Exercise

“I was on the Treadmill 2 days after I delivered” And in Surgery 2 months later!

April 27th, 2017

Pushing too hard to regain your pre-pregnancy physique and activity level can actually have the opposite effect and lead to injury.

In the last post, I shared how many of my clients compare themselves and their post partum progress to celebrities, who more often than not, have a full staff of people helping them with their babies, enabling them to rest, prepare them specialized diets and personally train them to get back to their pre-pregnancy physiques. I have spoken on this topic many times before in an earnest effort to put mamas’ worries to rest that they are not “slackers” if they don’t “bounce back” to their pre-pregnancy weights immediately post partum. For Mamas on Bedrest especially, most people don’t expect you to immediately dash through your homes putting everything into neat and tidy order post bed rest. You won’t have the energy. Some of you will need physical therapy to be able to regain your strength and mobility.  So I continue to encourage you to put the comparisons aside.

I also wanted to draw readers attention to a post on our Facebook Page by the Association for Prenatal and Perinatal Psychology and Health  “Women need a whole year to recover from childbirth despite the ‘fantasy’ image of celebrity mothers, study claims” 

A whole year??! Most American women balk at this statement and as one of my readers clearly stated,

“A year… wow. I wish. That’s literally impossible for most moms in the U.S.”

What a tragic statement about the US’s concern for women’s health, maternal health and the health and well being of mamas and their babies. I could write (and have written!!) an entire post about how the US doesn’t value childbearing as evidenced by our maternity policies and birth outcomes. I’ll refrain from reiterating my utter disdain at this time. But I  do want to address some very important issues that result when women resume their pre-pregnancy activities too soon, and how it can be detrimental to their own health and the health of their newborns.

Bonding – New mamas and their babies need time to bond. While there is already a very strong connection between mama and baby from the pregnancy, new mamas need to learn “this” baby’s cues; the cry of hunger, the cry from being wet, uncomfortable, tired….seasoned mamas know that every child is different, and it takes time to learn the needs and habits of their new little one. Likewise, a newborn is being bombarded with a whole world full of new cues and stimuli. The one thing that this little one needs to know is that when he/she cries, Mama (or some other caregiver) will be there to take care of them. This is the crux of the “fourth trimester” those 8-12 weeks in the early post partum when mamas and babies get to know one another, know each others cues and form their own “communication.”

Breastfeeding – I have said it before but it bears repeating; Breastfeeding is natural but it isn’t always easy. Some baby and mama duos have a hard time establishing a rhythm for breastfeeding. Getting into comfortable positions, establishing a good latch, baby being able to suck and swallow, mom not experiencing nipple pain,…this can all take time. Asian cultures have “The Golden Month” which is the first 40 days after a mama delivers. The women of her clan come and care for her, her family, her home and the baby so that she can rest and breastfeed. Mama does no housework, in fact, mama not only doesn’t leave the house, she stays mostly in bed! The elder women prepare nourishing foods and perform time honored rituals that help mama regain her strength-and establish good milk supply.

Out of necessity, here in the US many mamas must be back at work by 6 weeks. They may or may not have established their milk supply. Many will try to pump at work, but many work places don’t have adequate facilities nor provide adequate breaks in which a woman may pump and store her milk, and clean her supplies. Sadly, this situation results in many American women not breastfeeding beyond 6 months.

According to one of my favorite websites, Post Partum Progressapproximately 15% of Post Partum American women will have post partum depressive symptoms annually. That equates to approximately 600,000 American women! Many women won’t begin to exhibit symptoms for 60 days, well after the standard 6 week post partum visit. So many American women are undiagnosed, untreated and bogged down with the inability to focus, care for their babies, themselves or their families. Post partum depression is a serious medical condition as it can progress into a major depression (sometimes requiring hospitalization) or progress to post partum psychosis which can be deadly. Women with post partum depression need immediate medical attention so that they don’t hurt themselves or their babies. More important, post partum women need careful, longer term surveillance post partum, with many experts recommending that post partum health surveillance last throughout the first year!

Bodily Injury – Due to the pressure of the pregnancy on the pelvic floor and the subsequent pushing and stretching that occurred with labor and delivery, many women lose muscular tone in their perineums and experience prolapse-when a woman’s inner organs (mostly the uterus, bladder and rectum) present outside of her body. I see this primarily in women who begin too rigorous of an exercise program too soon. While not only being uncomfortable, organ prolapse can cause serious medical complications. Currently, with the exception of (mild) bladder prolapse for which a pessary can be placed to tuck the organ back up into the pelvis, the treatment for organ prolapse is surgery. Do you see the irony? While trying too aggressively to get back into shape (after bedrest?) you can land yourself back in bed! Ladies, a gentle walk with your baby in the stroller, yoga or prenatal/post partum fitness classes are the best way to get back into shape while being gentle with your body. Always remember,

“Nine months on, Nine Months off!”

I hope that these tips have helped you to remember the wonderfully fabulous beings that you are! Mamas, you’ve created and given life and that is far more important and worth celebrating than the latest celebrity siting!

 

What are your tips for getting back into the groove post partum? Share them in our comments section below and help another mama!

Mamas on Bedrest: To end the bedrest debate, we need more healthy mamas!

September 22nd, 2015

Greetings Mamas!!

