Well Rounded Birth Prep

Well Rounded Birth Prep

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Sunday, June 12, 2011

12 week belly pic & stuff I'm doing to try to stay healthy

Hello all,

Thanks for your patience. I haven't written much lately--sorry about that. I have a stack of Post-it notes literally an inch tall with blog ideas that I need to get around to writing "when I have time." I do mean to...

Here's what I've been up to thus far with this pregnancy. (Please consult your care provider regarding the best supplements, exercises, etc. for your situation. I'm not diagnosing, prescribing, or recommending anything at all, just sharing my experience.)

I'm on Rainbow Light One-a-day Prenatal Vitamins. I'm also on 5000 IU of Vitamin D3 and refrigerated Now brand acidophilus. I plan on adding garlic tablets for immune boosting after the nausea is gone altogether, and possibly Floradix Iron + Herbs as I approach mid-pregnancy to reduce risk of anemia.

I have been taking a Pilates class 3 days a week (30 minute class) on and off for 4 years now. After finding out I'm pregnant, I've been far more diligent to attend whenever possible. My 6 year old and 8 year old daughters attend and take the class with me while the 2 year old and 5 year old are in babysitting at the gym. Considering that this is my 6th pregnancy in 9 years (5th live baby), I can't afford not to have good abdominal tone. When a mom's abs and uterus have been stretched from this many pregnancies, it can tend to make the abdomen hang and stretch even further late in pregnancy. This is a less favorable position for pre-labor and labor. I'd like to do what I can to keep strong abdominal tone for optimal positioning.

I'm also taking water aerobics 3 days a week (1 hour class), back-to-back after Pilates. That sounds really intense until you find out that I'm one of 2 non-senior-citizens in the water aerobics class. I would like to try to find a way to continue taking water aerobics throughout this pregnancy, if possible. I also keep thinking that I need to add in 2 days a week on the treadmill in between the water aerobics days. The reason I'm so focused on this is that my pregnancy where I took the best care of myself with diet and exercise was my easiest labor, delivery, and recovery of all of them. I realize there are many factors, but that's the point. There are things I can control, and things that are out of my hands. I may as well stack the deck to my favor with the factors I *can* control.

I'm not strictly following the Brewer diet, but I am shooting to eat a minimum of 80-100 g of protein daily as outlined by Brewer's recommendations to help prevent pre-eclampsia, PIH, IUGR, and other problems. As with the other things, there are more factors than just diet, but I'd like to do the best I can proactively. I use the meal tracker on free site babyfit.com to track my protein intake. (Let me know if anyone knows of a more user-friendly free online diet tracker and food database than that one.)

I'm finally starting to get my appetite back and I'm hungry frequently. I graze all day long, nibbling on little portions, rather than eating large meals at any point. This helps stabilize my blood sugar which is very sensitive during pregnancy (I'm not diabetic though). I carry food with me everywhere I go. Usually in my purse or diaper bag is a string cheese, whole wheat crackers, a Luna bar, a Kashi granola bar, a Larabar, a pear or apple and a small Tupperware of dry roasted almonds. I carry 32 oz of water with me everywhere I go. I never drink soda. I drink 100% juice (no sugar added) a few times per week.

I'm trying to be mindful of posture to promote optimal fetal positioning and encourage baby's anterior positioning for the future. My posture *now* does matter. I'm trying to sit up straight more, slouch less, sit on the exercise ball more, engage my abs more, and avoid slumping on the couch. I'm also trying to train myself to stop crossing my legs (really hard to stop!) since the pelvis narrows in the front when momma frequently crosses her legs, which can contribute to posterior positioning (and a longer, more difficult labor).

I got established with a chiropractor who specializes in pregnancy chiropractic and the Webster technique, for preventative care during this pregnancy, starting at 7 weeks gestation. I had moderate SPD with my 3rd pregnancy in 2006 and severe SPD with my most recent baby in 2008, so I want to do what I can to prevent it from becoming debilitating this time. Some SPD is hormonal and chemical in nature (relaxin and other pregnancy hormones) and there's little that can be done beyond management of SPD symptoms, but some SPD is positional. It's then that chiropractic can help prevent and/or treat SPD.

I would feel better telling you all this if I hadn't had a donut for breakfast and an ice cream sundae after dinner today. I guess it's all about balance. No ice cream tomorrow. Pilates, water aerobics, and real food instead.

Here I am at 12 weeks along. And yes, there's only one baby in there.

