Skin Changes in Pregnancy

pregnant-bellyWhile we all expect certain things to change about our body during pregnancy—we will gain weight, our bellies will grow larger, our breasts will change—some physical changes may come as a surprise.  For some of us,  our skin changes, our feet grow, our hair changes, or other seemingly non-reproductive related changes transform our bodies.  Today, we’ll take up common changes to the skin that may occur during pregnancy.

 Itching

Skin itchiness can be common in pregnancy and can affect the abdomen, breasts, hips, thighs, and/or back.  This is often due to the skin stretching to accommodate your growing baby.  Also, increased sweating and decreased bowel function may cause the skin to work harder to eliminate toxins.  This affects the liver (responsible for processing toxins and an increased hormonal load), which may cause the skin to itch.  Itching may also be related to stress.

 Things that may help relieve itchiness include:

  • Using mild or no soap and avoiding skin irritants in beauty products.
  • Using a loofah or body brush may stimulate the skin and clear away dead cells.
  • Exercise will help get your circulation going, helping to get to the root of what causes the skin to itch
  • Drink lots of water.
  • Ensure you are getting Essential Fatty Acids in your diet, which can improve moisture and reduce inflammation.
  • Cocoa butter and coconut oil are great moisturizers and can aid with stretch marks too
  • Calendula oil can reduce itching and irritation

The pregnancy “glow”

Not just an old wives’ tale, the pregnancy glow is actually a physiological phenomenon.  Pregnant mamas carry an increased blood volume, which causes the cheeks to take on a blushed appearance.  Increased oil gland secretion also gives the skin a waxy luster.

The mask of pregnancy

Some women develop patches of skin discoloration known as chloasma sometime in the second trimester.  These spots, often brown or yellowish, appear on the face, particularly on the upper cheeks, nose, chin and forehead.  This skin change in pregnancy is the result of pregnancy hormones (estrogen and progesterone) stimulating melanin (skin pigmentation) production in an uneven fashion, giving the appearance of a blotchy tan.  Darker skinned women and brunettes may also develop dark circles around the eyes because of this change in melanin production.  While this skin change cannot be prevented, limiting sun and other UV exposure can help lessen the effects.

Acne

For some women, they notice their skin improves in pregnancy, while for others it is the opposite.  If you notice an increase in breakouts, you may want to consider the following:

  • Avoid abrasive scrubs or exfoliants; pregnant skin is too sensitive for these
  • Opt for milder, oatmeal-based facial scrubs
  • Do not use Accutane or Retin-A, which can cause serious birth defects.

A small percentage (about 1%) of women experience itchy, red, acne-like breakouts on their belly, thighs, bottom, and limbs.  This tends to stop and go throughout the second half of pregnancy and typically resolves soon after birth.

 Linea nigra

For women who are not aware of this possible pregnancy skin change, it may come as a surprise when a faint line begins to appear vertically down the belly and grows darker and darker as the weeks go on.  This line is known as the linea nigra and is common in pregnancy due to hormonal changes.  It can grow from the belly button downward, or upward, or both.  It is sometimes straight and sometimes meanders a bit!  This line typically fades within the first months following birth.  Some people speculate that this line appears as an evolutionary “route marker,” helping newborns navigate their way to the breast after birth.

Along those same lines, the areola and nipples also darken in color during pregnancy, perhaps to create a contrast babies are most adept to see when newly born.  Some women find that their areolae remain a bit darker than they were before pregnancy.

Skin tags

Skin tags, caused by hyperactive growth in a superficial layer of skin, can develop in pregnant women, much to their surprise.  These tiny polyps are harmless and are often found where skin rubs on skin or clothing, such as the armpits, inner thighs, neck folds, bra line, and other areas.  These often disappear in the months following delivery, though they can be removed if they are bothersome.

Moles and Freckles

Many pregnant women notice that existing moles, freckles and birth marks grow bigger or darker during pregnancy.  New moles may also appear.  While this may just be part of pregnancy for you, be sure to consult with a dermatologist if moles seem particularly dark, raised, or have irregular borders.

Red palms and soles

Called palmar erythema, redness and itchiness of the palms and soles of the feet may occur in pregnancy, as early as the first trimester.  This is not a harmful condition.

Heat rash

Pregnant women are more vulnerable to heat rash caused by overheating, dampness from excess sweating, and the friction of skin against itself or clothing.  Heat rash is characterized by a reddish, pimply, irritated appearance of the skin and commonly strikes in the breast creases, the inner thighs, and the armpits.

Spider veins

Some women notice the development or increased visibility of spider veins, small squiggly purple or red capillaries just below the skin, during pregnancy.  These can develop on the limbs or the torso and are caused by pregnancy hormones.

It’s also common for spider veins to appear on the face or in the whites of the eyes during delivery due to intense pushing.  These are called nevi and often disappear sometime after birth.

If you have questions about skin changes in pregnancy, be sure to discuss with your midwife at your next appointment.

Ten Tips for Partners at Birth

dad at birth 2While we tend to focus on preparing mama for birth, it is also essential that papas, partners or any other labor supporters to feel prepared.  While it would take the length of a book (or more) to fully prepare papas and partners for the birth experience, here are ten quick and easy essentials to keep in mind.

1.  Be responsive to your partner’s cues and protect her space.  Follow her lead.  Do what you can to ensure she is feeling safe and supported.  Keep the lights dim, the room quiet and the atmosphere calm.

2.  Minimize questions, distractions, and instructions (from yourself and others) especially during contractions.  Don’t take silence personally, it is probably a sign that she is going inside and focusing on the monumental task she is undertaking.  Silence is often a really good sign.

3.  Help her to be comfortable.  Suggest position changes regularly.  Observe her alignment and support her head, torso, low back, arms, hips, knees, and feet as needed.  Keep her warm, but offer ice packs or a cool cloth if she gets too warm.  Use comfort techniques you’ve learned together before the birth.

4.  Maintain your center and your stability.  Find your own breath.  Tend to yourself so that you can tend to her.  Do so discreetly so it doesn’t serve as a distraction.

5.  Take her to the bathroom hourly.

6.  Help her keep the pitch of her voice low and monitor her facial and physical tension.  Help her relax.

7.  Give her encouragement and tell her you love her.  You might even kiss if it feels right.  Feelings of love from mama help her release oxytocin, which can help with labor.

8.  If her breathing gets rapid, shallow and panicked, model a slow, even, deeper breath for her.  Maybe try to make eye contact with her as you do this, it can help to ground her.

9.  Keep her hydrated and nourished.  Offer regular sips of water (you can do so without words).  Offer labor snacks in early and active labor.

10. Help her maintain her rhythm.  Let her find what works best for her and find ways to support her there until its time for her rhythm to change again.

What other advice would you give to papas and partners for labor & birth?

Leg Cramps in Pregnancy

Pain in the LegLeg cramps are a common condition in pregnancy.  These bothersome cramps can be the result of circulation changes, carrying extra weight, or mineral deficiencies.  They can also be caused by lack of exercise or, conversely, exercise that is too vigorous.  In the case of the former, this lack of exercise also decreases the body’s mineral absorption, compounding the problem.

Leg cramps in pregnancy are often worse at night.  Some women experience sharp strong cramps, while others may have dull, vague, achy, pulling, restless leg sensations.

Muscle spasms that cause leg cramps in pregnancy are often caused by a lack of calcium, magnesium, and/or iron.

When a muscle cramp strikes, these may help in the moment:

  • Stand up and place your foot flat and push your heels into the ground.  Massage the muscle vigorously and firmly.
  • Flex your foot by gently holding it and curling your toes up toward your knee.  Massage the calf.  You can do this standing or lying down.

Don’t massage an area that has varicose veins.

