folate

Pre-conception Considerations: Things to Think About Before Getting Pregnant
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Pre-conception Considerations: Things to Think About Before Getting Pregnant

I’ve had several ladies reach out this year asking for information to consider as they hope to conceive sometime in the next few months. As I started replying to some of these inquiries, I realized that it might be helpful for others in similar positions to have some of this information at their fingertips. My hope is that some of these suggestions can help you to achieve the healthiest pregnancy possible as you actively prepare your body for the amazing stress and strength that growing a baby places on your entire system-this is certainly worth seriously considering and prepping for, and I can guarantee you won’t regret any time and effort you invest before pregnancy!

Let’s start at the beginning:

  • Educate Yourself on Your Hormones and Cycle:
    • Understanding how your body works, and how to read your fertility signs (temperature, cervical mucous, etc.) can make a huge difference in both your ability to conceive and in determining an accurate due date. There are some disorders or challenges that can be identified early on if you have been keeping track of your fertility signs, and this can save you time, money and heartache if you know what to look for and when to get medical intervention. Simple things such as knowing you ovulate “late” compared to traditional due date calculators can save you the challenge of being considered “overdue” when you actually didn’t have an accurate due date to start with!
    • For better understanding, I highly recommend the book Taking Charge of Your Fertility by Toni Weschler. This guide helps you to really get to know how the women’s body works, how to chart your cycle, and how to understand all the information you are pulling together. The TCOYF app is also a great way to track your cycle, and it’s free! Another helpful book on the subject is The Fifth Vital Sign by Lisa Hendrickson-Jack (as a disclaimer, I JUST ordered this book and have it sitting in my “to read” pile-it looks great, but I haven’t read through it yet!).
    • For those particularly wanting to use fertility tracking as a guide to Natural Family Planning, the Art of Natural Family Planning Student Guide is a good way to delve into some of the details, which can also be an aid in achieving pregnancy.
  • Birth Control/Hormonal Contraception:
    • If you’ve been on hormonal contraceptives, it’s important to remember that it can take up to three months for normal cycles and fertility to return. The sooner you can get off any hormonal BC the better for  your overall health! Aviva Romm has a great article on fertility issues after hormonal contraceptives and getting off the pill here: Post Pill Reset and I highly recommend the new documentary The Business of Birth Control for better understanding of how hormonal contraceptives can negatively affect your overall fertility and health while providing an introduction to other non-hormonal options.
  • Deal with Any Current Health Concerns Now
    • Do you have weight you need to gain or loose? Start understanding healthful eating, and work on that now BEFORE  you add pregnancy to the mix! I’ll add more on diet below, but healthful eating habits should begin now, and will provide a great foundation for the demands of pregnancy on your body.
    • Are you currently on any medication that could have a negative effect on a developing baby? Many health challenges (such as elevated BP) can be managed by diet, lifestyle and supplement changes, and these are best achieved before pregnancy. If you’re hoping to have a low-risk delivery at home, this is even more important to consider, as any compilation of medications can increase your risk and rule out homebirth. Also, remember that you should be under the care of a physician or medical provider before attempting to wean off any medications, especially for BP, anxiety, depression, etc. You need to do this safely, and sometimes these changes can take time!
    • Thyroid health: many women these days experience thyroid imbalances, and it can make a huge difference on your ability to carry a healthy pregnancy if you are on top of these imbalances before pregnancy, and have a provider who can work with any sort of needed thyroid medication especially during the early days of pregnancy. Learn more about thyroid and it’s effect on pregnancy by reading Aviva Romm: Thyroid in Pregnancy
  • Learn more about healthy food choices:
    • There are so many things to learn about how food and our daily choices affect the way in which our body works! From supporting the organs, optimizing brain function, regulating blood sugar…the food we eat has so much to do with how our entire body operates. Add to this the growth and development of an additional entire human body and placental organ, and you’ll start to get a glimpse of how important solid nutrition is to your body and that of your future baby! The best book on the subject that I have read is Lily Nichol’s Real Food For Pregnancy, and I would encourage any woman who is pregnant or considering pregnancy to read it and really digest her wisdom and suggestions. Lily covers more than just diet, and her overall suggestions when it comes to regulating blood sugar, exercise guideline, and prenatal vitamin recommendations are all amazing and educational.
  • Support your Liver!
    • This might seem like an odd topic, but did you know that your liver performs under extra stress during pregnancy? There are many pregnancy complications that can arise when the liver is not functioning well, and there are some studies that suggest that a healthy, supported liver can reduce the amount of morning sickness a mom might experience. With all of these factors on the table, I highly recommend either purchasing a liver cleanse and using it a few months before getting pregnant, or at least taking a high-quality Milk Thistle supplement for a month or two before conception, and continuing to take it during the first trimester. Here is an article that addresses this further: Milk Thistle for Morning Sickness
  • Prenatal Vitamins:
    • Start your research on prenatal vitamins now, and begin taking them daily. Remember, the critical time for baby’s development are in the early weeks, so your body needs to start getting a good foundation of nutrients so that your body is ready to nourish the developing brain, organ and other nutrient needs of a growing tiny baby. Many moms end up sick enough that they cannot continue taking prenatal vitamins during part of the first trimester, so having this foundation laid ahead of time is key!
  • Further Reading:
    • If you’re wanting to read more about how to optimize your fertility and prepare well, many providers recommend the book It Starts with The Egg. Rebecca Fett goes into detail about diet, supplements and other foundational principles of helping your body to achieve healthy conception!

