The positive impact of prenatal exercise

The following is a re-post of my August 2008 post Wanna Improve Your Odds?:

I mentioned back in April that I had been skimming the book Exercising Through Your Pregnancy, by James F. Clapp M.D. I was really impressed at that time with the amazing benefits of exercising through pregnancy. But I didn't read the book in-depth. I decided earlier this week that I wanted to take a closer look. Now that I've read several of the chapters and examined the data thoroughly, I am telling you... it absolutely blows me away.

There are risks inherent in pregnancy and childbirth, but we can do things to minimize those risks. We all know that good nutrition is essential for pregnant women. Poor nutrition often leads to pre-term and low-birthweight infants as well as pre-eclampsia in mothers. Eating well is one of the absolute best things you can do for your unborn child's physical and neurological growth. But now I'm convinced that exercise may be just as important.

I won't go into all the benefits of prenatal exercise here. I'd just like to focus on one set of benefits in particular--the effects of exercise on the course of labor. You might remember my very early post about the benefits of doulas. Having a doula assist your labor and delivery reduces many chidbirth risks significantly. Prenatal exercise has even more pronounced benefits.

Women who continue exercising regularly through the end of their pregnancies (three times a week for at least 20 minutes at a moderately hard to hard level of exertion) demonstrated the following reduced risks during the birth process...

* 35% decrease in the need for pain relief
* 75% decrease in the incidence of maternal exhaustion
* 50% decrease in the need to artificially rupture membranes
* 50% decrease in the need to induce or augment labor with pitocin
* 50% decrease in the need to intervene because of abnormalities in the fetal heart rate
* 55% decrease in the need for episiotomy
* 75% decrease in the need for operative intervention (forceps or cesarean section)

In addition, check these out...

* More than 65% of the exercising women delivered in less than four hours.
* 72% delivered before their due date (but fewer of them delivered before 37 weeks--preterm--than the control group). The exercising women delivered, on average, 5-7 days earlier than active women who did not exercise regularly.
* Significant reduction in the incidence of umbilical cord entanglement.
* Much lower incidence of fetus passing meconium from distress.
* Umbilical cord blood samples indicated that babies of exercising moms remained relatively stress-free with plenty of oxygen. They seemed to tolerate the stresses of labor and delivery better than the control group.
* The exercising mothers' infants were, on average, 14 oz lighter but overall growth was not compromised.
* Placentas of exercising mothers are larger, more efficient, and healthier-looking.
* Infants born to exercising mothers were more alert postpartum and needed less consolation from others.

(All of these results are taken from Dr. Clapp's studies as reported in Exercising Through Your Pregnancy. See this fabulous book for even more amazing benefits.)

It blows my mind.

Imagine how huge the risk reductions would be if you exercised through pregnancy AND had a doula. Whoah. We can do so much to avoid the pitfalls of pregnancy and birth. It gives me so much joy and hope to know that I am not at the mercy of chance. I have a great deal of power over my circumstances when it comes to pregnancy and birth. It is a wonderful thing to be able to choose to pro-actively reduce risks and bring so much benefit to myself and my babies. I love it!

First baths, etc.

I've got this new theory. I'm not going to suggest that I'm the first to come up with this. It's only "new" in the sense that it's "new" to me. I'd love to see it tested with some research on mothers and infants.

A few weeks ago I got thinking about the profoundly intense bond I developed with my son following my home birth. I had never experienced anything like it. Sure, I developed a deep love for my daughters, but it took much longer and came far less naturally. I have come up with many possible explanations for the intensity of the bond with my son...

* No Pitocin to interfere
* More intense oxytocin rush being in a comfortable, private setting
* Immediate and prolonged skin-to-skin contact
* First feeding within 15 minutes of birth (I can't remember exactly, but it was the first thing we did after holding him and delivering the placenta.)
* No hospital staff coming in and out of our room at all hours

As I was thinking, I realized another factor I hadn't thought of before...

Read the rest of this post over at my new website!

Still high

What could be better than gathering with 50 fellow "birth junkies" in a 3-day birth-binge? Oh my. The doula training was awesome.

I tell you what... the oxytocin in that room was palpable. In part because of 5 or 6 breastfeeding mommas with their babes. Compound that with the massages and comfort-measures we were practicing. (Massage and loving touch promote the release of oxytocin.) And then the 6 or 7 birth and breastfeeding movies we watched. I think, in fact, that watching a birth (particularly when physically present) can promote the release of oxytocin. But that's just my theory based on some interesting tidbits from this weekend...

