Exercise during pregnancy is definitely worth fitting into your schedule. You may want to hold off, however, on running a marathon or climbing Mt. Kilimanjaro. Walking, swimming, aerobics, and yoga, among other activities, will tone muscles, reduce stress and get your heart rate up a bit – always a good thing for you and your baby. We suggest taking your pulse every so often when exercising or purchasing a heart rate monitor to make sure that pulse doesn’t exceed 140 beats for an extended period of time.

Some women worry that strenuous physical activity will cause miscarriage. No scientific study has ever proven this to be the case. As mentioned, pregnancy is not a time to begin heavy-duty training, but it’s definitely not a time to stop using your muscles.

Another common belief is that exercise or other strenuous physical activity will initiate preterm labor.  Occasionally this can happen. If activities do result in labor symptoms, stop the activity and consult your healthcare provider.

Here are some thoughts to keep in mind while engaging in activities that require more physical exertion. Sports: Running, jogging, aerobics, bike riding, and other active sports can cause problems for some women. If you feel any symptoms, talk to your provider. Climbing stairs: If you find that several trips up and down the stairs each day brings on preterm labor symptoms, try to organize your tasks so that you make fewer trips, say one trip up and one down per day. Heavy lifting: Carry groceries or laundry baskets or toting heavy toddlers can start symptoms. If any load feels too heavy, ask someone to help you.  Instead of carrying your toddler, put her in a stroller, sit with her in your arms, or ask her to walk. Heavy housework: Scrubbing floors, washing walls or any other strenuous activity may have to wait until after the baby is born. Consider sitting when you iron or food clothes or even cook. Thankfully, most women will not experience preterm delivery. Preterm contractions, on the other hand, are frequent and something you should be aware of after your twentieth week of gestations. They do not necessarily mean that you need to stop exercising completely. Adjusting intensity and duration may be required. Your healthcare provider can help you work out a plan that’s best for you.

Wouldn’t it be nice to blame our moods on hormones? But moods are not dictated strictly by hormones. This belief is a myth.

Just think about it. Too many factors in life affect our moods. As one group of researchers pointed out in 2008, social, psychological, behavioral, environmental, and biological forces are all at work within a person, influencing how her or she responds to major life events, as well as daily events. In addition, stress, family and genetics can affect your pregnancy, your health and your moods.

Here are some points to consider regarding moods during pregnancy.

• Moods can affect those around you. If you notice that your spouse or partner is mirroring your moods, try a change of venue. It’s always our hope that you will stay open to talking about problems, fears, and other issue with your partner, family and friends, as they may have helpful advice or just gentle reassurance that all is well.
• Rest assured that your anger, happiness and fatigue usually will affect only you.Although you and your baby are one, you also are separate. Unless you or someone else is physically putting you in harm’s way, there is little that you can do to hurt your unborn child.
• A certain amount of anxiety accompanies pregnancy. If your worry and anxiety start interfering with your daily life or are so consuming that you think of nothing else, then you should meet with a professional who can help you reduce these stressors. As with most other times in life, severe anxiety will increase pain levels, which certainly is not desirable during labor. Women who have educated themselves about the labor process and who have good social support tend to have lower amounts of pain, and this may be due to decreased levels of anxiety.

If you have difficulty dealing with your moods, consult your health care provider. Often, there is more than one way to deal with depressive symptoms, anxiety, fear, stress and other overwhelming moods.

 

I doubt there is much more a discussion generating topic in obstetrics right now than that of natural childbirth.  It seems like this is the rally cry for those activists that hate everything about the medical system.  The unproven gesticulations and pandering that are oft empty and yet they cause discord amongst many women.

In my earlier days I was teaching a childbirth education class at Reynolds Army Community Hospital.  The purpose of the class was pain management in labor.  I had set a number one on the floor and then on the other side of the room I placea number ten.  I then asked the women who were definitely planning a medication free delivery to stand on the one and those definitely planning an epidural to stand on ten; those in the middle to arrange themselves accordingly.  I was a bit suprised back then when all but one of the 15 women aligned themselves on the side of the room with the number one, no pain medication.  Call it my naievity or the fact that I was projecting the fact that I would want pain medication in labor.  Either way, I was being educated that there was  force at work here and I needed ot listen to it.

