More on Preventing Childhood Obesity!

Rachael Blum of Santa Mon­ica, CA, has alerted us to an excel­lent arti­cle in the New Eng­land Jour­nal of Med­i­cine con­cern­ing the evi­dence for the role of exer­cise in preg­nancy in help­ing pre­vent child­hood obe­sity:  http://healthcarereform.nejm.org/?p=3321&query=home. Rachael, our newest DTP fam­ily mem­ber, has also alerted us to an LA Times arti­cle on this sub­ject:  LA Times arti­cle.

With the recent empha­sis on the impor­tance of move­ment in the fight against child­hood obe­sity, there is recog­ni­tion that ben­e­fi­cial fetal pro­gram­ming through mater­nal exer­cise can make a big con­tri­bu­tion to this effort. A com­bi­na­tion of proper mater­nal nutri­tion and mater­nal fit­ness may well prove to be most effi­cient and poten­tially effec­tive way to help chil­dren develop an appetite for motion!

One fac­tor in this is the find­ing that reg­u­lar, moderate-intensity exer­cise helps pre­vent obe­sity in the new­born: http://www.nlm.nih.gov/medlineplus/news/fullstory_97212.htmlt. This, may in turn, help pre­vent child­hood obesity.

Recess for everyone!!!

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Pre/postnatal Fitness Teacher Training

BECOME A TEACHER!!

DTP offers correspondence/online teacher train­ing. If you are a group fit­ness instruc­tor, per­sonal trainer, or think­ing about becom­ing one, check out the train­ing options.

Click on the Become a Teacher tab!

Read­ing, class plan­ning, and oper­a­tions infor­ma­tion are part of Teacher Training

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Weight Gain in Pregnancy — New IOM Guidelines

In May 2009, the Insti­tute of Med­i­cine (IOM) issued new guide­lines on weight gain in preg­nancy. You can find this report at the URL listed below. As you may be aware, they are rec­om­mend­ing lower weight gains than previously.

Here is the link to the Guidelines:

IOM Preg­nancy Weight Gain Guidelines

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Pregnancy Pathway, Birth — Birth Mode

The Sec­ond Stage of Birth is dif­fer­ent from the First Stage. The actual expul­sion of the baby requires a change in energy axis. Dur­ing dila­tion (first stage), oxy­tocin is most eas­ily released from the pitu­itary gland dur­ing relax­ation (see pre­vi­ous post), but dur­ing tran­si­tion, a change occurs so that the ergotropic response takes over and adren­a­line is key in help­ing oxy­tocin to spike.

What does this mean as far as prepa­ra­tion is con­cerned? While it is impor­tant to learn to relax or main­tain posi­tions such as one does in yoga, the abil­ity to sprint, or turn on an aggres­sive action at the end, is crit­i­cal. You need  good aer­o­bic con­di­tion­ing. Begin exer­cise with easy breath­ing and move­ment, then prac­tice aer­o­bic endurance and power moves at the end of your work­out! Fin­ish up with cool down and stretch­ing.

The con­trac­tions them­selves change. They remain intense for a longer stretch, but the time between them increases. Push­ing involves not only the uterus con­tract­ing, but the pres­sure exerted by the trans­verse abdom­i­nal (TrA) mus­cle. Sim­i­lar to squeez­ing a tube of tooth­paste, TrA pres­sure helps press the baby toward the exit — yes, that is the vagi­nal open­ing. If the labor­ing mother is not able to apply ade­quate pres­sure, labor assis­tants some­times apply pres­sure man­u­ally to the top of the uterus or — if need be — for­ceps or a vac­uum extrac­tion may be necessary.

How can a mom best pre­pare so that the TrA can pro­vide the needed pres­sure? Strength train­ing the TrA! Like any other motion requir­ing power strength, this mus­cle can be strength­ened to do its job! Here’s how:

pic­ture 1:  sit upright, inhale

pic­ture 2:  exhale, com­press abdomen and curl down

Return to upright and repeat 8 times. Rest. Repeat 8 more times.

