Tree Life Birth Care in White River Junction, VT, is our newest location for Total Pregnancy Fitness. The center is dedicated to providing balanced, evidence-based support to women and their families during pregnancy, labor and postpartum. They offer doula care, childbirth education, prenatal dance classes, and lactation consulting in the Upper Valley region of Vermont and New Hampshire. For more information, visit http://LifeTreeBirth.com or email Mary Etna Haac at DoulaMaryEtna@gmail.com.
Mary Etna R Haac, MPH, PhD, DONA-trained Birth Doula. Bilingual: English-Spanish. 703–447-98–94.
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)
In Part 4 of our continuing series on DTP’s offspring, meet Renee Crichlow, ACSM Certified Personal Trainer from Barbados, whose REAC Fitnessbusiness 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.
Recently, while talking with some moms in our postpartum exercise class, DTP’s Mom-Baby Fitness™ program, I realized it has been a while since I have addressed the notion of what we call “the 3rd body.” This stems from the idea that before you are pregnant, you live in your 1st body; then, while pregnant, you live in your 2nd body. After giving birth, many women feel their options are to try to get their first body back or live in what they are left with after birth. We suggest another way: create your 3rd body.
We discovered this 3rd body in working with women to gain the fitness necessary to have a healthy recovery and enjoy motherhood. What we found was that women were often becoming more fit than they had been before pregnancy, with less body fat and more muscle, yet their clothes did not fit the same. Sometimes the flaring of the ribs and/or hip bones made for a larger waist – despite less fat!
Many clients also feel a new, deeper sense of their core developed. In fact, over time they realized they actually liked this body better in some ways! After all, they came into the world with the pre-pregnancy body, but this body they actually created out of the profound experience of the physical self that pregnancy and birth provide. It extended the empowerment of birth into motherhood.
Extending this metaphor even further, of course, leads to the 4th and 5th bodies, if you have another child. Eventually, there are more bodies as women go through perimenopause, menopause, post menopause, and what I like to call the phenomenal wisdom stage. Each body represents a new opportunity to become someone strong and profound.
I figure I am to body #8 now, and in each stage I have found something incredible that I could not have at other stages. Long ago I gave up looking for my past bodies. Each one has been brilliant in some way, but in the end it had to be left behind if I was to enjoy life’s path to the fullest.
Living in the moment does require knowing where you are in time, space and energy. So, discard your past bodies with delight and move on. Use your energy to create yourself in the present.
It’s a process and you won’t fully live in your next body until you own the toll of the last one. A postpartum mom may experience hair loss, bigger feet, a mal-aligned spine, constant thirst if she is breastfeeding, exhaustion and a jelly belly. But, all these things will pass with time, if you eat right and exercise regularly. Oh, and you can bring the baby, who will have a blast meeting other babies!!
This is the time of year many of us consider where to make our charitable contributions. We have assembled a list of groups to which you might want to consider giving this year. By donating to these organizations you can help improve the lives of mothers, newborns,children and families around the world. Most will also send a card or email message to a mom in whose honor you give the gift.
UNICEF Inspired Gifts. You can choose gifts that improve education, water, health, nutrition, emergency care and other factors that affect the well-being of women and children.
The Fistula Foundation. This group exists to raise awareness of and funding for fistula treatment, prevention and educational programs worldwide. Fistula is the devastating injury cause by untreated obstructed labor.
The Preeclampsia Foundation. This organization supports research to prevent and treat one of the most dangerous disorders of pregnancy, one that accounts for a large percentage of premature births and low birth weight infants. Having preeclampsia is also a risk factor for later heart disease for the mother.
Clean Birth. Clean Birth Kits are designed to provide birth attendants and/or expecting moms with the tools they need to ensure a clean birthing environment. The Kits ensure the WHO’s “6 Cleans”: clean hands, clean perineum, clean delivery surface, clean cord cutting implement, clean cord tying, and clean cord care.
March of Dimes. The “mother” of all charities for helping prevent and treat disorders and diseases that affect children.
The challenges to safe motherhood vary depending where in the world you live. In some areas the challenge may be to get adequate nutrition or clean water; in other areas, it may be to prevent infection; and in still other locations it may be trying to avoid pregnancy before your body is ready or getting access to prenatal care. In the U.S., it may mean avoiding being sedentary and making poor food choices, or having to deal with the high technology environment of medical birth that can sabotage the innate physiological process of labor and birth.
Birth begins the bonding or unique love between mother and child.
The biology of birth is a complex series of cause-effect processes…baby’s brain releases chemical signals to the mother and the placenta begins to manifest the maternal immune system’s rejection of the fetus.
