Pregnancy Pathway

Pregnancy Pathway, Birth — Birth Mode

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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Pregnancy Pathway, Birth

There is no birth of con­scious­ness with­out pain.

Birth is a process with two major components

Birth is a life process with two major com­po­nents

Okay, be here now:  This is about a real­ly major experience…bringing human con­scious­ness into the world…opening a door to a room of love in your heart that you can only know by giv­ing birth to this person…changing your iden­ti­ty for­ev­er.

Get­ting your mind around the image: If you have not tak­en the time yet to get your mind around this, take a moment. Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sid­er:  Your body has the pow­er to cre­ate a per­son. Your body has the pow­er to expel this per­son when the rent is up.

Your brain, glands and organs are hav­ing a con­ver­sa­tion with the baby’s brains, glands and organs. At some point, this dis­cus­sion reach­es a place where it is time to end this arrange­ment of two peo­ple shar­ing one body. It is true that occa­sion­al­ly the pas­sen­ger does­n’t want to leave, but that is rare. And, we have a rem­e­dy for that. Let’s just focus now on the what hap­pens when it’s time to go.

Labor starts how? Well, it depends. Some­times con­trac­tions start in fits and spurts and take a while to get orga­nized. Some­times they start strong­ly from the get go, and for oth­ers the process of get­ting rolling can take a few days. Some­times it starts ear­ly, and some­times has to be helped to start. Once in a while, the water breaks and labor starts…or not. So, the first les­son of hav­ing a child come to live with you is that you need to be flex­i­ble in your expec­ta­tions.

In the next two posts, we’ll cov­er Labor and then the Birth Mode. Each of these process­es is unique. They involve dif­fer­ent ener­gy sys­tems. They require dif­fer­ent mind-sets from the moth­er and her sup­port team. The out­comes are dif­fer­ent. Going through the cen­ter of these process­es helps you deal with them, helps you recov­er from their stren­u­ous nature and helps you move on to being a par­ent.

Remem­ber: Breathe in deeply. Gen­tly blow the air out. Repeat. Repeat. Let go of any resis­tance. Slow your heart. Slow your mind. Con­sid­er:  Your body has the pow­er to cre­ate a per­son. Your body has the pow­er to expel this per­son when the rent is up.

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Pregnancy Pathway — Review and Labor begins!

Just to let read­ers know where we are on the preg­nan­cy path­way, here is the large graph­ic. We have just fin­ished Preg­nan­cy and are get­ting ready for Birth. Labor is beginning…are you tim­ing those con­trac­tions?!! If you have want to review any of the con­tent pri­or to Birth, you can scroll down and find an entry for each bub­ble. Or, use the Search Top­ics tool on the right side bar for a faster find.

So far, the blog has covered through Pregnancy; next Birth (purple)

So far, the blog has cov­ered through Preg­nan­cy; next Birth (pur­ple)

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Pregnancy Pathway — Exercise cont’d

MORE?!! You did­n’t think that was it? Only a few com­ments on evi­dence as to WHY mov­ing around, burn­ing calo­ries, being strong and learn­ing to relax while preg­nant is ben­e­fi­cial? No, of course not. You know there is more to it, like WHAT move­ment is safe and effec­tive dur­ing preg­nan­cy?

So, what is safe? Well, first, unless you have a very few con­di­tions that your health care provider con­sid­ers unsafe, every woman — fit, cur­rent­ly seden­tary, young or a lit­tle old­er — can exer­cise safe­ly in preg­nan­cy. How much of what kind depends on your fit­ness lev­el and exer­cise his­to­ry. Get med­ical screen­ing first.

If you are fit, you can do vigorous exercise

If you are fit, you can do vig­or­ous exer­cise

If you are fit, you just need to learn how to mod­i­fy some move­ments to accom­mo­date your bio­me­chan­ics. As your body changes, stress on the joints and tis­sues means a lit­tle less jump­ing or bal­lis­tic motion will be more com­fort­able and safer. If you are fit, you can con­tin­ue with vig­or­ous exer­cise and it will be of ben­e­fit to you and your baby.

