My Pregnancy Self-Care: Movement

Exercise

Exercise during pregnancy is essential for proper circulation and nutrient flow to the placenta so I have remained "active" aiming to get at least 10K steps per day and doing "organized" exercise 2-4 times per week. Experts recommend keeping the intensity of exercise at a level of "somewhat hard" on Borg's scale of Perceived Exertion (RPE) and always maintaining correct technique during lifts. Not much has changed in how I work out other than moving in ways so my growing belly doesn't get in the way. As you read this, remember that I am maintaining the level of exercise intensity that I had before I got pregnant, so I'm not implying that everyone needs to go out and lift heavy weights just because you're pregnant. The key is, is it somewhat challenging for you?

I know many people have been asking how my workouts have changed. I had an injured thumb for a little while in my first trimester so I naturally stopped doing heavy-grip-dependent exercises like deadlifts and pull-ups and focused more on bodyweight/lighter weight exercise. Now that my thumb has healed, I'm back to doing some heavier lifting. See the videos below. Since I'm planning to have a natural birth (God willing), I need to prep my body to have both the strength and the stamina necessary for holding a deep squat and tolerating discomfort, so I'm training for those goals.

In this video I'm comfortably doing back squats 5x5 of 155lb while 17 weeks pregnant. Feeling strong!

Deadlifting my final set of 5 at 185lb at 16 weeks pregnant

I've been doing a mix of exercises, including but not limited to deadlifts, squats, dips, pullups, overhead press, kettlebell swings (high rep), kettlebell deadlifts (high rep), box step ups, running sprints (at 80% capacity), rowing/bike sprints etc. In the photo below (right), you'll see me doing isometric biceps curls. I started by using 5 lb dumbbells and have progressed to 8 lb for 3 min so far. If you've ever held a baby, you'll know your back, arms and shoulders get tired. This is my version of progressively training to hold the baby for prolonged periods without having to compensate my posture.

Bodyweight (+ baby) ring dips, sets of 5

Bodyweight (+ baby) ring dips, sets of 5

Isometric biceps curls (8 lb) for 3 min.

Isometric biceps curls (8 lb) for 3 min.

In some cultures, it is traditional to discourage women from movement especially exercise. But the way I think of it is this: If a pregnant woman was in the wild and was being chased by a predator, would she act weak and allow the predator to win the race? Or would she step into her God-given power, one that gives her the strength and capacity to overcome anything that stands in the way of her life and the baby's? Pregnancy increases her blood volume such that she can perform at levels similar to an athlete blood-doping. Why shouldn't she take advantage of this and concurrently enhance nutrient delivery to the baby?

Now of course, this wild woman lives in the modern day and no longer has these built-in stressors throughout her day. However, as women, we still need to behave in this way. We have to build these controlled stressors into our life for the sake of our health and the health of the baby. With that being said, below is a video of me doing a 100m sprint at 80% capacity.

Below is the Partner WOD Mark and I did on the 4th of July (19 weeks pregnant) at SnoRidge Crossfit (great place!). I modified the burpees, doing pushups on plates instead of the floor (since belly would touch first) and instead of doing toes-to-bar, I just brought my knees up to 90-degrees. Everything else (KB swings, power snatches, and wall balls) I could do without modification. Thanks to Rob Wilson, we got some nice photos too!

Non-Exercise movement

Working out in a gym environment or doing other organized exercise only takes place maybe and hour or two out of the day. What about the rest of the time? If humans were made to move, then why should I be sedentary the rest of the day? Of course, we don't need to be moving ALL the time; it's okay to rest. The key is to be constantly varying the forces gravity applies to the body.

With this philosophy in mind, I aim for lots of non-exercise movement as well such as squatting and floor-sitting.  Here's a little of what biomechanist Katy Bowman has to say about the topic on a podcast about transitioning to floor-sitting, "Getting to the chair and getting back up again: That’s one range of motion. Not stopping at the chair level and continuing all the way to the floor just increases the range over which you are using your body. So it’s not only move more, it’s move more of you. So you’re using different body parts, using your same parts but to a different extent when you travel that full range."

