Preparing for a Healthy Pregnancy

By Sue Sveum

If you’re pregnant or hope to be soon, you probably already know that you should plan for anything — both expected and unexpected. And according to Dr. Amanda Schwartz, OB/GYN with Associated Physicians, diet and exercise are key components to having a healthy pregnancy.

EMBRACE EXERCISE

“Exercise is very important and strongly encouraged,” she says. “Women who were physically active before pregnancy can — and should — continue these activities during pregnancy and postpartum.”

Dr. Schwartz adds that women who weren’t physically active before pregnancy are encouraged to start exercising. It can be as simple as walking 30 minutes per day.

Studies show that women who exercise during pregnancy have decreased risks of gestational diabetes (GDM), C-section and forceps- or vacuum- assisted deliveries. Exercise can also help prevent postpartum depression.

Other benefits include lower rates of excessive weight gain, high blood pressure/preeclampsia, pre-term birth and abnormally high or low fetal birth weight.

HEALTHY DIET CONSIDERATIONS

“When it comes to diet, it’s a little more difficult to generalize, because it depends on so many other factors individual to each patient,” explains Dr. Schwartz. “Recommended weight gain varies, but pregnant women need approximately 300 additional calories per day.”

One important thing to remember is that some foods come with increased risk of infection that can be dangerous to pregnant women and their fetuses. Foods to avoid include:

  • Raw seafood
  • Unpasteurized juice, cider, milk or cheese
  • Undercooked eggs, meat or poultry
  • Cold hot dogs or deli meats
  • Raw sprouts

MANAGING THE UNEXPECTED – GESTATIONAL DIABETES

You may be doing all the right things and still encounter the unexpected. According to Dr. Schwartz, one of the more common medical complications (occurring in about 7% of pregnancies), is gestational diabetes — a condition in which carbohydrate intolerance (diabetes) develops during pregnancy and usually improves after delivery.

“The cause is unclear, but we believe it’s related to hormones signaling from the placenta,” says Dr. Schwartz. “Symptoms are uncommon — so GDM is generally discovered during a routine glucose challenge test for pregnant women between 24-28 weeks of pregnancy.”

Should pregnant women be worried if they get this diagnosis? According to Dr. Schwartz, women with GDM have a higher risk of developing preeclampsia, having a cesarean delivery and developing Type 2 diabetes later in life; however, these risks can be decreased with appropriate treatment.

“But we also know that exercise — especially weight training — increases lean muscle mass and improves tissue sensitivity to insulin, which may improve glycemic control in women with GDM,” she explains. “And women who appropriately treat and manage their glucose levels (usually through diet or insulin) can reduce their risk of serious newborn complications and their own risk for preeclampsia.”

Treatment usually begins with exercise, glucose monitoring and dietary modifications focused on caloric allotment, carbohydrate intake and caloric distribution.

And don’t worry about having to spend weeks laid up from GDM. “Bed rest is almost never recommended in pregnancy for any condition anymore,” Dr. Schwartz assures, adding that bed rest has actually been shown to increase risk of life threatening blood clots, bone density loss and deconditioning.

“I encourage all women to see their doctor for pre-pregnancy counseling prior to attempting pregnancy,” says Dr. Schwartz, “to discuss risk modification strategies and a plan specific to them.”

Associated Physicians | apmadison.com

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