If you are not so fit or are seden­tary, find a cer­ti­fied pre/postnatal instruc­tor and join a group where you will have fun, get some guid­ance and be mon­i­tored for safe­ty. How do you find such a per­son? Try our Find A Class or Train­er page.

What is effec­tive? Don’t spend your time on things that may be nice to do but don’t help you focus and pre­pare for birth, relieve dis­com­forts or have the sta­mi­na for birth and par­ent­ing. There is sub­stan­tial sci­en­tif­ic evi­dence and infor­ma­tion from large sur­veys that these things are help­ful.

Car­dio­vas­cu­lar or aer­o­bic activ­i­ty is the most impor­tant activ­i­ty you can do. Already fit? Keep work­ing out; join a class if you want sup­port or new friends. If you are seden­tary or some­what active, you can improve your fit­ness by doing at least 20 — 30 min­utes of aer­o­bic activ­i­ty 3 times a week. Work at a mod­er­ate pace — some­what hard to hard — so that you can talk, but not sing an aria! If you are more than 26 weeks and have not been doing car­dio, you can walk at a com­fort­able pace. Aer­o­bics is key because it gives you endurance to tol­er­ate labor and pro­motes recov­ery.

Strength and flex­i­bil­i­ty exer­cis­es that do not hurt and are done cor­rect­ly are also safe. There are some spe­cial preg­nan­cy exer­cis­es that actu­al­ly help you pre­pare for birth. Essen­tial exer­cis­es that aid your com­fort, align­ment and birth prepa­ra­tion include:

Kegels (squeez­ing and relax­ing pelvic floor mus­cles) — squeez­ing strength­ens them and thus sup­ports the con­tents of the abdomen, and learn­ing to release these mus­cles is nec­es­sary for push­ing and birth.

Abdom­i­nal hiss/compress and C‑Curve® - con­tract­ing the trans­verse abdom­i­nal mus­cles reduces low back dis­com­fort and strength­ens the mus­cle used to push and lat­er to recov­er abdom­i­nal integri­ty after birth.

Squatting

Squat­ting

Squat­ting — get­ting into this posi­tion strength­ens the entire leg in a deeply flexed posi­tion; start seat­ed and use arms for sup­port, sta­bil­i­ty and safe­ty. Leg strength improves mobil­i­ty and com­fort in preg­nan­cy and post­par­tum; plus, deep flex­ion is a com­po­nent of push­ing in almost all posi­tions.

Strength­en­ing for bio­me­chan­i­cal safe­ty — strength­en­ing some parts of the body helps pre­vent injury to bone sur­faces, nerves and blood ves­sels with­in joints re-aligned in preg­nan­cy. This can be done using resis­tance rep­e­ti­tions (weights, bands, cal­is­then­tics or pilates) or iso­met­rics (yoga or bal­let). A respon­si­ble class will focus on upper back (row­ing), push-ups, abdom­i­nals, gluteals, ham­strings, and mus­cles of the low­er leg.

Stretch­ing of areas that tend to get tight — reliev­ing some dis­com­forts through flex­i­bil­i­ty helps you main­tain a full range of motion. Sta­t­ic stretch­es, used in com­bi­na­tion with strength exer­cis­es or fol­low­ing aer­o­bics, is most effec­tive. Stretch­ing pri­or to exer­cise tends to pro­duce more injuries than not stretch­ing. Areas need­ing stretch­ing include the chest, low back, ham­strings and hip flex­ors (psoas).

Mind/Body skills are very impor­tant. There are two activ­i­ties that exer­cis­ers con­stant­ly tell us are a big help in preg­nan­cy, birth and par­ent­ing.

• Cen­ter­ing employs a bal­anced or neu­tral pos­ture, deep breath­ing and mind­ful­ness to help you work in a relaxed way. Ath­letes and dancers call this “the zone.” Start­ing your work­out in asso­ci­a­tion with your body estab­lish­es econ­o­my of motion, some­thing very use­ful in birth and par­ent­ing, and reduces risk of injury.