Here are some other ways to get some relief:

  • Avoid pointing your toes, as this can bring on cramps
  • Walk daily and do leg exercises, such as leg lifts and lunges.  Swimming is also great.  This encourages circulation and reduces cramping.
  • Elevate your legs for 20 minutes a day to improve circulation, with your legs above your heart.  Elevate periodically throughout the day when possible.
  • Avoid tight clothing
  • Soak your feet in hot water at the end of the day (consider adding wintergreen or camphor oil, and/or fresh grated ginger root)
  • Use a hot pack (rice pack, hot water bottle, etc) on the affected area
  • Prepare a compress of lavender essential oil to the affected area
  • Increase your fluid intake to 2 to 3 liters a day
  • Sleep with your feet raised above your head, by padding the end of the bed or propping the mattress up at the bottom.
  • Reflexology can help improve circulation and reduce and prevent cramping
  • Massage the affected areas, especially before bed.  Massage with an oil containing St. Johns’ Wort, arnica, and chamomile (available at co-op)

Dietary recommendations

  • Speak with your midwife about supplementing with liquid calcium/magnesium.
  • Eat foods high in calcium and magnesium: Spinach, Broccoli, Tofu, Dairy, Sardines, Tahini, Cooked egg yolks, Dried figs, Watercress, Cashews, Parsley
  • Vitamin E can reduce cramping.  Check with your midwife to be sure it is safe to take 200IU per day.  Whole grains, eggs, cold-pressed oils, sunflower seds, molasses, and wheat germ are some vitamin E rich foods.
  • Vitamin C deficiency can also cause leg cramps.  Make sure it is safe to take 2,000 mg daily.
  • Salt deficiency can also cause leg gramps so salt your food to taste with sea salt.
  • Herbs rich in calcium include nettle, chamomile, oatstraw, and dandelion leaf.
  • Speak with your midwife to see if black haw or cramp bark tincture is appropriate for you.

Colds & Flus in Pregnancy

Pregnant woman illness

Well, its that time of year…with the cold weather comes the cold and flu season.  Unfortunately, pregnant women are not immune to these common illnesses.  The good news is that, so long as a pregnant woman stays nourished with foods and fluids, colds and flus do not generally pose any threat to mom or baby.

If you are experiencing severe symptoms such as:

  • A fever
  • Frequent vomiting
  • Severe diarrhea
  • Persistent coughing

It is a good idea to contact your care provider.

 Preventing Colds and Flus

The old adage “an ounce of prevention is worth a pound of cure” is the best approach to preventing illness during pregnancy.

Basic self-care to prevent illness includes:

  • Eating nutritious and whole foods
  • Getting enough rest and sleep
  • Reducing stress
  • Getting regular moderate exercise
  • Maintaining a positive attitude
  • STAY WELL HYDRATED!

Of course, situations and factors outside of our control can make maintaining all of these elements difficult.

 First signs of illness: Take a time out

Excusing ourselves from our daily responsibilities at the first sign of illness can go a long way in preventing or reducing the duration and severity of our illness.  If possible, step away from all that can be left for another time—turn off the phone, ask for help with other children, take a sick day at work, cancel social engagements and do what nurtures you.  That could be taking a warm bath, enjoying a warm cup of tea, snuggling into bed with a good book or movie, listening to soothing music, some gentle yoga poses, a long nap, or something else.

Eating and drinking during illness

For some of us, colds and flus wipe out our appetite.  While this may be a natural by-product of the body’s fight against illness, our babies still need nourishment!  For this reason, it is important to continue to eat even when you are feeling sick.  If food doesn’t sound the least bit interesting, try clear veggie or meat broths, soups or plain toast.  Miso, chicken noodle soup, and veggie soups can actually be healing during illness.

Same goes for drinking, it is paramount to the health of you and your baby that you continue to consume an adequate amount of fluids—your baby needs amniotic fluid and your kidneys need this nourishment.  In fact, your body may actually begin contractions under the stress of dehydration.  Aim for a full glass of water, tea or broth every 1-2 hours, more often if you have a fever.

 Herbal and Dietary Treatment of Illness in Pregnancy

  • Vitamin C: Take 250 mg every 2 hours, not to exceed 2,000 mg in the first trimester and 4,000 daily in the second and third.  Don’t take Vitamin C at these levels for longer than 5 days.
  • Echinacea: This herb, safe in pregnancy, boosts the body’s immune system very effectively, especially if taken at the first sign of illness.  You can purchase Echinacea tinctures at the co-op, natural health food store, and Whole Foods.  Take one drop for every 4 pounds of body weight (140 pounds / 4 pounds = 35 drops, for example) you can repeat this every 4 hours or more often for acute illness.
  • Garlic, lemon, ginger, green onions:  all of these foods can be consumed to boost the immune system during illness.  Garlic is a bactericide, good for treating many kinds of ailments.  Ginger tea is a great natural treatment of illness.
  • Kudzu Root: Sold in chunks or as a powder, this starchy root is good for reducing fever, relaxing the muscles, taming the tummy, and soothing inflamed nasal, throat, and lung tissues. You can make Kudzu root tea by boiling a cup of apple or pear juice, adding 1 teaspoon of root powder which has been diluted in 2 tablespoons of cold water.  You can add cinnamon or ginger for warmth.

 Natural Cold Tonics

Full of immune boosting goodness, these mixed can be sipped safely at the first sign of illness:

“Terrible Tonic”

  • 3 cloves of fresh garlic, minced
  • ½ cup honey
  • 1 cup of apple cider vinegar
  • ¼ cup of purified water

Add all ingredients to a mason jar, shake and take 3 tablespoons 6 times a day.

Cold and Flu tea

In a pan, gently boil one quart of water, adding:

  • 4-6 cloves of chopped garlic
  • 2-3 chopped green onions
  • 1-2” of minced/grated/sliced fresh ginger

Let gently boil for 10 minutes.

Remove from heat and add:

  • 2-3 tablespoons of honey, or to taste
  • 2-3 tablespoons of lemon juice, or to taste
  • ¼ t cayenne pepper

 Over the Counter Medications Considered Safe in Pregnancy

When all else fails, over the counter medications may be desired.  As with herbs, many over the counter medications are not considered safe during pregnancy.  Talk with your provider about what over-the-counter medications are best for your situation.

15 Reasons to do Yoga in Pregnancy

yogaMany of us know that it is important to be active in pregnancy—it’s good for mom and it’s good for baby.  Yoga is one of the best forms of exercise for mamas-to-be.

In a nutshell:

Physically, yoga helps make muscles more supple, increase joint mobility, and improve posture, all crucial given the colossal changes that happen to the body in pregnancy. With improved posture comes better breathing and circulation.

Yoga and labor have many things in common, which makes yoga excellent practice for labor.  Yoga has many psycho-spiritual benefits, which can help a woman navigate the tremendous transformations of pregnancy and motherhood.  Being in a yoga class also offers community, which can be just as important as the actual practice of yoga.

Here are 15 specific reasons to do yoga in pregnancy.

Ways that yoga helps in pregnancy:

1.  Helps you carry your baby optimally.

2.  Helps to prevent backache

3.  Facilitates unrestricted breathing, resulting in good blood oxygenation for mom and baby

4.  Helps mom discover movements that alleviate pregnancy discomforts such as heartburn, leg cramps, or headaches.

5.  Better blood circulation, lowering risk of problems such as varicose veins, hemorrhoids, and fluid retention

6.  Helps combat fatigue

7.  Physical pain can be diminished through regular practice

8.  Increased self awareness and awareness of baby.  Becoming more body aware and aware of your baby and its energy can help you foster a bond with baby even before birth.

Ways that yoga helps a woman prepare for labor:

9.  Many yoga poses also happen to be ideal birthing positions, practicing before hand offers strength, comfort and familiarity with these positions.

10. Yoga helps you move to your edge and sometimes beyond, finding grace and ease in physical difficulty.  This is a beneficial skill in labor.

11. Yoga helps connect you to your body, giving you confidence and courage in its abilities and helping you develop a deeper awareness of what’s happening in your body

12. The focused breath work of yoga can help you find a breathing rhythm that works for you in labor.  Breath is SO key in yoga and in labor!  In yoga, you can also practice moving breath in your body—for example, moving breath down, which can also be vital in labor as you breathe your baby down.

13.  Yoga brings a shift in consciousness out of your thinking mind and into your more embodied, instinctive mind.  This, too, will be a benefit in labor, as it requires that you release thoughts and let your body express its wisdom (a wisdom that knows how to birth your baby!)

14. Yoga offers practice in releasing stress, tension and fear.  It encourages feelings of peace, safety, and presence.  All of this is good for labor.

15. Yoga makes the body strong, helping it through labor and helping create optimal conditions for healing after labor, regardless of what labor and birth brings.

What benefits of yoga have you discovered in your pregnancy and birth?

Did you know we offer prenatal yoga at Health Foundations?  The first Friday of every month our lovely yoga instructor leads a candlelight prenatal yoga class from 7pm to 8:15pm.  Join us next month!

Pregnancy-yoga

Stay tuned for an upcoming post with some of the best yoga poses for pregnancy and their benefits.

***As with all forms of exercise in pregnancy, it is imperative to listen to your body and honor your needs and abilities at this time.

Anemia

bloodtube

Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin (what the midwives check throughout your pregnancy) is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia — like fatigue — occur because organs are not getting what they need to function properly.

Supporting the nutritional needs of a developing fetus, building a significantly greater blood volume, and other changes make pregnancy a common time for women to experience anemia.

