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10
Most Frequently Asked Questions about |
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By
Bonnie Berk, RN, BS, CES, CPFT, CYI |
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Over the past twenty years, I have received questions from pregnant women and new moms on virtually every subject concerning pregnancy, childbirth and recovery. The following are the ten (10) most frequently asked questions as well as my responses. Please contact me if you have any additional questions or concerns. 1. I just found out that I am pregnant and feel tired all the time. Is there anything I can do to have more energy? The human body is truly amazing. During the implantation phase of pregnancy, and in the early weeks, baby's development is fragile. Nature's way of protecting the baby as well as the reproductive process is to produce hormones that tend to make us feel tired. Being an action-oriented society, it is difficult for us to accept the need for additional rest. In this case, however, rest is actually the best medicine. Adequate rest allows for more glucose to go to your baby to fuel growth and development. Plan to rest at least 30 minutes during the day. In the early months of pregnancy, just putting your feet up is a treat. In the second and third trimesters, try to lie on your left side for optimal blood flow to your baby. In addition to resting more frequently, I recommend eating small, frequent, well-balanced meals. By keeping your blood sugar at an even level throughout the day, you will have more energy for both yourself and the growing baby inside of you. Eating a good breakfast will fuel your body and keep your metabolism functioning optimally. Be sure to include iron-rich foods in your diet like spinach, raisins, red meat and fortified cereals. Some women experience iron deficiency anemia during pregnancy. If your fatigue persists, check with your health care provider and ask to have a blood test to check your iron levels. Inadequate hydration contributes to fatigue. Be sure to drink at least (8) glasses or more of water a day. And limit caffeine consumption, which will add to your lethargy. Caffeine initially is a stimulant, however, once the effects wear off, you become more tired. Mild exercise also helps to increase energy by improving circulation and bringing more oxygen to your muscles. Try to incorporate exercise into your daily routine. Here are some ideas:
2. Is it safe to exercise during pregnancy? Not only is exercise safe, it is an important part of a healthy pregnancy. Ideally, a woman exercises before pregnancy, continues throughout the pregnancy and resumes exercise postpartum. However, if you did not perform regular exercise prior to pregnancy, you can still begin an exercise program preferably one that is designed to meet the special fitness needs of pregnancy. In both cases, it is important to receive medical clearance and not exercise to the point of fatigue. Walking, biking, swimming and attending prenatal fitness classes are all good ways to exercise during pregnancy. Be sure to monitor your heart rate during exercise. Your heart rate should not exceed 70% of your maximal heart rate. To find your maximal heart rate, calculate 220-age. Then multiply by 70% to find out what your upper limit is. If you have any difficulty breathing during an exercise session, stop exercising and report the incident to your health care provider. Chances are you just need to decrease the exercise intensity. While performing moderate intensity exercise, you should be able to talk. This is a sign that you are taking in enough oxygen for both your self and your baby. It is also recommended that you avoid exercising on your back after the first trimester of pregnancy or (12) weeks. Exercising on your back may decrease blood flow to your baby. In addition to aerobic exercise, you can safely practice resistance exercise provided you do not hold your breath or perform the valsalva maneuver while exercising. The valsalva maneuver is when you hold your breath and bear down while increasing pressure in the abdomen. The key is to breathe comfortably throughout the exercise session. Strengthening exercises for the torso help prevent low back problems. If you are used to working out on resistance machines, go for low weights and higher repetitions. Stretching is an important part of any well-rounded fitness program. It helps to prevent injury to both the knees and low back as well as for overall muscular health. Be sure to stretch your hamstrings, buttocks and low back after each exercise session. The Motherwell® Home Exercise Video is a
wonderful resource for ideas on what exercises to include in your regime. Visit www.motherwellfitness.com
for more information. Before starting any exercise program, always consult your
health care provider. 3. What are some ways I can minimize excess weight gain during pregnancy? Gaining weight is inevitable when you are pregnant. However, how much weight you gain depends on the amount of food your consume and the amount of activity you engage in on a daily basis. The recommendation for the average pregnant woman, is 25-35 pounds. If a woman begins pregnancy already overweight then she should gain less. If she is underweight to begin with, then she should probably gain more. Consult your health care provider for what is an appropriate weight gain for you. Nutritional requirements increase during pregnancy, but that does not mean you need a whole lot more calories. In fact, think of adding nutrients rather than calories. But keep in mind that a pregnant woman should consume a minimum of 1800 calories a day. In pregnancy, you should eat (4) servings of protein a day including fish, chicken, beef, beans, eggs and nuts. Samples of one serving include a 4oz. Piece of chicken or steak, one egg, ½ cup of beans or nuts. Some practitioners recommend eating at least two eggs a day. Eating foods high in protein will help curb your appetite as well as regulate your blood sugar. Calcium needs are increased during