On the social media sites like Twitter and facebook that are countless doulas, birth activists, midwives, lawyers, pre-law students, SAHM, and others that are saying that we (modern medicine) are wrong for treating pregnancy like we do and that it is not a disease process.  I couldn’t agree more, but the mere fact that I am an OB-GYN makes these activists cringe when I agree with them.  The fact of the matter is most OB-GYN’s would agree with this statement and they are simply taking one side of the story and making grand generalizations.  You can’t make a woman take narcotics or an epidural.  Can you intimidate them or convince them to have an epidural?  Again, I doubt in most cases that there is any kind of intimidation and that most of these women are desirous to have the epidural but might be afraid because they would feel like a failure to this group of birth acitivists.  I would agree that the more invasive we become in labor the more we can increase the negative outcomes and that is why I do what the patient desires.  My induction rate is not reflective of my desires, bit of those of my patients.  My repeat cesarean section rate again is the decision between my patient and myself.  it is ludicrous to think that anyone is trying to manipulate patients into doing something they don’t want to do, and if a physician is indeed doing this then there are medical boards to look after them.

Natural childbirth is no myth.  it is a wonderful process that the many in the medical community embrace.  I want my patients to feel empowered and that they always have the first and last say in what happens to their bodies.  I ask them not to laminate their birth plans and to try and be flexible with themselves and I will be flexible with my paradigm.  it is all about teamwork not fear.

Meditative Exercise for Pregnancy

Baby Breathing©

Excerpt from upcoming “Spiritual Pregnancy” copyright 2010 Shawn Tassone and Kathryn Landherr

Shawn Tassone, MD and Kathryn Landherr, MD

http://www.handsoffmybellyguide.com

This exercise will bring you and your baby together through the breath of life.  In this exercise you will be bring guiding your breath through your lungs and circulatory system into that of your baby and then the baby will give you its waste and carbon dioxide to exhale.  Remember, you are currently one unit functioning as two beings.

Bring yourself either into a sitting position or lying on your left side with a pillow placed between your knees.  The goal here is to be as comfortable and weightless as possible.

Focus on your breath

This very breath, right now will soon be the oxygen that feeds your baby

Focus on relaxing your belly and take in a deep breath

With the next breath imagine this oxygen filling your lungs and entering your heart

With the next breath imagine this oxygen travelling into your bloodstream and heading downward towards your belly.

Once in the aorta the blood will pump towards your uterine arteries and begin filling the uterus with this oxygen rich connection.

Imagine the uterus as light and energy, warm and pulsating. The pulsations coming from you, surrounding your baby with the sounds of your heart and love.

With the next breath allow the oxygen to pulsate into the placenta filling it with the same love and warmth.  Imagine the placenta filling with each individual breath.

When the placenta is full of love, energy and oxygen allow it pass into the umbilical vein coursing towards the baby.

As the umbilical vein fills with oxygen rich blood notice how it bypasses the baby’s lungs (as this breath comes from you) and proceeds to your baby’s heart; the heart that you created.  Even inside this little heart is able to take the baton from you and send your oxygen rich gift throughout its own body.  As the baby’s body uses the oxygen rich love you have sent allow the baby to let go of carbon dioxide and other wastes and give them to you.  Let your baby know you want this and surround it with the acceptance that you are taking care of everything as only a mother can do.

This blood now courses into the umbilical arteries by the pumping of the baby’s heart in cadence with yours and enters the placenta.  With the next exhale now imagine that blood crossing the placenta and entering your vena cava on its way back to your heart.  This blood carries the elements and traces of your baby, this blood has touched every one of your baby’s cells.

Once in the heart this blood now pumps into the lungs and on the very next exhale feel the breath that has been inside your baby.  Notice how every breath has the scent of your child and the connection between the two of you.  Allow yourself to stay in this place until your are done and then slowly open your eyes and realize you are always in contact with your little one.

Earth:

Earth – the grounding the earth pushing back up on you.  This is where the sperm and the egg come together to form the human body.  The body is carbon based and the earth is carbon based.  As the baby moves inside of you it causes movement upon the earth.  The symbolism of the earth being a round egg similar to the maternal egg and how everything comes from that one cell.  We start from the earth and return to the earth.  I like to practice an earth meditation where you simply lie upon the ground and allow your skin to touch the ground beneath you and try to feel the pulsation of the earth.