Effects and Potential Complications of Anemia in Pregnancy

Without treatment, anemia can cause a number of problems for mom and baby.

For mom:

  • Greater fatigue in labor
  • Increased problems with even modest blood loss at birth
  • More difficult, slower postpartum recovery
  • Increased risk of postpartum hemorrhage
  • Greater risk of postpartum infection
  • Trouble establishing a milk supply

For baby:

  • Growth retardation
  • Lack of sufficient iron in their own bodies, which can potentially lead to anemia
  • Neural tube defects (with folic acid deficiency)

Symptoms of Anemia

  • Dizziness
  • Constant significant fatigue
  • Shortness of breath
  • Paleness of the fingernail beds, skin, and mucous membranes
  • General weakness
  • Loss of appetite
  • Constipation
  • Abdominal pain
  • Heart palpitations
  • Frequent colds or infections
  • Other symptoms depending on the type of nutritional deficiency

Causes of Anemia

During pregnancy, nutritional deficiency is a common cause of anemia.  While many people are aware of the connection between iron deficiency and anemia, there are actually three types of nutritional anemias: iron deficient anemia, folic acid anemia, and vitamin B12 anemia.  Because B12 anemia is rare, we will focus more on prevention of anemia caused by iron and folic acid deficiency.

Before covering these, we should also mention that given the marked increase in blood volume during pregnancy (50% greater than pre-pregnancy volume), it is natural for the red blood cell count to drop in the middle of pregnancy, simply because the blood becomes more diluted.  (The red blood cell count remains stable but the blood volume increases.)

But we digress.  Ideally, we recommend that women have blood work and a nutritional assessment prior to conception (see here for more about preconception planning) to determine their pre-pregnancy blood counts and begin eating optimally for pregnancy (some women are iron-deficient going into pregnancy).  However, a simple blood test during pregnancy can help us diagnose anemia and determine the appropriate action to take.

Treatment of Anemia in Pregnancy

Often, nutritional supplementation is our first course of action to address anemia in pregnancy.  As with most issues, prevention is preferred to waiting until a condition manifests and treating it, so let’s talk about dietary prevention of anemia (you can follow these before conception, during pregnancy, and even after birth, especially if you’ve experienced blood loss or are healing from birth).  These same dietary principles apply when treating anemia as well, though additional iron supplementation is commonly advised.

Dietary Prevention and Treatment of Anemia

Folic Acid

Folic acid is a B vitamin found in the following foods, which can be eaten throughout pregnancy:

  • Dark leafy greens** (aim to consume two large servings per day)
  • Wheat germ
  • Molasses
  • Nutritional yeast
  • Root vegetables**
  • Beans
  • Milk
  • Liver (organic liver is preferred as animal liver is prone to high concentrations of environmental and systemic toxins)
  • Spirulina
  • Herbs such as nettles and dandelion

**To obtain the highest amounts of folic acid through vegetables, consume them raw, steamed, or lightly sautéed.

Iron

Iron is essential in pregnancy to ensure the red blood cells can adequately oxygenate both mom and baby.  Baby also stores iron in its liver prior to birth and will depend on these iron reserves for the first 6 months of life, since breast milk is naturally low in iron.

Iron supplements are often suggested during pregnancy.  In pregnancy, it is difficult to get enough iron solely from your diet to treat anemia.   We recommend a plant based iron supplement that is well tolerated and does not cause the more common side-effects such as constipation and gastrointestinal upset seen when taking synthetic iron.

Regardless, consuming iron rich foods is an ideal way to build your blood and increase your iron to prevent or help in treating anemia in pregnancy.

Iron Rich Foods include:

  • Organic red meat and dark meat chicken and turkey contain the highest amounts of iron (and also provide lots of protein).
  • Beans and legumes (which also contain protein and lots of fiber)
  • Eggs
  • Dark green leafy vegetables (which also have minerals calcium and magnesium and chlorophyll, which dramatically reduce symptoms of anemia)
  • Seaweeds (such as kelp/kombu and dulse)
  • Berries and cherries
  • Sunflower and pumpkin seeds
  • Dried fruit (organic and unsulphured) such as peaches, apricots, raisins, prunes and figs
  • Nettles (Urtica diocea), Alfalfa (Medicago sativa), and Yellow Dock (Rumex crispus) are high in iron and powerful blood builders.  They can be taken as advised by your midwife as teas or in capsule form.
  • Nutritive Syrups such as Floradix or local herbalist-made syrups may also be an option

Given that dark leafy greens are excellent sources of both folic acid and iron, a great way to prevent anemia in pregnancy is to eat your greens! 

greens

Can’t stomach the thought of a rabbit’s smorgasbord on your plate?  Get creative.

Ways to sneak greens into other foods:

  • Chop up greens and add it to your pasta sauce or lasagna
  • Mix cut-up spinach into an omelet/eggs
  • Add small pieces of kale to your chicken soup
  • Sautee garlic, onions, or shallots in butter or olive oil.  Add greens. Cook them until wilted and soft. Add a splash of white wine or vinegar and cook until the flavors blend.

In addition to diet, cooking in a cast iron pot/pan can increase the iron content in foods.  Regular exercise increases the body’s need for oxygen, which causes the body to respond by allowing iron to be absorbed more easily.

 Tips for Iron Absorption from Food and Supplements

Because iron is not always well utilized by the body, follow these steps to optimize iron absorption in the body:

  • Eat iron with Vitamin C rich foods
  • Avoid caffeine, which inhibits iron absorption
  • Carbonated beverages may reduce iron absorption
  • Insure proper hydrochloric acid in the stomach.  A good acid level helps with digestion and absorption.   Avoid drinking lots of liquid at meals and use vinegar in your cooking or as a supplement with meals (apple cider vinegar is great).
  • Help prevent the destruction of red blood cells by eating vitamin E containing foods such as nuts, seeds, eggs, dairy, whole grains, high quality oils, avocados, soy, sea vegetables.
  • Avoid calcium ingestion with iron, e.g. milk antacid, prenatal supplements

Always speak with your midwife if you are concerned or have questions about anemia, optimal nutrition and intake of folic acid and iron, and related issues.  Anemia in pregnancy is manageable and it is much better to discover it and treat it before birth, to give you and baby the best chance at a healthy, happy pregnancy, birth and postpartum.

Types of Childbirth Education

shapeimage_2Rochelle Matos, Health Foundations Childbirth Educator and owner of With Love.

At Health Foundations, our patients receive lots of education about childbirth throughout their routine prenatal care.  While the midwives at the birth center spend much more time talking with and educating patients compared to what is routinely offered in the conventional maternity setting, there is so much to learn about pregnancy, childbirth, and postpartum.  For this reason, we encourage our families to take childbirth education courses.

As a Health Foundations family, you receive as part of your care two education courses: one in Early Home Care (of everything we want you to know about postpartum) and another in Managing Complications.  You also have a breastfeeding visit with a lactation consultant in your third trimester.  However, the more you can arm yourself with knowledge, the better prepared you will be for pregnancy, childbirth and beyond.

Childbirth education is a great way to prepare for labor and birth, help you make informed decisions, learn how to relax and cope during labor, name and work through your fears, help partners understand how to support mamas, and more.  Additional preparation classes may focus on specific issues such as breastfeeding, newborn care, prenatal yoga/exercise, baby wearing, cloth diapering, etc.

Health Foundations offers a childbirth education series that is designed specifically for families choosing to deliver out-of-hosptial.  We have classes for both first-time families as well as refresher courses!  We are also fortunate to live in a community with AMAZING birth resources.  To name just a few, the Twin Cities is home to The Childbirth Collective, Blooma, Welcome Baby Care, With Love, and so many more great birth educators and supporters of families giving birth and raising children in our community.

There are many amazing childbirth education classes offered in the Twin Cities.  To help you determine what may be right for you, here is a brief description of some of the popular types of childbirth education courses offered here and around the country.  Note that some local businesses and birth professionals offer their own “brand” of childbirth education courses, which can also be terrific.   The Childbirth Collective also offers donation-based Parent Topic Nights, which focus on different aspects of childbirth.

Lamaze 

When many of us think of Lamaze, we think about a specific breathing technique used in labor.  Lamaze has changed a lot in its 50+ years, moving from a method-based childbirth program to an evidence-based philosophy of childbirth.  “Today’s Lamaze affirms the normalcy of birth, acknowledges women’s inherent ability to birth their babies and promotes Lamaze healthy birth practices.”

Lamaze affirms women’s ability to give birth naturally and free of routine medical interventions but does educate women on interventions that may be necessary in some birthing situations.

