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.

In the past few decades, the average age for a first pregnancy in the U.S. has moved from the mid twenties into the mid thirties. In the same time period, the facts of conception — sperm enters egg released in mid cycle, then zygote implants in the uterus, along with how sex allows this to happen and how to prevent it — seems to have disappeared from middle and high school health classes. If that weren’t enough, as women have become more and more essential in the work force, the cost of having children as well as starting later, have driven down the birth rate. Similar conditions exist in most developed nations, although teen pregnancy rates are lower everywhere else.

The birthing population has bifurcated — we see older women (over 35) and teens as the major groups having children. On the one hand we have been working to reduce teen pregnancy while helping older and older women become first time moms. To a certain extent, they need the same information; its just that with teens we use this information to prevent pregnancy and with older women we use information to help them increase their odds of getting pregnant.

Understanding the menstrual cycle, ovulation, charting temperature — all the basic techniques of using the “natural” method of birth control — have become the first steps of the how-to-get-pregnant coaches. Beyond this, a number of sites have their own essential lists to help women be healthy and ready. Sites such as gettingpregnant.com, pregnancy.org/getting-pregnant, and storknet.com/cubbies/preconception/ provide additional information. Many suggestions — things to avoid eating, what proteins are needed for ovulation, how to reduce stress, what to do if there are sperm problems, how to find IVF clinics, donors and surrogates — are addressed.

How effective are these suggestions? Well, research tells us they are somewhat effective. None of the sites I contacted answered my query about how they measure or assess consumer outcomes when following their suggestions.

An interesting article in the NY Times 9/1/2011, entitled Are You as Fertile as You Look? openened with this sentence: “FORTY may be the new 30, but try telling that to your ovaries.” The reality is that being under 35 is still the best predictor of how difficult it may be for you to become pregnant. As the article makes clear, looking 30 and being 30 are not the same thing. Even healthy living does not prevent the loss of good eggs.

So, what conclusions can we draw? First, even if you come from a “fertile family,” it may behoove you to have your children in your late 20s or early 30s. Second, if you are putting off having children beyond that time, ask yourself what extremes you are willing to go to to have your own biological offspring. And, third, consider adoption. Frankly, it would be wonderful if adoption were easier, but in the drive to conceive at later and later ages we see the hand of biology and understand why adoption is not easy:  Our own offspring — our own DNA out there in the world — is a heady motivation.

If you are on the pathway of becoming pregnant, being under 35 is the best ally you have. If not, maybe some of the suggestions on the web will work for you. Whatever you decide, all the best.

One parting comment:  Regular moderate exercise — while it helps you stay young and healthy — will not prevent your eggs from being popped out every month. It will help you have a healthy pregnancy if you conceive, so stay with it!

Here is the link to the story and the subtitle:

http://branford.patch.com/articles/ann-cowlin-a-prenatal-fitness-pioneer-celebrates-30-years-of-work

What started as a “fledgling experiment” has become one Branford woman’s life work.

Thank you for taking a look!

Still looking for new ways to develop core strength & coordination for new moms…start with the posture on the left (inhale) and move to the one on the right (exhale). Keep the transverse abdominal sucked in. Repeat.…

The biology of birth is a complex series of cause-effect processes…baby’s brain releases chemical signals to the mother and the placenta begins to manifest the maternal immune system’s rejection of the fetus.

To help the ball get rolling, relaxation (the trophotropic response) helps promote the release of oxytocin. With the help of gravity, the head presses on the cervix, amplifying the uterine contractions. After an ultra-distance aerobic endurance test, the cervix opens enough to let the baby move into the vagina and the mother’s discomfort moves from sharp cramping into the bony structure as she transitions to the strength test of pushing. She transitions. Relaxation modulates into an ergotropic — adrenal — response to gather her power.

Pushing is an interesting term…more masculine, I think, than the one I prefer:  Releasing. Releasing or letting go of the baby. It’s a catharsis. In this portion of the labor another set of important processes help the baby clear its lungs of amniotic fluid, stimulate its adrenal system and challenge its immune system, as the contractions drive the baby downward. The mother’s deep transverse abdominal muscles — if strong enough — squeeze the uterus like a tube of tooth paste, to aid this expulsion. In the meantime, the labor is helping set up the mother to fall in love and produce milk. When the baby emerges and moves onto the mother’s chest, s/he smells and tastes the mother, recognizing her mother’s flavor and setting up the potential for bonding.

Any way you slice it, there are two parts to safe motherhood. One is a safe pregnancy…healthy nutrition, physical fitness, safe water, infection prevention, support and a safe environment. The other is a safe labor. In a safe labor, there is both an environment that promotes the natural process of labor and the means necessary for medical assistance when needed. Women die at an alarming rate from pregnancy or birth-related problems. Despite some progress made in recent years, women continue to die every minute as a result of being pregnant or giving birth.

