Holistic Pregnancy Manual: Maternal Health Manuals, #1

"Everything grows rounder and wider and weirder, and I sit here in the middle of it all and wonder who in the world you will turn out to be." ~ Carrie Fisher.

About this Manual

The manual is structured as an A-Z, making it easy and quick to use. Much of what I share in this comprehensive guide is theoretical and backed by science, some is ancient wisdom passed down through generations of women, and a large chunk has been acquired by my lived experience and working with mothers and their families. My aim is to share best practices and evidence-based information with a holistic approach.

The specific advice given can (and should be) adapted in a way that is culturally appropriate for each family.

About the HORMONES!

I feel the need to explain that you will find a lot of finger pointing at pregnancy hormones, blaming them for many of the pregnancy-related symptoms. This is simply the truth but I acknowledge that it can feel a little repetitive and monotonous.

Introduction

Pregnancy can be a notoriously joyful yet tricky time and what a woman needs at such time is a confidante. This Holistic Pregnancy A-Z Manual aims to be that confidante. Over the years that I have been working with families, it has so often amazed me how little they know about the options and solutions available to help them find more balance in their pregnancies and increase the possibility of an empowering birth experience. Knowledge is power.

During consultations, I end up spending much time answering the same fundamental questions and clearing up Google-confusion for parents. Reflecting on this, I decided to create an easy to use, A-Z manual, which not only provides practical ideas for common, uncomfortable pregnancy symptoms but also aims to answer many of the questions parents have to support them in making informed choices.

The Holistic Pregnancy Manual doubles as a handy, quick-reference pocket for professionals working in the field of pregnancy. 

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I have adapted my texts in certain places for the language to be more inclusive without excluding the traditional language of women or motherhood. When I use the terms woman/women and mothers I am referring to sex as a reproductive category versus gender as a societal role or gender identity.

Adaptation to pregnancy

Pregnancy is divided into three trimesters. This chapter looks at the holistic adaptation of the body, mind and spirit in each of these trimesters based on the PsychoNeuroEndocrine approach to pregnancy.

First Trimester 0 - end of 12 weeks

There is a physiological (normal) disruption in the hormonal system. For instance, there are mixed emotional sensations caused by cortisol, which is there to inhibit the immunity of the woman ensuring that her body will not reject the embryo.

To maintain some kind of balance, the woman’s body needs to adjust to this disruption, she needs to find a balance between the natural stress caused by these hormones and the resources to help her body adapt.

Simply said, the stress her body naturally needs to go through to hold onto her pregnancy is good stress as long as it is discharged and interrupted now and then. Each woman needs to see which resources and coping methods she has in order to do this.

There is chaos, this is normal, so it is important that women recognise right from the beginning what works for her to interrupt  that chaos so that it doesn't become chronic stress.

In the first trimester, every woman reacts differently to the hormones but the following influences her, both physically and emotionally.

●  Endorphins  (creates euphoria)

●  Oxytocin (encourages trust in life)

●  Oestrogen (nurtures the tend and befriend emotions)

●  Beta-hCG (is the big invader)

●  Progesterone (promotes slowing down, introversion)

●  Cortisol (will cause difficulty sleeping, creates anxiety, inhibits the immune system)

●  Prostaglandines (creates changes in proprioception)

The challenge  is for women to recognise the benefits that the hormones are creating  meaningful chaos and then, it is for them to find the best way to interrupt (manage) the stress that this chaos may be causing them.

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Second Trimester 13- 27 weeks

Many first trimester symptoms should slowly reduce and eventually disappear. The increasing levels of the hormones: oestrogen, progesterone and endorphins, are responsible for the bonding between mother and baby.

The mother discovers the baby. The uterus grows and becomes obvious, and the mother feels the foetus move. This is the foundation of the physical bonding that happens after birth. Most mothers dream of, talk and sing to their baby.