1) The Zone
Our doula trainer, Mary, talked about the way a pregnant woman's hormones can affect those around her. For instance, Mary told us about a study showing that men sharing a home with a woman in late pregnancy will experience a reduction in their testosterone levels. I suppose it's nature's way of preparing the male for fatherhood--promoting less aggression and more sensitivity and decreasing his libido in preparation for his wife's postpartum recovery period. Then Mary discussed how there can be a chemical chain reaction at birth. The people surrounding the laboring woman can enter into a kind of "zone" in which their bodies start producing hormones in response to the laboring woman's hormones. A woman in labor is radiating oxytocin like nothing else. And I think the people around her--if in-tune with her through their consistent presence--will also experience a surge in their own oxytocin levels. It makes complete sense. Of course God would prepare such a chain reaction... He knows the laboring woman needs the people around her to be supportive and nurturing--exactly what their elevated oxytocin levels will promote.

2) The Tears
If you know me well, you know that I'm not a crier. I once told my husband there are really only two things that will get me to cry. The first is emotional agony, the second is God. And I think God touches us quite often through our own body's chemical impulses. God is LOVE. Oxytocin is the hormone of love. I was brought to tears with just about every birth we watched this past weekend. Here are people I've never met giving birth to children I've never met, and I can't help myself... I cry every time I see those babies birthed and brought into their mothers' and fathers' arms. During one video, the combination of the music and the images of women being supported in labor had me wiping away fat tears streaming down my face. I'm convinced that you don't even have to be physically present with the laboring woman to experience an oxytocin rush in reaction to her labor/birth.

I think my oxytocin levels may have even gone a little too high, actually. It didn't even occur to me until after I got home last night that oxytocin may have been responsible for the excessive number of braxton-hicks contractions I experienced during the training. I know, from past experience, that I often have more frequent and intense braxton-hicks contractions following oxytocin-producing activities (use your imagination). Those contractions came over and over and over all weekend. Some of them were quite intense... almost painful. And I thought more than once that if I was going to go into pre-term labor, there couldn't have been a better time/place--at a hospital with doulas and a midwife present in the room! Thank goodness my baby is still safe inside though.

With the bonding hormone so plentiful, it's no surprise I formed friendships over the weekend. I sat next to these lovely ladies on Saturday and Sunday...That's Jessica and Cassie. It was so fun spending the weekend with them and holding Cassie's cute baby boy. And I'm thrilled that they have both offered to be my doulas. Plus Cassie's a photographer and said she'd take photos at the birth for us too! :-) I look forward to laboring and birthing my baby surrounded by loving, supportive women as well as my fabulous husband too.

Here I am with our doula trainer, Mary, after I got my certificate for completing the training workshop...Yay! Now on to fulfill the other certification requirements...

But, in the meantime, I'm doing some serious nesting. All of a sudden I've got the urge to clean and organize the entire house and purchase everything we will need for the birth and have it all gathered and ready. In fact, I spent several hours this morning cleaning my bedroom (one of the rooms I plan to labor and possibly deliver in), putting away baby clothes, vacuuming, and starting a birthing playlist in iTunes. I've never nested so literally before... I'm actually preparing the place where my child will be born. Cool!

Stay tuned for posts with tips and tidbits from the doula training workshop!

Turn off the lights!

Last night I heard about a study that reaffirms what our mammal cousins have known instinctively for thousands of years... birth should happen in a dark, comfortable place! It also helps explain why most women go into labor in the middle of the night (which is, of course, why doctors find inductions and cesareans so much more convenient). And why so many labors slow down or stall in a hospital setting....

Read the rest of this post over at my new website!

Labor is important

Ina May Gaskin, revered by many as "the greatest midwife in the world," explains:

Labor is important, because during labor, both the mother's and the baby's body is prepared for birth. The levels of certain hormones rise and ebb during labor. For instance, the mother's oxytocin levels rise markedly just before the baby is pushed out of her body. This protects her against postpartum hemorrhage. High oxytocin levels in the mother (which are accompanied by higher levels in the baby, too) prepare the nervous systems of both to be attuned to each other. . . . The euphoria that follows an unmedicated labor is a very special time for anyone who is privileged to witness it. It's even better for those who get to experience it.

