Assignment to Turn in:
Research a list of providers and online resources that may be helpful in working with some of the discomforts mentioned in the previous section. These should include medical resources as well as complementary medicine. Some examples may include a nutritionist, a reflexologist, or a naturopath. Make a handout to give to your clients if they have questions. Make sure to also include resources that may address any language barriers your clients may have. Attach the handout to this assignment.
1-B Common Discomforts of Pregnancy
As a doula, you will often be asked about how to cope with different pregnancy discomforts. While this is not your main reason for being hired, it is okay to help your client look for resources which may help. You should also have a basic idea of current practices for helping with these discomforts. This is not meant to be a substitute for medical care, but rather a guide to relieving common discomforts. If you feel that medical attention is needed, then please discuss it with the care provider.
Morning Sickness
70-85% of pregnant mothers will have some form of morning sickness. It can range from slight distaste to certain foods to full on vomiting numerous times during the day. While many feel the worst in the morning, it can extend all day. It can begin at the 4th to 6th week and usually is gone by week 16. Most of the time, morning sickness is just uncomfortable and annoying, but it can be severe enough to cause dehydration and problems associated with that. Progesterone is a part of the problem, as the increase in progesterone may make mothers more sensitive to odors. Other than that, morning sickness is still mostly a mystery.
What You Can Do
Eat small, frequent meals: Nausea is a symptom of abnormal blood sugars. Thus, when the stomach is empty, it may exacerbate the feeling of nausea. This may be why the nausea tends to be worse in the morning after not eating all night. Plan to eat easy-to-digest foods in the morning, as well as throughout the day.
Decrease triggers: Some people are sensitive to certain environmental triggers. These may include smells, tastes, sights, or spicy and fried food. Smell can be particularly difficult, because it is heightened during pregnancy. Sometimes it helps to keep a diary of what you are doing or what you are around when you feel nauseated. Try and steer clear of these things as much as possible.
Progressive muscle relaxation: This technique is used mostly for anxiety, but it has also been found to be helpful for those who are experiencing nausea and vomiting. This involves tightening specific muscles groups and then relaxing them. Deep breathing is also usually a part of this.
Acupressure: Acupressure is based off of eastern ideas of energy and Chi. The idea is that our energy pathways become blocked and can become unblocked by pushing on certain points. Acupressure has shown to have possible benefits for nausea. The point P6, in particular is helpful (acupressure will be discussed later on in the course).
Reduce stress: Fear and anxiety help exacerbate nausea and other stomach ailments, so addressing these problems is very important. Therapy may be needed for some, but there is a lot that you can do on your own. Things such as deep breathing, visualization, eating well, and getting enough sleep all help us cope with our fears and anxieties.
Vitamins B6 and B12: Vitamin B6 helps make your red blood cells, helps your immune system, your nervous system, and is involved in regulating blood sugar levels. It can be found in many foods we eat including whole wheat, brown rice, pistachios, garlic, liver, tuna, pork tenderloin, sunflower seeds, molasses, and hazelnuts.
Vitamin B12 is also involved in healthy blood and nerve cells and is important in preventing anemia. It also helps make DNA. Foods that contain B12 are clams, liver, fish, crab, lobster, beef, lamb, cheese, and eggs.
Both of these vitamins have been shown to help improve nausea and vomiting. A typical dose would be 30-100mg of vit B6/day and 4-50 mcg/day.
Teas: Ginger, peppermint, chamomile, citrus all help with nausea
Oils: citrus
Constipation
Early in pregnancy, constipation is probably caused by the increase in progesterone. This relaxes smooth muscle, which both your uterus and your intestinal lining are made of. Because of this, food moves through your system more slowly. Later, as your uterus gets larger, the intestines are being compressed, and this makes you more likely to be constipated. You also need more water during pregnancy and if you are not drinking enough, it will make this problem worse.
