Tag Archives: preconception planning

What I Did Differently in My 2nd Pregnancy (and why)

As a fitness professional, I’m hyper-vigilant about documenting little details regarding my wellness and changing body. I have charts and notes recording mileage and training plans from various marathons, bulking/cutting programs, my bridal workout plan, and both pregnancies, to name a few. I’ve come to appreciate these notes, even while admitting they’re a bit over the top. Referring to them has led to some helpful insights, especially in regards to my first pregnancy.

I kept detailed notes on every week’s symptoms throughout my first pregnancy (with my son Carter, now a true “threenager” whose favorite angsty response to questions is “nothin”). That pregnancy ended abruptly when I experienced PROMS at 36 weeks 2 days (Premature Rupture of Membranes – aka my water breaking before full term). My mom had my oldest brother at 6 weeks early, for no apparent reason and without any strong risk factors, so I suppose I had filed away the possibility of an early baby in some remote corner of my mind, but it still shook my world. I didn’t have any risk factors for preterm labor outside of my mom’s single experience (the rest of us kids were full term). So, when approaching the preconception planning of a second child I was torn on whether or not to accept the advice that OB after OB gave me; to receive weekly progesterone shots throughout the pregnancy to reduce the risk of preterm labor.

 

 

If I had given birth a few weeks earlier than 36 weeks (which is considered “late preterm”), then I think I would have accepted the progesterone shots without question. But I felt like I was so close to full term that maybe…just maybe…if I looked back over my pregnancy notes and did copious amounts of evidence-based research, I could consider alternatives. As it turned out, my notes were very revealing and made me realize a couple of things; 1) my cervix is very sensitive when pregnant so internal checks and even sex can trigger changes more rapidly for my body than other women’s, and 2) my signs of preterm labor began around weeks 34-35, a time when progesterone temporarily dips down in pregnancy before jumping back to new highs in the last month.

I had to ask myself a difficult question:

Could I risk going against doctors’ advice and try natural approaches for preventing preterm labor and increasing progesterone throughout all 40 weeks of gestation? Could I live with myself if my actions didn’t work out? Could I live with myself if I didn’t try to let my body self-regulate with a little extra TLC from a healthy lifestyle? 

I decided to give Mother Nature one more shot… and I delivered my second baby at exactly 40 weeks. I can’t be sure that my actions deserve credit for a full term birth – it might just be happenstance or luck. And I can’t recommend that women at risk for preterm labor do the same. But I can share my story a bit and help women consider all the ways we can help our bodies along, regardless of whether we’re also using additional medical interventions, like progesterone treatments, to prevent preterm labor.

To start, let’s talk a bit about what preterm labor is and how to identify it…

Disclaimer: The contents of this article are not medical advice. If you have concerns about preterm labor you should contact your medical provider to discuss your risk factors. If you believe you are currently experiencing symptoms of preterm labor contact your medical provider or call 911 immediately.  

 

36 weeks 2 days…aka day one of my oldest son’s life

 

Preterm labor

*All information in this section is quoted directly from the March of Dimes.

Definition: Babies born before 37 weeks.

According to the March of Dimes, signs of preterm labor in a pregnant woman may include:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
  • Your water breaks

 

 A few of the top risk factors for preterm labor include:

  1. You’ve had a premature baby in the past.
  2. You’re pregnant with multiples (twins, triplets or more).
  3. You have problems with your uterus or cervix now or you’ve had them in the past.

 

Medical risk factors before pregnancy for preterm labor and premature birth:

  • Being underweight or overweight before pregnancy. This can include having an eating disorder, like anorexia or bulimia.
  • Having a family history of premature birth. This means someone in your family (like your mother, grandmother or sister) has had a premature baby. If you were born prematurely, you’re more likely than others to give birth early.
  • Getting pregnant again too soon after having a baby. For most women it’s best to wait at least 18 months before getting pregnant again. Talk to your provider about the right amount of time for you.

