Tuesday, March 20, 2012

29 Weeks and 2 Days

Fetal Development Week 30
My baby's brain is developing more around this time. Up until now the brain should have been pretty smooth but now it's starting to develop the grooves and indentations that give our brains more surface area. Also, her bone marrow should be taking over the job of producing red blood cells now. So lots of development going on for my baby! I don't feel her kicking quite as much as I used to now what I feel is a lot of sliding and maybe pushing, or stretching. I can look down throughout the day and see my belly move, which usually makes me laugh because I wonder if other people are seeing it, of course they're probably not paying attention, but I still wonder. 
Last week I was tested for Gestational Diabetes, it's normally done around 28 weeks so obviously that's what I was last week. I drank this red punch drink that was 50 mg Dextrose (basically a sugar shot), it reminded me of Hawaiian punch! Then we waited for an hour and then had my blood drawn so that my blood sugar level could be measured. I'm assuming the test came back normal because they didn't call me later that week and they had told me that "no news is good news." 
I think I've been having Braxton Hicks contractions, well actually if they are what I think they are then I've been having them for a while, I just didn't realize it. They don't last too long but basically my uterus gets really hard (you can push on it and feel it through my skin and I used to think it was the baby stretching or something), and sometimes they make me feel a little sick to my stomach like a really weak menstrual cramp I guess, and then it just passes. They are becoming more frequent, which is normal I guess, but I usually have most of them in the evenings, however this week is the first week I've had a couple, or at least I think I did, in the morning. 
Allergies have been kicking my butt since last Monday! I was trying so hard not to take any medicine for it and hoping it would just go away but it didn't and yesterday I gave in. I called the nurses and asked what is safe to take while pregnant and finally started taking Benadryl last night and then Zyrtec today. I don't know that's helping yet, I'm still pretty miserable but I know sometimes it can take a few days to work. The Benadryl is definitely helping me sleep though so that's good.  I'm just so tired I feel useless most of the time, I hope this passes soon.

Thursday, March 8, 2012

How does Exercise affect the timing of delivery?

Well I have invested in a Maternity support belt and boy does it work wonders! I went to Destination Maternity and tried on like 5 different ones, they had some that were less bulky and were elastic all the way around but finally settled on the bulkiest because it was also the most comfortable (it isn't elastic all the way around so it doesn't dig into my skin as much as the others) and I really felt relief for my back the instant I put it on! The brand is Loving Comfort. I tried it out the first day by wearing it over my clothes while vacuuming the house. Then yesterday I went for a 3 mile run in it and perhaps I was just having a good day, but I finished my run 5 minutes faster than I normally do! Either way my back felt great after that run! Today I went for a very easy 2 mile run without the belt and that was okay too, but at least now I've got the belt because I'm sure I'll start needing it more often. 


Alright time to get down to business with a question that I've been wondering about lately. Does exercise induce preterm labor? Bear with me, this one takes a long path to get to the point but it's necessary to fully understand the point. Again I'm siting this information from James F. Clapp's book "Exercising Through Your Pregnancy." Research in industrial medicine has shown that "several types of on-the-job physical stress increase the incidence of labor starting more than three weeks before the baby is due (premature). The research also shows that these stresses increase the number of infants who weigh less than they should for the time they are born." In addition, it has also been found that when these workplace stresses are reduced these two problems are alleviated. Thus people assumed that physical stress is physical stress no matter where you find it and vigorous recreational activities (such as running) should be avoided in pregnancy. "However, the types of physical stress in the workplace that have had significant effects are much different physiologically from those of recreational exercise." These include:

  • quiet standing for four or more hours a shift
  • walking for protracted periods
  • long work shifts
  • frequent heavy lifting
It is understandable how this kind of job would produce feelings of extreme fatigue in a pregnant woman, and we can see how if she is regularly experiencing this stress it could result in an under-grown baby. Let's look at this scenario that Dr. Clapp uses as an example in his book:
  1. The woman has been busy or is allowed infrequent breaks so she doesn't drink because she doesn't have time.
  2. If she can drink, she doesn't because it will mean many trips to the ladies' room.
  3. This dehydration is compounded by her being on her feet for a long time, which causes blood to collect and pool in her relaxed leg veins.
  4. Swelling of the lower leg and ankle occurs because the back pressure from distended veins causes fluid to leak out of capillary vessels into the tissues.
  5. If she doesn't eat frequently, her blood sugar level falls.
  6. Fatigue sets in. 
The reduced blood flow (caused by dehydration) along with low blood sugar, reduces oxygen availability and decreases nutrient supply to the baby, in turn slowing its growth and increasing irritability of the uterine muscle and risk of premature labor. "Once it was recognized that recreational exercise usually does not produce most of these effects - symptoms of severe fatigue, pooling of blood in the legs, or low blood pressure - investigators began to separately quantify physical stress on the job and physical stress from recreational exercise to determine if either is associated with premature labor or smaller than average babies." Clapp goes on to say that all studies show that recreational exercise not only does not increase the incidence of smaller babies or premature labor, but it might actually decrease in the incidence of both.  So all of that was Dr. Clapp looking at the information that was available to him, now we can look at the study that he designed. The two questions he asked:
  1. Does continuing a regimen of sustained, weight-bearing exercise (running or aerobics as opposed to biking or swimming) throughout pregnancy increase the risk for premature labor?
  2. Do either sudden foot strike shock or bouncing, ballistic motions cause the membranes that surround the baby to burst before they should?
To answer these questions they "established an accurate due date for each woman who enrolled in the study...then monitored exercise performance throughout the pregnancy in the regularly exercising women who continued to perform sustained types of weight-bearing exercise at or above the basic fitness level throughout pregnancy."  The timing of their deliveries were compared to a control group (women with active lifestyles who did not maintain a regular exercise regimen).
 
