Pregnancy Pathway, Pregnancy — Behavior: Avoiding Risks

By dancingthrupregnancy | Published August 30, 2009

Some­times it seems like preg­nancy is a time of restric­tions. Avoid­ing risks can be one thing that makes it seem that way. But, bear with us here in an inter­est­ing trip through dan­ger and find­ing you find ways of enhanc­ing your pregnancy!

Risk Fac­tor #1:

Lack of pre­na­tal care. More than any­thing else, be sure you have care. Hav­ing some­one mon­i­tor your health and that of your baby dur­ing preg­nancy is vital to a good out­come.

Exercise! Avoiding it is a risk factor for diabetes and preeclampsia.

Exer­cise! Avoid­ing it is a risk fac­tor for dia­betes and preeclampsia.

Risk Fac­tor #2:

Not exer­cis­ing. Seden­tary behav­ior increases the risk for meta­bolic, car­dio­vas­cu­lar and immune disorders.

I know, I know, you don’t have time to exer­cise. Well, pay now or pay later, as they say. Make time to go to a class (make sure it includes 20 –30 min­utes of aer­o­bics) a cou­ple times a week. A class will also pro­vide social sup­port, another fac­tor that enhances your preg­nancy. Take a walk at lunch time. Prac­tice relax­ation techniques.

Risk Fac­tor #3:

Breath­ing dan­ger­ous fumes. Yes, this includes smok­ing and second-hand smoke. But, it also means avoid­ing envi­ron­ments where there is a lot smog (near high­ways), liv­ing with mold or dust, and fancy cleansers that may have dan­ger­ous chem­i­cals in them. Stick with vine­gar, ammo­nia or bleach as cleansers.

Smog can endanger your fetus!

Smog can endan­ger your fetus!

We are learn­ing that com­bus­tion exhaust from cars and trucks can neg­a­tively affect birth weight and pre­ma­tu­rity. If you live or work near a high­way or in an area where smog is preva­lent, what are your options? Can you trans­fer or move? Can you wear a mask? Talk to your care provider and fig­ure out the best pro­tec­tion for you and your fetus.

Risk Fac­tor #4:

Poor Nutri­tion. Yup, just go back one entry and find out how food affects preg­nancy. If you don’t eat enough pro­tein and drink enough water, you don’t make suf­fi­cient blood vol­ume to nour­ish your pla­centa and thus your fetus.

Read labels!

Read labels!

Eat whole foods and learn to read labels when you buy processed foods. What is a “processed” food? Any­thing with more than one ingredient!

Some pro­cess­ing (ex: home­made soup) takes lit­tle nutri­tion away, but some pro­cess­ing (ex: potato chips) takes every­thing good away and replaces it with unsafe sub­stances. Look for low sodium, low sugar, high vit­a­min and min­eral con­tent items with no sat­u­rated or trans fats.

Read the ingre­di­ents; if you don’t know what the words mean, maybe you want to pass it up.

Risk Fac­tor #5:

Alco­hol and Drugs. Com­mon items can be as dan­ger­ous as street drugs, which

There is plenty of time in life for a glass of wine...later.

There is plenty of time in life for a glass of wine…later.

No. No. No. Only meds from your prenatal care provider are okay.

No. No. No. Only meds from your pre­na­tal care provider are okay.

Caffeine? Only one cup & only if you must.

Caf­feine? Only one cup & only if you must.

can severely com­pro­mise you baby’s future. If you have a drug or alco­hol habit, get help.

Risk Fac­tor #6:

Genet­ics. You can have genetic pre­dis­po­si­tions for many preg­nancy issues. How­ever, that does not nec­es­sar­ily mean you will develop a given dis­or­der. For exam­ple, nutri­tion and exer­cise greatly reduce the risk and sever­ity of meta­bolic issues. Some genetic issues are unavoid­able how­ever, and your care provider will alert you to these, if they are relevant.

Risk Fac­tor #7:

Social issues — iso­la­tion, lack of sup­port, abuse, poverty. All of these fac­tors can have neg­a­tive effects.

