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Last Updated: Apr 20, 2011 - 9:38:09 AM |
Did you know that you can control your odds of experiencing some
pregnancy related complications? Everyone knows that nutrition has
some importance during pregnancy. As soon as others know you are
pregnant, you start getting the comments ranging from "eating for two"
to "don't gain too much weight," but what is the full story about
nutrition and pregnancy? Most American women do not get much guidance
on this topic from their doctors. The practical reason for this is
that nutrition is not a subject given a lot of attention during medical
school, which is largely focused on treating problems after they
occur. But many pregnancy related problems can be avoided or reduced
through excellent prenatal nutrition.
Anemia
Most women believe they need to supplement
their iron intake during pregnancy. It is true that pregnancy can
exacerbate a borderline deficient woman. Why is that? During
pregnancy, a woman's total volume of blood increases throughout
pregnancy by as much as 50% to be sure that both she and the baby are
getting sufficient volumes of oxygen and nutrients. This expansion
requires an increase in the number of red blood cells, impacting the
levels of the woman's iron stores. But contrary to popular belief, it
is good to see a slight lowering of iron levels, sometimes to as low as
a hemoglobin measurement of 10-12 g/dl especially at around 28-30 weeks
of pregnancy, the time of the most rapid blood volume increase, as this
signifies that the blood is expanding as it should. Of course, there
are times when iron levels drop too low, leaving a mom feeling tired,
depleted and out-of-breath. If your levels are not at least 10 g/dl,
you and your caregiver should definitely give some thought to the best
method of supplementing. Often prescription iron is not readily
absorbed, but your odds can be increased by avoiding calcium around the
time of taking your iron pills, taking them with vitamin C, and eating
lots of dark green leafy vegetables, at least 2-3 servings per day.
There are also natural supplements. Many women have better success
taking liquid chlorophyll, usually a byproduct of alfalfa, found in
either liquid or capsule form.
There are other types of anemia that can affect pregnant women,
some more common than others. Vegetarians, especially vegans, must be
aware of vitamin B12 deficiency anemia. B12 is an animal-derived
vitamin, so if she has not eaten any animal products for many years,
and has not supplemented, she may find this vitamin level is low. This
can be remedied through supplementation, but the rule about
supplementing B vitamins is that they must be supplemented in balance.
To increase levels of B12, take a complete B-complex along with the
extra B12. Folate, another B vitamin especially critical during
pregnancy, can also be a source of vitamin deficiency anemia. Other
anemias are associated with diseased cell structures, such as sickle
cell disease or aplastic cells. These are usually a concern to
individuals of particular genetic heritages, like those of African
descent.
All women can make a preventative effort at avoiding anemia, and
offering her baby the highest levels of oxygen and nutrients to grow by
eating 2-3 servings of leafy green vegetables every day, the darker the
better. Alfalfa, spinach, kale, artichokes, and other similar greens
are wonderful sources of iron, while legumes like beans and lentils are
great sources of B-vitamins.
Gestational Diabetes
Gestational Diabetes (GD) is a
disease of degrees. It is natural for pregnant women to become
somewhat insulin resistant, which means that her body is not as
receptive to insulin breaking up and removing excess sugar as it
usually does when not pregnant. The reason for this is that growing
another living being requires the extra energy from sugar to be
available for longer. But in Gestational Diabetes, there is too much
blood sugar circulating. The result of this can be a large baby with
many of the same risks of Type 1 or Type 2 Diabetes, which include such
frightening extremes as shoulder dystocia, where a baby gets stuck
during birth, or sudden fetal death. Women are usually tested for GD
late in their second term, and if a positive result, are sent to a
nutritionist to learn how to control blood sugar levels through diet.
Some women will also be put on insulin for the remainder of her
pregnancy.
By the late second term of pregnancy, dietary changes may be
difficult to adjust to, and results may be minimal. For the best
possible health of mom and baby, there is no reason to wait until such
a late date to embark on a blood sugar friendly diet. Avoiding
processed foods, white flours, white rice, high sugar foods, especially
those sweetened with high fructose corn syrup, and refined
carbohydrates, like prepared bread products, excepting whole grain or
sprouted breads, will go a long way towards keeping your blood sugar in
proper balance. Focus on eating foods as close to their natural state
as possible, increasing vegetables, whole fruits, and proteins.