Oestrogen and progesterone ensure growth of the uterus and foetus.

The sensors for oxytocin promote love and attachment, and lay the foundation for labour and birth.

Promoting parasympathetic dominance (so not constantly in the fight or flight sympathetic nervous system) is important in the second trimester.

Massage, acupressure, reflexology, chiropractic, osteopathic care, swimming, yoga, prenatal exercise can play a positive role here.

Being in the sympathetic nervous system (fight flight) in this trimester creates problems, both physical and emotional.

The challenge for women in the second trimester is to make time to rest, experience things they enjoy, and make space and time for themselves and their growing baby.

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Third Trimester 28 - 40/42 weeks

The third trimester can be a combination of everything that has occurred up to now.

The foetus begins to show competence. The mother will be able to feel the quality of movement, preferred times, preferred foods, preferred mother's position, preferred people to spend energy on. Some babies in the uterus choose a preferential way to communicate with some people and not with others. This creates a recognition of the baby. Mothers will often say things like, Oh, they are always super active in the evening or Look, here is their foot; always pushing on my ribs on the right etc.

Cortisol increases and disturbs the mothers pattern of sleep to prepare her for the lactation process.

Mothers begin to move towards separation - I can’t wait to meet the baby or I am fed up with being pregnant or I feel like a beach whale!

In the last 10 days of pregnancy, a new balance in the endocrine system (hormones) is created to ease the body towards labour and birth.

The  mother will move her focus to looking for coping techniques and information to support her through the birthing process.

The challenges in the last few weeks of the third trimester are patience, maintaining connection with the baby and finding ways to be predominantly in the parasympathetic nervous system so that her body can slowly move towards labour.

Allergies

Restricting your diet during pregnancy has not been proven to be effective in allergy prevention. In addition, restricting your diet may negatively impact your and/or your baby’s nutrient levels.

There are, however, certain nutrients that can improve the mother’s immune system and nourish the growing baby to reduce the chances of allergies.

Omega 3

Omega 3 fatty acids, which are found in oily fish, have strong anti-inflammatory benefits and have been thought to potentially change the immune system of the foetus before allergic responses are developed, especially in those with a genetic predisposition. Several  have shown a positive association between fish consumption in pregnancy and reduced allergy risk, especially eczema, which is a risk factor for food allergies.

Dosage

2000mg Omega-3 per day

Eat cold-water fish such as salmon, mackerel, halibut, sardines and herring two to three times a week.

Vitamin D

Vitamin D deficiency, both during pregnancy and your baby’s first year of life has been linked to an increased risk of allergic disease, including food allergies and eczema.

Dosage

4000 iu/day

Gut microbiome

Studies show that a healthy maternal gut microbiome is emerging as a potential protective factor for allergy prevention in infants. To optimise your gut health during pregnancy, aim to include a good variety of prebiotic fibre rich foods such as chicory, garlic, leeks, onion, asparagus, and Jerusalem artichokes. They're also found in lesser amounts in bananas, oats, yams and sweet potatoes.

Probiotic supplement

Trials have shown that women who take a probiotic supplement, particularly the Lactobacillus rhamnosus GG from 34-36 weeks of pregnancy and continued through the postpartum period until 3-6 months or until the baby was weaned, show reduced atopic eczema by almost 80% in infants at higher risk of allergic disease.

Zinc

Zinc supports the immune system and can help fight allergies. The recommended intake for zinc increases during pregnancy because zinc is necessary for the growth and development of your baby.

Dosage

As a supplement, 50mg per day

In food, good sources of zinc-containing foods that aren’t allergens include peas, beans, brown rice, pumpkin seeds, alfalfa and spinach.

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If you have a medically diagnosed food allergy, or are excluding foods due to a food intolerance, you should ensure that you are getting the required nutrients you need while you are pregnant.

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When to consult your care provider

Always alert your care provider if you have allergies or think you have an allergic reaction of any kind.

