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By: Paige Wyatt

Living a health lifestyle has never been more important than while you’re pregnant. Not only are you now responsible for your overall health and well being, but also that of your unborn baby. What we eat, how much we sleep, how much water we drink, our mental and emotional stress, as well as how much we exercise need to be taken into consideration for a healthy pregnancy.

The new 2019 Canadian Guidelines for Physical Activity Throughout Pregnancy has shed a new light on recommendations for prenatal physical activity. Not only can we help to reduce complications during pregnancy but it can also optimize health and wellbeing for both mother and child.

Previous concerns over fetal health during pregnancy have long been a deterrent for prenatal physical activity. The thought of exerting ourselves and potentially increasing our chances of miscarriage, stunting gestational growth, inducing preterm labour, and harming the fetus has caused a lot of expecting mothers to reduce and stop their exercise program. Less than 15% of women are engaging in the recommended prenatal exercise.

But, here’s the truth; these concerns have never been proven by research. Instead we’ve seen a rise in pregnancy complications such as gestational diabetes, preeclampsia, gestational hypertension and large for date babies, which may be the cause of rising maternal obesity.
Physical activity is now being looked at as a preventative and therapeutic measure to reduce pregnancy complications.

WHAT DO THEY RECOMMEND?

• All women without contraindications should be physically active throughout pregnancy
• 150 minutes of moderate-intensity physical activity per week
• Physical activity should be accumulated over a minimum of 3 days per week
• Aerobic and resistance training achieved greater benefits
• Pelvic floor muscle training (eg. Kegels) may be performed on a daily basis to prevent urinary incontinence
• Exercises should be modified to reduce supine position

WHAT ARE THE BENEFITS?

Women who exercise during pregnancy have a reduced chance of gestational diabetes, preeclampsia, gestational hypertension, cesarean delivery and operative vaginal delivery. Exercising while pregnant can also help reduce post partum recovery time, decrease depression and stress levels, as well as overall weight gain.

IS EXERCISE FOR EVERYONE?

No. These guidelines are intended for women who do not have any pregnancy complications. Although exercise exhibits many health benefits there are certain conditions that are considered absolute contraindications. EVERYONE should be thoroughly evaluated by their OBGYN before beginning an exercise program to ensure there are no medical conditions.
Absolute contraindications are as follows:
• Ruptured membranes, premature labour
• Unexplained persistent vaginal bleeding
• Placenta previa after 28 weeks gestation
• Preeclampsia
• Incompetent cervix
• Intrauterine growth restriction
• High-order multiple pregnancy (eg., triplets)
• Uncontrolled type 1 diabetes, uncontrolled hypertension, or uncontrolled thyroid disease
• Other serious cardiovascular, respiratory or systemic disorder

HOW TO START BEING PHYSICALLY ACTIVE DURING PREGNANCY?

According to the new guidelines there is never a better time to start exercising than the PRESENT. Even if you have never exercised before it is recommended to start. If you’ve never exercised, starting gradually and slowly increasing your intensity and frequency is recommended.
Although the more activity you do, the greater the benefit, even small amounts of physical activity have been proven to be beneficial. Exercise can be for everybody! Take a prenatal yoga class, go for a brisk walk, go for a swim, take an aerobics class or get your sweat on by stationary cycling.
Keep in mind that there may be periods of fatigue and discomfort as your body changes throughout pregnancy, and certain activities may need to be modified as pregnancy progresses. Remember, IT’S OKAY TO REST!

THINGS TO CONSIDER

1. 1. Take it easy! A good indication that you are not overdoing your workouts is by using the “Talk Test.” If you are able to carry on a conversation while exercising it is likely that you are not overexerting yourself.
2. 2. Always make sure you maintain adequate hydration- drink water before, during and after exercise.
3. 3. Avoid physical activity in excessive heat and humidity (eg. hot yoga). A thermo-neutral environment is recommended.
4. 4. Avoid activities that involve a risk of falling, or physical contact that may induce risk of fetal injury (eg. horse back riding, non-stationary cycling, extreme hiking)
5. 5. No scuba diving.
6. 6. No high altitudes.
7. 7. Seek obstetric advice if considering exercising above the recommended guidelines.
8. 8. Listen to your body and if you experience any symptoms while exercising such as persistent shortness of breath, severe chest pain, regular and painful uterine contractions, vaginal bleeding, persistent loss of fluid from the vagina, persistent dizziness, and faintness that does not resolve with rest STOP physical activity and consult a health care provider.

In summary the new 2019 Canadian Guidelines for Physical Activity Throughout Pregnancy has recommended moderate-intensity exercise during pregnancy to help reduce pregnancy complications and optimize health for both mother and baby.

https://els-jbs-prod-cdn.literatumonline.com/pb/assets/raw/Health%20Advance/journals/jogc/JOGC908_LR-1539864964137.pdf

https://sogc.org/news-items/index.html?id=229

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period

By Christina Pistotnik

The time between that positive pregnancy test and holding your newborn in your hands can be filled with a mixture of emotions. On one hand you are so excited that you are going to be a mother but on the other hand you can’t help but feel anxious because it is hard to know what you can and cannot do. Some of you invested time, energy, and financial contributions in order to get to this place, and of course you want to do everything you can to safely maintain this pregnancy.

