Pre-Conception Wellness: What Your Patients Need to Know
By Claudia Anrig, DC
Deciding to have a baby is one of the most important decisions a woman will ever make. But how many women are really prepared for a healthy pregnancy? Lifestyle choices that expose them to chemicals, stress and poor nutrition may negatively effect their ability to become pregnant and/or prenatal outcomes.
For chiropractors, our role can start with a simple statement to our women patients: "If you are thinking about becoming pregnant in the future and would let me know 6 to 12 months prior to starting the process, I would be more than happy to provide you pre-conception advice." Here's are some of the recommendations you can share with them:
More than 100 million women worldwide take the pill – including some for non-contraceptive reasons; for instance, to regulate their period or decrease the severity of the symptoms of premenstrual syndrome.1-2 Regardless of why they're taking it, many women are under the impression that as soon as they're ready to get pregnant, they only have to quit taking the pill and within a month or two they'll conceive. While this may be the case for some, it is not the case for others.
Many doctors recommend waiting at least 2-3 months after stopping the pill before even attempting to get pregnant. The typical reason given is to allow the body to return to its normal hormonal rhythms, though there really is no research regarding what possible effects the extra hormones may have on a developing fetus.
Our patients should also know that it may take time to conceive once they stop taking the pill; in roughly 10 percent of cases, a woman may not be able to conceive even a year after they stop taking the pill.3
Other Drug Use
With more than half of all pregnancies unplanned, it has been estimated that more than a million babies have been exposed to drugs in the first or second month of pregnancy.4-5 A study performed by Boston University and reports from the Centers for Disease Control and Prevention showed that 70-80 percent of pregnant women have reported taking at least one medication.6
The concern is that 90 percent of medications approved by the U.S. Food & Drug Administration from 1980-2000 had insufficient data to determine if they were safe to take during pregnancy. While many women are being prescribed these medications, studies have not been done to determine if these chemicals will cross the placenta and affect the fetus.7-8
From 2010-2012, several studies reported that not only is antidepressant use during pregnancy on the rise, but also that their use has been linked to birth defects. Additional studies have shown that children whose mothers took Zoloft, Prozac and similar antidepressants were twice as likely to be diagnosed with autism or related disorders.9-12
A patient with a history of medication use should be advised to speak with her physician to possibly look at alternative choices, and to dialogue about the risk and benefits of medication use during pregnancy.
Getting Ready for a Pregnancy
While having a baby is the most natural thing in the world, convenience increasingly interferes. Processed foods, caffeine, aspartame, high-fructose corn syrup, and chemicals for depression and contraception have all affected our bodies and potentially caused areas of concern. That's why, before considering conception, it's important to make a few lifestyle changes to ensure the pregnancy has the best chance of success:
Avoid the Chemicals: Most of our patients would agree that chemicals are unhealthy for them, but there have been links even between many food additives and pregnancy risks. For instance, an American Journal of Clinical Nutrition study published in 2010 concluded that daily intake of artificially sweetened soft drinks may increase the risk of preterm delivery. In addition, when aspartame, commonly known as NutraSweet, is consumed during pregnancy, it may potentially contribute to autism and spina bifida.13-14
Another concern is caffeine. Studies have shown that it crosses the placenta and can cause birth defects. Additionally, it can actually reduce fertility or delay conception. But perhaps the greatest concern is that two studies in 2008 showed women who consume 200 mg or more of caffeine daily are twice as likely to miscarry.15 Since over half of pregnancies are unplanned, it's wise for all women of childbearing age to reduce their caffeine intake. Just 2 cups of coffee contains almost 200 mg of caffeine.
Encourage Healthy Eating: What a woman eats is the fuel her body uses to help her fetus develop, so make sure that only the healthiest and most nutritious foods are being consumed. First, encourage eating organic as much as possible. The chemicals and pesticides used on commercially grown foods have not been tested for the effect they may have on the fetus. Genetically modified foods should be avoided as well since they have not been tested.
Besides eating organic, eating six small meals a day is ideal, as is drinking at least 8 glasses of water: natural spring, not purified or tap. Add in at least five servings of vegetables, along with healthy fats. The omega fatty acids are critical for fetal development, with omega-3 being especially important for neurodevelopment.
Omega-3s are found in seafood, flaxseed oil, nuts, seeds, spinach, broccoli, cauliflower and winter squash. Omega-6s are in flaxseed and grapeseed oil, pumpkin and sunflower seeds, and pine and pistachio nuts. Omega-9s are readily available in olive oil, avocados, almonds and most other varieties of nuts. It's important to try to consume some of each of these fatty acids each day.16-19
Exercise and Yoga: It's been shown that women who are not physically active prior to conceiving are unlikely to develop an exercise program after conceiving. Encourage your patient to start walking 15 minutes, out and back each day, five days a week. Then gradually increase by 5 minutes until your patient is walking an hour a day. Walking has been proven to be beneficial for each trimester of pregnancy.
A regiment of yoga has also been shown to be helpful for pregnancy-related muscular pain, helping strengthen those muscles used in birthing and decreasing stress hormones.
Chiropractic Care: Along with providing pre-conception advice, a regular regiment of chiropractic care can not only assist with a biomechanical advantage, but also influence hormonal and immune well-being. As women continue to look at ways to achieve what is best for their health and for prenatal care, there is a role for the doctor of chiropractic to serve this population group.
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