What if some­thing goes awry? Cesarean, or sur­gi­cal birth is an alter­na­tive. Major com­pli­ca­tions before labor include a pla­centa pre­via, infec­tion or unde­liv­er­able breech posi­tion. Dur­ing labor, the most com­mon prob­lem is dys­to­cia — stalled progress through dila­tion (first stage) or push­ing (sec­ond stage). In the push­ing stage, head to large for pelvis is the most com­mon difficulty.

What hap­pens next? If the birth is nat­ural, you will feel a tremen­dous eupho­ria. Bring the baby right up onto your chest for skin-to-skin con­tact. If you have had med­ica­tions, your response may be slightly blunted, but you will def­i­nitely be over­whelmed by the emo­tions of birth.

Third Stage is expul­sion of the pla­centa, which can no long remain con­nected to the shrink­ing uterus. When it detaches, the nurses or mid­wives will ask you to push and !plop! out it comes. It can be inter­est­ing to see what has nour­ished your baby for so long!

CONGRATULATIONS!  YOU’RE A MOM!

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Pregnancy Pathway, Birth

There is no birth of con­scious­ness with­out pain.

Birth is a process with two major components

Birth is a life process with two major components

Okay, be here now:  This is about a really major experience…bringing human con­scious­ness into the world…opening a door to a room of love in your heart that you can only know by giv­ing birth to this person…changing your iden­tity forever.

Get­ting your mind around the image: If you have not taken the time yet to get your mind around this, take a moment. Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sider:  Your body has the power to cre­ate a per­son. Your body has the power to expel this per­son when the rent is up.

Your brain, glands and organs are hav­ing a con­ver­sa­tion with the baby’s brains, glands and organs. At some point, this dis­cus­sion reaches a place where it is time to end this arrange­ment of two peo­ple shar­ing one body. It is true that occa­sion­ally the pas­sen­ger doesn’t want to leave, but that is rare. And, we have a rem­edy for that. Let’s just focus now on the what hap­pens when it’s time to go.

Labor starts how? Well, it depends. Some­times con­trac­tions start in fits and spurts and take a while to get orga­nized. Some­times they start strongly from the get go, and for oth­ers the process of get­ting rolling can take a few days. Some­times it starts early, and some­times has to be helped to start. Once in a while, the water breaks and labor starts…or not. So, the first les­son of hav­ing a child come to live with you is that you need to be flex­i­ble in your expectations.

In the next two posts, we’ll cover Labor and then the Birth Mode. Each of these processes is unique. They involve dif­fer­ent energy sys­tems. They require dif­fer­ent mind-sets from the mother and her sup­port team. The out­comes are dif­fer­ent. Going through the cen­ter of these processes helps you deal with them, helps you recover from their stren­u­ous nature and helps you move on to being a parent.

Remem­ber: Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sider:  Your body has the power to cre­ate a per­son. Your body has the power to expel this per­son when the rent is up.

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Pregnancy Pathway — Review and Labor begins!

Just to let read­ers know where we are on the preg­nancy path­way, here is the large graphic. We have just fin­ished Preg­nancy and are get­ting ready for Birth. Labor is beginning…are you tim­ing those con­trac­tions?!! If you have want to review any of the con­tent prior to Birth, you can scroll down and find an entry for each bub­ble. Or, use the Search Top­ics tool on the right side bar for a faster find.

So far, the blog has covered through Pregnancy; next Birth (purple)

So far, the blog has cov­ered through Preg­nancy; next Birth (purple)

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Pregnancy Pathway — Exercise cont’d

MORE?!! You didn’t think that was it? Only a few com­ments on evi­dence as to WHY mov­ing around, burn­ing calo­ries, being strong and learn­ing to relax while preg­nant is ben­e­fi­cial? No, of course not. You know there is more to it, like WHAT move­ment is safe and effec­tive dur­ing pregnancy?

So, what is safe? Well, first, unless you have a very few con­di­tions that your health care provider con­sid­ers unsafe, every woman — fit, cur­rently seden­tary, young or a lit­tle older — can exer­cise safely in preg­nancy. How much of what kind depends on your fit­ness level and exer­cise his­tory. Get med­ical screen­ing first.

