Pregnancy Pathway, Birth — Birth Mode

By anncowlin | Published December 5, 2009

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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Twins & Triplets — Exercise & Nutrition Tips

By dancingthrupregnancy | Published August 31, 2009

A detour: We received a ques­tion about nutri­tion and exer­cise for mul­ti­ples. So, here is some infor­ma­tion for those with twins and triplets. Add a com­ment if you have a ques­tion or expe­ri­ence to share on this topic! Next comes birth, we promise!!

If one is a girl and one is a boy, they're fraternal!

If one is a girl and one is a boy, they’re fraternal!

Nutri­tion for Multiples:

The pri­mary thing we tell peo­ple with twins or more is that the pro­tein needs rise about 30 grams/baby/day above the 70 — 90 grams/day needed for a sin­gle­ton. Water intake also needs to rise. Avoid thirst and as much as pos­si­ble, drink until urine runs clear rather than yel­low (as best as you can).

Mul­ti­ples is con­sid­ered a risk fac­tor, and for each risk fac­tor (mul­ti­ples, under­weight, teenage mom, inter-pregnancy period less than a year) an addi­tional 200 calo­ries is often rec­om­mended, with 400 extra calo­ries the upper limit.

Exer­cise with Multiples:

A crit­i­cal fac­tor in suc­cess­ful implan­ta­tion and growth of the pla­centa appears to be aer­o­bic fit­ness in the six months prior to and the first half of preg­nancy. Once bio­me­chan­ics become dif­fi­cult in mid-pregnancy, women with mul­ti­ples can con­tinue activ­ity safely as long as mon­i­tor­ing show the babies are grow­ing appro­pri­ately. A belly sup­port can be extremely help­ful when exercising.

Con­traindi­ca­tions for exer­cise include the dis­cov­ery that one fetus is grow­ing at a sig­nif­i­cantly slower rate than the other(s), that both/all are too small, that the placenta(s) is/are mal­func­tion­ing, or some other con­di­tion occurs, such as an incom­pe­tent cervix or pla­centa pre­via, that would be a fac­tor in any case.

Absolute size dif­fer­ence does not nec­es­sar­ily mean that one baby is grow­ing more slowly, as some fetuses may be a cou­ple weeks younger than their uterus-mate(s) if the mother ovu­lated twice in the fer­til­ity cycle. Or, s/he might be smaller if genet­i­cally des­tined to be a smaller infant at birth. Thus, growth rate is the mea­sur­able fac­tor that helps deter­mine if a fetus is at risk of not receiv­ing ade­quate energy. This can hap­pen when there are two pla­cen­tas and one pla­centa is work­ing more poorly than the other, or for some rea­son there is a flaw in the umbil­i­cal cord of an iden­ti­cal. The com­pe­ti­tion for energy places a slower grow­ing baby at risk.

Pro­tect­ing Mom and Baby:

The pla­centa is designed to nour­ish the baby and will do so at a cost to the mother first if there is inad­e­quate nutri­tion. Thus, activ­ity to the level the mother can tol­er­ate and fol­low­ing nutri­tional guide­lines above — in the absence of med­ical com­pli­ca­tions — pro­duces healthy off­spring. Mul­ti­ples will gar­ner all the same ben­e­fits a sin­gle­ton does.

Note about images:  we strive to use images we own or that are adver­tised as free on the inter­net. We want to thank google, bing and yahoo for mak­ing free images available.

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Pregnancy Pathway, Pregnancy – Exposure to Toxins and Infection

By dancingthrupregnancy | Published August 10, 2009

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, Pregnancy — Maternal Immunological Response

By dancingthrupregnancy | Published July 6, 2009

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

By dancingthrupregnancy | Published May 11, 2009

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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Pregnancy Pathway, Preconditions — Environment

By dancingthrupregnancy | Published February 21, 2009

Please refer to Feb­ru­ary 5 entry for entire graphic. Today: Envi­ron­men­tal Pre­con­di­tions to Preg­nancy.
bubblus_preconditions-environment
Our envi­ron­ment is with us all the time. Even if we think we are pre­vent­ing or con­trol­ling envi­ron­men­tal fac­tors that impinge on our bod­ies and minds, they are lurk­ing here, there, every­where, and they are myr­iad. Our envi­ron­men­tal influ­ences are every­thing from the air we breathe to the per­sons who raise or teach us, from the food avail­able to our hous­ing, from our job stresses to cul­tural forces or even the weather in our part of the world. These things help shape who we are phys­i­cally and men­tally, over the long term and from moment to moment.

08-4Are you pre­pared to become a par­ent? One way to tell is to look at your environment…is it healthy? Are you liv­ing in a sit­u­a­tion that you can count on? What about clean air, safe paint or safe food? What about water? What about peo­ple around you? Are they sup­port­ive? Does your envi­ron­ment help you stay healthy?

What about your body? Fac­tors in the envi­ron­ment that affect fer­til­ity (or lack of it) may deter­mine if  you can even become preg­nant, or when you can become preg­nant. Think about this:  Women who work together often cycle together. What if you work alone, say at home…does this affect your ovu­la­tion? One fac­tor iden­ti­fied in the low­er­ing age of men­stru­a­tion in girls is the increas­ing num­ber of hor­mones in var­i­ous meats. Another fac­tor is the pres­ence of non-biologically related older males in the house­hold. If these things are known, imag­ine what is not known about sit­u­a­tions, chem­i­cals or peo­ple in our envi­ron­ment that affect our reproduction!

