Healthy Pregnancy & Birth Essentials – Be Fit! Be Prepared!

Moving relieves stress.

Moving relieves stress.

Do you want a healthy pregnancy, labor, birth and early mothering experience?

This post is designed to provide basic information about achieving this goal. As with any life situation, there are things you can do to help achieve the best outcome of your pregnancy. Some things will be outside your control. Your baby will have blue eyes or brown hair or attached ear lobes depending on genetic factors. But many things are in your control. If you are fit and eat well you will help your baby’s development.

Circumstances can also play a role. For example, where you live can impact how much you walk or whether you are exposed to second-hand smoke. Sometimes you can change these things, but not always. We have put together just the basics, the things you CAN do to help yourself have a healthy pregnancy and birth!

  1. PRENATAL CARE – Repeated studies show that women who have regular health care started early in pregnancy have the best outcomes.
  2. AIR & FOOD – Your muscles need oxygen and blood sugar in order to achieve activities of daily living (ADL), fitness activities, labor, birth, and caring for a newborn. Muscles – including the uterus – need these two essentials in order to this work. Therefore you must do these things:
    • Breathe deeply to strengthen your breathing apparatus.
    • Eat in a way that is balanced (carbs, fats & proteins in every meal or snack) and colorful (fresh fruit & veggies) to train your body to
      Fresh fruit provides vitamins & minerals!!

      Fresh fruit provides vitamins & minerals!!

      produce an even supply of blood sugar and provide needed vitamins & minerals. You need 200 – 300 calories every 2 – 3 hours, depending on your size. Prenatal vitamins are your backup safety mechanism. Eat real food, not edible food-like products (example: potatoes, not potato chips).

    • Drink fluids (primarily water) and eat protein to maintain an adequate blood volume. Blood delivers oxygen and sugar to your muscles, placenta and baby. Pregnancy increases needed blood volume by about 40%. More if you exercise regularly.
    • You don’t need other items, especially things that are dangerous, like alcohol, cigarettes and drugs. Continue safe sex.
  3. PHYSICAL FITNESS – Pregnancy, labor, birth and parenting are ENDURANCE events. Strength, flexibility and mindfulness will help, but only if you have stamina to tolerate the stress to your cardiovascular and respiratory systems.
    Aerobic Dancing improves stamina while having fun!

    Aerobic Dancing improves stamina while having fun!

    • Cardiovascular conditioning or aerobics is the cornerstone of fitness. Make sure to get 20 – 30 minutes of moderate to vigorous aerobic activity 3 or 4 days a week. Find a qualified prenatal aerobic fitness teacher. If you are more than 26 weeks pregnant, start very, very slowly.
    • Core, shoulders, hips, pelvic floor – these areas need adequate strength training and gentle flexibility for range of motion.
    • Relaxation practice has been shown to help reduce the active phase of labor.
    • Mindfulness can be a big help in birth if you have adequate endurance and are not in oxygen debt, out of blood sugar, dehydrated or too tired.
    • Find classes here: DTP Take-a-Class
  4. EDUCATION – Be sure these items are included in your childbirth education course:
    • Landmarks of labor & birth progress
    • Sensations at various points in labor
    • Physical skills that promote labor progress and help achieve a healthy birth

      Learn the benefits "skin-to-skin" after birth.

      Learn the benefits “skin-to-skin” after birth.

    • Pain Management techniques to help you deal with the intensity of birth
    • How to maintain oxygen and sugar supply in labor before going to the hospital and while in the hospital
    • Standard hospital procedures (so you can decide when to go to the hospital)
    • Complications that can lead to medical interventions, including surgery
  5. GET SUPPORT – Make sure you will have continuous support for your labor and birth
    • Spouses, partners, and female family members can be helpful if they accompany you to your Childbirth Education class and know how to help you during the process.
    • A Doula is a great option for support because they are trained to guide a mom and family through the birth process.
  6. POSTPARTUM ACTIVITY WITH BABY – This is a great way to get in shape after birth.
    • Early General Fitness in the first few weeks: walk with the baby in a stroller or carrier, work on kegels and suck in your belly.
    • After 4 – 8 weeks you will be ready to join a Mom-Baby fitness group!
Birth begins the bond or unique love between mother and child.

