Pregnancy

Listeria and Pregnancy: What Is It, Symptoms, and How to Avoid Infection

Listeria and Pregnancy

Listeria is one of those scary words during pregnancy that you’ve heard but may not be exactly sure what it is. You probably know the basics about what foods you should not eat to avoid infection but what is listeria, exactly? And why is listeria so dangerous for pregnant women and their unborn babies? 

These are all excellent questions and a great place to begin when educating yourself about these dangerous bacteria. Here are the basics about listeria and why it is crucial that you take steps to avoid these bacteria while pregnant. 

What is it?

Listeria is a form of bacteria that can be found in uncooked vegetables, fruits and meats, unpasteurized milk and cheeses and processed foods. Listeria moncytogenese can originate in water and soil and animals can also act as carriers for the bacteria. When food comes in contact with listeria, it is considered contaminated and the bacteria can only be killed by cooking the food to the proper temperature or through pasteurization. 

Why is there an increased risk for pregnant women?

When a person becomes ill from the bacteria listeria, they are said to have listeriosis. While this is a rare condition, pregnant women are approximately 10-20 times more susceptible to infection than non-pregnant adults. Contracting listeriosis during pregnancy can result in serious complications for both mom and baby including miscarriage, premature delivery, infection to the newborn, and in extreme cases fetal or maternal death. As many as 1/5 cases of listeria infection in pregnant women result in stillbirth or neonatal death.

What are the symptoms of listeria infection?

Symptoms of listeriosis can begin as early as several days after exposure or as late as one month later. They may include:

  • Mild flu like symptoms
  • Headaches
  • Fever
  • Vomiting or diarrhea
  • Muscle pain

Fortunately with early detection, an aggressive antibiotic regimen can help prevent the infection from crossing the placental barrier and infecting the baby. This can greatly reduce the chances of severe complications like miscarriage or stillbirth. If you suspect you may have become infected with listeria, contact your doctor immediately who can perform a blood test to check for the presence of the bacteria.

How can I avoid listeria infection while pregnant?

With extra attention to what you eat and proper food safety and handling, you can greatly reduce your risk of coming in contact with the bacteria listeria while pregnant. Here are some tips to preventing infection during pregnancy and keeping you and your baby healthy:

  • Skip deli meats and hot dogs unless reheated to steaming (160 degrees F)
  • Avoid soft cheeses that may not be pasteurized such as Brie, feta, goat cheese, Camembert, 
  • Mexican cheeses (queso fresco, quesos blanco and panela), and blue-veined cheeses. Hard cheeses and semi-soft cheeses like mozzarella are fine, as are cream cheese and cottage cheese.
  • Do not eat pate or other cold meat spreads
  • Do not eat refrigerated smoked salmon unless it has been cooked in a dish.
  • Keep food prep areas clean
  • Wash your hands before eating or handling food
  • Cook foods to their proper internal temperatures
  • Keep your refrigerator clean and set at 40 degrees or less
  • Wash fruits and veggies thoroughly before eating
  • Avoid raw or uncooked meats and seafood
  • Refrigerate and freeze leftovers promptly.

For more foods to avoid during pregnancy, check out this article. 

Although it is important to take measures to avoid listeria during pregnancy due to the potential for serious complications, remember that instances of listeriosis are extremely rare. In the US, approximately 1,700 people each year become infected with the illness of which only 17 percent are pregnant women. With a healthy, pregnancy conscious diet and safe food handling practices, there is no need to be fearful of listeria infection. Listeriosis is fortunately very preventable in most cases. For questions about maternal and fetal health, natural birth or any and all pregnancy related topics, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

All About Exercise During Pregnancy

Pregnancy Yoga

You may think that pregnancy is a free pass to lie on the couch and indulge your cravings, but the reality is your body needs exercise just like when you’re not pregnant. Exercise during pregnancy has both physical and emotional benefits for mom from reducing the occurrence of backaches and other bodily discomforts to boosting your mood and energy level. Although some considerations must be taken to ensure your exercise regimen is safe for you and baby, in most cases, you can continue with your pre-pregnancy routine with moderation. Even if you weren’t previously an active person before pregnancy, now’s a great time to speak with your care provider about incorporating a healthy amount of exercise into your daily routine. Here are some of the most important things to know about exercise during pregnancy.

