I’m a runner, and I remember being SO worried about losing my running fitness when I became pregnant with my daughter. One of the first things I asked my OB was whether or not I could keep running. Fortunately, she thought it was a great idea, and even encouraged me to continue my regular workout schedule. I kept running until I was about 26 weeks and my belly became too cumbersome; at that point, I climbed on the elliptical trainer and continued working out until the day my daughter was born. The fitness paid off big time: the difference between how I felt at the end of my second pregnancy — worked out every day — and my first — gave up the workouts and gained 70 lbs. — was astounding. I had plenty of energy, felt great, and the swelling and back-aches were minimized. Not only that, but I was back to my pre-pregnancy weight by the time I came home from the hospital (before you start hating, remember this weight includes the weight I never lost from my first pregnancy).

Evidence for Exercise Throughout Pregnancy

Obviously the carefully compiled anecdata of one pregnant woman does
not constitute scientific evidence, but there is, in fact, actual evidence that seems to point to exercise being a great thing for people in general, and pregnant women in particular. One study of 131 women, published in the American Journal of Obstetrics and Gynecology, found that women who continued a regular running or aerobics program had shorter labors and less frequent fetal stress than those who discontinued their exercise program in the first trimester. While their labors tended to begin earlier (277 +/- 6 days gestation vs 282 +/- 6 days), the exercise group had similar rates of pre-term delivery and also had a lower incidence of surgical delivery than the non-exercise group.  Unfortunately, most of the studies on pregnancy and exercise are small. The one Cochrane Review of the subject concluded that, while there is evidence that pregnant women who engage in vigorous exercise at least two to three times per week improve or maintain their physical fitness and that — contrary to what was once thought — prenatal exercise does not cause pre-term labor, larger studies are needed to be more definitive on the subject.

In spite of the dearth of evidence, the American College of Obstetrics and Gynacology (ACOG) has decided there is enough to recommend that ‘‘[i]n the absence of either medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.’’  But what makes for a good and safe workout?

The FITT Principle of Training
One of the best ways for anyone, not just pregnant women, to exercise safely is to follow theFITT principle of training, which stands for frequency, intensity, type and time. Pregnant women can use the following guidelines, adapted from a study published in Current Sports Medicine Reports:

Frequency
Your body needs time to recover between any kind of exercise, both cardiovascular or resistance-based. For a sedentary woman, 3-4 sessions of cardiovascular exercise a week is probably an appropriate frequency, where a woman who has been exercising regularly, 4-5 times may feel better. An elite athlete would probably be fine training 5-6 times a week, but even she would need to make sure her body has time to rest. When it comes to resistance exercise, or lifting weights, it all depends on what you’re doing. If you’re doing a full body workout each time, you will need to leave a day of rest between sessions. I like to break up my resistance workouts and do one body part on each day. This means I can lift five days a week and still give my muscles the rest they need between workouts.

Intensity
Intensity is a measure of the amount of effort you are exerting when you exercise. You can measure this in a couple of different ways; you could rock a heart rate monitor, or you could use something like the Borg Rate of Percieved Exertion Scale, which is easier for those who are not technically minded (and also free!).  For sedentary women, working out with a rate of perceived exertion (RPE) of moderate to moderately hard would be appropriate. For women who are used to exercising, an acceptable range of RPE would be moderately hard to hard. For an elite athlete, a hard RPE or heart rate of 70%-80% of maximum would probably be fine.

Type
Type refers to the kind of exercise you choose in order to achieve the results you want — in this case, health and fitness. In order to improve your fitness, you need to choose exercises which are continuous in nature and use your large muscle groups, like running, cycling, circuit training, walking, etc. Novice exercisers should choose something low impact, like walking, biking, or swimming. Women who are already into fitness and elite athletes should also choose low impact exercises when trying something new, but can probably safely continue any exercise their body is already used to, such as running or dancing. In general, as long as your body is feeling good while you’re doing it, an exercise is probably ok.