What You Can Do
Stay hydrated: Drink at least 8-10 glasses of water a day and avoid coffee or soda. Both of these will actually dehydrate you because they cause your kidneys to eliminate water from your system. Dehydration is one of the most common causes of constipation because the large intestines soaks up the water from the stool. If there is not enough, it causes your stools to be hard and difficult to pass. Thus adding fluid to your stools will keep them soft.
Exercise: Exercise helps to keep food moving through your digestive track. This helps with digestion as well as strengthening other muscles needed for birth. Too strenuous of exercise can actually have a harmful effect on the digestive system and is not recommended . For those who are having problems with constipation, walking or moderate exercise is the best.
Eat small, frequent meals: Eating large meals may distend (cause to swell from inside) the digestive track making constipation worse. Small, frequent meals also keep it active all the time.
Increase fiber intake: Fiber helps to move foods through your digestive track. You must also make sure, though, that water intake is adequate. If there is not enough water in the digestive track, it can actually make constipation worse, because water is needed to help move the food through. Raw fruits and vegetables are the best sources of fiber, especially prunes, dates, and figs.
Probiotics: It is thought that by helping promote healthy gut function through the use of probiotics, it will help relieve constipation. Some studies are showing that this may be the case. It may work by lowering the acidity in the colon which helps to improve gut function.
Cramps
Cramps during early pregnancy can be caused by a growing uterus and stretching ligaments. During later pregnancy, cramp-like contractions can also be normal. In either case, a medical professional should be seen as it can also indicate something more serious. If they are just the normal aches and pains of pregnancy, though, there are some things you can do to help relieve the pain.
What You Can Do
Apply heat: Heat helps to relax muscles. It also block the effect of chemical receptors that cause pain. You can use heat in numerous different ways including a heating pad, a hot water bottle, or a bath.
Chamomile: Chamomile contains a chemical that both helps relax muscles and nerves. This makes it a great way to help reduce pain felt by cramps. Chamomile tea has not had enough tests done to say that it is for sure safe during pregnancy, so use your best judgement and talk to your doctor about it.
Incorporate a natural movement exercise program: This course teaches a specific program that helps open up the space and increase the blood flow to the uterus. These types of exercises are highly recommended.
Depression
The shift in hormone levels as well as the life changes brought on by having a baby can lead to some depression during pregnancy.
What You Can Do
Share your feelings: It is important that depression is not just brushed under the rug or ignored. Find someone that you feel comfortable with to discuss what you are feeling and why.
Exercise: When you exercise, endorphins are released, these chemicals create a positive feelings. It has also proven to reduce stress, boost self-esteem, and improve sleep. Walking is a great one to do during pregnancy and is also a part of the natural movements exercise program.
Connect with nature: There is some evidence to suggest that being outside works well as an antidepressant. There are theories that this helps because of increased vitamin D or the need to reconnect with nature. Ways to get outdoors include gardening, hiking, or go for a picnic at the park.
Omega-3 essential fatty acids: Research is now showing that there may be an association between depression and low levels of omega-3 fatty acids. Requirements are even higher during pregnancy because a growing fetus needs it for brain development. So making sure you have this in your diet is important. 3 grams daily is a recommended dose.
Massage: Massage may be an effective way to decrease depression. It may do this by decreasing stress and increasing the release of oxytocin that helps you feel better.
Fatigue
During pregnancy, a mother’s body is working hard and using a lot of extra nutrients in order to grow a baby. Progesterone slows down metabolism, which can make you feel sluggish. Frequent urination at night also makes sleeping more difficult. All these things taken together can leave you feeling very tired.
What You Can Do
Rest: Try and take extra naps or go to sleep earlier if you can.
Pace yourself: Know your limits and don’t be afraid to say no. Ask for help with housework or take things at a slower pace.
Exercise: Moderate exercise will actually increase energy. Even more interesting is that it may increase energy even more than stimulant medications can. So instead of reaching for the energy drink, go outside and take a walk instead.
Eat small meals: Digesting a lot of calories at one time can make you feel light headed or fatigued. Sweet processed foods may do the same thing. So plan to eat little bits frequently throughout the day.