In closing, I hope you’ve found these suggestions informative! I’d love to hear what else you would add to this list, and what has helped you as you’ve prepared for pregnancy. Maybe you’re not pregnant yet, but you’ve found a great resource…or maybe you followed some preconception guidelines and are currently in the middle of pregnancy…either way, I’d love to hear what you found most helpful!

Anemia During Pregnancy & Postpartum: what it is & what to do about it
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Anemia During Pregnancy & Postpartum: what it is & what to do about it

If you are like many moms, struggling with low energy can be a challenge during pregnancy. Understanding how to support your body as it faces the increased demands of growing a baby can help you to have a better experience, and improve your recovery during the postpartum weeks. For many moms, the lack of energy is due to low hemoglobin levels, which can be linked to low iron. There are many ways to boost these levels naturally, thus providing your body & baby with the nutrients they both need in order to thrive!

What is Hemoglobin?

In a nutshell, hemoglobin is component of your blood that carries oxygen to your cells. If your hemoglobin count is low, you can experience some or all of the following symptoms:

  • Low energy
  • General Fatigue
  • Shortness of breath (especially after climbing stairs or exerting yourself)
  • Heart palpitations
  • Dizziness or lightheadedness

How do I find out if I have low hemoglobin?

Having routine labwork performed during pregnancy can tell you where your hemoglobin levels are. In my practice, we often check these levels towards the beginning of pregnancy, and then again after you reach 28 weeks of pregnancy. As you progress in pregnancy, your blood volume expands, preparing you to be able to handle the blood loss that occurs with delivery. For many women, their total volume increases over 25%, and tends to peak by the time you hit the beginning of the third trimester. Testing your hemoglobin soon after 28 weeks tells us how your body has handled this blood volume expansion, and gives us time to really hit support should your levels be low at this point in pregnancy.

What if my hemoglobin levels are low?

If your results are low, my first step is to look at all of your lab results to see if we can get a clue as to WHY they are low. There are a few different types of anemia, and the two most common in my practice are:

  • Iron Deficiency: caused by a lack of iron, which can show up as low hemoglobin combined with a low hematocrit ratio on your lab results.
  • B12/Folate Deficiency Anemia: caused by a lack of adequate B12 vitamins and folate, and can be indicated by an elevated “mean corpuscular volume” (abnormally large red blood cells) on your lab results in combination with a low hemoglobin level.

In occasional instances, low hemoglobin levels can also happen if a mom bleeds excessively after delivery. This is one of the reasons that it is so important to get your hemoglobin in an optimal place before birth, as it increases the body’s ability to handle blood loss. But if your hemoglobin is low and you need iron support after having your baby, the following suggestions will also pertain to you!

What can I do to bring up my hemoglobin?