 

Coming home from the hospital with baby #1 (my son Carter)

 

Things I Did Differently in My Pregnancies

Although I did a lot of things differently in my second pregnancy, there are a few things I did the same that I feel are worth mentioning first. In both of my pregnancies I avoided smoking and alcohol. Some moms feel like by the third trimester the baby is “fully baked” and an occasional glass of wine or beer won’t do any harm. I can see the logic, and to each their own, but I feel that the evidence regarding baby brain growth accelerating in the third trimester (the brain triples in weight!) is enough to confirm that I don’t want to flirt with any toxins beyond an occasional “taste sip” of someone else’s beverage.

In both pregnancies I followed a healthy diet, eating plenty of fruits, veggies, lean proteins and healthy fats (plus a daily sweet indulgence after dinner!), and maintained an exercise regimen focusing on lots of hip and core stabilization. Lastly, as is my nature, I nested like a crazy person both times. My husband may be experiencing PTSD from my latest “honey do” list that had him scrambling up ladders, re-caulking our kitchen, and car shopping for a new vehicle. 

The things I did differently the second time I was pregnant were primarily actions driven by the desire to avoid another preterm labor. As mentioned, it’s impossible to say whether these actions influenced my body’s ability to get to full-term this time around or if I was always going to have a second baby at full term. Either way, these natural approaches to preventing preterm labor are ones any woman can incorporate into her prenatal care after talking to her OB about her personal risks for preterm labor and whether or not progesterone shots are strongly encouraged for her…

C-Reactive Protein

This protein can be high in a mother’s bloodstream because of acute or chronic infections, and may be the reason why women with urinary tract infections during pregnancy are more susceptible to preterm labor. C-reactive protein is a marker of inflammation but it can be lowered and controlled by a Mediterranean diet, adequate vitamin C, and probiotics. Hence, I tried to eat fruits higher in vitamin C during my pregnancy (kiwi, strawberries and citrus), started a new, higher CFU probiotic designed for prenatal health, and made sure that I ate the maximum allowance of low-mercury fish for pregnant women alongside other healthy fats like nuts, flax, avocados and olive oil.

Omega 3s

There is some evidence that an increase in Omega 3 fatty acids can help reduce the risk of preterm labor primarily thanks to their effect on balancing prostaglandins (which help the cervix ripen in preparation for labor and help the uterus contract – hence a better balance of this hormone would do the reverse and slow down physical preparations for labor). Thanks to this research, I made sure to bump up my Omega 3s, starting with adding a serving of ground flaxseed to my morning oatmeal.

 

Mega-Hydration

Uterine irritability can be triggered by dehydration. I was informed of this when I went in to the labor and delivery unit at 24 weeks with pregnancy #2. I was throwing up uncontrollably thanks to a virus that my toddler and husband had been ill with just a couple days prior. They only suffered a fever and lack of appetite whereas my body went into full-blown chaos; fever, chills, violent vomiting, etc. While I was getting treatment for an anti-nausea medication at the hospital the nurses hooked my belly up to monitors to assess potential contractions. Extreme dehydration can throw some women into preterm labor or labor because uterus begins to experience contractions. My belly wasn’t contracting in full but it was “irritable” – aka experiencing an abnormal amount of tightening that could potentially progress to contractions. The nurse who was caring for me sent me home with one of those giant hospital cups that has a handle and straw, and that holds up to 32 ounces when full. She told me to drink 3-4 of them a day in addition to my other beverages. I was a bit shocked by the volume but took it to heart and can say with certainty that I stayed better hydrated in my second pregnancy than my first.  (Summary:  To prevent uterine irritability and contractions drink at least 10-12 cups water/day.)

 

Coming home from the hospital with baby #2 (my son Colby)

 

Dental Health

Believe it or not, it’s true; challenges in dental health (ex: gingivitis) can contribute to preterm labor. Say whaaaa? Yup, bacteria from the mouth actually migrates to the placenta and can cause inflammation that can trigger preterm labor. Most women who experience a direct correlation between poor dental health and experiencing preterm labor are women who haven’t had proper dental care, but that being said, it never hurts to cross your T’s and dot your I’s. This is why, despite not having any former dental problems, I became extra diligent about brushing my teeth for a long time and flossing each day during pregnancy. Admittedly, my flossing habits were in need of some improvement.