Time
Time is pretty self-explanatory — it refers to the length of time spent on any given workout. Beginning exercisers should start with no more than 30 minutes, but can increase that time slowly if they feel comfortable. Regular exercises will probably do well with 30-60 minutes of continuous exercise, while elite athletes can tolerate 60-90 minutes.

When Exercise is Not Safe in Pregnancy
While they promote exercise for most pregnant women, ACOG does leave some women out. In their opinion on exercise during pregnancy, there are some absolute contraindications to exercise and also some relative contraindications.

Absolute contraindications are:

• Significant heart disease
• Restrictive lung disease
• Incompetent cervix or cervical cerclage
• Multiple gestation with risk for preterm labor
• Persistent second or third trimester bleeding
• Placenta previa after 26 weeks of gestation
• Premature labor during the current pregnancy
• Rupture of membranes
• Pregnancy-induced hypertension

Relative contraindications are:

• History of sedentary lifestyle
• Intrauterine growth retardation
• Poorly controlled hypertension
• Poorly controlled seizure disorder
• Poorly controlled insulin-dependant diabetes
• Severe anemia
• Chronic bronchitis
• Maternal cardiac arrhythmia
• Poorly controlled thyroid disease
• Extremely overweight (morbid obesity)
• Extremely underweight (BMI 12 or lower)
• Orthopedic limitations
• Heavy smoker

Another important caveat they give — if you should encounter any of the following problems while exercising, stop immediately and contact your care provider:

• Vaginal bleeding
• Difficulty breathing before you start working out
• Dizziness
• Headache
• Chest pain
• Muscle weakness
• Calf pain or swelling
• Pre-term labor
• Decreased fetal movement
• Amniotic fluid leakage

In the absence of these conditions, exercise can be safe and enjoyable during pregnancy. There is an ever-increasing body of evidence in support of exercise during pregnancy, and for most women, it is clear that the benefits far outweigh any theoretic risks. The risks that may exist are small when proper guidelines and precautions are followed. And here is where I make my disclaimer: I am not a medical professional. Make sure you are seeing your health-care provider regularly and discuss any fitness regimen with her. As a your body changes throughout the pregnancy, you may need to to adjust your workouts to ensure continued safety. Happy Exercising!

Sources:
ACOG. Committee on Obstetric Practice. Exercise during pregnancy and the postpartum period. ACOG Committee Opinion 267. Obstetrics & Gynecology 99:171–173, 2002.

Kramer, M.S. Aerobic exercise for women during pregnancy (Cochrane Review). In: The Cochrane Library, Issue 4. Oxford: Update Software, 2002.

Paisley T.S., E.A. Joy, and R.J. Price. Exercise during pregnancy: A practical approach. Current Sports Medicine Reports 2:325–330, 2003.

Here are some ideas:

- Become a one car family ( we were one for 7 years until recently).  Add up the cost of gas to and from work, insurance, up keep i.e oil changes, car payments, etc for that second car.  Also, the money you could make if you sell it.

-Cut back on cable.  I know what you are saying; WHAT?!  I WILL MISS _______(fill in the show)!!  There is netflix and the vast world of online viewing (fancast.com for example).  Trust me when I say, I don’t miss it much.  I find myself much more productive.

-Eat at home more.  What a gift to your kids to eat together with them in a calm setting where you don’t have to worry about how long they can be entertained.  Also, they can become more involved in the cooking process and possibly eat healthier because they get to help pick and and prepare the ingredients.

-Plan meals.  This is such a saver because you aren’t making those last minute trips to the grocery store for one item while coming out with a few bags full.

-Make your own coffee.  Not only cheaper but healthier because you control what goes in.  You can even get a variety of sugar free syrups.

-Buy children’s clothes second hand and shop Craigslist (it’s amazing what people sell and the deals!).

-Remember we want to raise well adjusted kids, so having all the latest and greatest isn’t the best for them anyways.  Teach them how to save and earn things they really want.  They will appreciate what they DO have more and will more likely be givers.

-Start a garden and plant those foods that are a little more spendy like blueberries and tomatoes.  It’s a perfect way for your kids to have an appreciation for healthy food and they understand where food comes from.  If they are a little older, perfect weed pickers (and a great way to earn some extra money)!