• Relax­ation is anoth­er key activ­i­ty; it relieves stress, pro­motes labor in the ear­ly stages and helps you enter the zone!

Remem­ber: Birth is a Motor Skill™

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Worthy Global Human Endeavors

There are only two tru­ly wor­thy glob­al human endeav­ors:

1. Humane Birthing. Find out more from the White Rib­bon Alliance for Safe Moth­er­hood.

2. Space Explo­ration. Find out more from the Augus­tine Com­mis­sion.

Pass it on.

If you are not yet con­vinced about the glob­al need for humane care for preg­nant and birthing women, google (or bing, or yahoo…) “fis­tu­la.” If you want more first world infor­ma­tion, com­pare med­ical birth with what’s on YouTube; while these two approach­es to birth are at odds in con­tem­po­rary med­i­cine, in a humane set­ting they are both nec­es­sary.

As for space, let me para­phrase Craig Nel­son’s notion:  In time, the Earth will per­ish. This is noth­ing you need to lose sleep over. It will be a long, long time before this hap­pens. But, we need to start now to pre­pare. In time, the Earth will per­ish, and we will need to be some­where else when that hap­pens.

These two things will reap all the rewards that need be reaped. The enabling of safe moth­er­hood and our move­ment into space are the only things that ensure human sur­vival.

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Pregnancy Pathway, Pregnancy — Maternal Immunological Response

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

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!!

Sign up for this Blog (top tool­bar, click blog info and sub­scribe)!! Learn from our more than 30 years of help­ing make healthy moms & healthy babies.

Vis­it our web­site:  www.dancingthrupregnancy.com

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Pregnancy Pathway, Conception — Review & Small Rant!

REVIEW: Evi­dence is clear - pre-preg­nan­cy mater­nal health sta­tus, includ­ing phys­i­cal fit­ness, healthy nutri­tion and an uncom­pro­mised immune sys­tem affect the health and well-being of both moth­er and off­spring, in both short and long term.

This is the mes­sage sum­ma­ry from our first two areas of dis­cus­sion:  Pre­con­di­tions and Con­cep­tion — the green and sand col­ored sec­tions on the chart below.

pregnancy_pathway

COMING ATTRACTIONS: We are about to move on to the blue sec­tion — Preg­nan­cy!!  So, book­mark this Blog for future ref­er­ence!

Also, you can sub­scribe to this Blog by click­ing on Blog Info in the upper right cor­ner and then click­ing on Sub­scribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fit­ness, nutri­tion and a healthy immune sys­tem play sig­nif­i­cant roles in the out­come of preg­nan­cy and the future health of moth­er and child, we are appeal­ing to young peo­ple of child­bear­ing age to be care­ful about your bod­ies. The alliance of egg and sperm shapes the world. With 6.5 Bil­lion egg/sperm com­bi­na­tions (yes, peo­ple) present­ly liv­ing on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remem­ber that show?) is cooked.

Humor­ous incur­sion: In case you need fur­ther enlight­en­ment on this whole area, there is a great web­site that will help you out. Be pre­pared to be amused and amazed!

The Truth about Eggs and Sperm

Hope­ful­ly, this gets you in the right mood and keeps you smil­ing. After all, once you actu­al­ly are preg­nant, we have more seri­ous mat­ters to dis­cuss.

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Pregnancy Pathway, Conception

Today: Con­cep­tion!

For com­plete graph­ic, see Feb. 5 or 23 post.

bubblus_conception

The health of the moth­er and her pri­or expo­sure to sperm have a dra­mat­ic effect on con­cep­tion. To find out why and how, we have to start with this ques­tion: 

What is con­cep­tion?

Is it fer­til­iza­tion, a process by which an egg absorbs a sperm, engulf­ing the male’s half of the genet­ic code? Per­haps it is the point at which this egg/sperm con­coc­tion (the cor­pus) reach­es the uterus and the tro­phoblast cells begin to invade the endometri­um (uter­ine lin­ing)?