Some key factors to consider as you weigh your options for iron and vitamin support:

  • Typically natural-based supplements take consistency and time to really be effective. This is why to start helping your body early, as the body will then have time to respond. Many iron and vitamin supports will take one to two weeks to really start working to bring levels up.
  • Look for products and options that are whole-food or plant based when possible, as these will cause less constipation and be able to be more easily utilized by your body.
  • Pay attention to labels, and stay away from supplements that contain synthetic ingredients. This is particularly key when it comes to “folate”, as you do NOT want the synthetic form called “folic acid”. Due to genetic issues, many women are unable to adequately absorb synthetic folic acid and synthetic forms of B vitamins, which increases the specific problem of B12/folate deficiency anemia. To understand more about folate and the importance of methylated vitamins, check out this article here by Wellness Mama.

Now onto options for increasing iron levels!

Borderline anemia: if your levels are borderline, and you are looking for some general ways to boost your levels and provide more support to your body, these are some great ways to start:

  • Use cast iron cookware for cooking.
  • Eat foods high in iron (beans, lentils, red meat, liver, spinach, turkey, pumpkin seeds, broccoli, black strap molasses, etc.)
  • Increase your vitamin C intake with a high-quality Vitamin C supplement once or twice daily.
  • Make sure you aren’t mixing calcium supplements with your iron-rich foods or supplements (they will block the absorption of the other, negating the benefits of either one!)
  • Alfalfa Tablets, Moringa capsules & Yellow Dock tincture.
  • Drink several cups Red Raspberry Leaf tea daily during the 2nd and 3rd trimesters (and during postpartum as well), or drink several cups of NORA tea daily (a combination of Nettles, Oatstraw, Red Raspberry Leaf and Alfalfa). To learn my favorite recipe for Red Raspberry Leaf, click here or for NORA tea, check out this link.

True Anemia Support: for those who need to seriously boost their hemoglobin levels, here are some additional supplements to consider, in addition to the list above:

Many moms have found this combination very effective at bringing up their iron quickly (combined with some of the above suggestions):

  • Liquid Chlorophyll (drink 2-3 tablespoons daily, and 1/4c. daily during the first week postpartum)
  • Hemaplex Tablets (make sure it’s these tablets, as they do not contained the synthetic forms of folate)
  • Desiccated Liver capsules (grass-fed organic is best)

Others have found the combination of Chlorophyll with one or two of the following to work for them:

For additional information on anemia during pregnancy, I’d encourage you to check out the following links:

And for more suggestions on anemia in general, Aviva Romm has some great suggestions here: Aviva Romm on Anemia

I’d love to hear from you: what has helped to bring your hemoglobin up, and help you have adequate iron levels during pregnancy and postpartum?

Basic Supplements for a Healthy Pregnancy
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Basic Supplements for a Healthy Pregnancy

Are you confused with the myriad of pregnancy supplements out there, and wondering how to make the best choices that are good for you & baby while at the same time not depleting your budget? Have you wondered, too, which supplements are key and which aren’t actually necessary? And which supplements are going to actually provide you with the nutrients you need? And what are the basic supplements you should focus on? You’re certainly not alone in your musings!

As a midwife and a mom, I’ve had the same questions. I also know that it can be overwhelming to sort through brands, AND remember to take multiple vitamins and pills every day, especially if they have to happen at different times. I also want to make sure the moms and babies I’m caring for are getting the nutrients they need, which means NOT relying on the cheapest brands and options. If you’ve spent any amount of time researching options, you know that there lots of things to consider as you think about vitamins and supplements. Ideally, you want to use a brand that focuses on whole foods, organic sources, and includes bio-available nutrients (such as folate instead of synthetic folic acid). Of course, these vitamins aren’t going to be the cheapest ones available, which means that you will want to choose wisely, and consider using fewer supplements and making sure the ones you ARE taking are high-quality!

For those who have wondered, here is a list of the basic supplements that I routinely recommend to clients. Of course, more need to be added in the presence of specific conditions, but for most moms, these are the basics that I would encourage any mom to take during pregnancy (and while you’re nursing!):

For special considerations, these are typically the first recommendations:

  • B Vitamin (if dealing with low energy especially: your midwife can do blood tests to determine if it’s caused in part by a B vitamin or folate deficiency).
  • Iron (if low energy seems to be iron deficiency related)
  • Magnesium drink at night before bedtime to help promote restful sleep: Natural Calm
  • Trace Minerals to help with restless legs, leg cramps, muscle soreness: ConcenTrace Trace Mineral Drops

Most moms with low-risk pregnancies who are consuming a high-quality diet don’t need more than these to have a healthy pregnancy and healthy baby! For more information on understanding diet & supplements and their effect on mom and baby’s health (and what ingredients are important to be aware of!), I’d highly encourage you to check out the following sites:

Dr. Aviva Romm on Prenatal Vitamins

Lily Nichols on Folate vs. Folic Acid

Lily Nichols-information on diet and nutrition during pregnancy

And finally, if you’re looking for a place to purchase vitamins and supplements, I encourage all my clients to check out www.vitacost.com, as I typically find the best prices at that site!