-Did you know that many generic items have the same ingredients as the name brand?  Want an amazing example?  We need seasonal allergy medicine in our house.  The name brand was almost $21, the generic brand (with the same ingredients and dosage amount) almost $6!

-If you have a gaming system, find some friends with the same one and trade games.

-Go to your local library and search out book on the subject of money/budgets to become an expert on your personal circumstances and goals.

Above all, remember your kids spell love T-I-M-E.  They won’t say you were the greatest because you gave them everything, they will say you are the greatest because of how many kisses, hugs, and games you played with them. When you start looking for creative ways to live a full, frugal life, they will find you! I promise because we are proof.

Photo by Mike.HanlonLooking back, I wish I had sought more support from someone who was trained in postpartum issues and breastfeeding support, such as a postpartum doula or lactation consultant.  Knowledge is power and through my training to become a postpartum doula I have gained the knowledge that would have helped me back then.  I truly believe that first year would have been a more enjoyable time for the whole family.

I do not judge those who exclusively use formula.  I feel sad because I know they just don’t have the knowledge and are robbing themselves of such an amazing opportunity.  Did you know that breastfeeding causes the brain to release happy chemicals into your body?

Here are some amazing, evidence-based facts about breastfeeding that you may not have known(if you want the sources, let me know):

• There is less waste product produced from human milk i.e easier diaper changes.  In my experience, less, shall I say, pungent too.
• Zinc and iron are more effectively absorbed from human milk than from formula milk
• Breastmilk conforms to the needs of your baby.  A cold running through your house?  Your breastmilk will pump up the antibodies to help out babies little body.
• If your baby is premature, your breastmilk will have a makeup similar to colostrum for up to a month in contrast to a full term baby which is a couple days.
• Human milk has a laxative effect, while formula milk can cause constipation.
• Formula  fed babies have an increased risk for allergies and allergy related conditions such as eczema.
• Formula increases the sensitivity to infections which can result in the dreaded diarrhea.  Again, another practical easier diaper experience:).
• Babies weaned before 1 or formula fed have a higher risk of speech-language disorders.
• Diabetic mothers who breastfeed are more likely to need less insulin.
• Your belly shrinks quicker and you can zip up those jeans faster postpartum.
• The risk of osteoporosis goes up for mother and child when formula is used.

These are just SOME of the benefits for mom and baby.  Amazing, huh?  According to a Parent’s Network poll in American Baby, 32% of first time moms plan to use a lactation consultant, while 57% actually hire one.  If you are a first time mom or have had previously had breastfeeding difficulties, search out local lactation support before you birth so you are prepared if breastfeeding becomes a bumpy road.  Remember the portrayal of establishing  breastfeeding being this natural and easy process is just that a portrayal and not always reality.  Sometimes your body isn’t compatible with breastfeeding.  These instances are very few and very far between.  Most of us just need a little expertise to get us going.

To start you on your search:

• LaLeche League
• International Lactation Consultant Association
• Check your local hospitals
• Kelly Mom
• Search google or bing using lactation consultant or postpartum doula along with your city and/or state
• Ask other moms you know
• Find local support groups and check them out before you birth
• Near Portland or Salem? contact us.  Near Newberg or McMinville?  contact Laura Dunn
• Ask your Childbirth Educator

Those ideas should start you on your way to finding help locally.  I wish you all success in this amazing journey of bonding with your baby.  If you are local

I HAVE gone on since to successfully breastfeed two more children.  You can be successful too if that is your goal!

A report was published last December about the biological aspect.  Here is an article going over the results of that study.  It concluded that the first 6 months postpartum are vital for the mommy’s body to heal itself.  Waiting 11 months to conceive is recommended.  The article discusses the risk factors and statistics if you are interested in reading that aspect.

Some of the other details of child spacing that need to be considered are; Are both parents mentally and emotionally ready to add more responsibility?  What are the pros and cons of the sibling relationship if they are close in age or further apart?   Thinking ahead to when the kids graduate high school, how old do you want to be?  Is there a cut off age the mommy wants for being pregnant?