Exercise group criteria:
  1. Maintain exercise regimen at least 50% of prepregnancy level. (Example: if she ran 6 miles before becoming pregnant, she could remain in the exercise group as long she continued running at least 3 miles throughout pregnancy)
  2. Her level of exercise also had to remain above that required to maintain basic fitness.
Over 70% continued to meet these criteria and in most cases, performance was above 50% of prepregnancy level. "Over the last three months, their average exercise intensity fell a little bit (from 66 to 59 percent of maximal aerobic capacity), but, in many cases, the time spent each week in exercise increased."
Of the women who stopped or cut back after the 30th week, we ask why did they stop?
  1. No longer had enough time once they started preparing for the birth.
  2. Pressure from people around them who were concerned that the exercise might hurt the baby or initiate preterm labor.
  3. Becoming concerned themselves.
"Physical discomfort was way down on the list."
They followed all of the women on to the timing of delivery and therefore have information on 3 rather than two groups.
  1. Over 200 who continued vigorous exercise to within a week of delivery
  2. Over 80 who exercised vigorously throughout early and midpregnancy but later cut back or stopped
  3. 250 physically active controls who rarely engaged in sustained exercise but occasionally played tennis, walked, gardened, etc. 
The RESULTS!
Running and aerobics did not cause the water to break before the onset of labor at term (the end of the 40th week). "The chance that this would occur before the beginning of the 37th week was low and was the same in all three groups. This was also true at the end of pregnancy. Even after the cervix had begun to dilate, women could continue to run or participate in aerobics without increasing the chance that the membranes surrounding the baby would burst before the onset of labor." More women in the exercise group actually delivered earlier than the control group but were still at term. In other words, exercising women didn't necessarily deliver earlier than 40 weeks, but most of the controls delivered 5 to 7 days later than the exercising mothers. "The timing of women who stopped exercising midpregnancy was no different than the controls."

As always I think this is good information, it gives me hope that I will be able to continue running for the next 13 weeks, but always listen to your Doctor or other healthcare provider as sometimes complications do arise. Listen to your body and rest when you need to, as in any stage in life there needs to be a good balance between rest and exercise. Drinking water to stay hydrated is always important but it is even more so while pregnant. One of my friends recently said it best when she was expressing that as pregnant women we aren't handicapped but we don't have to be super heroes either. 

Tuesday, March 6, 2012

27 Weeks and 1 Day

Fetal Development Week 28

Well we had our first baby shower over the weekend it was a lot of fun and I know I need to post pictures but I'm in a hurry right now so I can't just yet. We got lots of cute clothes and blankets plus our infant carrier and car seat! The baby's room is now mostly empty of all the boxes that had been cluttering it since we got married, so it looks like our baby girl will in fact have a bedroom! 
As far as exercise and pregnancy there is still so much information to share that I'm having a hard time organizing it but trust me I am working on it. So things I will soon be talking about are more benefits to the mother and also to the baby. I haven't talked enough about the benefits to the baby, plus there are more concerns that need to addressed such as "will weight bearing aerobic exercise cause pre-term labor or early rupture of membranes?" As a runner I know I've been wondering about that too, speaking of running the reactions I'm getting when I tell people that I'm still running are starting to get really funny!  One person asked me how my feet were and apparently he was referring to the swelling that usually starts around now, and I responded "oh they're a little sore from the race I just ran." and he was like "you're still running? with the baby." I laughed and said "well yes, she's right here," and pointed to my belly! 
Last week I ran Mon/Wed/Fri, 3 miles about 40 to 45 minutes. Friday's run was by far the best, I don't know why but I just felt so good and strong. Again, I am running slower than I used to and I take more walk breaks but that's okay. Now that was last week and I don't know what happened over the weekend but yesterday I ran 3 miles and it didn't feel so good, it was the first time my low back started hurting and I just felt so heavy. So I think I am going to look into a belly support belt to use at least when I run, I've read different opinions on them and I've decided that if it helps me continue running longer it's worth it! So anyway soon I will share some more information about exercise during pregnancy! So stay tuned!