To help the ball get rolling, relaxation (the trophotropic response) helps promote the release of oxytocin. With the help of gravity, the head presses on the cervix, amplifying the uterine contractions. After an ultra-distance aerobic endurance test, the cervix opens enough to let the baby move into the vagina and the mother’s discomfort moves from sharp cramping into the bony structure as she transitions to the strength test of pushing. She transitions. Relaxation modulates into an ergotropic — adrenal — response to gather her power.
Pushing is an interesting term…more masculine, I think, than the one I prefer: Releasing. Releasing or letting go of the baby. It’s a catharsis. In this portion of the labor another set of important processes help the baby clear its lungs of amniotic fluid, stimulate its adrenal system and challenge its immune system, as the contractions drive the baby downward. The mother’s deep transverse abdominal muscles — if strong enough — squeeze the uterus like a tube of tooth paste, to aid this expulsion. In the meantime, the labor is helping set up the mother to fall in love and produce milk. When the baby emerges and moves onto the mother’s chest, s/he smells and tastes the mother, recognizing her mother’s flavor and setting up the potential for bonding.
Any way you slice it, there are two parts to safe motherhood. One is a safe pregnancy…healthy nutrition, physical fitness, safe water, infection prevention, support and a safe environment. The other is a safe labor. In a safe labor, there is both an environment that promotes the natural process of labor and the means necessary for medical assistance when needed. Women die at an alarming rate from pregnancy or birth-related problems. Despite some progress made in recent years, women continue to die every minute as a result of being pregnant or giving birth.
What keeps us from having a better record on motherhood is often lack of care in the developing world and too much intervention in the U.S.. They are two sides of a coin. Mothers’ experience and health needs are not on equal footing with other cultural values. In places where basic prenatal care or family planning are low priorities, at-risk women are vulnerable to the physical stresses of pregnancy and birth. In the U.S., machine-measured data is paramount, even if it produces high rates of false positives, unnecessary interventions or counterproductive procedures. We are learning that obesity and sedentary lifestyles have detrimental effects, but fewer pregnant women than their non-pregnant counterparts exercise.
Despite the money spent to support the technological model of pregnancy and birth in the U.S., there are parts of the world with lower rates of maternal deaths — especially Scandinavia, Northern Europe and parts of the Mediterranean and Middle East (Greece, the United Arab Emirates, Israel, Italy and Croatia). In fact, in the U.S., maternal deaths are on the rise.
It’s a tricky business. Clearly Western medicine has a lot to offer the developing world when there are medical concerns. On the other hand, importing the U.S. model could create more problems than it solves. Instead, the micro-solutions now being developed in many locations will be observed and evidence collected by organizations such as the White Ribbon Alliance and UNICEF.
There is an effective international midwives model adopted by JHPIEGO, the Johns Hopkins NGO working toward improved birthing outcomes. It assesses the local power structure, social connections, potential for trained birth assistants, and location of available transportation to create a network so that locals will know when a labor is in trouble and who can get the woman to the nearest hospital.
In the U.S., there are in-hospital birth centers that allow low-risk mothers the opportunity to labor and birth in a setting designed to encourage the innate processes. Women are beginning to vote with their feet…staying home for birth. Women are going abroad to give birth. At the same time, women are coming to this country to give birth, believing it is safer than where they are. There are several ways these scenes could play out.
But, I’ll wager, improving outcomes will involve compromise: Watchfulness and support in most births, plus better ways to assess danger and provide technology. No matter where you live in the world, the solution may be essentially the same.
We have long known that vaginal birth and breastfeeding are key factors in the development of a healthy immune system in infants. Passing through the vagina exposes the baby to an array of bacteria that help stimulate its unchallenged immune system. Breast-fed babies receive anti-bodies, proteins and other molecules that protect it from infection and teach the immune system to defend the infant.
Breastfeeding is key for long-term health.
Recent research at UC Davis has shown that a strain of the bifido bacteria — acquired from the mother — thrives on complex sugars (largely lactose) that were previously thought to be indigestible. The bacterium coats the lining of the immature digestive tract and protects it from noxious bacteria.
This combination of interactions affects the composition of bacteria in the infant gut as it matures. Another example of how evolution has “invented” the perfect nutrition for infants, this research contributes to the notion that evolution has selected for many genes that serve normal birth and breastfeeding by protecting the newborn. Intervening with the normal progression of birth and breastfeeding — while occasionally necessary — interrupts these beneficial adaptations and contributes to allergies and autoimmune disorders.
I love Yoga. But…Power Yoga, Hot Yoga, Fast Yoga, Pilates-Yoga, Fresh Yoga, Baby Yoga and even Prenatal Yoga…not so much. I find these phenomena strange.