The Benefits:

There are many ways that exercise can benefit your mind and body while you are pregnant. Just a few of these benefits include:

  • Improved posture
  • Stress relief
  • Warding off illness
  • Improved sleep
  • Preventing excess weight gain
  • Reduced back pain
  • Increased muscle strength
  • Better mood
  • More energy
  • Less fatigue
  • Reduced chance of developing gestational diabetes
  • Building stamina and endurance for labor
  • Reduced risk of having a baby that is born too large
  • Reduced risk for postpartum depression and anxiety
  • Preventing pregnancy-related high blood pressure

How Much Exercise?

The American College of Obstetrics and Gynecology recommends that pregnant women get at least 30 minutes of moderate exercise per day, most days per week. This recommendation applies to women with healthy normal pregnancies and no known complications that would make exercise dangerous for them or their baby. 

Which Exercises Are Safe?

As a general rule of thumb, you want to exercise at a moderate level in which you feel comfortable, not one in which you are straining yourself. A good gauge for determining if an exercise is too strenuous is to see if you are able to carry on a conversation while doing it. If you are so out of breath that it is difficult or uncomfortable to talk, you are probably pushing yourself too hard. It’s also always important to remember to warm up, cool down and stay hydrated just as you would if you were not pregnant. Some safe and healthy exercises for pregnancy include:

  • Swimming
  • Low impact aerobics
  • Walking briskly
  • Elliptical machines
  • Stationary cycling machines
  • Yoga
  • Tennis and racquetball with caution
  • Jogging in moderation
  • Strength training with light weights

Exercises to Avoid:

  • Any activity that requires considerable balance or coordination
  • Any contact sport (soccer, football, softball, basketball, volleyball, etc.) 
  • Anything that requires you to hold your breath
  • Any activity involving jumping, hopping, bouncing, running intensely, or skipping
  • Anything with the possibility for abdominal trauma such as sports that require quickly changing directions or jarring movements
  • Fall risk sports (riding horses, skiing, snowboarding)
  • Any activity that requires you to lie on your back after the first trimester
  • Exercises that involve waist twists
  • Sit-ups
  • Double leg raises
  • Straight leg toe touches
  • Deep knee bends
  • Any exercise in hot or humid weather
  • Scuba diving
  • Gymnastics
  • Water skiing
  • Surfing
  • Exercise in high altitude

Although most pregnant women can safely engage in a regular exercise routine, there are some circumstances and medical conditions that may prompt your care provider to advise against physical activity. These circumstances may include:

  • Presence of medical conditions such as asthma, heart disease, lung disease or diabetes
  • Threatened or recurrent miscarriages
  • Weak cervix
  • Low placenta
  • Previous incidents of premature labor or birth
  • Pregnancy related high blood pressure
  • Carrying multiple babies

You should always speak with your health care provider before incorporating any new exercise into your daily regimen while pregnant. They can best advise you as to whether or not your exercise plans are healthy and beneficial and help you come up with a plan that works for you. It’s also important to remember to listen to your body. If you find yourself feeling dizzy, short of breath, experiencing chest pain or heart palpitations, or if you are having any pregnancy related complications such as bleeding, fluid leakage, contractions or decreased fetal movement, stop exercising immediately and contact your care provider. 

Exercise done safely and in moderation can be a great way to stay healthy, improve your mood and take care of yourself and baby during pregnancy. Simply use caution and good judgment, and you should be able to enjoy a normal physical fitness routine. Health Foundations offers a variety of fitness class opportunities for moms and moms-to-be ranging from Candlelight Yoga to Postpartum Core Training and more. To learn more about these great opportunities to stay mentally and physically fit, click here.

Back Pain During Pregnancy

Back Pain During Pregnancy

Most pregnant women experience some form of back pain during their pregnancy. Although lower back pain does not typically become an issue until the fifth month or mid second trimester, it can begin as early as 8-12 weeks for some women. You are more likely to suffer from prenatal back pain if you have struggled with back issues prior to your pregnancy. Back pain during pregnancy can range from mild discomfort and treatable at home to acute chronic pain that necessitates treatment from a specialist. If you are one of the 50-80 percent of women who experience some degree of back pain while pregnant, determining the cause and type of pain will help you choose the best treatment approach. You don't have to accept that pain is a normal part of pregnancy

Before identifying the potential cause or causes of your back pain, it is important to differentiate between the two types of pain that are typical during pregnancy. The first is lumbar or lower back pain and the second is known as posterior pelvic pain. Understanding the characteristics of each type of pain will help you determine its possible cause and what you may or may not be able to do to relieve it. 

