American College of Nurse Midwives updates

Two updates on the ACNM web­site of interest:

• the value of exer­cise in pregnancy

• health care reform

Check out the ACNM site!!

Posted in 1, baby, birth, exercise, health care, pregnancy, worthy global human endeavors | Tagged , , , , , , , , | Leave a comment

Pregnancy Pathway, Pregnancy – Exposure to Toxins and Infection

Hot topic for today: Tox­ins and infec­tions in pregnancy.

Pregnancy Exposure to Toxins and Infections

Preg­nancy Expo­sure to Tox­ins and Infections

A mother-to-be needs to be aware of items that can have adverse effects on the health and devel­op­ment of her fetus, as well as her own health. Two of these fac­tors are tox­ins and infec­tions.

1. Tox­ins can be food, envi­ron­men­tal fac­tors, and med­ica­tions, alco­hol or drugs. Let’s start with food. Inter­est­ingly, many plants have slight tox­ins in them that can have a small neg­a­tive impact dur­ing early fetal devel­op­ment. One the­ory of nau­sea and vom­it­ing in early preg­nancy is that this helps the mother’s body pre­vent these tox­ins from inter­fer­ing with nor­mal devel­op­ment. Pica — espe­cially eat­ing dirt that is largely clay — may be another man­i­fes­ta­tion of how the body strives to counter plant tox­ins, as clay can coun­ter­act some of the effects of these tox­ins. So, plant tox­ins can be one food source in early pregnancy.

Another source is food addi­tives (things you can­not pro­nounce, so read the ingre­di­ents!). We have no idea how many chem­i­cals and hor­mones added to foods affect fetal development.

NIH illustration of reading food label

NIH illus­tra­tion of read­ing food label

Risk-aversion involves avoid­ing items that are risky. If you are not sure, don’t eat it. For up to date infor­ma­tion, look at the FDA site on food safety or the NIH site on read­ing food labels.

Envi­ron­men­tal fac­tors that may affect fetal devel­op­ment can include air pol­lu­tion, house­hold cleansers, mold and other items encoun­tered any­where one goes. Things we breathe can be par­tic­u­larly dan­ger­ous, so be sure to keep cleanser use to sim­ple items such as vine­gar, ammo­nia or chlo­rine bleach. Wear­ing a mask while clean­ing is also a good idea.

Med­ica­tions, drugs or alco­hol that might nor­mally be con­sid­ered safe for a non-pregnant per­son — some­thing as sim­ple as aspirin — can be dan­ger­ous as they affect blood clot­ting fac­tors and threaten the pla­centa. Or, because they cross the pla­cen­tal bar­rier but can­not be metab­o­lized by the imma­ture fetal liver, they are toxic and induce dam­age to the fetus.

2. Infec­tions are of con­cern, as well. It is pos­si­ble that an active infec­tion at the time of fer­til­iza­tion and implan­ta­tion can con­tribute to dys­func­tion in preg­nancy because it inter­feres with the nor­mal immune responses of early preg­nancy. Hyper­ten­sion in preg­nancy may be related to infec­tion in the early days of preg­nancy. Some infec­tions — par­tic­u­lary sex­u­ally trans­mit­ted infec­tions — are known to have detri­men­tal effects on the baby’s health. Preterm pre­ma­ture rup­ture of mem­branes (P-PROM) almost always reflects active infection.

Tak­ing Pre­cau­tions: First, be sure to let your health care provider know about any ill­ness or infec­tion. Sec­ond, take care of your­self. Fol­low rec­om­men­da­tions for fre­quent hand­wash­ing and carry ster­ile hand gel in your purse or back­pack. Avoid places where hygiene might be com­pro­mised. Prac­tice safe sex.

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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.

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