The Bradley Method 

The Bradley Method also believes that childbirth is a natural process that can happen free of medical interventions (in most cases) with proper preparation.  This method emphasizes the importance of the husband or partner to the birth process, discusses diet and exercise in pregnancy, and covers natural coping and relaxation techniques for labor.  Most Bradley courses are 10 to 12 weeks long.

ICEA-based classes

The International Childbirth Education Association (ICEA) “is a professional organization that supports educators and other health care providers who believe in freedom to make decisions based on knowledge of alternatives in family-centered maternity and newborn care”.  This organization certifies childbirth educators.  The ICEA doesn’t necessarily promote a particular set of techniques for managing labor, so you may want to ask the educator what will specifically be covered in the course.

Hypnobirthing® The Mongan Method

HypnoBirthing® is a childbirth education course that embraces birth as normal and natural and refutes the idea that birth must be accompanied by pain and suffering.  This childbirth education program emphasizes relaxation, visualization, and self-hypnosis techniques to help women and their partners achieve a calm and comfortable birth experience.  Mamas using this technique will often listen to hypnosis audio recordings during pregnancy to prepare for the use of self-hypnosis (with or without the recordings) during labor.  The class is typically taught in 5 weekly sessions.

Birthing from Within

Birthing from Within is a spiritual and creative-based education experience that sees birth as a rite of passage, seeks to prevent or minimize emotionally difficult births through compassionate and honest preparation, sees value in and recognizes the profound impact of women’s birth stories, suggests expressive means of preparing for childbirth, and supports holistic prenatal care that is informative and transformative.

Calm Birth

Founded in mind/body medicine, Calm birth is a method of meditation for pregnancy and childbirth.  The course covers the physical, emotional and other benefits of meditation before and during labor and birth and offers guided meditations to help women and their partners prepare for a calm and conscious childbirth experience.

Preeclampsia in Pregnancy

Preeclampsia, also known as toxemia, is a potentially serious condition that can develop during pregnancy and negatively affect both mom and baby.  While this condition is very serious, evidence demonstrates that good nutrition and excellent care (self care and medical care) during pregnancy can decrease the risk of preeclampsia.  Read on to learn more about this pregnancy-related illness.

What is Preeclampsia?

Preeclampsia is characterized by symptoms of high blood pressure and excess protein in the urine (and often severe swelling) after 20 weeks of pregnancy in a woman with normal blood pressure before pregnancy.

Causes

In the past, toxins in a woman’s bloodstream were thought to cause preeclampsia.  While this theory has fallen out of favor, medical experts still don’t fully understand what causes this condition.  Currently the following are thought to be possible causes of preeclampsia:

  • heredity
  • faulty implantation of the placenta
  • low blood flow to the uterus
  • immune system problems
  • blood vessel damage
  • poor nutrition (especially Vitamin D deficiency)

Preeclampsia is more common in first pregnancies, women under 20 and over 40, obese women, women carrying multiples, women who develop gestational diabetes, and women with a history of migraines, diabetes, kidney disease, lupus, and other conditions.  Some evidence suggests that urinary tract infections or periodontal disease may increase the risk of preeclampsia.

Prevention

While some risk factors are out of our control, maintaining an excellent diet and getting excellent prenatal care are two ways women can prevent preeclampsia.

In addition to following Health Foundations’ nutrition recommendations, the following are specific recommended dietary measures to prevent preeclampsia:

  • Consume 80 to 100 grams of protein daily.  Women with sufficient protein intake are at a low risk of preeclampsia
  • Take 5000 IU of Vitamin D daily, if recommended by your care provide
  • Consume adequate complex carbohydrates with each meal and snack
  • Don’t restrict salt intake, which is necessary to maintain the blood volume you and baby need
  • Avoid or significantly limit junk food
  • Take a quality prenatal vitamin and any other supplements recommended by your care team
  • Avoid constipation and diarrhea as much as possible
  • Some herbalists recommend nettle, spirulina, and dandelion greens

Symptoms 

Preeclampsia often starts abruptly sometime after 20 weeks of pregnancy. If your blood pressure was normal prior to pregnancy, symptoms can include:

  • High blood pressure (140/90 or greater)
  • Severe or continuous headaches (not resolved by Tylenol, rest, and hydration)
  • Vision changes (e.g. blurring, dimming, double vision, flashing spots or lights) lasting over 2 hours
  • Sudden weight gain, over 4 pounds a week
  • Severe swelling of hands, feet or face
  • Dramatically decreased urination
  • Upper abdominal pain, usually on right side under ribs
  • Nausea or vomiting
  • Dizziness
  • Excess protein in your urine
 Call or page the midwives if you experience any of these symptoms. 

 Diagnosis is often made during a routine prenatal visit.  High blood pressure is often the first indicator, followed by a urinalysis indicating protein in the urine.  You may also have blood work, an ultrasound, and/or a biophysical profile/non-stress test if these first two indicators are found.

Outcomes and Complications 

Most women with preeclampsia deliver healthy babies.  Risks are greater with more severe cases of preeclampsia and those that begin earlier in pregnancy. Because preeclampsia falls outside the range of normal in pregnancy, birth center births and home births are not considered safe.  When preeclampsia is discovered in Health Foundations clients, we work to transfer care to a hospital where mom and baby can get the care they need.

Treatment

The only cure for preeclampsia is delivery (blood pressure typically returns to normal within a few weeks).  To manage your condition until it is safe to deliver baby, your medical care team may recommend any of the following:

  • Medications to lower blood pressure
  • Corticosteroids
  • Anticonvulsive medications
  • Bed rest

Preeclampsia may require labor induction and delivery. Cesarean birth isn’t always necessary, but may be recommended if inducing labor becomes difficult due to baby’s gestational age (earlier gestational age= more difficult induction).

Complications

Complications of preeclampsia may include:

  • Lack of adequate placental blood supply, resulting in small for gestational age babies, slow growth, low birth weight, preterm birth and early breathing difficulties for baby
  • placental abruption (placenta separates from the inner uterine wall before delivery), which can cause heavy bleeding and placental damage, a life-threatening scenario for mom and baby
  • Stroke
  • HELLP syndrome, a life-threatening condition characterized by severe nausea and vomiting, headache, and upper right abdominal pain.
  • Eclampsia, which is essentially preeclampsia plus seizures.  This life-threatening condition can cause permanent brain, liver and kidney damage, coma, or even death in mom and baby.

Because of these serious risks, it is important to keep every scheduled prenatal appointment and to contact your care provider with any of the possible symptoms of preeclampsia.

 An Ounce of Prevention…

While preeclampsia is a scary condition, the good news is that it can often be avoided with proper diet and nutrition in pregnancy.  This is one of the many reasons we take nutrition so seriously at Health Foundations and why we go the extra mile to educate our patients about optimal diet in pregnancy.  Sadly, many prenatal care providers don’t take enough time to educate women on this essential component of their health.

With advanced training in nutrition (Dr. Amy Johnson-Grass has a Masters in Nutrition, for example) and a focus on holistic wellness, our midwives understand the importance of prenatal nutrition and work with all our patients to optimize their health in pregnancy in order to prevent serious complications and improve birth outcomes for mom and baby.

Gather this Friday for Birth Story Sharing

HFBigroomgatheringJoin us this Friday Sept 20 from 4:30 to 6:30 to share your birth story, listen to other women’s birth stories, or both!

Come share and gather birth wisdom!

This is open to all mamas——bumps and babies welcome.

You can choose to share or just listen–if you want to share, please note that upon signing up.  You can sign up by emailing jaime@health-foundations.com

We will have tea and treats. The cost of this gathering is $15.

Join us for a wonderful afternoon of amazing stories!  We look forward to seeing you then!

10 Great Foods for Pregnancy

salad in preg

Eating during pregnancy can invite an entirely new way of eating and thinking about food.  For example, a woman who used to eat a small breakfast at 11 am, skip lunch, and eat dinner after a long day at 8pm, may find she wakes hungry and craves a full high protein meal, can’t go longer than two hours without eating, and suddenly hates all vegetables/meats/fruits/or red foods…

Because you are no longer simply eating for your single adult body (but are, miraculously, building the body of another person!) it’s a good idea to educate yourself about how to eat optimally during pregnancy.  Sometimes, all the details about grams of protein, milligrams of iron, what to avoid, and how to take various supplements can get overwhelming; so here is a simple list of ten foods that are highly nutritious and beneficial during pregnancy.  Feel free to incorporate these into your diet as they work best for you (taking what you like and leaving the rest).

foodsEggs

With more than a dozen vitamins and minerals, lots of protein and less than a 100 calories each, eggs are a great food for pregnancy.  Cheap, easy to cook, and versatile, eggs are an excellent source of choline, which is crucial to baby’s growth and brain health and helps prevent neural tube defects.  Insufficient choline consumption in pregnancy can lead to structural problems in the baby’s brain.  Some eggs also contain omega-3 fats, which are also important to baby’s brain health.  Healthy women are advised to consume 1-2 eggs daily.