Connect with the Earth underneath you.  Go out into nature and within a safe place, lie on your left side and allow your bare pregnant belly to touch the ground.  Allow the baby to be supported by the Earth as are you.  If the baby is moving, envision his or her little feet pushing against the Earth through your belly.  One other option is walking a labyrinth or engaging in a walking meditation where every footstep you repeat the name of your unborn baby; if there is no name then choose some other mantra that fits.  You also want to look at your connection with the Earth and the foods that you eat.  You receive vital elements like magnesium, calcium, and iron from the foods you consume; these food provided to you by the sun, water, and Earth.

Fire:

Fire – synonymous with the heat and pulsation of the blood.  Fire is a cleansing element and is also associated with the raw unpredictable power that can be translated to labor.  Fire is unpredictable like the hormones that are powerful messengers flowing through her blood.  The blood itself being red and rich with oxygen carries vital power to the baby through the placenta and umbilical cord.

A special ceremony involving the unpredictability of fire is allowing the flames to consume your fears.  There is an unpredictability to becoming a mother, whther for the first or fourth time.  Take time to write those fears on separate pieces of paper and after writing them down place them into a paper bag or some other parchment and close them up sealing them away from you forever.  In a safe place (preferably outdoors) light a candle or start a fire.  I would recommend a real fire and not some butane induced simile of a fire.  Once the flames are well underway take your bag of sealed fears and burn them in the fire watching as the smoke rises into the atmosphere.  Envision those fears are being shared with the fears of all the other expectant mothers creating a maternal bond that cannot be broken

Water:

Water – obviously water is symbolic for the amniotic fluid.  The amniotic fluid is made mainly from the fetal waste, but it also carries chemicals that are responsible for the maturation of the baby’s lungs and it protection and cushions the fetal bones and umbilical cord.  The baby breathes amniotic fluid late in the second trimester as it practices its own breathing technique.  The amniotic fluid can be increased if the woman is well hydrated because what she drinks will go through to the baby and thus if she is increasing her fluid volume it translates that the baby will urinate more and increase the amniotic fluid.

There is a never-ending support that can be formed by water.  The baby is supported in a weightless type of environment and the fluid is just as essential as the oxygen for development.  Plasma makes up the matrix for the red and white blood cells and we all need water to survive.  If you have the benefit of a heated pool or hot tub you can try to warm the water to 99 degrees and submerge yourself in the warmth of the weightless water.  Feel what your baby feels in this warm environment provided by your warmth and love.  Envision that you were also once in this environment and were provided this luxury by your mother and how you are connecting to the eons of mothers that have come before you.

Multiple Births: Myths and More

By Shawn Tassone, MD and Kathryn Landherr, MD

Multiple births are on the rise in the United States. Twenty years ago, the number of twins born in this country was 90,118; in 2006, that number increased to 137,085. This increase is a result of fertility drugs, medical technology that is used to “save” high risk pregnancies, and women bearing children at older ages. Approximately 35 percent of pregnancies that occur from the use of fertility drugs result in multiple births. Of course, a woman can naturally conceive twins, triplets or quadruplets, particularly if she is:

• Over age 35
• Has a history of multiple births on her side of the family
• Is of African descent
• Has had one previous multiple pregnancy

Myths have always surrounded the topic of multiple pregnancies and births. Following are some statements and beliefs that we frequently encounter in our clinic.

• The majority of multiple births come from infertility treatments.

Believe it of not, this statement is false. The majority of multiple births occur   naturally.

• You can’t breastfeed multiples, or if you do, you must never supplement with or use a bottle.

Another false statement. You can breastfeed twins and you can use a bottle.

The logistics of breastfeeding twins is a good conversation to have with a  lactation specialist.

• There’s a good twin and a bad twin in every pair.

Maybe in movies and books this tends to be true, but not in real life.

• Multiples are always born by C-section.

Although the chances of having a C-section increases with a multiple  pregnancy, the procedure is not always required. If conditions are favorable,  many doctors are willing to try a vaginal delivery. In fact, obstetricians even  have a lower C-section rate with twins than with single births.

• Twins have ESP.

There are no hard facts to prove that twins are more psychic than others.  This is more the stuff of movies and fiction.