There is not an absolute sep­a­ra­tion of genet­ics, envi­ron­ment and behav­ior. If we are genet­i­cally pre­dis­posed to cer­tain dis­or­ders, for exam­ple, we may or may not develop them, depend­ing on envi­ron­ment. Some per­sons are inclined toward autoim­mune dis­or­ders, but they may do well or poorly depend­ing on the air pol­lu­tion where they live. Some indi­vid­u­als may develop immune dis­or­ders. And, this sit­u­a­tion may adversely impact inflam­ma­tory responses dur­ing implantation.

Peo­ple who strive to take care of them­selves even if they live in hor­ri­ble con­di­tions can use their behav­ior to improve their chances for suc­cess in every­thing from a healthy preg­nancy to a mean­ing­ful exis­tence. Even if genet­ics and the envi­ron­ment are against the process, behav­ior can some­times over­come the odds. Granted, it’s not likely you can pro­duce 6’5″ off­spring (see last post on genet­ics!) if the egg per­son is 5’2″ and the sperm per­son is 5’7″, but much is pos­si­ble beyond that.

So, what do you do about your envi­ron­ment if you are think­ing about becom­ing preg­nant? Take stock. Ask your­self what, if any­thing, might have to change. Ask what you can or can’t accept for your off­spring, if you know there are envi­ron­men­tal fac­tors that aren’t per­fect. Fetuses are amaz­ing crea­tures; the pla­cen­tas that sup­ply and defend them are ruth­less and will pro­tect a fetus at all costs. But, you can give your body and poten­tial baby a good chance to do well by pro­vid­ing a six month span of a healthy envi­ron­ment lead­ing up to con­cep­tion. And, healthy for mind as well as body.

When your baby comes into the world, a door opens in your heart to a room you didn’t even know was there. In that room is a cer­tain kind of love and car­ing that can­not be described. It is love for this being who is and isn’t you. As a mother, you have been her/his envi­ron­ment for nine months or how­ever long you have shared. The womb is a small, pro­tected, orga­nized envi­ron­ment, one that reflects your larger envi­ron­ment. So, take stock now, ahead of time.

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Pregnancy Pathway, Preconditions — Genetics

By dancingthrupregnancy | Published February 18, 2009

Please refer to Feb­ru­ary 5 entry for com­plete graphic. The Pre­con­di­tion we will dis­cuss today is Genetics.

bubblus_preconditions_-_genetics

There are genetic fac­tors totally out­side your con­trol that deter­mine things as sim­ple as your offspring’s hair or eye color, how the ear­lobe attaches to the side of the head and whether or not s/he can roll the tongue. More com­plex things, such as a pre­dis­po­si­tion to types of can­cers, bleed­ing dis­or­ders or var­i­ous other dis­eases, also have a genetic basis.

Because the male con­tributes the sex of the off­spring, once con­cep­tion hap­pens, the sex off the fetus is deter­mined — at least genet­i­cally. But, it turns out not every­thing genetic is set in stone. In utero, hor­mone expo­sures may affect how male and female char­ac­ter­is­tics develop, so that some girls will be very girlie, some will be tomboys, and some may be gay. A sim­i­lar effect will influ­ence how boys develop.

Genetic, envi­ron­men­tal and behav­ioral pre­con­di­tions can be  inter­twined. Envi­ron­men­tal fac­tors can alter genes, caus­ing them to express pro­teins that would oth­er­wise be dor­mant. Like­wise, our behav­ior affects some of our genes. If we have a fam­ily propen­sity for heart dis­ease, but we eat a healthy diet, exer­cise and avoid risky behav­iors, we alter the impact of our genetic code.

Keep in mind that some things will be com­pletely deter­mined by genes. It is not rea­son­able to hope, for exam­ple, that our off­spring will be 6’5″ if both par­ents are short (or vice versa). If the mother has “thrifty genes” — that is, genes that make it easy for her to gain weight — she may well do so dur­ing preg­nancy, even if she fol­lows a rea­son­ably healthy lifestyle. If the immune sys­tems of both par­ents have some sim­i­lar­i­ties, it may affect the mater­nal immune response to the implant­ing tro­phoblast cells, thus affect­ing the pla­centa and, indeed, the entire pregnancy.

So, how do we advise peo­ple who are think­ing of preg­nancy to pre­pare them­selves for a healthy preg­nancy genet­i­cally? Surely, to deter­mine all the poten­tial genetic pos­si­bil­i­ties is not fea­si­ble or afford­able at this point. Maybe in another cen­tury! But, we can know some fac­tors:  Is there sickle cell ane­mia in both fam­i­lies? Is there a Mediter­ranean type of sickle cell dis­or­der? What about clot­ting fac­tors or dif­fer­ences in Rh? What about dis­eases or dis­or­ders that are not com­mon, like ALS? These are things that poten­tial par­ents may want to discuss.

Like so much of life, we can’t know every­thing. There are no guar­an­tees. There is a lot to be learned still about human genes and how they work.

This blog has at its heart the notion that phys­i­cal activ­ity has tremen­dous ben­e­fits for mother and offspring…and for part­ners, too. How does the genetic com­po­nent affect this? First, pre­con­cep­tion fit­ness low­ers some risk fac­tors for moth­ers and babies. Sec­ond, each mother’s genes will make it eas­ier or more dif­fi­cult for her to enjoy or ben­e­fit from the activ­ity of exer­cise. We appre­ci­ate this and encour­age young moms-to-be to find some­thing enjoy­able that you like doing and find peo­ple or sit­u­a­tions that sup­port you in being active now before you become pregnant.

If you need assis­tance or advice, please go to www.dancingthrupregnancy.com (use the BlogRoll)

Find Ask the Expert under the Con­sumer menu. Let us know how we can help!

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