There is no exact, magic number.  It is a decision that each couple needs to make taking their lifestyle, opinions, and expectations into consideration.  If you are pondering this for your own life, take out a piece of paper, consider the questions, and write down your answers (there is something about writing them down).  Then, for the next few days just let your mind simmer.  After a few days revisit your answers.  Have they changed?  Are they still the same?  If they have changed, write down the new answers, again letting your mind simmer for a few days.  Keep doing this process until your answers remain the same.

Hopefully the questions prompted your mind to consider more questions to answer.  Leave a comment and let me know the questions you came up with.  Also, if you are one considering this for your own life, I would love to hear your thoughts!

Describe the experience (factually, no emotions).
It helps to stand back as if just an observer. Pretend you are a “fly on the wall”. Be as
unbiased and objective as possible.
What was the succession of events?
Where were you?
Who was there?
Are there parts you don’t remember or are hazy?
What were people saying?
What thoughts went through your head?
Now, add in the feelings.
What were your different feelings through the whole experience? Why?
What was your partner feeling?
How did you know the feelings of those around you?
How was your body feeling? Was it tense and stressed? Was it relaxed and calm?
Reflection.
Why did you act as you did?
What alternative choices could you have made? What could the outcome have
been?
Were your goals and expectations met? Why or why not.
What was good and bad about the experience?
What were your assumptions at the beginning? Did they help or hinder you?
What internal/external factors influenced your decision making and actions?
Your new insight and learning.
How will this experience affect future choices?
What did you learn about yourself?
What did you learn about those around you?
Have your assumptions changed? Why or why not.
If the situation arises again, what would you do differently?
Share what you have learned with a close friend and be proud of your accomplishments!

You have your sweet puppy or kitty curled up on your bed at night. Enter, new baby. All of a sudden adorable pooch is banned to the floor confused and annoyed at this new thing taking up it’s territory. Pets need to start being prepared as soon as the test comes back with a positive.

Here are some great articles to get you started:
The Humane Society
Baby Center

A great video with an education officer from the RSPCA:

If you are in the Portland area and want to meet with a dog trainer, go to http://cooperativedogtraining.com/

Step 1
Think about how you want to feel when you’re birthing your baby, perhaps one of relaxation, feeling in control, or confidence?

Step 2
Now think about a time when you experienced those feelings, bring that moment clear into your mind and everything about that moment. What could you see, what could you feel, smell, taste, really use all of your senses to bring back that memory as vividly as possible.

Step 3
Anchor that feeling either by pressing your thumb and forefinger together, or by associating it to specific music or a specific picture.

Step 4
Repeat this process and each time experience the feeling more vividly and use the same anchor.

Step 5
During birth, or whenever you want to experience that feeling again, use the anchor and those feelings will wash over you.

To ensure they continue to be effective, anchors need to be distinctive, unique, intense and reinforced.

Remember that all of these techniques are not only useful during pregnancy and birth, but also when looking after your baby as well as passing these skills and techniques on to them as they grow up.

There are many more techniques out there which can be learned, if you are interested in an NLP course then contact the original Society of NLP which was founded by Richard Bandler. You can find courses and seminars on this website: www.purenlp.com

Juliet is the founder of the “Natural Birth | Birthdownload” website and the creator of the antenatal programme The Psychology of Giving Birth. You can also follow her on Twitter.

As you are sitting here reading this, did you just straighten up a little?  As you are sitting (straight with your core engaged), put your hands under your buttocks.  Do you feel a bone poking out on either side?  These are your “sit” bones.  Now, hunch over and give that core a break.  You don’t feel those bones, right?  Your pelvis is now tipped backward which can encourage your baby to change their position in your uterus.  Prolonged bad posture can cause your baby to be in an unfavorable position for birth.  This can cause a longer labor and “back” labor (most of your pain is centered on the lower back)

You want a labor as short as possible and the most pain you can eliminate the better, right?  Pay attention to posture!  Here are a couple great articles on pregnancy and posture.  Dr Sears and WebMD

This is a great, short video on childbirth affirmations.  Watch it, ponder it, then create and memorize your own.  It may even help to have them on cue cards for your partner during labor. What affirmations have/do you use?

