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.

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

There are more couples that do not have a birthing plan when they arrive to labor and delivery than couple with an established plan.  I think there is a question out there a to whether or not a birth plan needs to be established.  There are many out there that feel like you need to be protected from your doctor and the hospital and a birth plan is the best approach.  I suppose, if you felt like you needed to be protected from your physician and hospital then you should do everything in your power to not deliver with them.

There are many sites out there for you to make your own birth plan and I would say it is a good idea to visit one of these sites and plug in your information so you can see some of the issues that might arise when you go into labor.  You may need to confront issues like, pitocin, epidural, pain meds, episiotomy, internal fetal monitors, cesarean section, and things of that nature.  It would be nice for you to have a potential feeling one way or the other on these interventions so they are not foreign.

Discuss your birthing plan with your provider and make them aware of what you would like to happen in your pregnancy.  The power of intention being laid may make a difference in the outcome of your delivery process and it doesn’t hurt to have the providers intentions set as well.  In a few instances, some couples will present and act like the birth plan is their shield and that the hospital is out to get them.

Let me share a story.

I was on call for  another group of physicians and a patient presented from their office into labor.  She was very adamant about her birth plan and was very direct in her statements towards the provider, hospital, and the nurses.  I could feel the anger in her words by the tone of the letter and I wondered why she was delivering in the hospital when she obviously felt very strongly that the hospital had policies and procedures in place that she was very opposed to; there is a midwifery birthing center her in Tucson.  I found out that her insurnace would not cover her birth at the “birth center” and so she was stuck with us and our ways and she felt the need to be defensive.  What is truly sad here is that her insurnace company would not cover her birth where she wanted to birth, and this needs to change.  The second thing that struck me as that she felt the need to protect herself from us.  Add on top of this that she did not know me because I was covering for her doctor and you had a patient that was very leery of the system.

She progressed through labor well and I visited with her  a couple of times as she labored.  She was surprised when I told her that she could do what she wanted and I was only there to help her if she needed me.  This is truly my policy.  I did ask for her to be flexible and that if I had information for her that I would present it and she could decide what to do.  She delivered in a squat position on the floor and it was the first birth where I delivered a baby like this, practically laying on the floor.  She was very appreciative at my flexibility and the joke was that may muscles were so sore from squatting with her, I don’t think I am very flexible.  She had a second degree laceration and I informed her that it was not bleeding very much and asked if she wanted sutures which she did not, and I did not put them in.

You see, we can work together, and the birth plan can be a road map for your successful birth process.

Well, it’s official, our “Hands Off My Belly” site is up and running thanks to our wonderful web designer and new friend B e t h A d r i a a n s e. Check out her website at http://www.bethadriaanse.com . We are currently in the mode of building our twitter site which can be reached at Pregnancy Myths Twitter or by linking off of this website.

It is the goal of this website to hear from you, the readers, mothers, fathers, and significant others. We want you to share with us your pregnancy stories that have a potential myth or superstition surrounding them. Please include all things that you did not see in our book and we will gladly add them to any future editions of the book, if we use your myth we will send you a signed copy of our book.

Hopefully you will bear with us as we ramp up for the book which is set to be released September 22, 2009.

Sincerely,

Dr. Tassone