Women’s Health & Fitness Programs
Many important health issues for girls and women involve matters of reproductive
health, childbearing, fertility and aging. Research informs us that an active, healthy
lifestyle provides a number of benefits throughout a woman’s life span:
reduced discomforts from pregnancy, labor, birth, recovery & menopause
reduced risk of hypertensive disorders of pregnancy and premature birth
potentially shorter active labor and reduced risk of cesarean delivery
more rapid return to joyful activities, less excess weight following birth
mother-infant interaction, leading to infant psychomotor enhancement
reduced rates of obesity, cardiovascular disease, and type 2 diabetes
reduction of some cancers, osteoporosis, falls and loss of muscle mass
improved social support, networking and stress management skills
greater belief in one’s ability to be strong and capable (self-efficacy)
So let’s get on with the topic of How to Get Pregnant, starting with why do we need to know this?
In the past few decades, the average age for a first pregnancy in the U.S. has moved from the mid twenties into the mid thirties. In the same time period, the facts of conception — sperm enters egg released in mid cycle, then zygote implants in the uterus, along with how sex allows this to happen and how to prevent it — seems to have disappeared from middle and high school health classes. If that weren’t enough, as women have become more and more essential in the work force, the cost of having children as well as starting later, have driven down the birth rate. Similar conditions exist in most developed nations, although teen pregnancy rates are lower everywhere else.
The birthing population has bifurcated — we see older women (over 35) and teens as the major groups having children. On the one hand we have been working to reduce teen pregnancy while helping older and older women become first time moms. To a certain extent, they need the same information; its just that with teens we use this information to prevent pregnancy and with older women we use information to help them increase their odds of getting pregnant.
Understanding the menstrual cycle, ovulation, charting temperature — all the basic techniques of using the “natural” method of birth control — have become the first steps of the how-to-get-pregnant coaches. Beyond this, a number of sites have their own essential lists to help women be healthy and ready. Sites such as gettingpregnant.com, pregnancy.org/getting-pregnant, and storknet.com/cubbies/preconception/ provide additional information. Many suggestions — things to avoid eating, what proteins are needed for ovulation, how to reduce stress, what to do if there are sperm problems, how to find IVF clinics, donors and surrogates — are addressed.
How effective are these suggestions? Well, research tells us they are somewhat effective. None of the sites I contacted answered my query about how they measure or assess consumer outcomes when following their suggestions.
An interesting article in the NY Times 9/1/2011, entitled Are You as Fertile as You Look? openened with this sentence: “FORTY may be the new 30, but try telling that to your ovaries.” The reality is that being under 35 is still the best predictor of how difficult it may be for you to become pregnant. As the article makes clear, looking 30 and being 30 are not the same thing. Even healthy living does not prevent the loss of good eggs.
So, what conclusions can we draw? First, even if you come from a “fertile family,” it may behoove you to have your children in your late 20s or early 30s. Second, if you are putting off having children beyond that time, ask yourself what extremes you are willing to go to to have your own biological offspring. And, third, consider adoption. Frankly, it would be wonderful if adoption were easier, but in the drive to conceive at later and later ages we see the hand of biology and understand why adoption is not easy: Our own offspring — our own DNA out there in the world — is a heady motivation.
If you are on the pathway of becoming pregnant, being under 35 is the best ally you have. If not, maybe some of the suggestions on the web will work for you. Whatever you decide, all the best.
One parting comment: Regular moderate exercise — while it helps you stay young and healthy — will not prevent your eggs from being popped out every month. It will help you have a healthy pregnancy if you conceive, so stay with it!
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.
COMING ATTRACTIONS: We are about to move on to the blue section — Pregnancy!! So, bookmark this Blog for future reference!
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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!
Please refer to February 5 entry for complete graphic. The Precondition we will discuss today is Genetics.
There are genetic factors totally outside your control that determine things as simple as your offspring’s hair or eye color, how the earlobe attaches to the side of the head and whether or not s/he can roll the tongue. More complex things, such as a predisposition to types of cancers, bleeding disorders or various other diseases, also have a genetic basis.
Because the male contributes the sex of the offspring, once conception happens, the sex off the fetus is determined — at least genetically. But, it turns out not everything genetic is set in stone. In utero, hormone exposures may affect how male and female characteristics develop, so that some girls will be very girlie, some will be tomboys, and some may be gay. A similar effect will influence how boys develop.
Genetic, environmental and behavioral preconditions can be intertwined. Environmental factors can alter genes, causing them to express proteins that would otherwise be dormant. Likewise, our behavior affects some of our genes. If we have a family propensity for heart disease, but we eat a healthy diet, exercise and avoid risky behaviors, we alter the impact of our genetic code.
Keep in mind that some things will be completely determined by genes. It is not reasonable to hope, for example, that our offspring will be 6′5″ if both parents are short (or vice versa). If the mother has “thrifty genes” — that is, genes that make it easy for her to gain weight — she may well do so during pregnancy, even if she follows a reasonably healthy lifestyle. If the immune systems of both parents have some similarities, it may affect the maternal immune response to the implanting trophoblast cells, thus affecting the placenta and, indeed, the entire pregnancy.
So, how do we advise people who are thinking of pregnancy to prepare themselves for a healthy pregnancy genetically? Surely, to determine all the potential genetic possibilities is not feasible or affordable at this point. Maybe in another century! But, we can know some factors: Is there sickle cell anemia in both families? Is there a Mediterranean type of sickle cell disorder? What about clotting factors or differences in Rh? What about diseases or disorders that are not common, like ALS? These are things that potential parents may want to discuss.
Like so much of life, we can’t know everything. There are no guarantees. There is a lot to be learned still about human genes and how they work.
This blog has at its heart the notion that physical activity has tremendous benefits for mother and offspring…and for partners, too. How does the genetic component affect this? First, preconception fitness lowers some risk factors for mothers and babies. Second, each mother’s genes will make it easier or more difficult for her to enjoy or benefit from the activity of exercise. We appreciate this and encourage young moms-to-be to find something enjoyable that you like doing and find people or situations that support you in being active now before you become pregnant.
If you need assistance or advice, please go to www.dancingthrupregnancy.com (use the BlogRoll)
Find Ask the Expert under the Consumer menu. Let us know how we can help!
Please refer to the Pregnancy Pathway chart in the February 5, 2009 entry. During pregnancy, there are some factors within our control and some that are not. The Pregnancy Pathway, designed by Dancing Thru Pregnancy® founder and Yale University Movement Specialist Ann Cowlin, and Certified Nurse Midwife Robyn Brancato, is intended to describe the flow of factors that influence pregnancy and its outcome.
In the weeks to come, we will focus on individual areas. Our goal is to help women understand how they can optimize their pregnancy by focusing on what they can control that results in beneficial outcomes.
Ann and Robyn are also founding members of the Women’s Health Fitness Institute, a non-profit organization whose mission is research and public education outreach in women’s health fitness. Our comments for this blog are based on scientific evidence and 30 years of tracking individual pregnancy outcomes from women throughout the world. Some entries will include references to the relevant studies.
By helping women understand what endeavors are effective in producing benefits for mothers and their offspring, we hope to aid moms-to-be and those considering pregnancy to be fully present and active in the empowering process of becoming a mother.