Lumbar/lower back pain:

  • Is felt at or above the waist in the center of back
  • May radiate in the legs or feet (also known as sciatica)
  • May worsen with prolonged episodes of sitting or standing
  • Feels similar to lower back pain experienced while not pregnant
  • May also cause tenderness of the muscles surrounding the spine

Posterior pelvic pain:

  • Is 4 times more prevalent than lumbar pain
  • Is a deep pain experienced below and to the side of the waistline and/or across the tailbone
  • Can be experienced on one or both sides
  • Can be felt in the buttocks and backs of thighs
  • Does not easily resolve with rest
  • Can be experienced as pubic pain
  • Physical fitness does not lessen the likelihood of onset

Common Causes of Back Pain during Pregnancy:

  • Weight gain: Normal weight gain during pregnancy can range from 25 to 35 pounds. That is a considerable amount of excess weight for the spine and lower back to support. Your growing baby is also putting added pressure on your uterus, blood vessels and the nerves in your pelvis and back.Hormonal changes: During pregnancy, your body produces the hormone relaxin which helps to relax and loosen the joints in the pelvic region to prepare for childbirth. Consequently, this hormone can also cause other ligaments to loosen including ones that support the spine. This can unfortunately lead to instability and back pain. Relaxin also helps breech babies get into optimal position.
  • Posture: Your growing baby bump causes your center of gravity to shift which also can negatively impact your posture. These changes to your posture can often be the culprit of back pain during pregnancy.  Improving posture is one of many reasons to do yoga during pregnancy.
  • Stress: Similar to when you are not pregnant, stress can cause excess tension in the muscles in your back when you are expecting. This tension and stress can cause back pain and spasms.Other often unavoidable actions that may sometimes increase back pain during pregnancy include running, walking, lifting, bending, twisting and climbing stairs.  

Treatment for Back Pain during Pregnancy: 

  • Alternating hot and cold compresses: Try starting with icing your back three times per day for twenty minutes each time. After two days, switch to applying heat to your back three times per day for twenty minutes each time. Never apply heat to your stomach during pregnancy. 
  • Exercise: Moderate exercise during pregnancy will strengthen your muscles and increase your flexibility. Try taking a brisk walk or going for a swim.
  • Practice good posture: Give a little extra attention to sitting up straight and keeping your shoulders back rather than slouched over. You can also try sleeping on your side with a pillow between your knees to alleviate stress placed on your back from your growing belly.
  • Reduce stress in your life: Essential oils are a great way to reduce daily stress, but If you are feeling a considerable amount of emotional stress that is taking a toll on your back, consider talking with a trusted friend or family member or seeking professional counseling.
  • See a chiropractor: Chiropractic care is a great, safe and natural way to reduce back pain and other physical discomforts common during pregnancy. Health Foundations works in partnership with Dr. Amber Moravec at Naturally Aligned Family Chiropractic to provide relief from pain during pregnancy and labor through regular chiropractic care. 
  • Try acupuncture: The Chinese medicine practice of acupuncture has been found to be successful at alleviating lower back pain during pregnancy among other prenatal physical discomforts. Health Foundations offers community acupuncture with Jenna Niggeler every Wednesday evening from 6:00pm - 8:00pm - call the office at 651.895.2520 to schedule an appointment.

Other simple measures that may help prevent and alleviate back pain during pregnancy include:

  • Wearing flat supportive shoes
  • Squatting rather than bending over to pick things up
  • Tylenol when approved by your care provider

When to Call Your Care Provider:

Although back pain during pregnancy is unfortunately very common, you should call your doctor right away if you experience severe or increasing pain or pain that comes on quickly that is accompanied by rhythmic cramping. These symptoms may indicate rare but serious complications such as pregnancy related osteoporosis, septic arthritis, vertebral osteoarthritis or preterm labor.

Back Pain during Labor:

Lastly, it is not uncommon to experience back pain during labor. Back pain that may be indicative of labor will be persistent, rhythmic, and increasing in intensity and it will not be resolved by changing your position or activity. If you believe you are in labor, contact your care provider to determine the appropriate next steps. 

Back pain during pregnancy is an unfortunate but often manageable condition. Determining what factors may be contributing to your pain can help you figure out what changes you can make to your lifestyle and what treatments you can seek for relief. To learn more about coping with back pain during pregnancy or chiropractic care and other wellness services, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

15 Ways to Involve Your Partner in Your Pregnancy

Pregnancy with partner

When you are sporting a growing baby bump, you receive lots of attention from family, friends and even strangers. Everyone wants to know how far along you are, how you are feeling, and if you know what you are having. All the doting on the mom-to-be can leave dad wondering what his role is during the pregnancy and sometimes even feeling a little left out. If you want your partner to feel more involved in your pregnancy and are looking for ways to include him, check out these tips on ways to share the joys of your special journey. After all, you wouldn’t be where you are today without him.