If iso­la­tion is a sim­ple mat­ter of need­ing to meet other moms-to-be, join an exer­cise pro­gram. That way, you get both sup­port and exer­cise; just be sure it includes aer­o­bics, along with cen­ter­ing, relax­ation and appro­pri­ate strength.

If your sit­u­a­tion is more dire, seek the help of a care provider or social worker at your local hos­pi­tal or clinic. Safety and sup­port are crit­i­cal for you at this time. Get the help you need. There are peo­ple who care. And, if you know of some­one who needs help, help them.

If you have other risk fac­tors to offer, please post them in the com­ments. Thanks!

What’s next?  BIRTH!!

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Pregnancy Pathway — Exercise

By dancingthrupregnancy | Published August 14, 2009

How lucky is this? Just a few days ago, yet another study was released and has been cir­cu­lat­ing on Med­scape and other med­ical sites that indi­cates exer­cise is ben­e­fi­cial in preg­nancy, whether the mother is a pre­vi­ous exer­ciser or not. Just in time for this entry!

Behavior Affects Pregnancy Outcome

Behav­ior Affects Preg­nancy Outcome

Phys­i­cal exer­tion (we call it “exer­cise” nowa­days) is a nor­mal state for healthy humans. Only in the last cen­tury has the desire to rest or the need to store extra calo­ries as fat become more pos­si­ble to achieve than our need to move about to survive.

Preg­nancy is a state in which both of these fac­tors (rest­ing and stor­ing calo­ries) are enhanced through organic changes in body chem­istry, adap­ta­tions that favor fetal sur­vival. The cur­rent seden­tary lifestyle exag­ger­ates these meta­bolic changes and results in syn­dromes that increase the risk for a num­ber of meta­bolic, car­dio­vas­cu­lar and immuno­log­i­cal dis­or­ders of pregnancy.

When con­fronted by the idea that it is coun­ter­in­tu­itive to think exer­cise in preg­nancy might be safe (let alone ben­e­fi­cial) I am dumb­founded. To me, it is coun­ter­in­tu­itive to think that a seden­tary lifestyle in preg­nancy might be safe!

Burning Calories in Pregnancy Improves Outcomes!

Burn­ing Calo­ries in Preg­nancy Improves Outcomes!

What is the evi­dence that exer­cise in preg­nancy is ben­e­fi­cial? Keep in mind that some stud­ies have been exe­cuted more expertly than oth­ers. But, what is com­pelling is that numer­ous well-respected researchers have sought to test the hypoth­e­sis that exer­cise is not safe, but come away with results that indi­cate the opposite!

Here are some of the major findings:

• The pla­centa is larger and has more trans­port sur­face in exer­cis­ers than seden­tary women

• The fetuses of (aer­o­bic) exer­cis­ing moth­ers make ben­e­fi­cial car­dio­vas­cu­lar adaptations

• Women who do aer­o­bic exer­cise are less likely to develop severe preeclamp­sia or ges­ta­tional dia­betes, and the long term health prob­lems that accom­pany these disorders

• Women who are aer­o­bi­cally fit recover from birth 10 times faster than seden­tary women (as mea­sured by time needed to metab­o­lize free rad­i­cals pro­duced in labor)

• Women who exer­cise in preg­nancy are more likely to be phys­i­cally fit in midlife

• Babies of aer­o­bi­cally fit women are at reduced risk for pre­ma­tu­rity and low birth weight
DTP_mover2
So, we have arrived at the take-home mes­sage: MOVE!! Preg­nancy works best when you move and burn calo­ries in a mod­er­ate to vig­or­ous fash­ion. But, alter­nate this activ­ity with rest and good nutri­tion, and be sure to stay well hydrated.
If you want more specifics and resources on this topic, try these:
“Women and Exer­cise” in Varney’s Mid­wifery.
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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, Preconditions — Behavior

By dancingthrupregnancy | Published February 23, 2009

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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