 

No High-Intensity Interval Training

We’ve known for a while that exercise can impact hormones. It helps women who are estrogen dominant become more balanced and it releases feel-good hormones like endorphins. Men and women benefit from a boost in testosterone during exercise too. Changes in body composition in response to exercise bring additional benefits for the endocrine system. As it turns out, progesterone is yet another hormone that can be impacted by exercise…more specifically, it can be lowered by high-intensity interval training (HIIT).

During my first pregnancy I did a couple HIIT workouts each week – it was my jam. I always kept my heart rate within safe ranges and I knew how to modify high-impact and intense exercises for safety. It felt like I was doing no harm. In retrospect, maybe that kind of exercise wasn’t the best. If nothing else, it didn’t kill me to put it on the back burner during my second pregnancy, plus I think my pelvic floor enjoyed a rest from high-impact moves – and for that, my body is already saying thanks (and I’m only 2.5 weeks postpartum!).

 

Lowered Physical Stress

Studies show that women who spend 5+ hours on their feet each day are at a higher risk for preterm labor. This is a tough pill to swallow for a busy body like myself who works in fitness. With this knowledge in my back pocket, I worked to lower physical stress during my second pregnancy. I took more naps and got off my feet when I was fatigued instead of powering onward in my stubborn determination to get stuff done. It was difficult to discipline myself at first but with a toddler to care for, this may have ended up becoming my saving grace.

 

Delayed TTC

Women who wait 18 months from giving birth to one child to conceiving another are at less risk for preterm labor. In other words, any woman who gives birth to or gets pregnant with subsequent children in under 1.5 years is at a higher risk for a preterm baby. Hence, I took my time gradually weaning my son around a year and a half old and let my hormones stabilize for a few months before jumping into the TTC roller coaster for the second time.

 

Right to Refuse Internal Prenatal Checks

It’s hard to feel like we have a right to deny basic prenatal routines like internal cervical checks in the third trimester – but as mothers, we totally can reserve that right! You have full control over the process and no one can force you to do something you’re not comfortable with. I was thrilled when I told my OB that I was concerned internal checks might cause my water to break early again (it broke a handful of hours after an internal check in my first pregnancy). Thankfully, my OB understood my concerns and said that internal checks don’t do a lot for most of the third trimester except satisfy curiosity. I was blissfully in the dark until 39.5 weeks when I got my first check and discovered I was already 4 cm dilated! (So *that’s* what the random back pain and cramps were at 38 weeks – early labor contractions!).

 

 

Visualization

I’m not sure if there’s any science to pointing to visualization helping you get to full-term in pregnancy but I will hang my hat on how a difference in my mindset facilitated a healthier and longer pregnancy the second time around. I was so anxious and ready to be “at the end” in my first pregnancy. Perhaps that caused me to have higher inflammation, push harder, ask for more internal checks and more. There are a number of ways this could have caused me to treat my pregnancy differently. I’m so glad that I wanted nothing but to be extremely (even painfully) pregnant instead of having a preterm baby in my arms. This mindset drove small daily actions that I believe added up and helped me achieve a healthy pregnancy.

 

I did a few other things differently in my second pregnancy too, like avoiding most decaf coffee brands due to how the beans are decaffeinated using chemical solvents and requesting that I be allowed to drink an organic fruit juice drink for my prenatal glucose screening instead of that nasty, unhealthy orange drink they offer in the office. I also stood my ground in labor and delivery, electing to avoid pitocin and an epidural and marveling in shock (and pain) when my natural labor efforts jumped me from 6 cm dilated to 10 cm in one contraction (in a warm bathtub!).

It wasn’t always comfortable trying to do things differently for my second pregnancy but it was well worth it (just check out the sweet, healthy glow of my full-term baby boy Colby!).

 

Worth the wait for this little sweetie

 

(Please forgive any typos…still only a couple weeks postpartum over here! See y’all in a few months for some fresh content…okay…maybe even longer…we’ll see how mothering two headstrong boys shakes out.)

 

Yours in health and wellness,

Maggie

 

 

 

 

 

Balancing Female Hormones with Food

Perhaps it’s TMI…but this past summer after weaning my son, my hormones went bonkers. Not just for a month or two. For a while. And it drove me INSANE. Per usual, frustrating experiences with my health cause me to dig my feet into the ground a little harder and push like a bull-headed Taurus (which I am) to find information and natural remedies to help my body. The experience catapulted my understanding about several female hormones and how we can help them normalize.