1) Share your news together: Whether you get to make your announcement in person or choose to do a post on social media, be sure to include your partner in the excitement. Wait until you are both available to tell family and friends and tag him in any online announcements.

2) Invite him to your midwife/OB appointments: This seems like an obvious one, but let your partner in on the excitement of hearing the heartbeat and learning about baby’s development at your check-ups. He may not be able to make it to all of your appointments, but include him when you can.

3) Take parenting and childbirth classes together: When you are pregnant, there are many educational programs available to you and your spouse to prepare you for your baby’s arrival. Sign up for a birthing class, Infant CPR and First Aid and even a breastfeeding class together. The more informed Dad is, the more he will feel like part of your team.

4) Brainstorm baby names together: One of the most fun parts of having a baby is getting to choose a name! Let your partner be involved in suggesting names and start a running list of your mutual favorites.

5) Register for baby gifts together: If you are both first time parents, you may be feeling in the dark about what you will need for your baby. Registering together and seeking some guidance from friends and family can help you both feel confident that you will have everything you need for your little one.

6) Plan your nursery together: Two brains are better than one when coming up with a creative and functional plan for your baby’s nursery. Get dad involved with painting, building furniture and any other tasks he may enjoy.

7) Write your birth plan together: Having a birth plan can help you both feel assured that your wishes will be respected during the process of labor and delivery. Your partner should be your biggest advocate during the birth and will feel much better prepared for the job if he’s involved in the planning.

8) Exercise together: Ever heard of sympathy weight gain? Developing a moderate exercise regimen that you can do together will help you both stay fit and healthy throughout the nine months. It also may be a while before you can exercise together again after baby arrives!

9) Consider having a couples’ shower: Long gone are the days where baby showers are exclusively gatherings for women. Many expectant parents are choosing to have couples’ showers where they can invite all of their friends and celebrate baby-to-be together.

10) Read parenting and birthing books together: Reading is a great way to get prepared for the life changing experience of having a baby. If he’s not interested in paging through What to Expect When You’re Expecting and other classics, try getting him a book that is specially geared towards dads like, Be Prepared: A Practical Handbook for New Dads.

11) Keep a journal for your baby: Whether it’s a blog, or a handwritten notebook, keep a record of your pregnancy together that you can later share with your little one. Include letters to your baby-to-be and pictures of mom and dad pre-baby. Your child is sure to get a kick out of this one day.

12) Cook freezer meals together: You’ve probably heard from friends who have kids that one important way to prepare for baby is to stock your freezer with meals that can be warmed up easily. Preparing healthy meals to keep you both going during the sleep deprivation can be a fun and useful activity to do together while you await the arrival of your baby. 

Great freezer meals: Eggplant Parmesan - Cottage Pie - Chicken Enchiladas

13) Have your partner pack their own bag: You probably know exactly what you need to bring to the birthing center or hospital on the day of your delivery but have you considered what your partner might need? Have him pack his own bag with a change of clothes, snacks and anything he can bring to support you or keep you entertained during labor. 

14) Communicate: Even though your body is the one carrying and birthing the baby, your husband likely has his own set of fears and excitement about the impending arrival. Be open about your own feelings and encourage him to do the same. Getting any anxiety about becoming parents out in the open can help everyone feel more supported. 

15) Nurture your relationship: It’s easy to get caught up in the excitement of pregnancy and having a baby. Don’t forget that your relationship preceded your pregnancy and still needs regular TLC. Take advantage of this child-free time to go on dates, be spontaneous, take a trip and focus on one another. Your relationship may take a backseat for a little while once your little one arrives and you’ll be thankful for this time you had together.In addition to getting your partner involved in the excitement of your pregnancy and preparing for baby, it’s also important to let him know how he can best support you. Communicate your needs to your partner and let him know how he can help. If he’s been uninvolved thus far, it may be because he doesn’t know how to help. Pregnancy is a journey to be experienced together and a time to strengthen your bond as teammates. At Health Foundations, we encourage not only your spouse but your whole family to be as involved as you would like them to be in your experience. For questions about this or any and all other pregnancy and birth related topics, contact Health Foundations for a free consultation with a midwife and a tour of our beautiful Birth Center. We are here to help!

Pregnancy Classes

What is a Midwife?

Midwife Kat

Wondering if midwifery care is the best option for you?

If you are pregnant or considering becoming pregnant, you may be beginning to explore your options for the type of birth you would like to have. You probably have friends who have given birth in hospitals and may also know people who have used midwives or even had home births. But what exactly is a midwife and how does one compare to a doctor? Good question!