If you are fit, you can do vigorous exercise

If you are fit, you can do vig­or­ous exercise

If you are fit, you just need to learn how to mod­ify some move­ments to accom­mo­date your bio­me­chan­ics. As your body changes, stress on the joints and tis­sues means a lit­tle less jump­ing or bal­lis­tic motion will be more com­fort­able and safer. If you are fit, you can con­tinue with vig­or­ous exer­cise and it will be of ben­e­fit to you and your baby.

If you are not so fit or are seden­tary, find a cer­ti­fied pre/postnatal instruc­tor and join a group where you will have fun, get some guid­ance and be mon­i­tored for safety. How do you find such a per­son? Try our Find A Class or Trainer page.

What is effec­tive? Don’t spend your time on things that may be nice to do but don’t help you focus and pre­pare for birth, relieve dis­com­forts or have the sta­mina for birth and par­ent­ing. There is sub­stan­tial sci­en­tific evi­dence and infor­ma­tion from large sur­veys that these things are helpful.

Car­dio­vas­cu­lar or aer­o­bic activ­ity is the most impor­tant activ­ity you can do. Already fit? Keep work­ing out; join a class if you want sup­port or new friends. If you are seden­tary or some­what active, you can improve your fit­ness by doing at least 20 — 30 min­utes of aer­o­bic activ­ity 3 times a week. Work at a mod­er­ate pace — some­what hard to hard — so that you can talk, but not sing an aria! If you are more than 26 weeks and have not been doing car­dio, you can walk at a com­fort­able pace. Aer­o­bics is key because it gives you endurance to tol­er­ate labor and pro­motes recov­ery.

Strength and flex­i­bil­ity exer­cises that do not hurt and are done cor­rectly are also safe. There are some spe­cial preg­nancy exer­cises that actu­ally help you pre­pare for birth. Essen­tial exer­cises that aid your com­fort, align­ment and birth prepa­ra­tion include:

Kegels (squeez­ing and relax­ing pelvic floor mus­cles) — squeez­ing strength­ens them and thus sup­ports the con­tents of the abdomen, and learn­ing to release these mus­cles is nec­es­sary for push­ing and birth.

Abdom­i­nal hiss/compress and C-Curve® - con­tract­ing the trans­verse abdom­i­nal mus­cles reduces low back dis­com­fort and strength­ens the mus­cle used to push and later to recover abdom­i­nal integrity after birth.

Squatting

Squat­ting

Squat­ting — get­ting into this posi­tion strength­ens the entire leg in a deeply flexed posi­tion; start seated and use arms for sup­port, sta­bil­ity and safety. Leg strength improves mobil­ity and com­fort in preg­nancy and post­par­tum; plus, deep flex­ion is a com­po­nent of push­ing in almost all positions.

Strength­en­ing for bio­me­chan­i­cal safety — strength­en­ing some parts of the body helps pre­vent injury to bone sur­faces, nerves and blood ves­sels within joints re-aligned in preg­nancy. This can be done using resis­tance rep­e­ti­tions (weights, bands, cal­is­then­tics or pilates) or iso­met­rics (yoga or bal­let). A respon­si­ble class will focus on upper back (row­ing), push-ups, abdom­i­nals, gluteals, ham­strings, and mus­cles of the lower leg.

Stretch­ing of areas that tend to get tight — reliev­ing some dis­com­forts through flex­i­bil­ity helps you main­tain a full range of motion. Sta­tic stretches, used in com­bi­na­tion with strength exer­cises or fol­low­ing aer­o­bics, is most effec­tive. Stretch­ing prior to exer­cise tends to pro­duce more injuries than not stretch­ing. Areas need­ing stretch­ing include the chest, low back, ham­strings and hip flex­ors (psoas).

Mind/Body skills are very impor­tant. There are two activ­i­ties that exer­cis­ers con­stantly tell us are a big help in preg­nancy, birth and parenting.

• Cen­ter­ing employs a bal­anced or neu­tral pos­ture, deep breath­ing and mind­ful­ness to help you work in a relaxed way. Ath­letes and dancers call this “the zone.” Start­ing your work­out in asso­ci­a­tion with your body estab­lishes econ­omy of motion, some­thing very use­ful in birth and par­ent­ing, and reduces risk of injury.