Trophoblast Invastion? No...Chihuly glass exhibit at the Desert Botanical Gardens, Phoenix AZ

Tro­phoblast Invas­tion? No…Chihuly glass exhib­it at the Desert Botan­i­cal Gar­dens, Phoenix AZ

Tro­phoblast inva­sion caus­es spi­ral arter­ies in the moth­er’s cir­cu­la­tion to open and form a pool that will nour­ish the fetus. Depend­ing on the “dis­cus­sion” between the moth­er’s immune sys­tem and tro­phoblast, this inva­sion may go well or poor­ly. How well it goes will affect the course of the preg­nan­cy.

Or, what about the point around 8 weeks post onset of last men­stru­al cycle at which the respon­si­bil­i­ty for nour­ish­ment of these cells is trans­ferred from the cor­pus to the pla­cen­ta? By this point about 30% of poten­tial preg­nan­cies have spon­ta­neous­ly abort­ed because of genet­ic or inflam­ma­tion prob­lems.

Anoth­er can­di­date is the Quick­en­ing, the point the Bible refers to as the start of life. This is  the occa­sion — around 4 months post onset of last men­stru­al cycle — when the moth­er first sens­es move­ment in her womb. Is this con­cep­tion? It cer­tain­ly ris­es to the test of con­scious­ness of a phe­nom­e­non (oth­er­wise known as a con­cept).

What if the engulf­ing of the sperm hap­pens in a dish in the lab­o­ra­to­ry? What if large dos­es of egg induc­ing med­ica­tions are required to prompt eggs to mature and con­sid­er engulf­ing sperm? What if hor­mones are required to allow the first few cells to grav­i­tate toward and inbed them­selves into a uter­ine sur­face not real­ly that friend­ly to their con­tin­u­a­tion?

You can see that it is not a sim­ple mat­ter to estab­lish a start­ing point. There are sev­er­al process­es that must go right to form a viable human. All along the way, the moth­er’s health plays a key role. Inter­est­ing­ly, the extent of expo­sure to the father’s sperm also plays a role, as do immune fac­tors in the com­bined moth­er’s and father’s genes.

08

Most impor­tant for our         pur­pos­es here is that women who are reg­u­lar aer­o­bic exer­cis­ers pri­or to preg­nan­cy or who begin in ear­ly preg­nan­cy show reduced risk for devel­op­ments of the pla­cen­ta that pro­duce a dys­func­tion­al preg­nan­cy.

Upcom­ing posts will dis­cuss mater­nal health and sperm expo­sure in more detail.

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Pregnancy Pathway, Preconditions

Please refer to Feb­ru­ary 5 entry for com­plete graph­ic. Today we turn to the ques­tion of pre­con­di­tions to preg­nan­cy and how they might affect mater­nal and off­spring health.

Preconditions

Pre­con­di­tions

Pre-exist­ing fac­tors that can influ­ence health out­comes include genet­ic fac­tors (fam­i­ly risk for heart dis­ease, for exam­ple), envi­ron­men­tal fac­tors (liv­ing in a build­ing with mold, for exam­ple), and behav­ior (eat­ing well and exer­cis­ing, for exam­ple). In each cat­e­go­ry, fac­tors will con­tribute to the health of the moth­er and even­tu­al­ly to off­spring health.

It is impor­tant to under­stand what major genet­ic fac­tors may affect your off­spring and whether the envi­ron­ment or behav­ior can help off­set neg­a­tive fac­tors. For exam­ple, there may be a his­to­ry of preeclamp­sia dur­ing preg­nan­cy in your fam­i­ly, but vig­or­ous aer­o­bic exer­cise in the six months pri­or to preg­nan­cy pro­vides a high degree of pro­tec­tion from this risk. Preeclamp­sia puts both moth­er and off­spring at risk for com­pli­ca­tions.

Oth­er genet­ic fac­tors that may be of con­se­quence include autoim­mune dis­or­ders, aller­gies, and meta­bol­ic syn­dromes. For exam­ple, so-called “thrifty genes” may pre­dis­pose you to a high weight gain in preg­nan­cy. But, you may be able to off­set health prob­lems asso­ci­at­ed with this by stay­ing active and eat­ing well.

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