Other sources of choline include chicken, turkey, collard greens, and cauliflower.

Beans and legumes

There are so many beans to choose from and many ways to prepare and enjoy them.  Of all the vegetables, beans have the highest concentrations of protein and fiber, both important in pregnancy.  In order from highest to lowest protein concentrations are soy beans, fava beans, lentils, red kidney beans, black beans, haricot beans, black-eyes peas, garbanzos, and lima beans.  Beans can be used in burritos, salads, soups, chili, pasta dishes, casseroles and more.

Beans are also a great source of iron, folate, calcium, and zinc.  Half a cup of lentils, for example, contains nearly fifty percent of a pregnant woman’s daily folic acid requirements.

Salmon

Salmon is a high quality protein, a great source of omega-3 fats (DHA), and has low amounts of mercury, which is the reason to limit consumption of other kinds of fish in pregnancy.  Omega-3 fatty acids are great for baby’s developing brain and eyes.  During pregnancy, you can aim to eat about 12 ounces of salmon each week (wild-caught is best).

Quinoa

High in magnesium, manganese, copper, iron (3mg per cooked cup), and B Vitamins, quinoa is one of the only complete proteins in the plant world (containing about 8 grams of protein per one cooked cup).  Quinoa can be used in place of rice or any other whole grain.  It can be used in baking (try quinoa flakes in place of some of your flour), added to soups, salads, made into a tasty side dish with veggies, desserts, and more.

Sweet potatoes

Sweet potatoes are rich in carotenoids (which lend them their color), which the body converts to vitamin A.  While too much vitamin A from animal sources can be dangerous in pregnancy, carotenoids are a plant pigment that is only converted to vitamin A as needed.  In addition to vitamin A, sweet potatoes also contain vitamin C, folate, and fiber.  They are also inexpensive and easy to prepare.  Try them mashed (with a little ginger to ease nausea), baked, in soups and stews, in salads, or as part of a main dish.

Greek yogurt

Greek yogurt typically has twice the protein of regular yogurt and is a great source of calcium, which is important for mama and baby’s bones, teeth, and more.  Be careful not to get yogurt that is too loaded with sugars.  If you want to add flavor, you may consider adding your own berries or flavoring to control the sugar load.  You can also cook with yogurt—add yogurt, vinegar, and spices as a creamy marinade for chicken or other meats.  You can also use yogurt to make dips and sauces.

Walnuts

Walnuts are a great source of omega 3 fatty acids, especially for those who aren’t big fans of fish and eggs.  Walnuts and other nuts are a great source of protein on the run.  Consider making a trail mix snack bag with walnuts, dried apricots or peaches (high in iron), and other nuts and berries.

Dark leafy greens

Loaded with vitamins and nutrients such as vitamins A, C and K, iron and folate, dark leafy greens are great in pregnancy.  These include spinach, kale, Swiss chard, and collard greens.  You can make salads, add into soups or smoothies, or sauté with a little garlic and coconut oil.

Lean Organic meats

Lean organic meats are a great source of protein and (heme) iron, which are both vital in pregnancy and postpartum.  Lean meats, such as those around 95-98% fat free, and those that are organic are preferred.  Beef and pork have the added benefit of containing choline.

Colorful vegetables and fruits

Vegetables and fruits have so many outstanding health benefits that if they were pharmaceuticals, they would be hailed as wonder drugs that all people everywhere were encouraged to consume daily.

Eat a variety of red, orange, yellow, green, and purple, fruits and vegetables to ensure that you and your baby get an array of different vitamins, minerals, and antioxidants.

As far as what to get organic, check out the Environmental Working Group’s list of the “dirty dozen” and “clean fifteen” fruits and vegetables (based on pesticide use on crops).

Water

Okay, this is number 11 and water is not a food…but water is so important in pregnancy that it deserves to be on this list!  For mama, adequate water consumption in pregnancy prevents dehydration, reduces the likelihood of nausea, cramps, swelling, dizziness, constipation, hemorrhoids, heartburn, and even preterm labor.  Sufficient water intake can also prevent urinary tract infections.  Water is also crucial to building up your blood, amniotic fluid, and breast milk.

What are your favorite ways to eat these foods in pregnancy?

Why Write your Birth Story?

WritingBirthStoryCoverArtGrowing, birthing and caring for a new baby is one of the most joyful times in our adult lives, and also one of the most demanding.  During the postpartum period, so many peripheral tasks may be vying for our attention (and, for many of us, all we really care to do is stare at our beautiful new baby…and sleep whenever possible.)

Making time to write your birth story may seem like one extra thing on the to-do list, but there are many reasons to make this task a priority.

Writing your birth story is a transformative, cathartic experience, with the power to help you process, make meaning from, heal from, preserve, celebrate and honor your unique experience of birth.

The following are eight great reasons to write your birth story.

1:  To remember

Writing your birth story preserves your memory of this important event for a lifetime (or longer!)  In the early days, you may run through your birth story again and again in your mind, remembering all the little details of this amazing experience.  But as time goes on, these details inevitably fade.

While it is ideal to begin writing in the early postpartum, it’s never too late.  If it has been months or longer since the birth of your baby, it is still very much worth your time to write your birth story (you surely remember more of it now than you will ten years from now!).

Memory-joggers, such as labor playlists and pictures, can help you recall fading details.  Talking to your partner or others present at your birth can also help to fill in the details of your birth, so you can write and preserve these memories.

TIP: If you can’t sit down to write out the narrative of your story, at least jot down some notes in those early hours and days after your baby’s arrival.  In the last weeks of pregnancy, consider getting a small bedside journal or type notes into a phone app or email to yourself.  (This can be helpful not only for jotting down birth story details but also for remembering the questions you want to ask your care providers—midwives, doulas, pediatrician, etc).

2:  To process and reflect

The experience of giving birth is one of the most profound, transformational, and emotionally rich experiences we will have in our lives.  In fact, how we gave birth can have a profound effect on how we see ourselves, how we feel about ourselves, and how we interact with others—including our baby.  For many women, it is imperative to their well being to talk about and process their birth stories.

Given the intensity of the birth experience, our memories can be jumbled or even chaotic-seeming until we have a chance to process them and assemble them in narrative form.  Writing can stabilize our experiences.

Writing your birth story enables a unique mode of processing that can’t necessarily be achieved through talking alone.  Writing accesses different parts of our brain—it is a reflective and reflexive practice that can help you process your story on a deeper level, helping you to explore and understand your experience in a particular way.  People often discover how they feel about something or find feelings transmuted as they begin to explore them through writing.  New perspective can be reached as you process and reflect on your birth experience by writing it down.

3:  To Heal

Along those same lines, writing your birth experience can be a healing experience.  One woman, reflecting on writing her birth story, commented: “At first I felt disappointed and angry that I didn’t not get to have the natural birth that I wanted.  But as I wrote about our transfer, how I ultimately delivered my baby, and how I felt when I held her, the anger changed and I felt like I was speaking not just for myself but for other women that don’t get to have their ‘perfect birth.’ I also realized that though the birth didn’t go as planned, I was surrounded by support of my husband and midwife. I ultimately felt strong and like I did my best in a situation I couldn’t entirely control.”

Both writing and storytelling are time-honored methods of healing from challenging life experiences.  While writing can’t always take away the trauma of difficult childbirth (or any experience), it can help us to express how we are truly feeling—it can give voice to the grief, disappointment, shock, and sorrow—and may help us come to terms with what happened and begin to make peace with it.

When we share our story on paper or maybe with others, we can find support, feel less alone, and become more empowered.  Saying: “this happened to me and this is how I am feeling about it” is a powerful exercise on the healing path.  Remember, while you can’t always change the past, you always have the power to change your connection to the past in this moment.

If you are struggling with aspects of your birth experience, you deserve to have the support you need to continue processing and healing.  In addition to writing, speaking with a counselor, having body/energy work, making birth art, healing through movement, and other measures can go along way to helping you find peace after difficult childbirth.

4:  To share

When we write about our birth experiences, we can share them with others—which has a number of potential benefits.  Sharing our story can help us bond with other people and find support.

When we share with our partners and other support people, it helps them gain insight into our perception of the birth, which can increase empathy and understanding and invite conversations about aspects of the shared experience.  When we share with other women, especially other mothers, we can find support, understanding, and camaraderie.