Amniotic Fluid & Sac

This is the sac or bag filled with amniotic fluid in which the developing baby grows. The amniotic sac is made up of a tough but thin transparent pair of membranes. The inner membrane, the amnion, contains the amniotic fluid and the foetus. The outer membrane, the chorion, contains the amnion and is part of the placenta.

The membranes may rupture naturally as labour begins, although it is more usual that they remain intact until closer to the pushing stage of labour.

Rarely, babies are born in their amniotic sac. This is referred to as en caul. Folklore developed suggesting that possession of a baby's caul would bring its bearer good luck and protect that person from death by drowning. Cauls were therefore highly prized by sailors. Medieval midwives often sold them to sailors for large sums of money; a caul was regarded as a valuable talisman.

There are situations in which a care provider might suggest to manually rupture the membranes to speed up or to induce labour. This should only be done with informed consent.

Anaemia

Iron deficiency anaemia is common in pregnancy due to an increased need for iron because your body is making more blood. A certain amount of anaemia is normal and even expected in pregnancy because although your blood volume increases, the number of red blood cells remains constant.

Slight anaemia in mid-pregnancy is a positive indication of increasing blood volume.

Mothers carrying twins (or triplets) pregnancies close to one another and vegetarian or vegan mothers have a higher risk of becoming anaemic.

Keep an eye open for the symptoms listed below because severe anaemia may slow your baby’s growth or result in premature birth. Also, anaemia makes your body weaker, you may not recover as quickly after childbirth.

Symptoms for anaemia can easily be confused with normal pregnancy symptoms and are pretty non-specific, but if you have any doubt and the following symptoms seem to be persistent, you should suspect a certain level of iron deficiency anaemia.

Symptoms

●  Tiring easily

●  Weakness

●  Pale skin, gums, eyes, and nail beds

●  Fast or irregular heartbeat

●  Shortness of breath

●  Headache

●  Restless legs

●  Light-headedness

●  Cravings for non-food substances like starch, sand, chalk or ice (a symptom called pica)

Medical Treatment

Depending on the extremity of your anaemia and if it is caused by low iron levels, then your care provider may prescribe iron supplementation in the form of ferrum.

Avoid antacids, milk products, tea or coffee for 30 minutes before and after taking iron supplements because these prevent the iron from being absorbed.

Iron is very difficult for the body to absorb from supplements which results in dark bowel movements and possible constipation.

If your anaemia does not require an iron supplement from your care provider, then your best bet is to restore iron levels through diet and supplements.

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THERAPIES AND IDEAS for Iron Deficiency Anaemia

Golden Tip

1 tablespoon of liquid chlorophyll daily helps your body to manufacture more haemoglobin. Alternatively, use any green food powder supplement.

All green foods contain high amounts of chlorophyll, so any powders made from young barley, wheatgrass or spirulina are good. Always take the recommended dosage on the packaging.

Nutrition

Iron Rich foods

It takes time but anaemia can be tackled by increasing the amount of iron rich foods you eat, specifically the heme-iron foods which are more readily absorbed.

>Heme-iron present in animal foods is more readily absorbed: fish, shellfish, red meat, liver, poultry and fish.

>Non-heme iron foods: nuts, seeds, dark green leafy vegetables (chard, mustard greens, kale), dried fruits, iron-fortified cereals & breads, legumes (beans, peas, lentils) and blackstrap molasses are less absorbed and need to be either soaked or cooked and eaten in combination with Vit C foods (tomatoes, citrus fruits, strawberries, melons, papaya, bell peppers, broccoli etc.)

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The absorption of iron is improved by Vitamin C - include foods/drinks  that are high in Vitamin C when consuming iron rich foods and taking an iron supplement. Iron absorption is hindered by tea, coffee, milk products, antacids and calcium rich foods. Avoid these for at least half an hour before and after taking a supplement and/or consuming iron rich herbs and foods.

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