and preeclamp­sia in some women with pre­dis­pos­ing fac­tors such as an endothe­li­um that already is sen­si­tive to injury due to age, insulin resis­tance, or pre­ex­ist­ing hyper­ten­sion.

Is there a plain and sim­ple truth about sperm expo­sure and preg­nan­cy risks? Alas, no. But, know your cir­cum­stances. If you are young, pro­tect your­self. Wear a con­dom. When you are ready to be a mom, you will be ready to fig­ure out your risks. So, this, too fol­lows the axiom:

Events in life are rarely plain and nev­er sim­ple.

Pregnancy Pathway, Conception — Review & Small Rant!

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REVIEW: Evi­dence is clear - pre-preg­nan­cy mater­nal health sta­tus, includ­ing phys­i­cal fit­ness, healthy nutri­tion and an uncom­pro­mised immune sys­tem affect the health and well-being of both moth­er and off­spring, in both short and long term.

This is the mes­sage sum­ma­ry from our first two areas of dis­cus­sion:  Pre­con­di­tions and Con­cep­tion — the green and sand col­ored sec­tions on the chart below.

pregnancy_pathway

COMING ATTRACTIONS: We are about to move on to the blue sec­tion — Preg­nan­cy!!  So, book­mark this Blog for future ref­er­ence!

Also, you can sub­scribe to this Blog by click­ing on Blog Info in the upper right cor­ner and then click­ing on Sub­scribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fit­ness, nutri­tion and a healthy immune sys­tem play sig­nif­i­cant roles in the out­come of preg­nan­cy and the future health of moth­er and child, we are appeal­ing to young peo­ple of child­bear­ing age to be care­ful about your bod­ies. The alliance of egg and sperm shapes the world. With 6.5 Bil­lion egg/sperm com­bi­na­tions (yes, peo­ple) present­ly liv­ing on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remem­ber that show?) is cooked.

Humor­ous incur­sion: In case you need fur­ther enlight­en­ment on this whole area, there is a great web­site that will help you out. Be pre­pared to be amused and amazed!

The Truth about Eggs and Sperm

Hope­ful­ly, this gets you in the right mood and keeps you smil­ing. After all, once you actu­al­ly are preg­nant, we have more seri­ous mat­ters to dis­cuss.

Small Rant, Review, References & Coming Attractions

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Small Rant — Women, their preg­nan­cies, births and moth­er­ing styles are all unique. The big issue in child­bear­ing these days is con­trol. Fear of los­ing con­trol, who con­trols birth (do YOU give birth or are you deliv­ered by oth­ers?), hav­ing the self con­fi­dence and skills to know when to let go of con­trol yet be okay. It’s inter­est­ing to hear what hap­pened to some­one else, but (here’s the rant part) this can often be fright­en­ing because — let’s face it — cat­a­stro­phe gets our atten­tion. What­ev­er you’ve heard, you still have to do it your­self. Preg­nan­cy, birth and par­ent­ing cre­ate a steep learn­ing curve.

Review — Our job at the DTP Blog is to help with the learn­ing curve through evi­dence-based infor­ma­tion. We are mov­ing along a path­way. Here it is, in a small ver­sion (see Feb. 5 for full ver­sion):
pregnancy_pathway

So far, we have dealt with Pre­con­di­tions (the Green items). If you under­stand what you can and can­not con­trol along your Preg­nan­cy Path­way it can help pre­vent you from spin­ning your wheels or wast­ing mon­ey. Some things are worth doing (self care, good food, exer­cise) and some are not (self-indul­gence, tox­ins, stress). Pre­con­di­tions to preg­nan­cy — genet­ics, envi­ron­ment and behav­ior — are worth pay­ing atten­tion to if you are of child­bear­ing age and think or know you are mov­ing along this path­way.

Ref­er­ences - We have used hun­dreds so far and will use many, many more, but only some of you will find the sci­ence some­thing you want to pur­sue, so please go to our DTP web­site (use the Blogroll) for more infor­ma­tion on research in this field. Here are some texts that explain much more: “Women and Exer­cise” in Varney’s Mid­wifery (edi­tions 3, 4 & 5), Jones & Bartlett Pub.; Women’s Fit­ness Pro­gram Devel­op­ment by Ann Cowl­in, Human Kinet­ics Pub.; and Immunol­o­gy of Preg­nan­cy by Gil Mor, Springer Pub.

Com­ing Attrac­tions — next, we talk about con­cep­tion. Yes, this is an excit­ing part, though not per­haps why you think (!). It turns out con­cep­tion is fraught with many twists and turns.

Humor­ous incur­sion:
Q: Why does it take a mil­lion sperm to fer­til­ize just one egg?
A: Because none of them will stop and ask direc­tions.
[Sor­ry, couldn’t resist.]

After that we will like­ly rant and review again, have more humor­ous incur­sions, pro­ceed on to the preg­nan­cy and birth expe­ri­ences, then dis­cuss health out­comes for mom and baby in the short and long term.

Why do we spend our time on this? From a bio­log­i­cal per­spec­tive, humans can do noth­ing more impor­tant than cre­ate healthy off­spring. Wars may be fought, the banks fail or cars become a thing of the past; we might even become post-racial; but, hav­ing babies doesn’t real­ly change. It remains a pri­mal expe­ri­ence. It’s nes­tled in a high tech world, but its still pri­mal. Women have always had guides; we take this role seri­ous­ly.

Stay tuned!!