I came across this site and think it should be the go-to place for any mama on the journey to snuggling with a new little one. It is simply The Cradle. It is very well put together, user friendly, and full of helpful info.

When I say the word doula to most people, all I get back is a blank stare. I then have to explain what exactly I do. Are you one of those? Here is a great explanation I have created.

BIRTH DOULA
The professional birth assistant is a woman who tends to the birthing family from early labor until a little after the baby is born. She is trained to deliver continuity of care from home to hospital, be there through changing hospital shifts and alternating physician schedules; serve as advocate, labor coach, and support partner, and above all, help manage the fears of both parents. If it is a home birth, she is trained to take over tasks so the partner can be 100% present. A doula’s presence does not make a birth partner’s presence unnecessary. To the contrary, her presence frees the partner from certain aspects of concern and allows the partner to interact more closely with the birthing woman. The goal is to give the parents-to-be the freedom to focus inward and increase the intimacy of the experience for both the mother and her partner as they meet the challenges and rewards of their unique birthing experience, thereby leaving her with a sense of empowerment and a beautiful and positive birth memory.

POSTPARTUM DOULA
A postpartum doula is a non-judgmental woman with a quiet presence in the home. Most postpartum doulas are mothers themselves who have their own children and enjoy motherhood. By giving emotional and breastfeeding support along with practical newborn care tips and taking care of necessary household tasks such as: grocery shopping; meal preparation; doing the dishes, laundry or tending to the older children, postpartum Doulas help ease the transition into motherhood.

Unlike a baby nurse who focuses her care solely on the newborn, a postpartum doula encourages and teaches parents how to care for their newborn, to interpret their baby’s cues, and to trust their instincts in responding to their baby’s needs, infusing the parents with the confidence and support they need to develop their own parenting style.

Breastfeeding is one of those things that can feel like taking the SAT test all over again.  When was the last time the baby ate?  Is that why the baby is crying?  What side am I supposed to start on this time?  At 2am it’s even worse!  Imagine taking the SAT without any sleep the night before.  If you are pregnant with your first, please don’t be too scared.  Somehow you make it through.  Then, you think about having another one.

I found this product that is a DOH! moment.  It is so simple and yet so practical.  It is a nursing bracelet.  There is a detachable charm which you move to keep track of the time of feedings.  Also, if you are like me and can’t ever remember which side to start on, you can switch wrists to remind you.

Click on any picture.  It will take you to the different sites where you can purchase these smart beauties.

• Tired/Weary – During the beginning and near the end this can be a huge problem.  If you feel your feet dragging, take a cat nap.  During lunch time or early afternoon, allow yourself 20-30 minutes to rest.  Set an alarm, and take a snooze.  Also, in the evening if possible, go to bed an hour earlier than you usually do.  For me, that makes a huge impact.
• Nausea – This is trial and error.  What may work for someone else or even a previous pregnancy, may not work now.  You can leave a couple crackers by your bedside at night.  When you wake up, take some nibbles and let it settle before getting out of bed.  If after you eat, it feels your food may make a reappearance, take a rest.  Put your head down on the table or your desk, or sit up on the couch with your head resting on the back.  Then close your eyes and rest for 5 minutes.  You can also try chewing a piece of mint gum or sucking on a mint.  Also, eat smaller amounts and eat more often so you aren’t ever very hungry.  Sometimes, you just have to let yourself vomit in the morning before putting anything in your stomach.  That certainly is the case for me this time around.  Puke, get it over with, then enjoy breakfast.
• Swallowing the vitamins – I have always found, in the morning, they would cause breakfast to reappear.  Eat a couple bites of something right before bed, then take your vitamin.  Your body needs some food to be able to distribute the nutrients from the vitamins so make sure you eat a little something too.
• Equilibrium – Your center of gravity is changing.  Be cautious going down stairs or hills (especially the steep ones).  This is really important if you continue to exercise, just be aware.  Trust me, the stair climbers and ellipticals can be a doozy.  Be conscious of your foot wear.  I’m a heels kinda gal.  There are times when I have no problem, then times like Monday where it seemed I had never walked in them before.
• The baby – Always listen to your gut.  If you feel something is “off”, don’t hesitate to call your doctor.  Please promise me you will go to all your prenatal appointments?!
• Breathing – Deep breathing is great for the mind and body.  All the air you take in, goes to your baby too.  If you feel stressed (the baby feels that too), take some deep breaths.  Sometimes I find myself taking shallow breaths.  When you feel this or stressed, take a few minutes to close your eyes, breath deeply, and focus only on your breaths.