Why? Well, 40 years ago – when I first learned Yoga – it was a privilege. A person came to Yoga in the search for a meaningful life path. It was a blend of the spiritual and the physical, and it required a commitment to what was revealed within the practice. Before being allowed to take my first class, I had to demonstrate that I already practiced meditation. It was not exercise per se.
It was not adaptable like it is today. Depending on the teacher, you learned an ancient system – Hatha, Vinyasa, Ashtanga, Iyengar, or Kundalini. Those were the major methods that have Hindu roots, and those who practiced these art forms knew what they were doing. The teachers themselves had worked on their craft for decades. Today, I know only a few teachers who have a profound grasp of each of these methods.
Why is Yoga so popular?
Is there something within the work itself – even in the diluted forms, hybrid versions and the celebrity/competitive studios – that allows it to thrive in the self-centered, free-wheeling, branding-crazy marketplace of the early 21st century developed world?
I find the answer to this in a strange place: Zen practice, Bhuddism. One of my favorite notions is from Suzuki’s text Zen Mind, Beginner’s Mind. “When you feel disagreeable, it is best to sit.” This is an element of nin – constancy – or being present in the moment. Not patience, which requires a rejection of impatience and therefore cannot accept the present as it is. When you sit – just sit period, that’s it – all that is real is the moment. This is at the heart of all spiritual experience.
I’m not an expert in Yoga. I don’t teach Yoga, although I have integrated Yoga-based skills into my work. I have practiced Hatha and Vinyasa over the years enough to learn how certain skills are treated…belly breathing, slow deep breathing, maintaining position and listening to the wisdom of the body, and isometric strengthening in preparation for more expansive shapes or motions. Long ago, I integrated these skills from my Yoga experience into my teaching style because these skills are effective for the populations with which I work. But, I do not teach Yoga.
Can Research Help Us?
Researchers find Yoga a nightmare. There is so much variance now in the practice that findings from any one study cannot be transferred to the general population. One of the most revealing experimental-design studies found that none of the claims of Yoga improving metabolism could be demonstrated. When asked why they thought this outcome had occurred, the teachers who were used in the study said they thought the participants in the study were not fit enough to do Yoga!
One of the most successful Yoga teachers in my area, and one of my favorites, has for decades used a bicycle for her primary mode of transportation. She credits her longevity and success to Yoga. I attribute it to bicycling. Dr. Cooper is right…fitness (which means aerobic fitness) is the biggest bang for the buck. Unless you are fit, it is hard to execute some of the more subtle demands of many exercise regimens.
Some Yoga teachers will say that you can make Yoga aerobic or that some forms are aerobic. OK, then it’s aerobics, not Yoga. Whenever I see “aerobic Yoga” it reminds me of aerobic dancing. It’s helpful to remember that Yoga developed in a time and place where survival was dependent upon fitness. People didn’t need to do more aerobics to find enlightenment. They needed reflection and to be present in the moment.
So, I insist on aerobic fitness as the first goal of a fitness regimen. In the pre/postnatal field, this is the only consistently demonstrated factor in improved outcomes. As a birth preparation there are Yoga-based factors that will help in labor and birth IF THE WOMAN IS FIT ENOUGH. It is the fact that some Yoga-based skills help fit people find nin that is my justification for continuing to use them in conjunction with aerobics and special pre/postnatal preparation and recovery exercises.
But, there are cautions. Not all Yoga assanas (positions) are safe for pregnancy. Down-dog, in particular, scares me because of incidents reported in obstetrical literature in the 1980s and 1990s that indicate such a position is implicated in fatal embolisms. Some shapes are just not doable and others become less comfortable over time. The ones that work have been identified since the 1940s and 1950s and integrated into birth preparation courses.
What’s Next?
All exercise components -
Mind/Body
Strength
Flexibility
Aerobic or Cardiovascular Fitness
- are necessary for a balanced fitness routine. Too much emphasis on any one factor often results in injury. Aerobics is where the greatest health benefits reside. Recent research has demonstrated that it is physical “fitness” (which we can measure) as opposed to just spending time in physical activity (which can be a wide range of intensities) that is responsible for improved health outcomes. Strength and flexibility training need to be purposive. There are things we don’t need to do unless we are going to play pro football or dance Swan Lake! Mind/Body skills help us recover and prepare.
I for one will be glad when we get beyond yoga and back to cross training!
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
This is the time of year many of us consider where to make our charitable contributions. We have assembled a list of groups to which you might want to consider giving this year. By donating to these organizations you can help improve the lives of mothers, newborns,children and families around the world. Most will also send a card or email message to a mom in whose honor you give the gift.