One of my favorite resources that I refer to and suggest to newly expectant mothers is called Motherisk. It is a Canadian site and program facilitated by the Toronto Hospital for Sick Children and they provide evidence-based information about what is and is not safe during pregnancy. I really enjoy it because it is easy to use and contains a vast array of information all on one site. Plus they have a toll free number (1-877-439-2744 ) that you can call and speak directly to a nurse that will help you out with any concerns you may have.

Having reliable resources and specialists to support you during pregnancy is important because it can help ease uncertainty surrounding an important time in your life.

What about acupuncture, is it safe during pregnancy?

Since the majority of my patients start seeing me while in the process of trying to conceive, I get this question quite a lot in my practice and the answer is; Yes, acupuncture is a safe and effective form of treatment in pregnancy. This is because it utilizes the body’s own healing process to help maintain pregnancy by keeping the uterus calm and stabilizing progesterone which keeps the lining secure until the placenta takes over. Plus it helps to minimize uncomfortable pregnancy symptoms which include; nausea and vomiting, aches/ pains, insomnia, and energy issues.
Plus, an added bonus when receiving acupuncture treatments is that it has a very calming affect on the body. Therefor, it can help with stress and anxiety that you may be experiencing during this time.

As an acupuncturist specializing in fertility and pregnancy, I am happy to safely treat you for any of your pregnancy concerns. Call Whole Family Health to book your appointment or learn more about our Fertility Services today!

October is Pregnancy and Infancy Loss Awareness Month, and in honor of heartbroken parents, blessed little lost ones, and all dear folk touched by this grief, we recognize this all too commonly shared experience.

We all process this kind of loss in our own way, and in our own time. One of life’s humbling mysteries – sometimes there is an explanation, and other times there is not. Either way, we are left to grapple with that which we don’t have control over, and to practice with somehow making peace with it, while sorting out how to move forward.

Often losses can be isolating, held close and private, locked in the silent hope of the first trimester. Hopefully to be spoken of later, perhaps when a little less emotionally raw.

While later term losses or stillbirths may be collectively grieved; empty-armed parents, navigating how to move forward at the mercy of often unpredictable waves of emotion. Moving through a life unchanged and yet forever changed – buoyed or sunken by the community’s varying depth of understanding and expectation.

It is said that 1 in 4 pregnancies end in miscarriage by age 35, and once we start talking about it, we realize that everyone knows at least one person who has suffered a loss- if they haven’t experienced one themselves.

What does life after loss look like? There is no right or wrong way to grieve, we all do it in our own way and in our own time. Some of us are de-railed for a short time, and others of us never quite ‘get over it.’ Some of us need potato chips, while some of us need long walks, or both. Whatever it may be, allow the time and space to be with it in whatever way works best.

Here are some things that will help in the wake of pregnancy loss:

1. Breathe. Studies show that Mindful breathing exercises shift us out of fight or flight and activate our pre-frontal cortex- which is responsible for higher executive functioning. This supports our recovery from traumatic events and helps us to be present with and to integrate these experiences in a healthy way.

Mindfulness allows us to have the perspective we need to see our way through difficult times, without avoiding or being completely high-jacked by the negative impacts of the associated stress. Accessing resources like a Mindfulness class or a Mindfulness App like Headspace have far-reaching benefits.

2. Nourish and renew. Pregnancy loss and stillbirth can be draining both physically and emotionally. Eat replenishing foods, that are nutrient-rich and tonifying. Try to stay away from refined and processed foods, while gravitating toward a whole foods diet.

Stick to warm and cooked meals, especially in the colder seasons. These are more easily digested, and your body doesn’t have to work as hard to metabolize them. Bone broths, which are rich in amino acids, vitamins and minerals are easily absorbed, rehydrating, and fortifying.

3. Follow up. Follow up with your doctor. Especially if bleeding or pain persists or if your energy levels are slow to recover. Your doctor can run standard blood-work to check on hormone and iron levels after a loss. He or she can also determine if there is any indication for ultrasound imaging to ensure that no pregnancy products remain and/or that healing from any procedure is going smoothly.

If you have had more than one loss, your doctor will likely want to run a Recurrent Pregnancy Loss Panel, to rule out any potential contributing physiological factors.

4. Acupuncture. Acupuncture promotes blood flow, regulates inflammation, supports hormone balance, and decreases stress. It helps with recovery from both spontaneous miscarriage, procedures and stillbirths, as well as supports regulation of your cycle after loss.

Treatment plans are individualized, based on factors relevant to your particular case, and can include regular acupuncture, customized Chinese herbs, and a review of recommended supplements, diet and exercise.

If a Western diagnosis has been identified, and/or Western Medical treatment is necessary, we make modifications to support this process. The primary aim is to help your body re-set. Should you plan to create and carry another healthy pregnancy, then we also help to prepare for this, while supporting the mental-emotional process and doing what we can to prevent another loss.

Pregnancy and infancy loss is not uncommon, and the more we speak to it, the better
we are able to understand and support one another. Bless the hearts of those who know
this kind of loss first-hand and bless the hearts of those who love and support them.

Dr. Alda Ngo

For more information on how we can support recovery and prevention of pregnancy
loss, please feel free to contact us for a free 15-minute phone consultation.

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