When the mother experiences labor, she also has higher levels than usual of beta endorphin. This hormone then triggers another hormone, prolactin, which prompts her body to get ready for milk production at the same time that it prepares the baby's lungs for more efficient breathing.

Labor also gives the baby's torso a good squeeze, which helps to dry out the lungs and make them ready for breathing air in the outside world. Cesarean-born babies typically have wetter lungs, which can mean a higher rate of needing breathing assistance at birth. (Interview with Ina May Gaskin by Stacy Fine)

Birth in the Bible

I was thinking a while ago about what the scriptures say about birth. God told Eve that she would have "sorrow" (which, in the Hebrew, meant travail, pain) in bringing forth children. I think people have traditionally interpreted this as God cursing Eve and punishing her. But I don't think that's what He was doing at all.

When I read these scriptures, I see a loving Father explaining to Eve that because she will be leaving the Garden, He will be changing her body so that she will have the ability to bear children ("I will greatly multiply thy sorrow and thy conception (increase fertility, discomfort and size)") and He is letting her know that bearing children will be painful. He is preparing her and Adam for the trials ahead of them.

I believe that opposition is a necessary part of life--without pain and hardship, we cannot truly know happiness and joy. This is evidenced in the scriptures as God tells Adam that the difficulties he will encounter in the world are "for thy sake"--for his (and Eve's) benefit.

Isaiah described Christ's Atonement this way: "He shall see the travail of his soul, and shall be satisfied" (53:11). The word "travail" is generally associated with the pains of a woman in labor. When Christ suffered the Atonement, that act--suffering those pains for us--was the greatest act He ever performed and the one which ultimately brought the greatest joy imaginable. Imagine the aftertaste of that experience! "[He] shall be satisfied"... more satisfied than anyone has ever been, no doubt!

I don't believe God was cursing Eve, and He wasn't cursing Christ. Pain isn't inherently bad. Intense pain makes intense joy more possible. The more pain we experience, the more we can understand the profound Atonement of Jesus Christ. Not that we should hurt ourselves on purpose, but when pain comes to us through life, we can try to bear it with patience knowing that it will make our capacity to experience joy that much stronger.

In fact, pain is an ally in childbirth. When we experience pain, our bodies are bathed in endorphins--feel good hormones--and other important processes take place in our bodies to make the labor and delivery go smoothly and to prepare our babies for life outside the womb. It is all so intricate and well planned out. God knew what He was doing!

Most women who tell horror stories about labor aren't the ones who embraced birth, trusted their bodies, and experienced it the way our bodies were intended to experience it. They are usually the ones who cut themselves off from the pain (by choice or out of necessity), and consequently cut themselves off from an even greater joy. Women who give birth without drugs (by choice) are usually eager to talk about their birth experiences and describe birth as being very positive. They glory in their birth experiences even though (or, perhaps, because) they experienced more pain than they had previously experienced!

When I think about labor pain and the account of Adam and Eve, I don't think why did God do this to women??? I love Him more because I can see that He has all knowledge and His workmanship was designed perfectly. The process of birth was designed just as it should be, and, when we try to interfere with that process, it not only often causes birth complications, but it also interferes with our capacity to experience the profound ecstatic joy we can be bathed in when birth happens as it was intended to happen.

"The Birth of a Breastfeeding Baby and Mother"

Check out this column by Judith A. Lothian (PhD, RN, LCCE, FACCE) in the Journal of Perinatal Education. Here's the abstract:

"In this column, the author describes the way in which the normal, natural process of labor and birth prepares both mother and baby for breastfeeding. Birth practices including induced labor, routine interventions, epidural analgesia, and separation of mother and baby disrupt the process of early breastfeeding for mother and baby. Normal, natural birth sets the stage for uncomplicated breastfeeding."

Five Ways Pitocin is Different than Oxytocin

I have been doing some research about oxytocin and stumbled upon this great overview of the ways Pitocin and oxytocin differ in the process of labor. If you're considering an induction with Pitocin or are just curious, check it out!

Little known facts about Pitocin and induction

"Pitocin is the most abused drug in the world today." ~Roberto Caldreyo-Barcia, MD, former president of the International Federation of Obstetricians and Gynecologists

• Pitocin is not approved by the FDA for elective (patient or provider convenience) inductions or stimulation of labor (moving things along).

• Pitocin generally produces contractions that are much longer, more intense, and more painful than normal contractions....

Read the rest of this post over at my new website!