Pregnancy Do's and Don'ts
By Dr. Claudia Anrig
DO practice wellness, not "fadness": Just because it's the latest thing doesn't mean it's the greatest - or the safest. Be sure to carefully consider every option presented to you during your pregnancy. Whether it's a new vitamin or exercise regimen, or a new medical procedure, take a moment to discuss your options with your health care provider first.
DON'T get overscheduled: Stress can have a negative impact on your pregnancy, causing health problems such as hypertension, and may potentially cause a miscarriage. It's important to look at your life realistically and not get overscheduled. Spreading yourself too thin during these important nine months won't just negatively affect you, but your unborn child as well.
DON'T be sedentary: What's a sedentary lifestyle? If you aren't active for a sustained 20 minutes at least three days a week, you're living it, which may lead to weight gain. Excessive weight gain during pregnancy has been linked to labor difficulties and gestational diabetes. If you're typically a person who doesn't move a lot, now is the time to change. Consistent (safe) movement is so important for you and your developing baby.
DO a combination of exercises: Regular exercise such as walking, water aerobics, prenatal yoga or riding a recumbent stationary bicycle will increase your heart rate, which will increase your blood flow. However, these types of activities aren't so stressful that they're unsafe for you or your baby. Also, remembering to take deep, even breaths during exercise will increase the oxygen content in your blood.
DON'T forget the importance of good nutrition: Diet plays an important role during pregnancy. Eating whole, living foods begins by understanding that if it's in a box, a can or package, there's a good chance it's been nutritionally compromised. Processed foods are generally less healthy and have already had most, if not all, of their important vitamins and minerals processed out of them. Remember, without sound, complete nutrition, you and your developing baby will suffer.
DO consider the source of your prenatal vitamins: Good prenatal vitamins will have everything your body needs to help your baby develop. Of course, you need the standard prenatal vitamins and minerals (such as vitamin B, iron, etc.) but you also need calcium/magnesium, choline and fish oil (omega-3). More important than the right vitamins and minerals is the right quality. It is always best to purchase your vitamins from a reputable health food store or your health care provider, not your local corner store or department store. Paying a little more for quality prenatal vitamins will ensure you're getting what you and your baby need.
DO reduce your caffeine intake: Research suggests caffeine can cause miscarriages if you're already pregnant and, if you're not already pregnant, can interfere with conception.
DON'T get a "routine" ultrasound: The American College of Obstetricians and Gynecologists recommends that ultrasound examinations only be performed for specific reasons, but many health care professionals include at least one ultrasound at 18-20 weeks as part of their routine prenatal care. Since there haven't been any documented negative effects, it's considered safe. The problem is, just because the effects aren't documented doesn't mean they don't exist. Even the Food and Drug Administration says, "While ultrasound has been around for many years, expectant women and their families need to know that the long-term effects of repeated ultrasound exposures on the fetus are not fully known."
DON'T take medication unless absolutely necessary: While it's true that your health is paramount, you need to carefully consider any drugs you take during pregnancy. Studies have shown that many drugs will cross the placenta and negatively affect your baby; these include antibiotics, antihistamines, diuretics, anticonvulsants and diabetes treatments. (Ask your doctor for more information.) While it has generally been thought that if there were only trace amounts of the chemicals you were given in your baby's blood, then the baby was OK, recent studies are proving this to be untrue.
DON'T take antidepressants: A recent study in the Archives of Pediatrics & Adolescent Medicine (2009) found that selective serotonin reuptake inhibitors (SSRIs) easily cross the placental barrier. This was proven by these chemicals being found in the umbilical cords of newborns whose mothers took these drugs during pregnancy. This same study showed that exposure to SSRIs during pregnancy may be associated with a higher risk of pre-term labor, low APGAR scores and admission of the infant to the neonatal intensive care unit.
DO find a "health care team": Many women are choosing to not just have a midwife or OB/GYN, but to have an entire health care team during their pregnancy. Obviously, the first person in this team is going to be your midwife or OB/GYN. This person should be chosen carefully based on your desires for your delivery. Don't be afraid to interview several before making a decision, making a point to ask about their C-section rate. While it's true that C-sections should be treated as a last resort, the fact that the national average has jumped 50 percent in the past decade proves that this isn't always the case. Remember, a C-section is invasive surgery; if you can avoid it (and the potential risks), you should.
DO consider having a doula: A doula is your advocate during your delivery; making sure that your wishes are considered is her primary responsibility. A doula will stay with you throughout the entire labor and delivery, providing emotional support and doing what she can to see to your physical comfort. For more information about doulas or to find one near you, talk to your doctor and visit the Web site of the Doula Association of North America at www.dona.org.
DO rely on your family wellness chiropractor: Many think a chiropractor only treats back and neck pain, but many more women have discovered the benefits chiropractors can provide in terms of prenatal care. Preconception and prenatal chiropractic care for you can mean less morning sickness, less lower back pain and a shorter, more quality labor and delivery. More than that, chiropractic care supports the integrity of your pelvic function, which includes the uterus, the associated muscles and ligaments, and the interfacing of the nervous and hormonal systems, which is important for you and your baby.
DO realize you have a choice between home or hospital: Choosing whether to give birth at home, in a birthing center or a hospital is definitely a decision that you should get to make in most cases. Today, more and more women are choosing to give birth in the comfort of their own home with family and friends nearby, which is typically less invasive and will usually have no medical intervention unless absolutely necessary. Studies suggest women with planned home births have significantly less obstetrical interventions or adverse maternal outcomes, and that newborns delivered at home vs. in a hospital are less likely to require resuscitation, oxygen therapy or meconium aspiration after birth.
DO have a birth plan established: Creating a birth plan is the best thing you can do to make sure your wishes are considered during your delivery. A birth plan should include basic decisions such as moving around during labor, when to start pushing, fetal monitoring and labor induction, but also contingency decisions, including whether to get an epidural, an episiotomy or a C-section. Of course, that's just the beginning. Your birth plan can also have special instructions for the nurse and staff regarding who should be with you during the delivery, who you want to stay with the baby should there be complications, and more. A birth plan tool is available at www.birthplan.com.
DO recognize your right to make decisions: When all is said and done, remember that this is your pregnancy and your baby, and you have the right to ask questions and get second opinions when you are unsure about anything. You are in control and should make your decisions based on the information provided by those you trust. Remember that at every turn, you control what you allow during your pregnancy and delivery, and that at any time it is alright to say, "No," and expect your decisions to be honored. This is not about choosing to ignore medical advice and put you or your baby at risk; it's about making decisions in conjunction with your health care team to have a safe, natural pregnancy.
Claudia Anrig, DC, practices in Fresno, Calif., and is on the board of directors of the International Chiropractic Pediatric Association, an organization that can answer your questions regarding the value of chiropractic care during and after pregnancy.