January 22, 2024
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In honor of @MaternalHealthAwarenessDay I have put together my top 7 tips for pregnant women to help promote a healthy and happy pregnancy. But before we dive into the details, let’s take a moment to highlight this year’s theme for maternal health awareness day: access in crisis. According to a 2022 @MarchofDimes report, 34.9% of counties in America are classified as maternal care deserts meaning that there are not hospitals providing obstetric care, no birth centers, no OB/GYN and no certified nurse midwives. Women who are in maternal care deserts will have to travel out of their county, sometimes by hours, to give birth or receive prenatal care. Unfortunately, early statistics and reports are showing that maternal care deserts are only growing.
This fact is likely a large contributing factor to America's scary maternal mortality rate. The US ranks almost dead last of all developed countries in maternal mortality rates and the comparison between the US and other is downright terrifying. The mortality rate for US women is 23.8 deaths per 100,000 live births which doesn't sound too bad until you compare it to Canada (8.4), the UK (6.5) or the Netherlands (1.2). Even scarier, black women in America are almost 3x more likely to die during pregnancy, childbirth, or the first year postpartum than their white counterparts. How are we one of the richest countries with advanced knowledge and technology and yet be so far behind? Sadly, the research shows that the US mortality rates have been steadily INCREASING over the past 2 decades and the trend does not seem to be changing. It truly is a crisis and needs to not only be talked about but policies need to change. If you want to read more about this crisis and the factors leading to it please visit The CommonWealth Fund, ACOG, and March of Dimes.
Now that I have totally bummed you out (or hopefully lit a fire for change) let’s talk about some tips to help pregnant women have safer and healthier pregnancies. Now this list is not an exhaustive list of all the things pregnant women should do; that list would be more like a novel. You won’t see the obvious advice like not smoking or drinking alcohol, eating well balanced meals, or getting quality sleep. What I am highlighting are the aspects that don’t get talked about as much and I personally and professionally think are vital.
*This is only advice and not a substitute for medical care. If you have questions or concerns, speak with your medical provider for guidance.
Advocate for yourself!
This is the most important bit of advice I give all my patients, pregnant or not. Unfortunately, women tend to be dismissed more in the medical system than men even when you are pregnant. This is too big of a topic to explain here (look for another blog post about that in the future) but if you want to read more about this I highly recommend the book “Doing Harm” by Maya Dusenbery. That is why you have to take control of your health and be your own advocate. What do I mean by this? Self advocacy is defined as the ability to speak up for yourself. You do this by identifying your needs, communicating them clearly to others, and helping others understand how to support you. If you feel you are not getting the care you need or your wants or needs are being dismissed you need to speak up. If you are trying to communicate to a provider, friend, family member, etc and they are not responding appropriately it might be time to change how you are explaining your needs or finding a different provider who understands. In the end, YOU ARE IN CHARGE OF YOUR BODY! Let’s be clear, I am not saying to ignore medical advice. If you are questioning medical decisions, get a second opinion. If multiple providers are saying the same thing, it might be time to change your expectations.
Listen to your body and trust your gut!
No one knows your body better than you. You can read all you want about what is “normal” during pregnancy but if something feels off DO NOT IGNORE IT!. Just because a book or online article says something is “normal” does not necessarily mean what you are experiencing is. I firmly believe that all moms, even new mom-to-be’s, have a great instinct when something is not going right. Your intuition is usually pretty smart so listen to it. If you are not sure what you are feeling or experiencing is normal, ALWAYS CALL YOUR OB/MIDWIFE! No issue is too small when it comes to the health and safety of you and your baby. If you call your provider and they dismiss the issue but your gut is still saying something is wrong, go in to be checked out anyway.
Find support
Pregnancy, childbirth and becoming a mom is no joke; it’s hard work physically, mentally, and emotionally. Having someone there to support you through this experience can make a world of difference whether it’s holding your hand, helping you get to and from appointments, cooking a meal, or being an advocate with you. I understand that not all mamas have a significant other or live close to family. That definitely makes it hard but there are other options. If you are in this situation, consider hiring a doula! Doulas provide guidance and support during pregnancy, childbirth and postpartum. I used a doula with the birth of my son and it significantly helped my husband and I prepare for birth as well as supporting me during birth. If you are local to Tucson and looking for a doula, reach out to me! I know many amazing doulas locally and would be happy to send you to a trusted professional.
