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.

Pregnancy Pathway, Pregnancy – Behavior, part 2: Nutrition

Let us discuss food!      Yeah, food!

Fresh fruit = vitamins & minerals!!

Fresh fruit = vitamins & minerals!!

Question:

How many extra calories do you need in each trimester to offset the metabolic cost of pregnancy?

Answer:

First trimester – 0; Second trimester – 300; Third trimester – 500 (source: Institute of Medicine).

Keep in mind that you may also need calories for any fitness program you are doing. If you are continuing a program, the only change is due to the pregnancy.

If you begin or increase your activity, you need to take that into account. One yoga class = 100 – 150 calories. One aerobics class = 200-400 calories. Walk one mile = 100 calories.

1 slice whole grain bread = 50-100 calories

1 slice whole grain bread = 50-100 calories

Be sure you read food labels so that you can balance your food intake and your calorie output. A small woman (under 5’3″ & 130 lbs.) probably needs about 1200 calories per day as a base. A medium sized woman needs about 1400, and a large woman (over 5’9″ & 160 lbs.) probably needs 1600 to 1800 calories. Add your activity and pregnancy needs to your base amount.

Question:

What foods are necessary for a healthy pregnancy?

Answer, part A:

PROTEIN. Lean proteins like turkey and those with omega 3 fats like ocean fish and eggs….yes! EGGS!

Turkey is a good protein

Turkey is a good protein

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Eggs are a perfect pregnancy food!

Eggs are a perfect pregnancy food!

70-90 grams of protein are necessary each day, along with  adequate water.  These are needed to make an extra 40% blood volume required to support the placenta.

Answer, part B:

WATER. Two (2) quarts of water…more if you are very active…are needed to make extra blood and to prevent dehydration.

Question: What else?

Fresh vegetables also provide fiber

Fresh vegetables also provide fiber

Answer: CARBS. Fresh, colorful fruits & veggies provide necessary vitamins and minerals, as well as fiber. Eat 5 servings a day from all the colors:  yellow, orange, red, purple and green, and you will get live vitamins all day long that help your baby develop properly! Fruits, vegetables and whole grains are low glycemic index carbohydrates – the good ones!

Dairy provides calcium

Dairy provides calcium

Question:

Do I need dairy products and red meat? Can I get the needed minerals in other ways?

Answer:

Calcium is needed in adequate amounts for bones and teeth. It is most easily obtained by drinking milk or eating cheese, yogurt or cottage cheese. Soy, dark green leafy vegetables and calcium fortified juice are alternatives.

Iron is necessary for red blood cells to take up oxygen. It is found in high amounts in beef,  and lesser amounts in raisins, spinach, and prune juice. Prenatal vitamins are your insurance against deficiencies of these essential minerals.

Question:

Anything else that’s essential?

Answer:

Yes! Healthy FAT!!

Avocado is an excellent source of omega 6 fat

Avocado is an excellent source of omega 6 fat

In addition to omega 3 fats found in fish, walnuts and flax seeds, you need also need omega 6 fats, which are found in avocados, olive oil and other vegetable oils. Healthy fats help balance cardiovascular constriction and dilation, reducing the risk for hypertension.

Last Question:

What is a healthy weight gain?

Answer:

In 2009, the National Academy of Sciences revised its recommendations. It now bases desirable weight gain on pre-pregnancy BMI (Body Mass Index…google this!).

BMI less than 18.5 (low) – 28 to 40 lbs.; BMI between 18.5-24.9 (normal) – 25 to 35 lbs.; BMI 25.0 to 29.9 (high) – 15 to 25 lbs.; obese women (BMI over 30.0) – 11 to 20 lbs.

Coming Next: Avoiding Risks.

Pregnancy Pathway, Preconditions – Behavior

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.