The bedrest debate continues as more and more studies are advocating treatment of the causes of bedrest in lieu of activity restriction. However, there are those that are convinced that bedrest is an effective treatment for preterm labor and prolongs pregnancy. Let’s take a look at the evidence.

For over 25 years, Judith Maloni, RN, PhD researched bedrest and found that the practice has no apparent benefit and has been shown to be harmful to pregnant women. Her publication, “AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth”(1), Maloni denounced the bedrest prescription because there was no evidence to support the practice.

In 2007. NASA released an article which showed that female astronauts in space lost bone mass and muscle mass and strength in as little as 2 weeks of inactivity, and the effects were even more pronounced at 60 days.(2) They recommended that if women do have to be on limited activity for an extended period of time, they should engage in a modified exercise program to maintain bone and muscle integrity.

The World Health Organization and Amnesty International have both denounced the bed rest prescription and have had sharp criticism of the United States-which boasts the highest costs of maternity care than any other country in the world, yet has some of the highest rates of complications, bed rest, interventions, cesarean sections and maternal and infant morbidity and mortality-to rethink their maternity care practices and to bring their maternity statistics in line with the rest of the world.

In 2013, physicians in the American Congress of Obstetricians and Gynecologists began questioning the practice of prescribed bedrest and Christina McCall, MD (3) and Joseph Biggio, Jr., MD (4) both called on their ACOG colleagues to stop the practice of bedrest citing the harm that is poses to pregnant women.

However, bedrest remains a mainstay in obstetrical practice. Here in Austin, the 2 major hospital systems each have large antepartum units which cater to women experiencing pregnancy complications. My colleague Angela Davids, founder of Keepemcookin.com, recently blogged about an article by Drs. Christine Piette Durrance and Melanie Guldi (5) in which the authors concluded after an extensive review of PRAMS (Pregnancy Risk Assessment Monitoring System) data of some 200,000 women, that limited inactivity does reduce preterm birth before 33 weeks by 7.7% and low birth weight infants (weighing less that 1500 grams) by 15.4%.

So what are mamas to think? Should they abandon bedrest? Remain on bedrest? Is there a way to not have to go on bedrest, to not encounter the complications that lead to the bedrest prescription?

At this juncture if you are a mama on bedrest, I WOULD NOT recommend abandoning the care plan that your provider has put into place for you. If you have questions about whether or not bedrest is necessary in your case, speak with your provider and voice your concerns. I am a firm believer that if you have hired (chosen) a provider for services, then you should follow their directions. Now if you are having reservations about being on bed rest, its efficacy and whether or not it is doing harm to you, you must have a candid conversation with your OB and get your questions answered so that you can make an informed decision.

I myself am a proponent of mamas getting off bedrest. I believe the way to do it is to help women to be in the best shape BEFORE they ever think about getting pregnant so that when they are pregnant they are strong and healthy. Many of you reading this may be saying, “Well fat lot of good that does me now!” I sense your frustration. There is nothing we mamas on bedrest do better than second guess ourselves! But what you did in the past (no matter how recent) is of no consequence. As Dr. Maya Angelou eloquently said, “When you know better, you do better.” You know better right now, so begin taking exquisite care of yourself right now! As much as possible,

  • Eat healthy, nutrient dense foods.
  • Drink lots of water (1/2 your current body weight but in ounces).
  • Rest (I know that sounds ridiculous, but many mamas on bedrest are so stressed out they don’t sleep well and don’t rest. Your body is not only maintaining you, it is also growing another fully complete human being. That most certainly deserves a nap!
  • Do stretches t keep your muscles supple and limber. (BedrestFitness!)
  • Keep your spirits up

I don’t know what is to become of bedrest and the bedrest prescription. I do know for the nearly 1 million women who will experience bedrest, you have to take care of yourself. If you are in the Austin, TX area, look me up! I always enjoy mixing with mamas and would be happy to serve you.

How are you surviving bedrest? Share your tips and comments section below.

 

References

Judith Maloni, Ph.D.  AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth (Biological Research for Nursing 12(2) 106-124)

Mark Ransford. NASA-Funded Study finds Exercise Could Help Women on Bedrest November 15, 2007

Christina McCall, MD, “Therapeutic” Bed Rest in Pregnancy, Unethical and Unsupported by Data”, vol 121, No.6 June 2013, 1305-1308

Joseph Biggio, Jr., MD.“Bed Rest in Pregnancy, Time to Put the Issue to Rest!” vol 121 No. 6, June 2013, 1158-1160

Christine Piette Durrance and Melanie Guldi. Maternal Bedrest and Infant Health.

Mamas on Bedrest: Get Your Body Back After Bedrest

June 17th, 2014

Mamas on Bedrest and Beyond introduces the Get Your Body Back After Bedrest Program. These 30, 60 or 90 day programs help mamas regain strength and muscle tone, lose the baby weight, boost their nutrition and increase overall wellness. Each program is customized to individual mamas and begins with a 5 Day detoxification and then slow, steady, transformation to a pre-pregnancy level of health and wellness (or better!) Former Mamas on Bedrest are able to participate in the programs when they are at least 6 weeks post partum and have been released from medical care from their obstetricians or midwives. Our first programs will kick off on Sunday, July 13th, and supplies need to be ordered by July 3rd for timely shipping. If you are ready to “Get Your Body Back!” send an e-mail to info@mamasonbedrest.com today and we’ll get you started!