Filed under: Aerobics, Yoga, birth, exercise, labor | Tagged: aerobics, birth, breathing, exercise, moms-to-be, mother, yoga | Leave a Comment »

Accepting the importance of fetal programming places responsibility on the mother-to-be to do all she can to insure her body provides nutrients and oxygen to her growing infant while avoiding possible risks and toxins. At the same time, genetic and environmental factors contribute greatly to the potential for some disorders and problems that arise. Thus, we must be careful in assigning guidelines for acceptable behavior or blame for poor outcomes to pregnant women.

On the one hand, we can all see the negative consequences of something like fetal alcohol syndrome…clearly the result of maternal behavior. Is a pregnant woman whose baby has been damaged in this way guilty of abuse?

But, what if a mother is obese, eats poorly and ends up with an infant with a disturbed metabolism. Is this abuse? What if the mother has an infection that results in cerebral palsy? Or what if she lives near a highway and involuntarily inhales fumes that negatively affect the placenta?

How do you get a healthy baby? Of course, there are no guarantees. There remain many unknown factors that can affect the course and outcome of a pregnancy. Some factors we are aware of, such as avoiding certain fumes or chemicals.  There are some behaviors we know can maximize the potential for a good outcome, such as eating adequate protein, aerobic conditioning and strength training. [Note for new readers…lots of these factors have been covered in our previous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cautionary tale:  There is a species of goat that, if they eat a certain type of skunk grass on day 14 (and only day 14) of pregnancy, will not go into labor. Why? Plant toxins in this grass interfere with the development of a small portion of fetal brain, the paraventricular nucleus. This nucleus is involved in the signaling cycle of labor. Without it, the mother will not go into labor!

What are the take-home messages here?

• Probably no one is ever a perfect fetus…too many possible threats.
• There are some threats we can avoid…being lazy, over-eating, smoking.
• There are some threats we cannot avoid, so we do the best we can.

Do the best you can by your baby…aerobic fitness, good nourishment, sleep, good hygiene and de-stressing your life.

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!!!

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

1. Women who return to vigorous (vigorous, as in jogging or aerobic dance) prior to six weeks postpartum…

• have less weight to lose
• experience a more joyful state of mind
• do better on the Lederman Maternal Adaptation scales (how well they adapt to motherhood)

…than women who are sedentary during this period (Sampselle, 1999…this is not new information)

2. Postpartum obesity is a dangerous short and long term health risk (Leddy, 2008).

Who should exercise and when, following birth?

Day 1: If you have a vaginal birth, begin your “body scan” the first chance you get. Within the first day, the first chance you get to focus on yourself, take a mental trip through your body. See if you can squeeze the kegel muscles. Try exhaling and sucking in your deep abdominal muscles. Note if your shoulders need to relax. Take some deep breathes and begin to help your body recover.

If you had a cesarean: Wait a few days to 2 weeks at most to work on this.

After that: As soon as you can, get up and walk around. Start walking in 5 or 10 minute strolls several times a day (ask someone to hold or watch baby so you can allow your body to recover a non-pregnant upright). If you had a cesarean, hold a pillow to your abdomen until you have control of your abdominal muscles and stand tall.

How can you get more information on this?

Go to our website:

http://dancingthrupregnancy.com/take-a-class/postpartum-exercise/

Find a class. If you had a typical birth and your baby has been slowly and safely exposed to new people, by four to six weeks you and baby should be ready for a structured activity session that includes baby. It will also provide focus and adult interaction during the week.

How do you know if you did too much?

Your lochia, or the bleeding/discharge from the placental site, will increase if you have been too vigorous. If you are healthy and have no anemia issues, your lochia will likely cease by three to four weeks, six at most.

What are safety issues?

Don’t exercise if you have a fever, a warm red spot on your leg that may be painful (or not), or sore nipples that need attention. Call your care provider. If you or your baby are sick, it is best not to go into a group setting. If your baby is not well or just doesn’t seem right, call your pediatrician.

The most important reason to join a mom-baby fitness program may be that it will help keep you sane.

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.

The first step is always to take the Basic Pre/postnatal Fitness Certification course and exam. Our course has been in existence for 25 years and we have trained the founders of many of the programs you can find on the web today.

Once you have passed the Basic exam, you have options about further training, including the hands-on Practicum, advanced planning and marketing information, licensing of trademarks and consulting services.

Click on the Become a Teacher tab!

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

December 5 at Yale-New Haven Hospital.

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!