Sharing can have an unknown or unanticipated ripple effect.  You never know how your story will help someone else.  But it probably will.

5:  For your child

And let’s not forget our little ones (as if we could).  Writing down your birth story will enable you to share this story with your child and family for decades to come.

Consider for a moment what you know about how you were born.  Do you know the details?  Did your mother document your birth in some way?  Do you wish you knew more?

People whose mothers have a written their birth story often report gratitude for having such a treasured account of how they came into the world.  It can make your child feel special and important to know that you took the time to document their birth.  Whether or not it was an ideal situation, this birth was how they came into the world and it will always be special for them to know about it.  The experiences you had and the lessons they teach can have a profound impact on your child, both when they are young and when they grow up (and perhaps have children of their own).



“I printed out our birth story and placed it in my daughter’s baby book so she can look back and read about the day she was born. I can only hope that it will inspire her to have a birth without fear when she is ready to birth to her own baby someday,” reported one mama. 

6:  To preserve the beauty and spirit of the birth process

Many women (and men!) are profoundly affected by the stories of birth.  Birth is a sacred and primal process that connects us to our roots and to something greater than ourselves.  Author and healer Tami Lynn Kent calls birth the process of coming to the spirit door.

Like the beautiful children we birth, each birth story is completely unique and all have elements of the extraordinary in them.

Some women are driven to write their birth stories in an attempt to capture that beauty and power in words.  It can take some courage to do this.  While it may be “safer” to stick to the medical facts, writing about one’s full experience of birth—the physical, emotional, and spiritual—can be a powerful act.  Being honest about the deeper layers of your birth experience can be a true gift to yourself, your family, and anyone fortunate enough to hear your story.

7:  To help and inspire others

For most of human history, storytelling was the most potent way to transmit knowledge among kin.  In the past, we had a much greater connection to the world of birth and babies than we do today.  By the time we reached adulthood, we would have likely heard many birth stories, if not witnessed many births ourselves.

One woman writes: It’s sad that we don’t live in a culture where women gather post birth, removed from responsibility and routine, to sit around the fire under the stars with our female clan (including the elders and the young) and share our birth stories. Too many of our stories get lost in our hearts.”

While we are less connected to birth and birth wisdom today, telling our stories can be a way to reconnect to ourselves, each other and the wisdom of birth.

Telling your birth story can help other women in your life.  We can learn so much from each other and our mothers; and our children can learn from us when we take time to talk about our birth experiences.

When things don’t go as planned and we are brave enough to share our story, we can help other women who have or will experience similar situations.  Likewise, when we have a positive experience of birth, sharing our story can be a way of showing other women what it looks like to birth naturally, or without fear.  Hearing positive birth experiences is a powerful antidote to the mainstream perceptions of birth as a risk-laden, painful medical event.  In this way, the personal can become political, as we spread the truth that birth can be a positive, fearless, beautiful experience.

8:  To change our collective perceptions of birth

It was not so long ago that women were put under anesthesia (“twilight sleep”) during labor, completely disconnected from the experience of their births.  It is not uncommon in many parts of the world for women to have few options or control over their birthing experiences.  Even those with more choice may feel like it’s not acceptable or desirable to speak about their birth experiences.  It can almost feel taboo to speak candidly about birth, much less celebrate and honor this experience.

Writing and sharing your birth story can be a political act.  It can be a way of saying “Birth is important.  The WOMEN who birth are important.  MY birth is important. “ Regardless of how you feel about your birth, putting words to your experience is a powerful way to show that your experience matters.  Because it does.

Some women may feel reluctant to write their stories.  Maybe they don’t know where to start, are afraid they aren’t going to tell it right (impossible!), or get stuck in the practical limitations of sitting down to write with a little baby to care for.   But nothing worth doing is ever easy (cases in point: pregnancy and childbirth).  While not easy, these labors of love are worth it.

If you’ve written your birth story and want to share it with others, please consider submitting your birth story to be posted on our blog (with pictures too if you wish!)
If you need a little help carving out time, want to receive some guidance and feedback, or just want to write and share your story among other mamas, please consider joining us for our upcoming Write Your Birth Story Workshop in September 2013.
For information about either birth story submission or the upcoming workshop, contact Jaime@health-foundations.com.

Calling all new and expecting Dads! New Dad’s Group

Gals, encourage your partners to consider this fantastic new Dad’s Group forming in the Cities for expecting and new papas.  Their first meet up is THIS Friday August 9th at 7:30 at Psycho Suzi’s.  

Here is what organizer Jeff Hellenbrand had to share with us about this awesome new group:

There are several groups in the Cities for expecting mothers, but I couldn’t find any equivalent for guys. As an expecting father, most of my friends do not have kids yet. Instead of boring my friends with all of the details and anxieties of the pregnancy and birth, I decided to create a meetup group just for new and expecting dads.

What makes this group awesome is that we have no agenda. It’s an excuse for new and expecting dads to meet, hang out and have fun. We’re guys. So we talk a lot about work, music and sports. But we also end up talking about pregnancy and fatherhood. And I think that’s a conversation that’s too important to not be having. But none of us wants to feel like we have to talk about that stuff or that we can’t talk about something else when we feel like it. Anybody who considers himself a new or expecting dad is welcome.
Our next meetup is coming up fast! Since this is our first meeting for most of the guys, I wanted to have something fun and low-key.
We’re meeting at Psycho Suzi’s on Friday, August 9 at 7:30pm. Here’s the link to the event: http://www.meetup.com/Dudes-Becoming-Dads/events/130418752/
It’s important that guys RSVP for this one (preferably early next week) so a large enough space can be reserved at Suzi’s.

Fatigue in Pregnancy

It’s remarkable to many women just how tired they can feel in pregnancy, especially in the first and last trimesters.  While the amount of sleep your body demands may be shocking, its important to remember all the hard work and energy your body is devoting to creating a healthy baby.

By the end of the first trimester, your body has helped your baby develop all of his or her body parts—an amazing accomplishment!  Your body is also undergoing tremendous transformations (e.g. significant hormonal changes, remarkably increased blood flow and volume) and your psyche is adjusting to this monumental change in your life.  With good reason, the first trimester is when many women feel the most tired.

As pregnancy proceeds, your body is working hard to support and nourish your growing baby, making the later months of pregnancy tiring as well.  Some women feel they have more energy in the second trimester.

While fatigue is your body’s normal and useful message that you need more sleep to accomplish all of this incredible work, it can be hard to cope with this sometimes overwhelming need for rest in pregnancy, especially if you are working or have other children.  Though you may not be able to eliminate your fatigue, there are many ways you can cope and support your body at this time.

AT BEDTIME:

  • Get lots of sleep (at least 8 to 10 hours) with as many of those hours before midnight as possible, as this is when your body recuperates.
  • Take naps if possible.  It’s common for women to take hour-long (or longer!) naps daily during pregnancy.
  • Support your tummy, lower back and legs with pillows (or one pregnancy pillow) during rest, especially in your last trimester.
  • Sleep in a well-ventilated room, as oxygen replenishes your cells while you rest.

IN THE KITCHEN:

  • Eat small meals regularly (every 2-3 hours) to maintain balanced glycogen and insulin, the two hormones that regulate your blood sugar levels.  Carry nuts or fruit with you on the go.  Too much sugar in the diet can contribute to fatigue.  Ensure you are getting enough protein and complex carbohydrates.
  • Stay hydrated: Drink 2-3 liters of water a day to promote healthy digestion.  Constipation can contribute to fatigue.
  • Avoid coffee, while it can temporarily boost your energy, it also causes a crash that can actually increase your fatigue.
  • Alternative energy boosters include: Peppermint tea (as long as it doesn’t aggravate heart burn), Spirulina or kelp supplements, Nettle tea

DURING LEISURE TIME:

  • Yoga and meditation are regarded as energy-enhancing practices.
  • Take a bath with two drops each of lavender, neroli, and mandarin essential oils.  Other great essential oils for fatigue include peppermint, lemon, orange, sandalwood and rosemary (AVOID essential oils, however, in the first trimester)
  • A brisk walk in fresh air, when possible, can increase oxygen intake, improve circulation, appetite and bowel function, and decrease fatigue.
  • Massage can be invigorating and relaxing.

Speak with your midwives about your fatigue.  You may want to be checked for anemia, which is common in pregnancy and can certainly cause fatigue.

Be kind to yourself, prioritize your activities (maybe reducing your responsibilities if possible), and don’t be afraid to ask for help.  You are doing important and difficult (and ultimately rewarding!) work right now.

Please speak with us if you have any additional questions or concerns about fatigue in pregnancy.