Move through your world with a little more caution.  Remember the belly does need a little extra space.  What other tips do you have?

• You will want to be fitting near the end of your pregnancy.  You can go to any department store or lingerie shop.
• Just like any other clothing item, not all brands are equal.  What may fit well with one brand, may not with another brand.  In some cases, you may need to shop around and try on many.  If you have a favorite brand, start there and see if they have any nursing bras.
• You may even want to bring along the nursing pads you will be using to make sure it’s a fluid fit.
• There are different ways the bra opens, make sure you are comfortable with it.  Also, try doing it one handed before committing.  Many times you will have baby in one arm and only one hand free.
• If you do choose to purchase them online, make sure you have been fitted (don’t feel obligated to buy from that place!).  If the website doesn’t provide the measurements of their garments, don’t be afraid to ask.
• Lastly, you can be like this thrifty mama.  I find what I want, then go online and find it for cheaper (usually able to get a nicer brand and still save money).

A great site I have used for bra measurements is Her Room.  If you have questions about breastfeeding, here are a couple great sites to check out-Babycenter, Breastfeeding.com, What to Expect,  and perhaps the best known, Le Leche League.  If you can’t find the answer, most hospitals have a breastfeeding clinic you can call.

*Don’t ever feel like a failure or get discouraged!  The art of nursing takes time and practice.  Don’t ever be afraid to reach out for help!*

Even though, your house may be crazy, you still need to take care of yourself.  What good would you be if you died from something that may have been prevented, if only you took action for yourself?  It isn’t selfish by any means!  As mommies, we have to take care of ourselves first or we won’t be able to care properly for our families.

Our boobies (yes, i said boobies), should be at the top of that list.  We have come to learn much more about breast cancer in recent years.  It is growing at an amazing rate, and did you know a majority of women who get breast cancer are the first in the family (this has rung true for my family)?

Here’s some facts:

-Estrogen fuels breast tumors.  Fat cells produce estrogen.  This means, take care of your body and take steps to get rid of your fat.  Also, you will have more energy to play and care for your kiddos.

-This leads me to exercise, which is really just movement.  Don’t think you have to go to the gym.  Lace up your shoes, pull out the stroller, and go for a walk (just work up a sweat, no lolly-gaggin’).  You can even dance with your toddler for a little while.  We know how much sweat we can work up entertaining a little one! This exercise kills off that estrogen producing fat.

-Don’t worry about your birth control raising your risk.  A Danish study of more than 54,000 women found, they don’t increase the likelihood of breast cancer.

-Lastly, the breast is best.  This isn’t just for your baby, but you too.  Breastfeeding lowers hormone levels, however, you have to keep it up for several months for the full benefit.

Now, lace up your shoes, and go for a walk.  If a walk would be a hassle with the number or age of kids, just play with them and work up a sweat.

A few resources to check out:

1. Male Lactation on Wikipedia
2. Strange but true: males can lactate; (Scientific American, 2007)
3. Father’s milk-male mammals’ potential for lactation (Discover Magazine, 1995)
4. Widower learns to breastfeed (2002 news article about a 38-year-old Sri Lankan father)
5. Milkmen: Fathers Who Breastfeed (UnassistedChildbirth.com) Along with the article is a movie.  The movie is a little weird, be forewarned:)
6. Why do men have nipples? (StraightDope.com)

Clothing for the breastfeeding Father. Click the picture for more.