I’d love to hear what prenatal vitamins and other supplements have worked for you! Feel free to share in the comments below so we can all learn together. And be sure to share this post with other moms that might benefit from the links and information!

Boosting Energy During Pregnancy
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Boosting Energy During Pregnancy

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If you’re like me, one of the huge challenges of pregnancy (especially early pregnancy!) is the severe lack of energy. Honestly, if you stop and think about it, your body is pouring so much into making a tiny baby that there just isn’t enough energy to do much else! While you might KNOW that your productivity can’t be measured by what you get done visibly, it can be hard when you feel like there isn’t enough of mommy to go around to all the needs at home.

In this post, I want to share a few tips that might help you get through pregnancy while keeping your energy levels up. There are many different factors in the equation, and honestly each one could be the subject of a separate post. For instance, a diet that is low in simple carbs & sugars, and has a good array of healthful fats and proteins can make a big difference for some women. To get more pointers on this, I’d highly recommend reading Lily Nichol’s book Real Food for Pregnancy. Another factor is getting some sunshine and movement (a walk outside can help immensely!). Yet another factor is finding ways to curb morning sickness (this is another topic on my mind for a future post).

While you may find that early on in your pregnancy you may have to forego your prenatal vitamins due to sickness (did you know prenatal vitamins can sometimes make you feel worse those first months?!? My personal philosophy is that if the vitamins keep you from keeping food down, then it’s best to scrap them for awhile!), once you’re able to take pills again, it’s key to find a quality vitamin. Getting adequate levels of minerals, as well as easy-to-absorb forms of folate, B12 and other vitamins can all contribute to boosting your energy levels. Check your labels to make sure that your vitamins contain folate (and NOT the synthetic form called folic acid), and that the B vitamins are methylated in order to promote absorption. This article on Folic acid vs. Folate may help you to better understand the difference, and why it matters.

Whether you can take your prenatal vitamins or not, I’ve found that supplementing with additional B vitamins can be a huge help, especially during the early months when your body is working so hard and fetal development is so rapidly taking place. During one of my pregnancies, I found that B vitamin injections provided me with some relief from morning sickness as well as boosted my energy levels, and when those weren’t available for me for my most recent pregnancy, I spent some time researching other options. I stumbled upon this gem, and found it to be an incredible energy boost: Max Stress B is a fermented, liquid B complex that provides a combination of B vitamins in a form your body can utilize quickly. Another helpful supplement is a B complex lozenge, which you can slip under your tongue before getting out of bed in the morning, and/or take throughout the day. Two brands I have appreciated are Jarrow  and Seeking Health. If you are only looking for B12, I find that these lozenges are great when you need an extra boost and mama doesn’t have time or opportunity for a nap: Jarrow B12. I even keep these on hand and use them when I’m up all night at births!

Low iron (anemia) can also be a reason for low energy, though sometimes this can even be corrected by the above B vitamins, as some types of anemia are actually caused by a B12 and folate deficiency (your midwife or care provider should be able to determine whether this is the cause by looking at your prenatal blood work). If your hemaglobin is actually low, then some suggestions would include supplementing with a plant-based whole-foods iron supplement such as  Garden of Life Iron,  adding daily doses of liquid chlorophyll, and even regularly consuming Blackstrap Molasses , all of which can help to gently increase your iron levels. If you need more iron suggestions and information, check out this article from Mama Natural on anemia during pregnancy.

These are just a few suggestions to get you started, and if you’ve found something that helps you with maintaining good energy levels during pregnancy, I would love to hear about it. And if you try any of these recommendations, let me know how it works for you. I love getting feedback and knowing what works for different people!