Birth begins the bond or unique love between mother and child.

DTP Guest Blog – Cathy Moore, CNM: In the Belly of the Goddess

In The Belly of the GoddessCathy Moore CNM, is the founder of In the Belly of the Goddess in the Boston area. She earned her pre/postnatal fitness certification from Dancing thru Pregnancy® in 2006. She used much of what she learned to develop a series of classes in belly dance for pregnancy and birth. InTheBellyOfTheGoddess.com

DTP: Describe the focus or mission of your program.

Recognizing that Belly Dance has its origins as a Birth Dance

 we seek to restore it to its rightful place in this sacred process.

Cathy: My original aim was to teach belly dance to pregnant women as a tool of personal empowerment – both in the arenas of expressive creativity and for use in the labor and birth process.  My focus has evolved since I began the program.  I started with giving women what I felt was another “tool” to use to help them to cope with labor, and possibly to help them to achieve their goal of un-medicated birth, and so I taught just specific moves that I felt were useful for this purpose.  Over time, I added more aerobic movement, more “veil work” – (dancing with a silk veil), more “fun” exercises, and an end of class rest/shavasana period with either a guided meditation or affirmations.  Some of these changes that I made were a direct result of taking the DTP certification.In The Belly of the Goddess 2

DTP: What do you most enjoy about your work?

Cathy:   I love to get women into some jingly hip sashes, and get them laughing and enjoying dancing with each other.  I love to see a group come together and start bonding and exchanging info and experience.  And I love to hear how great they feel after a class – they really do shake out many of the aches and pains!

DTP: What is the most important thing you have learned from working with moms and moms-to-be?

Cathy: Both my clinical work as a practicing midwife, and though my belly dance business, I continue to learn how strong and capable women are.

DTP: What is your future outlook for your program?

Cathy: In my clinical practice with the Brigham & Women’s Midwifery Group, many of the women we care for are socio-economically disadvantaged.  I am hoping to bring my program to these women.  Recently, I have been offering one-time mini classes in Centering Pregnancy groups, and they are always well received.

This is the second in a series of articles about the programs that have been built by individuals who have been through DTP’s pre/postnatal fitness instructor training programs. Previous entries in this series: https://dancingthrupregnancy.wordpress.com/2012/10/

Dancing Thru Pregnancy 33; Ann 66

September is a big month on my calendar. It signals my birthday (1946), the birth of DTP (1979), the incorporation of DTP®, Inc (1982), and the month I met my husband (1983). All of this would be cause for celebration if it weren’t also the start of the semester at Yale and the arrival of 150+ individuals whose names I really want to learn! Consequently, here we are in October and I am just getting around to my ruminations on the fact that this year DTP is half my age.

Another milestone has me thinking a lot about this fact. This is the year I can apply for my full social security benefits yet continue working. The beauty of this plan is that I can start to work less!! Not that I will for a while, but reality is setting in. I have spent a significant portion of the last half my life preparing women physically for birth and recovery, educating movement teachers to do so as well, and researching, writing and speaking about the impact of physical fitness on maternal and fetal outcomes.

This has me thinking about my professional offspring. What I want to celebrate here on this blog are the pre/postnatal health and fitness professionals whose lives have intersected with mine. Individuals who have taken off from the training they received under our auspices and moved out into women’s health fitness in meaningful ways. So, in weeks to come, we will be featuring DTP “offspring” – discussing their evolution and current work. We have already prepared several posts and would like to hear from any health care or fitness professionals who would like to be included in our series. The only requirement is that you successfully participated in our education program at some point since 1984 when we began training teachers.

On the personal level, I have reaped many benefits from interactions with the millions of women who take classes, thousands of educators we trained, faculty members, research associates, and interns with the program. You have all enriched my life immeasurably and I celebrate you all!

