preeclampsia

Building a Global Team of Teachers for Healthy Pregnancy, Birth & Baby

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Danc­ing Thru Preg­nancy®, Inc.

Women’s Health & Fit­ness Pro­grams
found­ed 1979
MISSION STATEMENT
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)

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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…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, 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.