Famous People With a Twin

• Mario Andretti, race car driver (twin brother Aldo)
• Montgomery Cliff, actor (twin sister Roberta)
• Vin Diesel, actor (fraternal twin brother Paul Vincent)
• Joseph Fiennes, actor (twin brother Jacob)
• Andy Garcia, actor (parasitic twin brother removed from Andy’s shoulder; died soon after)
• Jon Heder, actor (identical twin brother Daniel)
• Scarlett Johansson, actress (twin brother Hunter)
• Ashton Kutcher, actor (fraternal twin brother Michael)
• Alanis Morissette, singer (twin brother Wade)
• Elvis Presley, singer (twin brother Jesse Garon died at birth)
• Isabella Rossellini, actress (twin sister Isotta Ingrid)
• Curtis Strange, pro golfer (identical twin brother Allen)
• Kiefer Sutherland, actor (twin sister Rachel)

There are so many men out there that have this strange fear that they will poke the baby in the head if they have sex with their significant other.  This is actually one of the funnier myths out there, and it is funny for a couple of reasons.

First of all, the baby is protected by the amniotic fluid, uterine tissue, and finally the cervix.  While the penis is hard it is hardly something sharp and destructive and the cervix is actually about as firm as the penis so if anything women might get vaginal bleeding from the cervix after intercourse.  I think the myths comes from the fact that men have this fascination with their penis’ and the fact that they think it is so long that they will actually be able to hit a baby that is 14 inches away in most cases.  It is also obvious that men have absolutely no conceptual understanding of the female anatomy or the potential anatomy of the pelvis.

TO ALL THE MEN, the female body is made so this type of trauma will not occur and so sex can be an enjoyable part of life even during pregnancy.  In 99.9% of cases the penis is directly pointing at the baby and in fact it is moving past the head of the baby because of the vector of the vagina and the way that we are all made.  Even if it is a straight shot I would say that we all need to be a bit more realistic about the size and length of the penis and the fact that it is not a vorpal weapon that will cut through anything it encounters.  The penis is a soft tissue organ and it is made that way for a reason, although Viagra commercials would have us believe that it needs to be erect 24/7.

Sex is good during pregnancy unless you are specifically told by your physician or caregiver that you need to refrain.  Occasionally, you might be placed on pelvic rest because of placenta previa or premature contractions.  The male semen has a chemical called a prostaglandin that can make the uterus contract.  So, unless you are specifically told not to have sex, go ahead and enjoy your body, either pregnant or not pregnant.  If he doesn’t want to have sex with you because he fears that he is going to poke the baby then give him an anatomy lesson and bring him back to reality.

I have been hanging out with some folks that simply have tons of questions regaridng pregnancy and I am stunned at the misinformation that is floating around out there.  One particular thing that seems to be very prevalent is that so many pregnant women believe in the “mucous plug”.  There is quite a bit of mythology surrounding the plug itself, but the main tenet is the belief that if you experience the mucous plug coming out of you then delivery is not very far away and this can either cause elation in the overdue woman or fear in the preterm woman.  Here is the real story.

Think of the cervix as a 2-3 inch cyclindrical tube with a very small canal that opens on one end into the vagna and on the other end into the uterine cavity.  The end of the tube that connects to the uterus is plugged by the bag of water or amnion that is resting up against it, but the end opening into the vagina is always opened or at least partially opened.  The lining of the cervix is row after row of cuboidal cells that secrete mucous all day long.  Because in many women the cervix is closed there is potential that the mucous could build up into a small quantity and then be expelled as it overflows.  Progesterone will make the mucous thick and gum like while estrogen will thin it out and make it more watery.  The point here is that the mucous can go from thick to thin and can come out of the cervix at any time and it is produced by the cervix on a continuing basis.  It is also not indicative of cervical change or impending labor.  There are those that would try to argue that the cervix will release the mucous “plug” when your cervix dilates, but again the mucous is being continually made and mixes with vaginal discharge that increases in amount over the course of the pregnancy.  The combination of mucous and discharge can seem like a large amount and I am sure that some women that have seen this discharge have also gone into labor soo afterwards.  I bet there are many women out there that had their babies hours after watching the news, but we don’t think the news is a sign of impending labor, because it is on every night.