Take care of your mental health
When you think about depression surrounding pregnancy you tend to think about postpartum depression but it is fairly common during pregnancy too. It is estimated that about 7% of women will experience depression during pregnancy and this rate increases significantly if there are pregnancy complications or the mother is dealing with pain during pregnancy. If you are having symptoms of excessive worry, inability to find joy in activities you usually enjoy, low self-esteem, and/or thoughts of self harm you should speak with your OB/midwife immediately. On the less extreme side, if you are simply feeling stressed and anxious, find someone to confide in. Do not bottle up your feelings or keep your negative thoughts to yourself. Taking care of your mental health during pregnancy can help you postpartum. So talk to someone, get out and do something enjoyable, exercise to increase good-feel hormones, meditate, or find another way to destress.
Stay physically active
In my experience, people tend to think of pregnant women as fragile. PUBLIC SERVICE ANNOUNCEMENT: Pregnant women are not made of glass and you do not have to wrap them in bubble wrap! Study after study has shown that exercise and physical activity is not only healthy but has a long list of benefits to pregnant women including reducing pregnancy pains, decrease constipation, decreased risk of gestational diabetes or preeclampsia, slight decrease in risk of cesarean section, promotes healthy weight gain, and better mood. You should continue your exercise routine you were doing pre-pregnancy with modifications for avoiding laying on your tummy or excessive heat. If you did not exercise pre-pregnancy it will still be safe to start exercising during pregnancy but you should consult your doctor first and find a women’s health physical therapist to guide you. If your provider indicates to you that you are not safe to exercise, get clarification on what you can and can’t do and try to be active within those restrictions (a women’s health PT can be valuable in this case as well). For a full list of exercise precautions during pregnancy visit the ACOG website.
Hydrate, hydrate, hydrate!
Staying hydrated is vital to everyone, especially when you are pregnant, but most people are significantly under hydrated or dehydrated. Generally speaking, you should aim to drink half your body weight in ounces of water PER DAY. Your specific needs may be higher or lower than that depending on your activity level, how much you are sweating, and medical status. So how do you know if you are well hydrated? It sounds odd but look at your pee next time you go. If it is pale yellow, you are doing great so keep drinking water at the same pace. If it is dark yellow or orange, you are dehydrated so drink more water as soon as possible. The darker the color the more dehydrated you are. Use the chart below to see what the color of your urine means. If you drink lots of water (half your body weight in ounces per day) and it is still dark in color, call your provider because this can be a sign of medical conditions. My recommendation to everyone is to track your water intake for a few days and see how much you are truly drinking. Most people find that they are drinking WAY less than they thought.
Track your numbers
During pregnancy your OB/midwife will be taking your blood pressure every visit to keep an eye out for hypertensive disorders such as preeclampsia. Hypertensive disorders are serious medical issues that can cause significant harm to mother and baby and they are not to be taken lightly. I know this from personal experience with postpartum preeclampsia but that’s another story for another day. However, if you are going weeks between doctor visits you won't necessarily know how your blood pressure is doing. For this reason I recommend all pregnant women get a home blood pressure cuff to track their blood pressure at home. They are relatively inexpensive and easy to find online or in drug stores. If you have an HSA or FSA you can use these accounts to purchase one. Once you have a unit, you want to make sure to take your blood pressure at the same time each day, usually in the morning before activity, and write down your numbers to show your provider (or put it in a health app on your phone). When you take your pressure make sure to follow the instructions on the machine closely. Signs you might be having issues with high blood pressure include vision changes, severe headache, swelling of the hands, face or feet, and vomiting. If you experience any of these, call your doctor immediately.
Normal BP: 120/80
Things are looking good, no need for concern
Elevated BP: 120-129/80-89
Your numbers are a little high, keep tracking your BP closely and let your provider know
High BP: 130+/90+
Your numbers are concerning, contact your provider immediately or go to labor and delivery to be checked out
Now these 7 pieces of advice are just the tip of the iceberg. There are so many other factors to help promote a healthy and happy pregnancy but if you follow these tips you are on the right track. It is my hope that the stigmas, misconceptions, and flat out falsehoods surrounding pregnancy will start to change. I believe that women deserve far better than what our medical system is currently providing and change will only occur with increasing awareness and education. Please read more about @MaternalHealthAwarenessDay and spread the word.
I would love to hear from you about your tips and tricks for a healthy and happy pregnancy! Comment below with your thoughts. As always, reach out to me with any questions and let’s support each other.
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