August 30, 2009

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!

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!

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.

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

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!!

July 6, 2009

Pregnancy Pathway, Pregnancy — Maternal Immunological Response

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

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!

April 27, 2009

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.

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!

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!

April 20, 2009

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.

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!

February 23, 2009

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!!

February 13, 2009

Pregnancy Pathway, Preconditions

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Please refer to February 5 entry for complete graphic. Today we turn to the question of preconditions to pregnancy and how they might affect maternal and offspring health.

Preconditions

Pre-existing factors that can influence health outcomes include genetic factors (family risk for heart disease, for example), environmental factors (living in a building with mold, for example), and behavior (eating well and exercising, for example). In each category, factors will contribute to the health of the mother and eventually to offspring health.

It is important to understand what major genetic factors may affect your offspring and whether the environment or behavior can help offset negative factors. For example, there may be a history of preeclampsia during pregnancy in your family, but vigorous aerobic exercise in the six months prior to pregnancy provides a high degree of protection from this risk. Preeclampsia puts both mother and offspring at risk for complications.

Other genetic factors that may be of consequence include autoimmune disorders, allergies, and metabolic syndromes. For example, so-called “thrifty genes” may predispose you to a high weight gain in pregnancy. But, you may be able to offset health problems associated with this by staying active and eating well.

February 7, 2009

Pregnancy Pathway, introduction

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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.