Back Ache
During pregnancy, a mother often gains 25-45 pounds. If they are not focusing on strengthening muscles and aligning the body that help to support this growing weight, it can lead to excessive back pain.
What You Can Do
Exercise: The number one thing you can do is start a natural movement exercise program as described in the course.
Wear flat shoes: High heels change our alignment so dramatically, that it can cause a lot of back pain in those who are not pregnant. Add the extra weight on, and it starts to really hurt.
Hot compresses: As described above, heat is very beneficial in treating pain. Putting a hot compress on can feel wonderful. Warm baths also help reduce pain.
Cold compresses: Cold compresses may also help reduce the amount of pain felt. It also reduce any swelling that may have occurred due to some injury.
Other health care practitioners: Other treatments may also be useful. Acupuncture, aromatherapy, and chiropractic care all may be beneficial. Make sure you use a provider that is trained to work with pregnant people.
Massage: Massage is another good way to help ease many types of pain. It is also useful for back pain.
Gas and Bloating
A mother may experience gas and bloating for the same reasons they may have constipation. Pregnancy causes more progesterone to be produced, thus relaxing the intestinal muscles and slowing digestion. This, in turn, produces more gas. During the third trimester, the movement of the intestines also slows down, having the same effect.
What You Can Do
Exercise: Again, the natural movement program will help to move food through your system as well as train your body so that all your systems are positioned correctly for the most effective way of moving food through your digestive system.
Healthy eating patterns: Eat slowly. Eating and drinking slower will reduce the amount of air you take in. Avoid carbonated drinks that only add to the amount of gas swallowed. Limit foods that typically cause gas. This includes cabbage, beans, brussel sprouts, and asparagus. Eat small meals throughout the day. Larger meals will sit longer in the digestive tract and produce more gas. Cutting out dairy may also help.
Headaches
Headaches during pregnancy is one of the most common complaints and can be caused by a variety of things. During the first trimester, hormones and an increased blood volume are thought the be the culprit, but headaches can also be caused by increased stress, lack of sleep, low blood sugar, dehydration, and poor posture.
What You Can Do
Decrease stress: Now would be a good time to re-evaluate what you really need to be doing in your life and what you can give up. If something makes you stressed, let it go if possible. Also, allow other people to help out with errands, housework, or other odds and ends.
Get fresh air: Headaches can be caused by poor ventilation and indoor air quality. If you find you are indoors a lot, it may help to go outside every few hours to get fresh air. Getting an indoor filter may also help.
Diet: Some foods may trigger headaches. Common ones include chocolate, cheeses, red wine, milk or processed sugar. Eating more protein may also help. Make sure you are drinking enough water.
Compresses (cold or hot): You can try seeing if either a cold or warm compress will help. A cold compress is good if the headaches are due to inflammation. A warm compress would be better if it is due to tension or stress.
Heartburn
Heartburn usually happens in the second and third trimester. This is due, in part, to progesterone relaxing the stomach muscles. This allows gastric juices to travel up the esophagus easier. During the third trimester, the baby is also growing and pushing up on the stomach, making the heartburn worse.
What You Can Do
Eat small meals: This will decrease the amount of acid and pressure in the stomach.
Diet: Don’t eat spicy or acidic food. Also avoid peppermint and chocolate because both of these can increase stomach acid. Drink water between meals to neutralize stomach acids and help move things down into the small intestine.
Use gravity: Don’t lie down right after you eat, but stay upright while your food is digesting. Prop yourself up when you sleep.
Hemorrhoids
The baby can create pressure in the pelvis, which causes the blood to pool in the veins and pop out. Varicose veins are in the leg, and ones on the rectum are called hemorrhoids.
What You Can Do
Positions: Don’t limit yourself to just a few positions throughout the day. Changing positions allows the pressures in your body to be distributed throughout your body. Try changing your positions 2-3 times every hour.
Posture: Keep your hips, rib cage and knees all aligned.
Diastasis Recti
What is it?