If it were up to me, my house would be furniture-free. Instead, I use small floor pillows and do my work at the coffee table (constantly changing positions) or we sit on the floor and read, talk, or watch TV. It's amusing how many people try to offer me a chair specifically because I'm pregnant. I understand it's well-intended, but what is actually better for my body and well-being is being on the floor! :)

berrysquatting

Squatting is easy to incorporate into your day-to-day life if you try to get outside and into the wilderness. It's actually recommended by midwives as a way for women to prepare for birth, since no woman in nature chooses to birth on her back. Fun fact: The pelvic opening becomes 30% larger during a squat than when lying on your back. A couple days ago, I probably did over a hundred squats to pick berries off the hiking trail after gardening (above is a photo of a different time berry picking at a farm). One step to take if you're not used to squatting is this: Every time you check your phone to scroll through social media or email, get into a squat. It's a great way to limit your screen use because eventually you will get uncomfortable. Two in one ;)

Now all this talk about movement makes me want to get up off the floor, go into the forest and pick some berries! Join me?

 

 

 

My First Trimester

So if you didn't know yet, now you know, we're pregnant!

In this post I will try to sum up how my experience has been throughout my first trimester. I think it's important to note that this my experience only and I don't want to project any experiences, positive or negative, onto others who may also be in their first trimester.

Hiking up to Poo Poo Point at 13 weeks. Those 8 miles were a lot harder than I remembered. An extra 9lbs. makes a difference!

Hiking up to Poo Poo Point at 13 weeks. Those 8 miles were a lot harder than I remembered. An extra 9lbs. makes a difference!

Weeks 1-4

I had quite the dilemma this March because as a Baha'i, we Fast from sunrise to sunset for 19 days in preparation for the New Year (Naw Ruz). For more on that, read my post here. However, my nutritionist-self knew that it would be very unlikely to be able to ovulate if I were fasting. Since being "with child" is an exclusion to Fasting in the Baha'i Faith, I prayed and decided that "bringing forth one who will make mention of Him" will take a higher priority than continuing with the Fast. This is my own personal decision and interpretation of the Baha'i Writings.

So I fasted for the first week of those 19 days. Expecting that my "normal" ovulation day would be a few days late, I decided to stop my fast to give my physiology some time to reset. However, as I expected, my ovulation was delayed by about a week! Which goes to show how important proper nourishment is for a healthy cycle!! Though, once my body sensed it was in a "safe place" with adequate nutrients and calories to sustain a baby, it was go time ;).

I experienced my first pregnancy symptom only 4 days after I ovulated! Coincidentally (or was it?), I first became nauseous upon getting in the car on our way to the Naw Ruz party. I was obnoxiously burping to give myself some relief. My whole life I've easily gotten nauseous especially when in the car, but this seemed different. I tried not to think too much of it, thinking it was WAY too soon to have any signs just yet.

On Day 28 of my cycle, about 6 days after ovulation, I experienced a very unusual uterine pain, very unlike menstrual cramps. It was as if there was a sharp tugging in the wall of my uterus. It happened again the next day and I instantly knew that I was experiencing "implantation", where the fertilized egg implants into the wall of the uterus. This was also confirmed by a slight drop in BBT (basal body temperature). At this point, I was both excited and fascinated that I was feeling the whole process! I suppose being very in-tune with your body does pay off. How amazing is the human body?! The following 3 days, I experienced quite severe nausea, night sweats, frequent urination, and sore breasts.

Circled is the "implantation dip" in basal body temperature (BBT)

Circled is the "implantation dip" in basal body temperature (BBT)

Weeks 5 and 6

During these days I began waking up several times throughout the night and being wide awake and energized by 4:30 am (much earlier than my regular 6:30). Thinking about the possibilities of why I might be awake, I decided to consider hunger as an option. Ding ding ding! Though I didn't feel hungry per say, I realized it was my cortisol keeping me awake (which is a hormone that goes up when the body needs food).  So I started keeping some almond butter with fresh fruit or bulletproof bars by my bed. Each food I had was equivalent to a particular duration of sleep that I would get from eating that food. Once I figured this out, I slept really well but am still getting used to "nightly feedings".