A significant piece to the blood sugar puzzle is what you eat at
what time of day. When high sugar foods are eaten and digested, the
blood sugar rises rapidly, followed by a plunge. The body, seeking to
regain balance, craves another sugar jolt. You can short circuit this
cycle by planning your meals carefully. Start the day with protein,
like eggs, peanut butter on whole grain toast or muffin, or cottage
cheese with whole fruit. Be cautious about fruit juices, which can
cause a quick jolt to the metabolism, due to the processed state of the
fruit sugars without the good fibers to go with it. A nice alternative
to both soft drinks and straight fruit juice is a fruit spritzer,
prepared with 50% fruit juice mixed with 50% seltzer water. If you
simply must indulge those sweet cravings, save them for the end of the
day when the subsequent fall in blood sugar will not set you up for
increased sweet cravings throughout the day. It is very important not
to deprive yourself to such an extent that you cannot maintain your
good eating habits. One possibility is making Sunday "reward day",
indulging in your favorite treat after dinner time.
Toxemia
Metabolic Toxemia of Late Pregnancy goes by a
variety of names: pre-eclampsia, eclampsia, pregnancy-induced
hypertension and HELLP syndrome. These are all aspects of the same
disease process, but for simplicity we will call it Toxemia. There has
been much debate about the cause of toxemia over the last several
decades. Dr. Brewer, who researched this phenomenon for many years,
became convinced that it is the result of poor nutrition, and had great
success even in women of the most modest social circumstances in
preventing the disease. Toxemia is a disease affecting several of the
body's major organs, which in its advanced state can be remedied only
through delivering the baby. As we mentioned above, the pregnant
woman's blood naturally expands to accommodate the growth and
development of the baby within her. If, for some reason, the blood
does not expand, a high degree of stress is put on the mother's body
systems, as she tries unsuccessfully to maintain nutrition for herself
and the baby. The resulting symptoms are extreme swelling, high blood
pressure, protein in the urine, and hyper reflexes.
The body requires a balance between many nutrients to function at
its best. The natural increase in blood supply is dependant on several
factors, protein intake, salt intake and fluid retention. Blood
includes a protein, known as albumin. The body can make some of its
proteins itself, but must also have an adequate source of dietary
protein to supplement what it cannot make. If a woman's protein intake
is too low, the body will not be able to produce the necessary albumin
to support the expansion of the blood volume. Additionally, the body
needs enough fluid to make the blood flow properly. This requires the
adequate intake of both water and salt. Why salt? That sounds
counterproductive! On the contrary, salt is needed to keep the fluid
where it belongs, in the blood supply. The body has a mechanism by
which fluid is attracted to salt, so if there is enough salt in the
blood supply the fluid will remain there. If there is low salt in the
blood supply, other tissues will have a higher salt content, causing
the fluid to move from the blood supply to those tissues. This causes
the extreme swelling that is symptomatic of toxemia. The thickened
blood due to lack of fluid and the low supply lead to high blood
pressure as the body works harder to get the blood where it is needed.
This is a simplification of a highly involved process, but identifies
the key factors we can affect nutritionally.
Dr. Brewer created a dietary plan for his patients to follow, which
has been widely popularized through his books and through the Bradley
Method and other alternative methods of childbirth education. His
recommendations are for 80-100 gms of protein every day, particularly
protein derived from eggs and high quality meats, though complete
proteins can also be derived from legume and grain combinations for
vegetarian moms, one quart or equivalent of dairy, 1-2 servings of dark
green leafy vegetables along with a citrus fruit (which we are already
eating to prevent anemia, right?), 3 servings of complex carbohydrates
in the form of whole grain or sprouted bread, or tortilla, other fruits
and vegetables including at least one yellow vegetable a week, one
whole potato including skin every week, lots of water (aim for 32 oz.
per day), and salt all food to taste or eat a truly salty food every
day. You can see how this particular plan incorporates all of the
other recommendations for prevention of anemia and keeping the blood
sugar in balance, as well.
Excellent prenatal nutrition not only provides the best start for
baby, but keeps mom feeling healthy, too, by preventing these and other
common complications of pregnancy. Use your pregnancy as a time to
experiment with new foods for their nutritional value. You may find
some new favorites to add to your family's menu.
For more information, check out these resources:
About the author:
Bekah Sealey
AAMI #1885 NC7
Doula, Midwifery student in WI
http://www.newbirthcs.com/
http://valleybirthnetwork.com/
Share your baby's Home Birth story: http://
morebabiespreferhomebirth.com/
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