pregnancy so you should eat at least (3) servings a day of high calcium foods like milk, cheese and yogurt. Choose low-fat options. In fact, skim milk has actually more calcium than whole milk. One serving is one (8) oz. glass of milk, one slice of cheese and one cup of yogurt. Avoid eating soft cheeses since they sometimes harbor bacteria that may be unsafe for pregnant women. If you do not eat milk products, soy and rice milks are good substitutes as well as tofu. Consuming (3-5) servings of vegetables and (3) servings of fruits a day will add to a healthy pregnancy. Include a green leafy vegetable like broccoli or spinach as well as a citrus fruit, like an orange or grapefruit, on a daily basis. If you are concerned with gaining too much weight, limit your intake of bread, pastas and potatoes. These foods tend to raise the blood sugar and send signals for your body to store more fat. Instead, eat no more than (6-9) servings of yams, whole wheat bread, brown rice or high fiber cereals a day. One serving is either one small yam, a slice of bread, ½ cup of rice or 3/4 cup of cereal. Check labels for fiber content in your foods. The higher the fiber the better. Pregnant women have slowed digestive tracts. Fiber helps digestion as well as elimination. Aim to consume about 24 grams of fiber a day. For optimal health, drink at least (8) glasses of water a day. Adequate water intake will make you feel better, give you more energy and help curb your appetite if you find you are eating too much. Some additional tips:
4. I've had back problems in the past and want to avoid additional problems during pregnancy. Do you have any suggestions? During pregnancy, the s-shaped curve in the back is accentuated. This puts increase stress on both the upper and lower back. Using good body mechanics in everyday activities will help prevent back problems. When lifting objects from the floor, avoid bending from the waist. Instead, step one foot forward and bend your knees to reach down. Avoid lifting heavy objects. Every morning when you get up, look in the mirror and stand in good posture. Keep the legs a hip-width apart, bend your knees slightly, keep a neutral position in the spine, align your shoulders under your ears and tuck the chin in so the head is well supported by the torso. Periodically throughout the day, remind yourself to do a "posture check." To keep the low back flexible and strong, get in to a table-top position with your arms under your shoulders and hips above knees. Take a breath and as you exhale, tighten your belly, round your back and tuck your chin in toward your chest. During the inhale, release the stretch and come back to the table-top position. Repeat for a total of twelve (12) times and then rest. When your back feels tired or achy, this exercise may also provide relief. Sometimes, pregnant women experience "sciatica". Typically, the discomfort comes from pressure on the sciatic nerve that runs through the sacrum at the base of the spine. The cause is frequently from the baby pressing on the sciatic nerve. It can also be due to a bulging spinal disc pressing on the nerve. There is usually a sensation of pain down one or both of the legs. The best position to relieve this discomfort is in a knee chest position. From the table-top position described above, lower the upper body and rest on your hands. This will take the baby off of the nerve and provide relief. While sleeping, stay on the side opposite to the side where you are experiencing any discomfort. Mild to moderate exercise helps to prevent and/ or relieve back discomfort. Walking, swimming and stretching will keep your back strong and flexible. The abdominal muscles support the low back so having strong abdominal muscles will also help. Sitting in a comfortable position, place your hands on your belly. As you inhale, expand the belly and as you exhale, pull the bellybutton toward the spine. Repeat this exercise at least 20 time a day. If you continue to have back discomfort that interferes with your ability to perform daily activities, consult your health care provider for other options including physical therapy and chiropractic care. 5. What is the Kegel exercise? Dr. Kegel was a urologist who noticed that weak pelvic floor muscles as a result of childbirth caused women to experience leaking of urine when they coughed or sneezed. He developed an exercise to help prevent and treat urinary incontinence in these women. Strengthening these muscles during and after pregnancy will help prevent urinary incontinence as well as improve blood flow to the perineum. After delivery, performing the Kegel exercises will help the pelvic floor muscles regain their elastic tone and help heal episiotomies. It can also enhance the lovemaking experience. Now, that's motivation! To perform Kegel exercises, sit comfortably on a chair and lean forward to feel your sit bones on the chair. Take a breath. As you exhale, imagine touching your vaginal opening to the inside of your belly button. Inhale and relax. Repeat for a total of 100 Kegels a day. It sounds like a lot, but try to practice at convenient times like when you are stopped at a red light, watching TV or during love-making. 6. Will sex during pregnancy hurt the unborn baby? Assuming you have no restrictions during your pregnancy, sex will not hurt the baby. One Obstetrician tells his patients they can have sexual intercourse up until labor as long as the baby's head doesn't get in the way! It is important for you and your partner to remain intimate throughout your pregnancy, however sexual intercourse is not the only way to express your love for each other. Hugging, kissing and just cuddling can be very satisfying. Mutual masturbation is also an option. Communication is the key for maintaining a positive relationship with your partner during pregnancy and after childbirth. Having a baby can be a very exciting time in both of your lives but can also put a strain on your relationship. Tell your partner what your wants, needs and desires are and encourage him to do the same. Concern for each other's welfare goes a long way during times of stress. After the baby is born, at least by the six week check-up, find alone time with your partner. If you can arrange it, make a date on a regular basis to spend time together even if it means taking a walk together or going food shopping. Your love made a beautiful baby. Be sure to nurture your relationship and everyone will benefit. 