The moral of the story is to take what you hear with a a grain of salt and write it down on your list of questions to ask your doctor.  I hope your doctor has not been bamboozled by the cervical mucous myths and is able to reinforce that you are making mucous and unless there is blood or significant amounts of thin fluid like urine there is nothing for you to worry about

Occasionally I will browse through Yahoo Answers and look at some of the questions as they will discuss common misconceptions and myths.  I found this hilarious post this morning posted by Bombshell and Baby.  The post captured the crazy atmosphere and recommendations that pregnant women are exposed to and I felt it was a reason why we wrote and titled this book.  I hope you enjoy this Pregnancy Manifesto

Dear Non-Pregnant Person,

I hope you find these guidelines helpful in your interactions with pregnant women as failing to follow them may result in serious physical harm. If you are thinking, surely she doesn’t mean me- then you should probably read this twice.

1) The appropriate response to a couple telling you they are having a baby is ‘Congratulations!’ with enthusiasm.

2) Through the wonders of science, we now know that babies are made ONLY by the mother and father- not grandparents. Unless the baby is in your uterus or you are the man that helped put it there, you may not ever use the phrase ‘my baby’.

3) On the same note, unless you made the baby as defined in 2, the pregnancy, birth and raising of the child are not about you. You do not have input. No one wants to hear your opinion unless they ask for it…

4) The body of a pregnant woman should be treated the same as any other body. You would not randomly touch someone’s stomach if they were not pregnant, nor would you inquire into the condition of their uterus, cervix or how they plan to use their breasts. Pregnancy does not remove all traces of privacy from a woman.

5) Likewise, no woman wants to hear comments on her weight…ever. A pregnant woman does not find it flattering that you think she is about is pop, must be having twins, looks swollen or has gained weight in her face. Telling her she looks too small only makes her worry that she is somehow starving her baby. Making such comments invite her to critique your physical appearance and you may not act offended. The only acceptable comment on appearance is ‘You look fabulous!’.

6) By the time we are 20-30 years old, most of us have picked up on the fact that the summer is hot. We are hot every summer when we are not pregnant. We don’t need you to point out that we will be miserably hot before the baby comes.

7) There is a reason that tickets to Labor & Delivery are not yet sold on Ticketmaster. Childbirth is actually not a public event. It may sound crazy, but some women really do not relish the idea of their mother, MIL or a host of other family members seeing their bare butt and genitals. Also, some people simply feel like the birth of their child is a private and emotional moment to be shared only by the parents. You weren’t invited to be there when the baby was created, you probably won’t be invited to be there when it comes out either.

Like everything else in life, unless you receive an invitation, you are NOT invited. This includes doctor appointments, ultrasounds, labor, delivery, the hospital and the parents’ home. You do not decide if you will be there for the birth or if you will move in with the new parents to ‘help out’. If your assistance is desired, rest assured that you will be asked for it.

9) If you are asked to help after the birth, this means you should clean up the house, help with cooking meals, and generally stay out of the way. Holding the baby more than the parents, interfering with breastfeeding and sleeping schedules and making a woman who is still leaking fluid from multiple locations lift a finger in housework is not helping.

10) The only people entitled to time with the baby are the parents. Whether they choose to have you at the hospital for the birth or ask for you to wait three weeks to visit, appreciate that you are being given the privilege of seeing their child. Complaining or showing disappointment only encourages the parents to include you less.

We have done numerous phone and television interviews for this group, and it seems there is a common question, “Why did you write this book?”.  It’s a good question since there are hundreds of pregnancy books on the shelves and at least 100 New Releases on Amazon for Pregnancy (we are ranked #16).

The main reason for writing the book is that we felt there was a gap in the database for pregnant patients.  Some of the books out there are confusing in their information and some of them really don’t address patient concerns.  So, we wanted to write something that would be fun to read an at the same time give the reader a wealth of hard to find information.  We also wanted to write something that could be added to in the future.  As we sat down to look at ideas, there was a consistent theme that we felt the best way to go about things was to answer patient questions that we discuss almost daily in the clinic.  Many of these patient questions also seemed to be based on either some sort of fear or a misleading piece of information given to them by a family member, friend, or even complete strangers.  With the concept of pregnancy myths and our load of patient questions we set out to write the book.  There are some pregnancy myths regarding fetal gender that almost everyone has heard of, but we are receiving more and more daily from people that are asking questions about things friends and family have told them.  ”My grandmother told me that I shouldn’t reach for the dishes because if I reach above my head the baby’s cord will get wrapped around its neck.”  Needless to say this causes anxiety and has a patient standing on her head to try and wash her hair for fear of putting her hands above her head.  You can see where this would cause an educated person to think twice and we were hoping that we could help disseminate truthful information and present it in a manner that will benefit the most women.  