Simply put, midwives care for the well-being of mothers and infants during the prenatal, birthing and postnatal periods. Although in most countries midwives are the primary care providers for pregnant women, in the US they only comprise approximately 10 percent of births. They are responsible for helping mothers sustain healthy pregnancies and have meaningful and safe birth experiences in addition to providing recovery support and infant care. Similar to doctors, midwives are trained to give physical exams, detect complications, order laboratory work and screening tests, and counsel and educate the mother to be. They also are qualified to deliver babies not only in hospitals but also in birthing centers.

Where midwifery is often said to stand apart from standard OB/GYN care is in the level of personalized attention and the ‘woman-centered’ approach. Midwives strive to promote the practice of normal birth that is medication and intervention free. Whereas movies and television tend to sensationalize birth as a painful and dramatic experience in a medical setting, midwives help to facilitate the natural birthing process in a calm and comfortable environment for mom. Because their all-inclusive approach aims to support women physically, mentally, emotionally and spiritually, midwives play an integral role in not only the life of the mother but also the entire family. 

Unlike doctors, midwives come from a variety of training backgrounds. There are three types of midwives in the US: Certified Professional Midwives, Certified Nurse-Midwives and Direct Entry Midwives

Certified Nurse-Midwives and Certified Professional Midwives are educated in similar extensive training programs requiring graduate level education. CNMs however, have the nursing component in their education and typically only practice in clinical and hospital settings. Certified Professional Midwives specialize in birth outside of hospital settings including home births and independent birthing centers. Both Certified Professional Midwives and Certified Nurse Midwives have met the requirements for certification by their respective Boards, the North American Registry of Midwives and the American College of Nurse Midwives. Direct Entry Midwives however are midwives who have been trained in the discipline through apprenticeship, self-study or a school or program that is specific to the practice of midwifery. All midwives follow a model of care that emphasizes the normalcy of the process of pregnancy and birth and that places the utmost priority on caring for all aspects of the mother’s well-being.

Now that you know what a midwife is and what they do, here are some reasons that this approach to obstetrical care might be for you: 

1. You want a warm and inviting birthing environment 

Health Foundations Birthing Suite

Health Foundations Birthing Suite

With the exception of CNMs, most midwives practice in out-of-hospital settings like birthing centers and private homes. Because of this, your birthing atmosphere is more likely to be homelike, quiet and calm with no beeping.

2. You want more personalized care

Midwives tend to be more intimately involved in your pregnancy and birthing process than doctors. Your midwife will typically spend more time with you to develop your personalized birthing plan and to ensure that you are healthy not only physically, but mentally and emotionally.

3. You want to avoid unnecessary interventions

Often in hospitals if your labor is not progressing quickly enough, they will administer drugs to speed up the process. The drugs can then cause the mother to have more painful contractions that consequently end up leading to the decision to have an epidural. The epidural tends to slow the progress of labor again which can ultimately lead to the decision to perform a C-section. Under the care of a midwife, you will not be rushed through your labor. All efforts will be made to respect your wishes of a natural birth and help you control your pain using alternative methods such as massage, acupressure, showers and baths, homeopathy and changing positions.

4. You want to be able to move around during your labor 

Midwives encourage mothers to try a variety of different positions throughout their labor to ensure that they are comfortable and progressing steadily. In hospitals, you will often be hooked up to IVs and monitors that necessitate staying in your bed. Your midwife will instead monitor your baby intermittently so that you can move about freely while laboring.  

5. You want to know who will be delivering your baby ahead of time

Often with traditional OB/GYN and hospital care, you will not know the doctor who will be on duty the day of your delivery.  Because midwifery care is aimed to be a more personalized experience, your midwife or members of your midwifery team with whom you have already developed a trusting relationship will most certainly be present on the day of your birth. 

Overall, midwives are a great option for women seeking a traditional, natural, and personal birthing experience and who wish to develop a trusting and rewarding relationship with their caregiver. Many midwives also perform regular wellness and primary healthcare that extends beyond the time of your pregnancy and birth. If you are high risk or are experiencing any complications in your pregnancy, consider combining the care of an obstetrician and a midwife. At Health Foundations, you can also elect to experience our Birthing Center’s quality of personalized care in a hospital setting under the care of our own Dr. Dennis Hartung. To learn more about the choice to have a midwife assist you in your pregnancy and birth journey, contact Health Foundations to schedule a consultation or schedule a tour of our Birthing Center.

The team at Health Foundations is seeking to redefine the maternity and women’s health care experience in America. P.S. We're hiring!


see some amazing birth stories:

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?