Rest well, mamas!

Optimal Nutrition in Pregnancy: A Primer

At Health Foundations, we know that nutrition during pregnancy is paramount.  Overwhelming scientific and anecdotal evidence shows that excellent maternal nutrition almost always results in healthy moms and healthy babies, while poor nutrition leads to complications.

Nutrition Primer PostThe pressure of busy lifestyles and weight ideals, plus lack of knowledge about nutrition are major obstacles to optimal health for many women—add to these feelings like nausea, fatigue, and other physical stresses of pregnancy and it can be extra challenging to eat right in pregnancy.  But by educating yourself about nutrition in pregnancy, taking this time to really honor and nurture your body and your baby, and listening to your intuition; you can achieve excellent nutrition during pregnancy—when its more important than ever.

There is much to be said about nutrition during pregnancy—too much for one blog post.  In future posts we’ll explore in greater detail the fundamentals of optimal pregnancy nutrition with special focus on:

  • the essential nutrients (i.e. protein, iron, calcium, vitamins A, D, C, E, and Bs, etc),
  • optimal foods in pregnancy, and
  • the use of supplements.

For this introductory post, we wanted to share some of the top advice we give to pregnant mamas in our practice about pregnancy and nutrition.

1  Don’t “Eat for two”—Eat for optimal health.  While you should listen to your body for what it tells you it needs, it’s important not to give into frequent cravings for junk or processed foods, sweet foods, and other calorie-packed treats.

Strive to eat a wide variety of minimally processed, whole foods.  Limit simple carbohydrates such as dairy and sweets and opt for veggies, meats (or other sources of protein) and a small amount of fruits. Eat organic whenever possible and avoid high mercury fish (such as shark, swordfish, king mackerel, walleye or tilefish).  Read more about fish here.

2  In terms of serving sizes and overall caloric intake, pregnant women only need about 200-300 more calories a day in the second and third trimesters—which is the equivalent to an extra small snack a day.

3  Protein, protein, protein.  Protein is so, SO important in pregnancy, and women need a lot of it during this period.  In fact, women should aim to consume about 4-6 servings totaling 80 grams of protein every day.  Women should strive to incorporate some protein into every meal and every snack throughout the day.

4  Frequent meals and snacks will help maintain a healthy blood sugar, which is important in pregnancy.  It can also reduce unpleasant conditions like nausea and fatigue.  Women should strive to eat every few hours, keeping meals smaller and snacks frequent throughout the day.

5  In terms of beverages, it is important to stay hydrated by drinking at least 6-8 cups of water every day.  Pregnant women should limit fruit juices and milk, which are packed with sugar, and reduce or eliminate caffeine.  Besides water, good liquids to consume in pregnancy include nutritive herbal teas (tisanes) such as nettle, raspberry leaf, and chamomile; EmergenC; and POM juice mixed with a little sparkling water.

6  No ice cream!  We know some of our mamas hate this one, especially during a Minnesota summer.  But we say this with good reason (and not to be mean!).  Ice cream is too highly concentrated with fat, sugar, and calories to eat safely on a regular basis during pregnancy.  Truly, we have seen the effects of frequent ice cream consumption on many women in our practice: they often have bigger babies and remarkably more difficult deliveries.    We strongly recommend that women avoid ice cream or strictly limit it to no more than a small serving once a week at the most.

7  While food aversions may keep you away from some foods (including vegetables), do your best to eat healthy despite these limitations.  We can work with you to come up with healthy choices that don’t make you gag at the sound of them.

8  Listen to your body and be kind to yourself.  Your body intuitively knows how to nurture its creations (i.e. your baby)—pay attention to how foods make you feel and to which foods you are drawn.  Practice kindness toward yourself during this time by nourishing your body not only with good foods, but with adequate rest, movement, and relaxation.

9  Enlist support.  Seek help from your partner or other close family/friends in meeting your nutritional needs (i.e. shopping for and making healthy foods).

10   Seek help from your midwives if you have any questions or concerns about healthy eating in pregnancy.

Stay tuned for more articles about nutrition in pregnancy.

Heartburn in Pregnancy: Ten ways to Calm the Fire

Heartburn in pregnancyHeartburn can be a vexing experience at any stage of pregnancy, from the early weeks to the hours before labor.  For some women, heartburn is a constant throughout pregnancy, for others it comes and goes, and some women are spared from this common pregnancy condition.

In normal digestion, food enters the stomach from the esophagus, hydrochloric acid (HCl) is released, and an enzyme is produced to break down proteins in food. When stomach acid returns (or refluxes) back up into the esophagus we experience heartburn.  Interestingly, heartburn can occur in the presence of too much or not enough stomach acid.

Heartburn during pregnancy is attributed to the increased level of progesterone (which softens smooth muscles) that can slow digestion and prevent the esophageal sphincter from closing all the way.  Furthermore, as baby gets bigger, digestive organs are forced upwards and out of their pre-pregnancy position, which can also prevent containment of stomach acids where they belong.

Here are ten great, natural ways to get relief from heartburn during pregnancy.

1.  Alkalizing drinks 

It sounds counter-productive, since it tastes acidic, but apple cider vinegar can work wonders for heartburn in some women.  Add two tablespoons of apple cider vinegar to a glass of water (you may wish to add some honey or a few drops of stevia to sweeten the deal).  Though this may seem to intensify the burn for a minute or so, it should subside, along with your heartburn.

Lemon water can also help ease heartburn by alkalizing the body.

Some women find that drinking during meals aggravates their heartburn, so you may consider hydrating between meals.

2.  Digestive Enzymes

Enzyme tablets containing papain (papaya) can be purchased at a health food store and chewed during or after every meal or whenever heartburn strikes.

3.   Helpful herbs

Demulcent herbs can coat, soothe, and heal the esophagus and stomach. The best demulcents for pregnancy are include:

  • Slippery elm bark powder—Thayer slippery elm lozenges can be purchased at Whole Foods or the co-op; take throughout the day as need for heartburn
  • Marshmallow root (pre-made heartburn teas often contain this herb)

Carminative herbs are anti-inflammatory and antispasmodic, and thus can soothe heartburn.  (Note:  stronger smelling herbs may not be well tolerated during bouts of morning sickness).  These herbs include:

  • Fennel
  • Aniseed
  • Lemon balm
  • Chamomile
  • Peppermint (note: for some women peppermint can aggravate heartburn)

Kudzu root, dandelion and catnip can also soothe the burn.  Herbs can be taken in tea form or as a tincture.

4.  Supplements

Probiotic can help to ease digestion and thus help soothe heartburn.  A Calcium/Magnesium supplement can also help.

Both are available at Health Foundations.

 5.  Foods

Yogurt can benefit your overall digestion.  Raw almonds or cashews, chewed slowly as a snack or after a meal, can ease heartburn by calming digestion. Some women find eating a baked potato with some fat source (e.g. cheese or butter) helps.  Including a healthy fat with each meal tends to help some women.

 6.  Avoid offending foods, which can include oily, heavy, spicy, or rich foods, chocolate, and caffeine.

 7.  Eat smaller meals more often and eat slowly and mindfully.

 8.  Don’t eat right before lying down, you may consider eating your evening meal at least 2 hours before bedtime.  If sleep or lying down aggravates your heartburn, consider sleeping with a few extra pillows to prop your head up.

 9.  Wear loose fitting clothing and breathe deeply.

 10. Get a chiropractic adjustment this can help move your stomach back into a more optimal position, especially as baby grows larger and upward pressure is rearranging your internal landscape.

We encourage you to speak with us about your condition if you are finding that these natural remedies are not providing relief.  Some over-the-counter heartburn medicines are safe to use during pregnancy.

Preconception Planning

PPcoupleMost couples don’t think about preconception planning—yet it can make a world of difference in fostering a healthy pregnancy and birth.

Every couple benefits from addressing their overall health and wellness in preparation for pregnancy, even if they are not having fertility issues. This preparation supports a healthy and happy pregnancy and eases the transition through postpartum into parenthood.

preconceptionP1For all the gardeners out there, consider this metaphor: preconception planning is much like preparing/improving the soil. Creating a healthy environment for your growing darlings even before they are planted optimizes their chances of thriving — sometimes in ways that later care doesn’t allow (e.g. water and sun; or, in our case, pregnancy care).

Health Foundations offers preconception planning services, including comprehensive visits to discuss your health and create an individualized plan that works for your family.

When should preconception planning begin?