7. What's the best way to prepare for Labor and Delivery? Learning to breathe diaphragmatically is the most important tool for preparing for the labor and delivery experience. This means that when you inhale, you fill the lungs with air and expand your belly allowing the diaphragm to drop into the abdominal cavity. As you exhale, the diaphragm will rise and the belly will contract. To practice this breathing, sit comfortably in a chair and place one hands on your chest and one hand on your belly. As you inhale, fill your lungs and move the air down to the lower lobes of your lungs by expanding your belly. As you exhale, contract the belly, pulling your belly-button toward your back. Try to breathe a little slower and a little deeper each time you practice. Spend at least (5) minutes every day practicing this breathing technique. Breathing with your diaphragm will also help you in times of stress or uncomfortable situations. There are so many things that we cannot control. What kind of labor we have is one of them. Birth plans can help you decide on choices you have during the birthing experience. However, you need to be flexible. Childbirth is an experience of "letting go." Physically, your body needs to allow the baby to be born. Emotionally, you need to be ready for all possibilities. You can't always control what happens to you, but you can control your reaction to it. Practice relaxation breathing to reduce stress during pregnancy, calm the mind and body during childbirth and meet the challenges of caring for a new baby. 8. How will I know if I have enough milk to feed my baby? The greatest concern for breast-feeding moms is whether the baby is getting enough milk. The easiest way to know is to count the number of wet diapers. A baby should wet at least 6 diapers per day. If your baby is not wetting at least that many diapers, then you should discuss this with your baby's doctor. Your fluid intake is the most important factor in producing breast milk. Be sure to drink at least 8-10 glasses of water a day or more if you are thirsty. Try to drink a glass of water with each meal and each time you breast feed to replenish your fluids. 9. How soon can I resume exercise after delivery? You can start to exercise as soon as bleeding stops and you have clearance from your health care provider. In the early weeks, taking your baby for a walk is the best way to start out building your stamina. Try walking at a comfortable pace 10-15 minutes and then increase to maybe twice a day. For general fitness as well as weight loss and weight maintenance eventually try to walk 30-45 minutes a day at a pace that you are able to talk but not able to sing. You don't need to go to a gym or buy special equipment in order to exercise. In addition to taking your baby for walks, put music on and dance with your baby. Babies love the movement and studies suggest that moving to music stimulates brain development in the newborn. It is important not to do too much too soon. If you feel fatigued after exercise or start to bleed vaginally again, then you need to slow down and decrease the intensity of your exercise session. Special exercise classes for new moms and their babies are excellent ways to get back into shape and network with other new moms. Postpartum is a time for your body to recover from pregnancy and childbirth. It is also a time for adjusting to a new baby. It may take (6-9) months before you resume your pre-pregnancy shape. By exercising regularly, eating sensibly and resting as needed, you will be able to meet the demands of motherhood feeling good and staying healthy. 10. I just had a baby and feel totally consumed with baby care. How do women find time to do anything for themselves, let alone exercise? There's nothing like a new baby to make you feel totally disorganized. Just taking a shower can feel like a monumental accomplishment! Get into the habit of scheduling at least 30 minutes a day for your self. It could be during one of the baby's naps or when your partner comes home. Try not to be too hard on yourself about housework. Put well-meaning friends and relatives to work. When people come to visit, ask them to vacuum, put a load of clothes in the washer, prepare a meal or watch the baby. Use your time to either take a walk, sit in the bath, read a magazine or just catch up on some rest. Taking a daily break will give you more energy to care for your new baby and put you in a positive frame of mind. If you are having a hard time finding time for your self, try this: Get a calendar and hang it on your wall or refrigerator in clear view. For the next day or two, plan a (30) minute window of time that you could possibly take some time for your self. Think about who might be able to watch the baby and what times they are available. Consider the usual times that baby naps. Talk to your partner and find out when he is available to care for the baby. On the calendar, mark the days and times you end up choosing for yourself. Then, on a piece of paper, write all the things
you would like to accomplish in the next several days. This is your "to
do" list. On another piece of paper, make three columns. On the top of the
first column, put an "A, "on the second a "B" and on the
third a "C." Then, prioritize your "to do" list. If it has
to be done today, put it in the "A" column. If it can wait a day or
so, put it in the "B" column. If it could wait for a week or more,
then put it in column "C." THE BEST WAY TO PREDICT THE FUTURE IS TO PLAN IT!
For more information about this and other subjects
related to preparing for childbirth,
Copyright 2005 Bonnie Berk, Inc.
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