Upon opening up about my own experiences, I discovered a trove of women dealing with equally pesky ups and downs with female hormones. And not all of them were moms who had recently stopped breastfeeding. Some of these women were trying to conceive and others were simply adjusting to new norms as they inched closer to 40 or 50 years old. Still others were feeling the uncomfortable symptoms of severe menstrual cramps, bloating and acne every month, or extremely long and heavy menstrual cycles. All of these women, in different walks of life, made me realize that very few of us actually know how to help our bodies find hormonal balance and wellness. While it’s true that we can’t control every aspect of our hormones, there’s still a lot we can do to take over the reigns. (Frequently, this kind of holistic advice isn’t readily available or discussed. We have to go hunting for it.)  

So, here are the three hormones that can cause us woes and foods we can eat to help them find balance in our bodies:

 

Prostaglandins

These hormones play a major role “in a wide range of body functions such as the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, and modulation of inflammation.” Prostaglandins are also involved in the start of labor for pregnant women, causing the uterus to contract. In fact, semen contains a lot of prostaglandins in it and may be one of the reasons that sex around the timing of one’s due date is said to jump start labor for some women. Forgive me, I had to throw out that weird but interesting factoid. Lastly, prostaglandins play a major role in inflammation in the pelvic region, especially. An imbalance of the different types of prostaglandins (PgE1, Pg E2 & PgE3) can lead to increased local inflammation and heavy menstrual cramps.

Prostaglandins can become out of balance and cause pesky, painful PMS symptoms when fatty acid supplies are too low. Essential fatty acids include both Omega-6 fatty acids and Omega-3 fatty acids, and they operate best in our bodies when they’re in balance with one another. When fatty acids are available within the body, The Center of Genetics, Nutrition and Health (based in Washington, DC) has found additional benefits for the reduction of breast cancer, rheumatoid arthritis and asthma! This is pretty mind-blowing and awesome (to me). So, even if your menstrual cycles are pain free and regular, there are still many benefits to eating a diet with plenty of fatty acids of both kinds. But note: Most people are deficient in Omega-3s and need to eat more foods chocked full of them. This begs the next question; Where can we find these foods?

 

Omega-6 Fatty Acid Foods

  • Flaxseed oil, flaxseeds, flaxseed meal
  • Hempseed oil, hempseeds
  • Grapeseed oil
  • Seeds such pumpkin seeds and raw sunflower seeds
  • Nuts, including pignolia (pine) nuts and pistachios
  • Borage oil, evening primrose oil, black currant see oil
  • Acai
  • Corn
  • Sunflower
  • Soybean
  • Cottonseed oil

Omega-3 Fatty Acid Foods

  • Salmon Fish Oil and Alaskan Salmon (wild-caught)
  • Cod Liver Oil
  • Walnuts
  • Chia Seeds
  • Ground Flaxseeds
  • Albacore Tuna
  • Hemp Seeds
  • White Fish
  • Anchioves
  • Egg Yolks

If you’re hesitant about adding any of these important Omega-3 foods to your grocery list then you can check out one of two convenient options for an Omega-3 boost to your system:

  1. Oatmega – a protein/snack bar full of fish oils that comes in a variety of flavors (don’t worry, you can’t taste the fish oil)
  2. Daily Harvest – a monthly, smoothie-delivery company that has creative, delicious and healthy ingredients, and several smoothie flavors that include omega-rich foods (I’m debating stocking my freezer full of these yum-yums)

 

 

Estrogen

For a long time women have naturally assumed that the aging process is accompanied by a precipitous decline in estrogen as we creep towards menopause (or sometimes fall headfirst into it). We hear that the older we get the less estrogen we have. In fact, by about 50 years old, women have approximately 35% less estrogen than they did in their “younger years.” But that’s not the full picture of what’s happening in our bodies…

As the female aging process begins around 35 years old (i.e., when fertility shifts due to changing hormones), women experience a much more dramatic dip in progesterone than estrogen. Progesterone actually drops by approximately 75% (!!!!!!) in the same amount of time that estrogen drops by 35%. This creates an imbalance in the two hormones that unfortunately leads to estrogen dominance. And “ED” isn’t any fun. Trust me, after weaning my son my hormones swung hard one direction (low estrogen) and then right back the other way (high estrogen). Both ends of the spectrum feel pretty crappy. Let’s just be honest.