Wednesday, June 1, 2011

Coping tips for "morning sickness"

My personal stash of nausea remedies. Top row, l-r: Old Ballycastle Ginger cocktail mixer; The Ginger People Ginger Beer; Vita Coco coconut water; lemon juice; Gatorade; Barritts Bermuda Stone Ginger Beer; Middle row, l-r: ginger Altoids; Reed's Ginger Candy Chews; The Ginger People Gin-Gins hard candy; Buderim Ginger Bears; The Ginger People Crystallized Ginger; Bottom row, l-r: Crystal Light Pure Fitness; True Lemon, True Orange, True Lime; Earth Mama Angel Baby Organic Morning Wellness Tea.

It's funny. I posted this link by the InfantRisk center on safe remedies for Nausea and Vomiting in Pregnancy (including safe OTC medicines) the day BEFORE I got my positive pregnancy test in April. Then it became relevant.

I really feel badly for mommas who have severe nausea and vomiting in pregnancy, which is the official term for "morning sickness," since the symptoms can occur any time of night or day (or even non-stop). For many moms, symptoms will ease up on their own by around the 14th week of pregnancy, but a few have various degrees of nausea and vomiting until delivery.

Unfortunately, not much research has been done on the causes of nausea and vomiting in pregnancy (beyond knowing that it's a side effect of hCG and other pregnancy hormones), nor in available treatments. It may be a matter of trial-and-error to find something that will help you cope, because what works for one momma has no effect for another. What worked with the last pregnancy might not bring relief with the next pregnancy for the same woman. Whatever gets you through is the "right answer."

Here's a list of options that have worked for some moms (some of whom contributed on my Well Rounded Birth Prep Facebook page). I hope you find something that works for you.