So the book is more of a companion guide to some the books already out there.  It is not made to replace any particular book, but it can fit nicely onto your shelf amongst your other pregnancy books or it can be given as a gift to your friend that is pregnant.  We are hoping that women will come to the website and talk about there pregnancy myths and superstitions from infertility to postpartum.  In sharing your questions you are helping to disseminate knowledge to those women that have questions.  You might think you are crazy for even asking, but we have found that there are many other women out there with the same questions.  There is security in truth and knowledge.  Help s spread the word and get your copy today.

ST

So much mysticism and mythology surrounds the pregnancy due date.  Much of the mysticism is held by physicians who hold on to the old ways of  determining when a pregnant woman will deliver.  Believe me, most physicians would love a way to determine the due date so we could plan our lives around the deliveries of our patients, but the truth is only 1-2% of women will actually deliver on their due date.  So what determines a due date, and what is the difference between EDC (estimated date of confinement) and EDD (estimated date of delivery) and what the heck is Naegele’s Rule.  This post will help show the origins of the due date and how we are currently using a system that is about 250 years old.

Franz Karl Naegele (1778-1851) was the German obstetrician who initially came up with the rule to determine a woman’s due date based on her last menstrual period (LMP).  There are many ways to calculate Naegele’s Rule.  I use the system where you take the LMP, add 7 days, and subtract three months.  So if your LMP was April 1, 2009 then your due date would be January 8, 2010.  You can impress your friends at parties with this maneuver.  There are problems with Naegele’s Rule and many people have pointed out that this 250 year old method is no longer appropriate for our advanced age.  What are some of the potential errors with calculating the EDC in this method?

• It assumes that you are having a regular period and that you ovulate on day 14 of your cycle.  I am a gynecologist and there are many women out there that have irregular cycles that ovulate on day 20, 25, 12, 15….you get my point.  This obviously would add potential error to the EDC determination and could change things by days to weeks.
• There is another assumption that the routine pregnancy is 280 days long and that is based on our current calendar system.  The problem with this is that there are many months that contain 30 days or 31 days and what happens in a leap year, or if you are not pregnant over the shorter month of February.  The point is that there is a movement out there that is trying to say that the number should be 288 days and that we are inducing women that have premature babies.  A study done in 1990 stated that the proper method for determining a due date was to take the LMP, count back three months and add fifteen days for a primiparous (first pregnancy) woman or 10 days for a multiparous (subsequent births) woman.  This was published in the journal Obstetrics and Gynecology.
• There are many that argue this method of calculating the EDC is as archaic as the term EDC itself.  Lending to the agrarian societies from whence it came, the EDC literally came from the fact that a woman was confined to her bed for the last part of her pregnancy to prevent preterm labor.  While we still prescribe bedrest today as a possible therapy for preterm labor it does seem odd that the medical establishment uses terminology from the 1700′s.

The due date is as individual as the pregnant mother.  While the EDC is currently calculated by Naegele’s Rule this does seem a bit archaic and inefficient; especially if we are using this dating method to determine inductions and postdatism.  There have been other methods with increased accuracy but they require a woman to measure body temperatures and be move involved in her own self-care.  Many reading this article are very involved with birth and feel as though self-care is very important, but there are many women out there that simply choose not to be observant of their own cycle.  So, what do we “do” with the “due”.  Unfortunately, I think we will keep going with the current system and back it up with ultrasounds which are accurate within 5 days if done in the first trimester.

Approximately 3% of so-called term births (occuring after 37 weeks) are completed with fetal lung immaturity and this could be because the baby may have been between 35-37 weeks and not term.

Are we too involved in the birthing process?  Are there better ways to determine the pregnant due date or should we not worry wbout and just let man/woman  be born in his own time.  The latin word natura gives rise to the word natural and means “to be born”.  Maybe we should just leave well enough alone.