To start this series, I am posting this very recent photograph of myself [left] with our current intern, Shannon [right], and one of our newest babies, Jack. The photo – taken by Jack’s mom, Angelica – provides a glimpse into the happiness that this program brings into my life. There are so many benefits that a healthy, active pregnancy provides to the mother and baby. This photo makes manifest the joy in the lives of those of us who work with the pre/postnatal population.

It is likely that Shannon is the last of the young women that I will personally take under my wing. I am so grateful to all of our college interns who have spent time here. But, it’s time for me to move into the next phase of my life. More writing, less teaching and – definitely – more time spent in my neglected gardens.

In a couple of weeks I will travel to Singapore to present a session on relief of the deep external rotators of the ilio-femoral joint at the IADMS dance medicine conference. This is one of the subjects in which my work as a ballet dancer, and now teacher, and my work in pregnancy fitness intersect in a meaningful way. From both fields I have learned a great deal about alleviating the biomechanical stresses that afflict both dancers and moms-to-be.

It is a great honor to work with moms-to-be and new moms. Over the next few weeks this spot will feature some of DTP’s “offspring” and their work. What a reward for me! Thank you all.

How to Get Pregnant – Coaching Topic #1

Hurrah! We have power at last…a week after hurricane Irene romped through, we have juice! Thanks for bearing with us while we camped out.

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!

Hip Hop Pregnancy!

We recently received this query from hip hop dance teacher Aysha Cheatham Bowling on the DTP facebook page and we thought it was so important that it deserved a blog entry.

Question:  I am a hip hop dance teacher and this is my first pregnancy. I am 6 months going on 7 months (due in Nov.). I have been experiencing a lot of Braxton Hicks with pain along with fibroid pain. I realize Braxton Hicks are very common in pregnancy, however the pain I experience at times can be debilitating. I have been dancing throughout my pregnancy so far, but had to cut back due to the pain. My class season is starting back up this month and I am getting worried about my ability to teach. What are some suggestions for teaching while pregnant? Any tips on warm up and movement modifications? Also, how does maternity leave work in the dance world? I am trying to figure out exactly how much time to take off. Everything is so unpredictable..lol. I am more familiar with what is common in the corporate world than dance.

Answers

1) Braxton-Hicks & fibroid pain – Braxton Hicks, or practicecontractions, are common from mid-pregnancy forward. The extent to which women are aware of them and how much discomfort they produce depends on several things – some genetic, some situational. One factor is fibroids. If your pain is so extreme that it limits activities of daily living (ADL), then you need to confer with your care provider to determine if there is something that can be done to alleviate the pain and/or whether you need to restrict ADL. If it is limiting your dance movement, you need to back off and find a way to tell or indicate to your students what you want them to do.

If the practice contractions are occurring more than 4 times an hour regularly while you are dancing and/or doing ADL, you need to confer with your care provider. When this happens, empty your bladder and drink 3 or 4 cups of water, lie on your left side and rest. If the contractions do not subside, call your care provider right away. NOTE: a full bladder can irritate the uterus causing disordered but uncomfortable contractions, so void your bladder at regular intervals.

2) Tips for teaching during pregnancy – By mid-pregnancy your alignment is shifting enough that all of your normal movement patterns are becoming inefficient. In addition to this changing alignment, your joints are at risk for damage due to hormonal changes in connective tissue, which normally helps maintain joint integrity. The bone facets that articulate together shift their relationship and nerves and blood vessels can be impinged. Therefore, making your movements smaller and less percussive are good strategies for preventing injury.

Check the pregnancy exercise tips on our website to find exercises especially designed for pregnancy. You may find some of these are useful warm-ups. Also, do side-lying relaxation every day for 10 to 20 minutes. Check the page on nutrition for childbearing, too, as nutrition plays a major role in keeping up your resources and energy.

3) How much time off will I need? – Yes, you are definitely entering the world of the unpredictable! Surely people have told you that your life will never be the same…in a good way! Well, it is true and one of the things that will be different is that priorities change and it is not always possible to predict how long things will take. Since you are fit and active and are remaining so during your pregnancy, your recovery time will be fairly quick. However, other factors will affect how long it takes you to get back into the studio. The course of your labor and birth, as well as the adjustments you and your baby and partner need to make in the immediate postpartum period, will influence when you are ready to start dancing.