• Relax­ation is another key activ­ity; it relieves stress, pro­motes labor in the early stages and helps you enter the zone!

Remem­ber: Birth is a Motor Skill™

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Worthy Global Human Endeavors

There are only two truly wor­thy global human endeavors:

1. Humane Birthing. Find out more from the White Rib­bon Alliance for Safe Motherhood.

2. Space Explo­ration. Find out more from the Augus­tine Com­mis­sion.

Pass it on.

If you are not yet con­vinced about the global need for humane care for preg­nant and birthing women, google (or bing, or yahoo…) “fis­tula.” If you want more first world infor­ma­tion, com­pare med­ical birth with what’s on YouTube; while these two approaches to birth are at odds in con­tem­po­rary med­i­cine, in a humane set­ting they are both necessary.

As for space, let me para­phrase Craig Nelson’s notion:  In time, the Earth will per­ish. This is noth­ing you need to lose sleep over. It will be a long, long time before this hap­pens. But, we need to start now to pre­pare. In time, the Earth will per­ish, and we will need to be some­where else when that happens.

These two things will reap all the rewards that need be reaped. The enabling of safe moth­er­hood and our move­ment into space are the only things that ensure human survival.

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Pregnancy Pathway, Pregnancy — Maternal Immunological Response

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

Maternal Immune Response During Pregnancy

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!

Be Pre­pared for Birth!

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Pregnancy Pathway, Pregnancy

Time for an entre: Preg­nancy!!

Up for discussion…

Health Influences in Pregnancy

Health Influ­ences in Pregnancy

Let’s start at the begin­ning…in the first trimester you feel sick and tired, right? Three things:

1) your immune sys­tem is pro-inflammatory (caus­ing nau­sea and fatigue), 2) your body is pro­tect­ing your fetus from some tox­ins (if you eat some­thing not so great for the fetus, you throw up), and 3) you have extreme swings in blood sugar lev­els so that after you eat, the level soars and you feel sick.

Num­ber 3 can be fixed with behav­ior, but you may have to wait out 1 & 2. To fix num­ber 3 eat very small meals fre­quently (6 or 8 times a day) and be sure to eat pro­tein, that is, eggs, meat, fish, fowl, cheese, nuts, rice & beans, soy, etc. with each small meal. This sta­bi­lizes blood sugar and pre­vents dra­matic ele­va­tions that can cause nausea.

In most healthy preg­nan­cies, the immune sys­tem will rebound in the sec­ond trimester so that you feel good; it is pro­tect­ing you again!  But, those wicked tox­ins and infec­tions are still out there in the envi­ron­ment, so the mes­sage is beware bad air (smog, smok­ing, indus­trial air pol­lu­tion), highly processed foods (lunch­meats, things with names you can’t pro­nounce), any drugs or meds not pre­scribed or okayed by your ob or mid­wife, alco­hol, and dan­ger­ous bac­te­ria, viruses and other microbes!

Exer­cise wisely…no sky-diving or scuba div­ing! Eat healthy food and get enough sleep. De-stress through relax­ation and med­i­ta­tive tech­niques. Don’t take risks with your health, but do stay active and start to pre­pare for birth and bring­ing home a baby (or two?).

Third trimester & the immune sys­tem goes on the fritz again — can’t keep this baby in here for­ever; must expel! You may feel sick and tired again. BUT, keep your pre­na­tal care appoint­ments, keep mov­ing, get good nutri­tion, rest and stay focused. Before you know it the real work begins, not to men­tion the 18 years of sleep deprivation.

Get­ting from here…

Being Fully Present in Your Pregnancy...

Being Fully Present in Your Pregnancy…

…to here..

Being Fully Present as Mom

Being Fully Present as Mom.

…is a jour­ney like no other. The adap­ta­tions of your body to the demands of preg­nancy are amaz­ing. If you pay atten­tion, you will learn more about the mean­ing of exis­tence from this than from any­thing else.

BE HERE NOW!!

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