Ideally, we love to see couples three to six months before they hope to conceive.  This gives us time to correct any nutritional deficiencies (such as low iron or Vitamin D), which can have a significant impact on the pregnancy.  Sperm live for approximately 3 months, so we want to get dad as healthy as possible before conception so that his contribution to the pregnancy is healthy and strong.  Eggs begin their maturation process around this time too; when, like sperm, they are most vulnerable to toxins, radiation, and nutritional deficiencies.

What does a preconception planning visit look like?

During a preconception visit, we will talk with you and your partner about your current health, lifestyle, diet, personal and family medical history, medications you are taking, work and home environments, past pregnancies, and you and your partner’s desires and concerns about getting pregnant.  Here are some of the issues we will explore during your appointment:

  • General current health:
  • Blood Sample
    • We recommend women receive a pap and cultures during a well-woman visit (which Health Foundations can provide)
    • Visit a dentist to get a cleaning and any necessary work done prior to conception
    • Talk to your provider about current medications to make sure they are safe at this time
    • Discuss any history of hormonal birth control
    • Have diagnostic/lab tests for various issues that can impact pregnancy and maternal health (all offered at Health Foundations)
  • Diet/Weight
    • Love coupleWe can work with you to optimize your diet to ensure the greatest health prior to and during pregnancy
    • Eliminate caffeine, alcohol, tobacco, and recreational drugs.
    • Drink plenty of water (aim for 8 glasses a day)
    • Weight: women 15% below their ideal weight may benefit from added pounds during pregnancy; women who are overweight, however, do not benefit from crash dieting prior to pregnancy, as this can deplete their health.  In either case, we can create a plan to create optimal health for you.
  • Lifestyle
    • Establish a consistent exercise pattern
    • Inventory your environment for chemical, heavy metal, and other toxic exposure (you may want to work with a professional on a detox plan)
    • Address emotional health and stress
  • Use of supplements
    • We recommend women begin prenatal vitamins at least three months prior to conception (folic acid is especially important to begin prior to conception to avoid neural tube defects in baby)
    • Omega-3 and DHA are also important
    • Nutritive herbal infusions such as alfalfa, nettles and red clover can support overall health
    • Vegans and vegetarians may want to begin B12 supplementation
    • Additional supplements may also be recommended based on the individual
  • Men’s health
    • Men should follow the same dietary and lifestyle recommendations as their partner
    • Men should also take a multi-vitamin for the months leading up to conception
  • Fertility awareness
    • PPchartingWe help couples understand their fertility so that they can maximize their chances of conceiving.
    • Taking Charge of your Fertility by Toni Weshler (book and website) and Fertility Friend (website) are great resources for understanding fertility awareness and how to chart your fertile periods each month
    • Inexpensive, reusable fertility test kits are available (less expensive than one-time ovulation tests)
  • Useful therapies
    • Acupuncture has proven benefits for women wanting to conceive
    • Massage, yoga, aromatherapy, and chiropractic can also help by reducing stress, balancing hormones, and overall physical wellness.
  • Having fun
    • Above all, we encourage couples to have FUN during this process!  It takes an average of 6 to 9 months to conceive—being stressed during this time will only make conception more difficult.  Plus, this is your time to really enjoy your partner and all those things that can be a bit more difficult to enjoy during pregnancy and into parenthood. 

Morning Sickness

Morning sickness

Morning sickness (which can actually strike any time of day or night) is a common but challenging ailment of pregnancy. Seventy-five percent of all pregnant women experience some degree of morning sickness—aptly called Nausea and Vomiting in Pregnancy.  Many women experience a general feeling of nausea, while half of all pregnant women feel sick enough to vomit.

Morning sickness often develops at 4 to 6 weeks and resolves around 14 and 16 weeks, although few women experience intermittent or continuous symptoms throughout pregnancy.  Hyperemesis gravidarum is the name for such serious cases.

On a scale from one to five, most women rate their symptoms at about a 2 or 3, which is very uncomfortable but still tolerable. Morning sickness can drastically affect even the simplest daily tasks, as well as diet, professional life, sleep, relationships, and emotional health.

Though the causes of morning sickness are not entirely understood, some believe it actually serves a protective function for your baby.  Some evidence suggests women who experience nausea/vomiting have a lower risk of miscarriage (although lack of sickness doesn’t increase the risk).  That said, nausea and vomiting can be uncomfortable if not debilitating and should be discussed with your provider.

While any pregnant woman may experience morning sickness, the following are thought to increase a woman’s chances:

  • motion sickness, migraines, or birth control-related nausea/vomiting prior to pregnancy
  • morning sickness with a previous pregnancy
  • carrying twins or multiples
  • female family members experienced morning sickness
  • carrying a girl (one study found severe nausea to be 50% more common in women carrying girls)

Naturopaths believe that the severity of nausea is associated with maternal liver health.

Here’s how to cope:

FOODS

trailmix

  • Choose high-carb, high-protein, low-fat, easy-to-digest foods.
  • Salty foods can help some women
  • Avoid greasy, spicy and fatty foods if they aggravate your symptoms
  • Yeast supplements and products can aggravate morning sickness
  • Eat small, frequent meals and snack often—an empty stomach can aggravate sickness; eating small amounts often can help maintain blood sugar levels, thought to ease nausea. Dried and fresh fruits and nuts are good snacks to have on hand.
  • Some women swear by eating dry foods, like a few soda crackers, a piece of dry toast, whole grain ginger biscuits, or rolled oats upon waking in the morning
  • Eat slowly
  • Avoid “trigger” foods or smells—while nutrition is important in pregnancy, be kind to yourself, listen to your body, and stick to foods that appeal to you and don’t aggravate your symptoms.
  • Take prenatal vitamin with food or at night if it seems to upset your stomach, Health Foundations carries prenatal supplements that are generally well-tolerated

FLUIDS

warm_tea

  • Sip water often, mostly between meals (especially if you have been vomiting)
  • Some women find lightly carbonated, electrolyte-containing, or sour drinks to be helpful
  • Water with lemon promotes a balanced alkaline system
  • Sip broths, barley water
  • Ginger tea and other forms of ginger can allay nausea
  •  Peppermint, chamomile, fennel and raspberry leaf tea can also reduce symptoms and provide nutrients (caution: peppermint can aggravate heartburn)
  • Avoid coffee and orange juice, they can aggravate symptoms and strain the liver

ginger

LIFESTYLE

  • Get fresh air and exercise (even though it may be the last thing you want to do, even a short brisk walk can help)
  • Try not to lie down right after eating
  • Sleep or rest as much as you can, this can reduce symptoms
  • Determine and avoid your non-food related “triggers”: such as a warm room, strong odors, changing positions quickly, flickering lights, car rides, etc.
  • Aromatherapy—place a few drops of lemon, ginger, or peppermint essential oil on a cloth/tissue and inhale
  • Deep diaphragmatic breathing can improve liver and gall bladder functioning.  You can also massage under the base of the ribcage for pressure relief
  • Avoid stress as much as possible

OTHER HELPFUL TREATMENTS

acupressureNausea

  • Vitamin B6 supplements can help ease nausea and vomiting
  • Acupuncture/acupressure (sea bands) may help
  • Hypnosis has some proven benefit in alleviating nausea
  • PrimaBella: available at Health Foundations, this FDA-approved device, which is worn like a watch, has helped many women
  • Medications: if your symptoms are severe or persistent or your nutrition is greatly compromised by morning sickness, don’t be afraid to speak with the midwives about medication options that can help

PrimaBella

When to call the midwives:

While you should definitely speak with the midwives about your nausea and vomiting, the following are cause for a more immediate call:

  • Nausea or vomiting is severe
  • You feel dizzy or faint when you stand up
  • You pass only a small amount of urine or it’s dark in color
  • Your heart races
  • You vomit blood
  • You can’t keep down liquids

Remember, as bad as morning sickness can be, this too will pass, sweet mama!

Welcome to the Health Foundations blog

A blog is born!

Greetings and welcome to Health Foundations’ new blog!  We are thrilled to create this virtual gathering place—a space for you to gather information, support, and resources during the childbearing year and beyond.

Here we will offer:

  • information about preconception, pregnancy, birth, babies, postpartum, and parenting
  • news about community and Health Foundations events
  • birth stories
  • insight from experts in the birth world
  • recipes
  • pictures
  • and much more

This blog is for and about YOU—our amazing Health Foundations families—we invite you to share with us your birth stories (and pictures!) as well as other stories about your birth and baby adventures.

We also welcome feedback—what would you like to see shared here?  What are your burning questions about pregnancy, birth, and new parenthood?

Please feel free to contact Jaime at Jaime@health-foundations.com with your questions, stories and feedback.

Thanks, come back and visit us again soon!

469755_10150978476250734_504943501_oPhoto by Gwendolyn Waite Photography