With professional dancers and athletes, it has been my experience that if the birth is vaginal, within a week new moms are working on their core strength and endurance and within a month are able to do an easy class for themselves. By two months, many are back at work, rehearsing and sometimes performing. Of course, breastfeeding – which is very important for both mom and baby – may affect how long you can work at any one time. If the birth is surgical (cesarean), it may take a week or two longer to get to each milestone.

Follow up thoughts – This is an exciting and meaningful time in your life. You will not believe how amazing you will feel when you first see your baby. Be fully present and relish in the moment. Be careful now; it’s better to take precautions and make sure you and your soon-to-be-newborn are safe. When we train DTP teachers the first priority we teach is safety!

I hope this is helpful and that you will keep me posted on your progress.

– Ann Cowlin, DTP director

Pregnancy Pathway, Outcome – Mom & Baby Health Status

This 2/1/2010 entry seems to draw attention consistently, so we decided it was worth re-posting it. The discussion concerns determinants of the health outcome for mom & baby in the Pregnancy Pathway. It reviews the pathway, and then continues to the last stage of the Pathway, the health outcome. Here’s the whole graphic:

So, the big question is: How can we predict the health outcome of mom and baby, given all the variables of preconception, conception, pregnancy, labor and birth?

Well, there are some things for which we can predict or estimate risk/benefit ratios, and there are some for which we cannot. Let’s start by going over the major things that are not very predictable. At the moment, genetics is pretty much unpredictable. Down the road…maybe…but for now, not so much. Some IVF labs claim they can slightly slightly increase the odds for one sex or the other.

Post-conception, chorionic villi sampling and amniocentesis are methods by which the genetic make-up of the fetus can be identified. These are done mainly to give parents a choice about continuing a pregnancy if there is a question about genetically transmitted disorders or conditions, such as Down Syndrome. But, for now, the best way to manipulate the genetic odds of health outcome for your offspring is to mate with someone who is healthy and has health-prone genes!

Once you are pregnant, it is clear that prenatal health care, exercise, healthy nutrition, stress management and adequate sleep play significant roles in increasing the potential for a healthy outcome for mother AND baby. In fact, not only short term, but also long term healthy outcomes are linked to these factors. These are factors within our control.

Risk factors – most of which are within in our control – that can adversely affect outcomes include environmental toxins, risky behaviors (unsafe sex, drinking, smoking or drugs), poor nutrition, sedentary behavior, stress and isolation (lack of social support). These risks, as well as the benefits, are all discussed in the previous posts.

At this point, it is important to note that there is a lot that goes into making a healthy pregnancy, birth and outcome that is within the control of the mother, providing she has family and/or social support to take good care of herself.

The labor process and birth mode can also affect health outcome, but in general the effect is short-lived. For moms who have received regular care and are in excellent health, the occurrence of a truly devastating birth outcome for mother and/or baby is extremely rare. The exception may be mental or emotional turmoil that can accompany a difficult, unexpected and uncomfortable situation, such as an unplanned cesarean birth.

 

Group exercise programs are a source of social support.

Three interesting research outcomes point to the importance of exercise groups. One is that exercise can help prevent some disorders of pregnancy, such as preeclampsia or gestational diabetes. Second is that the health benefits of exercising during pregnancy and the postpartum period are beneficial for both short and long term for mother and infant. Disorders of pregnancy are risk factors for future cardiovascular disease and metabolic disorders. Third is that exercise is most likely to occur when there is good social support.

Moving together is a “muscle bonding” experience that helps bind moms-to-be and new moms into a community of support. Within the group, moms can get help with tips for healthy eating and living, along with the support of others who know what she is experiencing. There are a lot of ways to get adequate exercise. When you are pregnant or a new mom, an exercise group can be one critical path to health and well-being.

Postpartum Exercise: Creating Your 3rd Body

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!!