You see, estrogen is kept in check by progesterone, especially in the latter half of our menstrual cycles. When estrogen is allowed to “run rampant” it likes to take our bodies on a wild ride. Large spikes in estrogen (both right before ovulation and a handful of days after) can leave us experiencing all sorts of uncomfortable symptoms.

*Some* Signs of Estrogen Dominance:

  • PMS
  • Hot Flashes
  • Infertility
  • Fatigue
  • Decreased libido
  • Increased weight gain, especially around the middle
  • Menstrual cramps
  • Headaches
  • Excessive/heavy/long menstruation
  • Thyroid problems
  • Depression
  • Insomnia or sleep disturbances

*Other Conditions That Science Suggests May Be Caused (in part) by Estrogen Dominance: Endometriosis, Fibroids, Fibrocystic Breasts, Cervical Dysplasia, Breast/Uterine/Ovarian Cancer.

Foods That Can Boost Estrogen

(*remember, this is typically the opposite of what people need)

  • Farm-raised, non-organic eggs, meat, fish and dairy products
  • Sugary and processed foods – caloric overload in our diets increases fat mass in the body which leads to estrogen overload (same applies to overeating any foods but sugar and processed foods often have “empty calories” that add up quickly)
  • Produce that has been sprayed with heavy pesticides
  • Soy products, especially when processed
  • Drinking from plastic water bottles – a recent widespread study was conducted investigating major brands like Aquafina, Dasani and Nestle, and found on average 15 free-floating plastic particles in each bottle (I don’t want to drink plastic! If only I could find a crying emoji to put in here…)

For foods that help keep estrogen in check, read on to the next section…

 

 

Progesterone

If you read the section about estrogen, it becomes glaringly apparent why progesterone is so important for women’s health. You’ll also remember that we discussed how much progesterone drops at a ridiculous rate as we women age. Why must every stage of life be complicated as a woman? Seriously. But the good news is that there are LOTS of foods that can help boost progesterone – and they come with a plethora of other health benefits, too.

Please note that progesterone can be too high for some women, although this is a bit less common than estrogen dominance which afflicts many women who are overweight, over-stressed and/or between the ages of 35-60.

A few signs of progesterone dominance include:

  • Weight fluctuations
  • Feelings of sadness or anxiety
  • Sleepiness
  • Bloating
  • Dizziness
  • Waking up feeling groggy
  • Not feeling like you

Foods that Boost Progesterone:

*Note: None of these foods contain progesterone per say, but they have the nutrients required for supporting the hormone’s production in the body, and many of us could use MORE of this particular hormone.

Meats:

  • Red Meat
  • Turkey
  • Oysters
  • Shrimp
  • Salmon
  • Trout
  • Tuna
  • Shellfish

Fats:

  • Olive oil & olives
  • Coconut oil or butter
  • Eggs
  • Avocado – also on fruit list

Veggies:

  • Brussels sprouts
  • Leafy greens
  • Kale
  • Collard greens
  • Swiss chard
  • Broccoli
  • Cabbage
  • Cauliflower
  • Sweet potatoes
  • Russet potatoes

Fruits:

  • Avocado
  • Kiwi
  • Banana
  • Prunes
  • Lemon

Nuts, Legumes & Seeds:

  • Cashews
  • Almonds
  • Hazelnuts
  • Walnuts
  • Black beans
  • Lentils
  • Chickpeas
  • Flaxseeds
  • Sunflower seeds
  • Pumpkin seeds

Grains:

  • Brown rice
  • Oats
  • Quinoa
  • Amaranth
  • Millet

Misc:

  • Cacao
  • Yogurt

 

I hope this is helpful information for you whether you’re a woman hoping to be expecting some day or a woman trying to understand the yo-yo of hormones that IS perimenopause. Godspeed to us all! 

Yours in health and wellness,

Maggie