What keeps us from having a better record on motherhood is often lack of care in the developing world and too much intervention in the U.S.. They are two sides of a coin. Mothers’ experience and health needs are not on equal footing with other cultural values. In places where basic prenatal care or family planning are low priorities, at-risk women are vulnerable to the physical stresses of pregnancy and birth. In the U.S., machine-measured data is paramount, even if it produces high rates of false positives, unnecessary interventions or counterproductive procedures. We are learning that obesity and sedentary lifestyles have detrimental effects, but fewer pregnant women than their non-pregnant counterparts exercise.

Despite the money spent to support the technological model of pregnancy and birth in the U.S., there are parts of the world with lower rates of maternal deaths — especially Scandinavia, Northern Europe and parts of the Mediterranean and Middle East (Greece, the United Arab Emirates, Israel, Italy and Croatia). In fact, in the U.S., maternal deaths are on the rise.

It’s a tricky business. Clearly Western medicine has a lot to offer the developing world when there are medical concerns. On the other hand, importing the U.S. model could create more problems than it solves. Instead, the micro-solutions now being developed in many locations will be observed and evidence collected by organizations such as the White Ribbon Alliance and UNICEF.

There is an effective international midwives model adopted by JHPIEGO, the Johns Hopkins NGO working toward improved birthing outcomes. It assesses the local power structure, social connections, potential for trained birth assistants, and location of available transportation to create a network so that locals will know when a labor is in trouble and who can get the woman to the nearest hospital.

In the U.S., there are in-hospital birth centers that allow low-risk mothers the opportunity to labor and birth in a setting designed to encourage the innate processes. Women are beginning to vote with their feet…staying home for birth. Women are going abroad to give birth. At the same time, women are coming to this country to give birth, believing it is safer than where they are. There are several ways these scenes could play out.

But, I’ll wager, improving outcomes will involve compromise:  Watchfulness and support in most births, plus better ways to assess danger and provide technology. No matter where you live in the world, the solution may be essentially the same.

It’s time to hit the main theme again:  Aerobically fit women are at reduced risk for things that go wrong in pregnancy, improve their tolerance for labor and birth, and recover more rapidly in the postpartum period.

Moving into Motherhood

The arrival of the holidays provides a good reason to bring this up, yet again! Pregnancy is a gateway time in women’s lives…we become more aware of our bodies, our sensations, our feelings, our needs, and how versatile and amazing our bodies are. We can make people with our bodies! During pregnancy, we often take precautions…we eat more carefully, avoid toxins, try to avoid stress. When the holidays arrive, we see indulgent behavior in a different light.

Yet, even with all this focus on behavior, we sometimes miss the biggest aid to a healthy pregnancy:  physical fitness. Research clearly demonstrates that fit women do better, are healthier and happier. More and more in the U.S. we see disorders of normal organ function that accompany sedentary pregnancy.

Let’s look at this a little closer (yes, I am going to repeat myself some more, but it is an important concept to spread). We live in a body model that rewards an active lifestyle.

Being sedentary causes things to go wrong

Not moving creates biochemical imbalances because the cardiovascular system atrophies and molecules created in the brain or brought in through the digestion may not get where they need to go for a healthy metabolism.

Your cardiovasculature is the highway that brings usable substances to the place they are used. You have to help it grow and develop, use it to pump things around and give it a chance to be healthy. Aerobic fitness does all these things.

Advice for young women of childbearing age

If you are thinking of pregnancy, have recently become pregnant, or work with women of childbearing age, we encourage you to open avenues of activity for yourself or others in this population. You can learn more from our blog dancingthrupregnancy.wordpress.com. You can seek out local pre/postnatal fitness experts on this site. Yoga is nice…we use some of it in our work, along other specific exercises for which there is a direct health benefit. But, we also see yoga converts who come into our program in mid pregnancy unable to breathe after walking up a flight of stairs. How will they do in labor? Not as well as those who have been doing aerobic dance or an elliptical machine 2 or 3 times a week.

The AHA/ACSM guidelines for the amount of aerobic exercise needed to improve cardiovascular status hold true for pregnant women just as they do for the rest of the population – a minimum of 150 minutes of moderate, or 75 minutes of vigorous, or a combination of these levels of intensity, per week. If you are not getting this level of activity, you are putting your health – and that of your offspring – at risk.

Pregnancy fitness is not only important for moms, but for the fetus as well. Evidence is clear that aerobic fitness improves brain, heart, immune and metabolic function…at all ages, including in utero. If continued early in life, healthy physical adaptations that occur in the uterus become reinforced behavior, preparing a good foundation for a healthy lifestyle. Babies are acute observers of movement and activity, and learn from each other. A key component of a good mom-baby program is the interaction of the babies themselves. A good teacher will facilitate healthy activity among our smallest class members!

There is growing evidence that at all ages, aerobic fitness produces the greatest number of benefits. Recently, researchers determined that aerobic fitness in 9 and 10 year olds produced benefits in the development of two important brain regions — the basal ganglia and the hippocampus — that are significant factors in problem-solving intelligence. This is just one of the latest reports that tells us the capacity to absorb and use oxygen (which improves with aerobic fitness) is a key to health, quality and length of life…beginning in the womb!