If I wait longer than 3 hours to eat, I am hit with some nausea but as long as I'm eating (protein, specifically) frequently, then I'm just fine. My husband gave me a ginger tincture to ward off the nausea if I haven't had a chance to eat. The regularity of meals reminds me of when I was vegetarian, eating every hour but never feeling satiated. Now, I feel satiated because my meals are well-balanced but for a while I felt like I needed to eat so often to prevent the nausea. It's important to note that the increased frequency of meals didn't really mean I was overall eating more. My meals were just smaller than they were pre-pregnancy.

I gained 6 lb. in one week! My guess is that the increased blood volume and breast size are responsible since I didn't notice any additional body fat. This was the only weight I gained throughout the first trimester.

I feel energized in workouts but my body is definitely letting me know (with instant nausea) if I've been pushing a little too hard. I've developed an understanding of how hard I can push in workouts and still feel good afterward.

Weeks 7-12

I've suddenly had to change my sleep hours. Staying up passed 10 pm is no longer an option. Some nights I would nap on the couch from 8-10 then head to bed or sometimes would just head straight to bed soon after dinner and always be asleep before 10. Gone are the occasional late night get-togethers with friends, sleep is now a priority.

Though needing to shift my sleeping hours, I've still felt that I've had stable energy throughout the day without compromising my focus at work or energy in my workouts.

During these weeks, I had the most "cases" of food aversions. Though not terrible, occasionally fried eggs or ground meats have smelled too strong for me and caused instant nausea. Surprisingly sardines, steak and liver have been fine!

Overall, my experience through the first trimester was quite pleasant. I can't really complain about much. Eating more often and using the bathroom more often seemed to be the most significant changes for me. I expected at least some nausea and had less than I expected and I was surprised that I didn't even vomit once! It turns out all the detoxification I did beforehand paid off! Stay tuned for a future post regarding how I've been caring for myself (specifics on diet, workouts, etc.) throughout my pregnancy. I know I've been getting lots of questions about how I've navigated my first trimester so I hope this is helpful for some of you.

My biggest surprise throughout this experience has been the fascination with witnessing the growth of a child that I have no physical input on. Yes, I'm kind of like the refrigerator, providing all of the necessary ingredients for creating a masterpiece, but God is the ultimate Creator and He is the Chef in this kitchen. I will pleasantly stand by and experience His miraculous Creation.

 

 

Always Tired? Maybe It's Iron Deficiency

Because my patient population involves primarily women of child-bearing age, I see iron deficiency A LOT.

We've been told for many years that we should be avoiding red meat and opting for more plant-based food options to be "healthier". Naturally, health-conscious women begin reducing or completely eliminating red meat from their diets. Depending on what their levels were before the diet change, it may take a couple years for iron to get so low that they start exhibiting symptoms.

Depending on the age this diet change was made, a woman may have no clue that this may be impacting her menstrual cycle. I can tell you from my own experience (and I see this reflected in my patients) that period cramps were extremely painful when I was iron deficient. I was vegetarian from the time I was in high school all the way through college, I was both extremely tired AND had heavy and painful periods. Oddly enough, the female body tends to lose more blood when a woman is iron deficient, further worsening the cycle.

Technically, a woman is not considered iron deficient unless her Ferritin is at 15 ng/mL or below. I can tell you from personal and clinical experience that every patient that I've had who had a Ferritin below 20 ng/mL really struggled to stay awake during the day.

This is one of the reasons why men typically do far better on a plant-based diet because their iron needs are much lower. Women often crave burgers and steaks as they are about 5 years into a vegan/vegetarian diet. Why? Because the body knows best! These cravings point our bodies in the direction of nutrient density.

It took me about two years to increase my iron stores from 32 ng/mL in 2013 to 56 in 2015. And that was while eating liver and red meat regularly (just not enough)!

So why do we need iron?

Iron's main role in the body is to carry oxygen on red blood cells. You've all heard of Lance Armstrong blood doping with EPO to increase his red blood cells right? Well, the reason why he benefited from more blood cells is because he had more oxygen carrying capacity! So think of it like this: If you become iron sufficient, how much better would you be able to perform in athletics, at work, or in school?!

If you've been exhausted and requiring caffeine and/or a nap to make it through the day, consider seeing me in my office so I can help determine what might be causing your fatigue. There are too many good things in life to go through it with sub-optimal energy!