General diet:
  • Healthy, well-balanced meals in general. 
  • Avoiding consuming liquids and solids at the same time.
  • Eating small meals more often (5 or more times per day) as opposed to larger meals 3 times per day. Some moms find relief eating small amounts almost hourly. Some issues with "morning sickness" are related to low blood sugar, and frequent small meals can help prevent this. A midnight snack can help if this is the case.
  • Avoiding greasy or fatty foods.
  • Reducing or eliminating refined sugar. Reducing dairy.
  • B complex vitamin supplement.
  • Keeping food by the bedside to nibble on before arising in the morning. Some moms swear that eating a cracker or half a cracker before arising was their salvation. Others find it doesn't make much difference.
  • Eating a low-fat or fat-free protein with a complex carb at each snack and meal when possible, such as string cheese with whole wheat crackers, or peanut butter with apple slices.
Foods and drinks:
  • Ginger in a variety of forms can alleviate morning sickness, heartburn, or reflux. Some options: Candied ginger, ginger gummy bears, ginger caplets or tablets for those who don't like the strong flavor, ginger Altoids, ginger hard candy, ginger chews.
  • REAL ginger ale or ginger beer (non-alcoholic) (most ginger ale is artificially flavored). 
  • Ginger tea, which you can purchase or make by steeping a slice of ginger root in hot water. One great brand of ginger tea is Earth Mama Angel Baby Organic Morning Wellness Tea with ginger root, spearmint leaf, chamomile, orange peel, lemon balm leaf, and peppermint leaf. 
  • Ginger syrup non-alcoholic cocktail mixer with real ginger. Can be mixed with seltzer water, Sprite, tea, or drink of your choice.
  • Crackers in many forms. Saltines, Wheat Thins, whatever works.
  • Gentle foods that you would eat when recovering from a stomach bug. Dry toast. Unsweetened applesauce. Bananas. Rice or plain noodles. Plain yogurt (lightly sweetened with honey, jam, or berries). Toasted whole wheat bagels. Chicken noodle soup. Broth. The same things that make good labor snacks.
  • Peppermints. Altoids. Mint hard candies or Tic Tacs. Mint gum.
  • Hard candies such as Lemonheads or cinnamons. Suckers. Preggie Pops.
  • Sour candies and foods. Sucking on a lemon. SweetTarts. Dill pickles and pickle juice. No joke. I've heard a few moms say they drank it straight up and it was the only thing that helped their morning sickness.
  • Decaf tea, hot or cold, unsweetened or lightly sweetened with honey. With or without a squeeze of lemon.
  • Lemon water (squeeze lemon wedge in water or use squirt of bottled lemon juice). True Lemon crystallized fruit wedge, also True Lime and True Orange. Eating powdered True Lemon straight out of the package may appeal to you if you find sour lemon soothing.
  • Beans. There's no research to back this, but some nutritionists say that legumes are the answer to helping the body absorb and eliminate the excess bile caused by hCG, which will alleviate or completely eliminate morning sickness. If you think about it, pharmaceutical companies are unlikely to fund or promote any research that could show that simple nutrition could help with morning sickness. There's no risk to trying to eat more beans to see if that helps; they're inexpensive, nutritious, and loaded with fiber and protein, which will help you meet the 80-100 g of protein expectant moms need daily.
  • Popsicles. You can make your own from juice, herbal tea, or fruit smoothies. Electrolyte drinks don't freeze well due to the salt content. Some moms find that popsicles, ice chips, or blended frozen drinks stay down more easily.
  • Electrolyte drinks, especially if you are becoming dehydrated from vomiting or from avoiding drinking due to nausea. Some options: coconut water (*not* coconut milk), Ultima Replenisher, Vitalyte, Crystal Light Pure Fitness, Gatorade, or make your own
  • Identify and avoid smells that nauseate you.
  • Avoid perfume, scented lotions, or fragranced soaps and shampoos if they bother you. Switch out your partner's and/or childrens' soaps or shampoos if they're bothering you. You can always switch them back after your nausea subsides.
  • Keep fragrances around that are pleasant to you. Some moms find mint, ginger, citrus (lemon, orange, or grapefruit), or chamomile to be soothing fragrances during morning sickness. Options: scented candles, sprays (body spray, linen sprays, room sprays), or essential oils applied to a cotton ball then double bagged in zip-top bags so you don't have to smell them unless you want to. Earth Mama Angel Baby sells a wonderful multipurpose Happy Mama aromatherapy Spray that may help.
  • If you have a toddler in diapers and it nauseates you to change poopy diapers, and if you can't find someone else to change him or her for you, it's OK to take them outside to change them so long as it's not subarctic temperatures out there. I've changed my poopy toddlers outside on a covered porch in too-hot or too-cold temps since I had everything ready and did it as quickly as possible. If I have to choose between that or smelling the aftereffects in my living room, I'm choosing the outside diaper changes.
  • If you can't stand the smell of food cooking, using the crockpot and plugging it in in the garage or basement is an option. Excellent for when you don't feel like eating but have to prepare something for everyone else, for when you're too tired in the evenings, or when the smell of cooking bothers you. Also good for those who are queasy earlier in the day but feel like eating by dinnertime. Your partner might be able to help you prepare the crock pot the night before and load it, ready to go, in the fridge, so that all you have to do is plug it in in the morning.
Other options:
  • Moderate exercise. Taking a walk. Getting fresh air.
  • Air circulation. A fan with a breeze pointing on mom's face.
  • A cool, damp washcloth applied to the face and/or neck.
  • Chiropractic can help alleviate morning sickness, and is extremely beneficial throughout pregnancy for many reasons.
  • Acupressure has been used for centuries to combat morning sickness. One simple way to try this is Sea-Bands which are sold in any pharmacy and are designed to prevent and treat motion sickness.
  • Acupuncture by a licensed practitioner can sometimes help.
  • Hazelwood necklaces. From Inspired by Finn: "Wood from the beaked hazel tree has the medicinal property of neutralizing the body's acidity, and helps the body create and maintain an alkaline balance. It is an ancient remedy first used by aboriginal people, and is effective for people of all ages... Beaked hazel wood can relieve acid-related ailments such as acid reflux, ulcers, heartburn, and other acid-related ailments. Our necklaces are a great remedy to take the edge off of heartburn and morning sickness during pregnancy."
  • If excessive salivation is an issue, it's better to spit it out than to swallow it, as swallowing it can exacerbate nausea.
  • Some moms find that homeopathics can help. Ask your care provider whether this is an appropriate option for you.
  • Some moms find that Vitamin B12 injections can help alleviate their symptoms for up to a week, for severe cases of nausea and vomiting. Ask your care provider whether this is appropriate for you.
  • Anecdotally, I hear moms say that when they are highly stressed and/or have a heavy schedule at work, their morning sickness is worse. Saying "reduce stress and work less" is easier said than done, but something to consider when looking at the big picture and possible options if morning sickness is severe.
  • Some moms report that when they have to get out of bed quickly in the morning, it makes them feel worse. For some, setting the alarm clock a bit earlier and hitting the snooze while snacking on crackers helps them acclimate. For others, letting natural sunlight in the windows helps awaken them gradually and gently. In any case, slowly rolling over, then slowly lowering legs to the floor, then slowly sitting up, slowly getting up and slowly walking to the bathroom may be less jarring to the body than hopping up suddenly when the alarm goes off.
Coping in the meanwhile:
  • Keep a few plastic bags tucked in your purse and in your car in case you can't get to a bathroom in time (or even pull over in time when driving).
  • Scout out where the nearest bathroom is wherever you go. This will come in handy when you have to pee on the hour anyway, even if you don't throw up.
  • Dehydration can lead to contractions and potentially preterm labor, so finding some way to keep some fluids down is crucial. Dehydration can also cause a urinary tract infection (which also causes contractions) and/or bladder infection which needs to be treated with antibiotics, which can lead to a yeast infection and gut flora imbalance. If dehydration is severe, your doctor or midwife may recommend an enema to help you absorb some fluids, or you may need to be rehydrated by IV. 
  • Prescription medications are available for moms with hyperemesis gravidarum (severe nausea and vomiting in pregnancy). Ask your doctor what meds are available, what the risks are vs. the benefits, and whether this is could be a viable option for your situation. In some cases, prescription meds are the only way moms with hyperemesis gravidarum can manage to keep any amount of sustenance down.
More links:

Nausea and vomiting in pregnancy-- (safe non-medicinal tips as well as safe OTC and prescription meds)-- InfantRisk Center

Help HER - Hyperemesis Education & Research Why HG is more than just morning sickness

The importance of staying hydrated while pregnant--Associated Content from Yahoo!

Common treatments for Hyperemesis Gravidarum-- Mothering Magazine

What remedy or combination of treatments worked for you? Or did nothing seem to help? Was it different with different pregnancies?

On seeing baby's ultrasound and uncertainty after loss

Trigger warning: This post is about coping with the emotions and issues of pregnancy following loss.

I've been getting really antsy lately to find out whether my baby is still alive. Judge me all you want, but unless you have lost a baby, you have no idea what it's like to wonder if your baby is dead or alive. I've had people judge my faith in God over this, telling me that I just need to have faith. How do they know how much faith I have or don't have? How much faith I have is irrelevant to whether my baby will make it.  I had faith in God when my Evan didn't make it. I had faith in God when my others did. I've even heard some say that by worrying about it, it's more likely to happen due to the Law of Attraction. Sorry, but I don't believe in that. Nobody deserves a miscarriage, attracts it, "asks" for it, etc.

Since my 2007 miscarriage was a "missed miscarriage," everything felt fine and normal. I had no symptoms of miscarriage (other than a dead baby). I had no cramping, no spotting or bleeding, no pain. I still had morning sickness. My uterus continued to expand and I was measuring on target because my womb was filling up with blood and amniotic fluid after my baby's death. I carried him around 6 weeks after he passed on, without having any knowledge of it until the next checkup when my midwife couldn't find the heartbeat.

For this reason, it has been no consolation to me that everything has felt fine and normal. It's not reassuring that I'm definitely showing. These "signs" didn't mean anything when Evan died.

I had my 10 week prenatal checkup this morning. I wasn't sure how long I would wait until asking to hear baby's heartbeat with the Doppler due to the small risk of possibly doing damage or causing miscarriage. I hoped to wait until I was at least in the 2nd trimester to reduce the risk since baby would be less fragile at that point, but I really wanted reassurance. I realize that listening in is only one moment in time and can say that baby is alive at that instant, but can't guarantee what will happen next week or next month. Nevertheless, I need to buy maternity clothes and I have been too scared to buy any for fear of taking the tags off then the baby might die and I would be stuck with the reminders.

The other midwife had taken the regular prenatal equipment bag on rounds today, so my midwife had the backup Doppler that only works half the time. It didn't work today. She hauled out an old monitor to try to listen in. Yes, a monitor, like a hospital monitor to listen to baby's heartbeat in labor. One monitor paddle is a Doppler, just in a different shape, but its flat shape made it impossible to angle downward into my pelvis to be able to hear baby's heartbeat. As a courtesy, my midwife offered to take a peek with her ultrasound machine. By this time, I already had my mind made up that I wanted to see/hear that baby is alive, so I accepted.

We saw ONE baby (not twins, despite how big people think I look for first trimester), right size for 10 1/2 weeks, with a heartbeat. That was reassuring, but not to the degree that I expected. I hoped to feel much better, perhaps even "back to normal." Maybe there is no such thing any more. Maybe it's just because we have no assurance of tomorrow. Knowing that my baby is "fine" today doesn't mean much since we're still in that first trimester when there's the highest risk of miscarriage.

I'm thankful for a good prenatal checkup today (all other measurements and markers were perfect as well), but I'll feel much better when I feel baby's movements. I pray that I'm blessed with a squirmy, active baby who makes his or her presence continually felt sometime in the next month or month and a half.