HERE'S NEVER BEEN a better time to have a baby. The vast majority of infants in the United States are born healthy, most mothers experience no serious problems during pregnancy, and many, if not most, deliveries are medically uneventful. Folic acid has been proven to help prevent several serious birth defects, and doctors have even learned to successfully treat certain disorders in babies while they're still in the womb.
Unfortunately, not all the news is so good. For example, the percentage of babies born prematurely--at less than 37 weeks gestation--rose to 12 percent in 2002, the highest level in two decades and a 27 percent increase since 1982. Gestational diabetes is skyrocketing: In the past 10 years, this pregnancy complication has increased 35 percent. The news on Cesarean sections isn't great, either--26 percent of babies are delivered by C-section now, compared with only 5.5 percent in 1970. While a growing number of those procedures are elective, many are unscheduled, unplanned and unwanted.
Overall, however, we know more than ever about how to have healthy babies, happy pregnancies and (relatively) easy deliveries. Following is a wrap-up of the latest news and advice on how to make this happen for you.
The Perfect Exercise
If you're looking for a workout to soothe your pregnant body and mind, try tai chi. A slow, graceful activity with a low risk of injury, tai chi reduces stress, sharpens coordination, builds leg strength and helps prevent back pain. It also creates a strong connection to your baby. This "taste of tai chi" was designed by Fit Pregnancy fitness editor Teri Hanson. TO START: Begin each move in Wu Chi Stance: With feet placed wider than hips, knees bent, arms resting at your sides, "sink" your weight into your legs. Then do each move slowly for 1 minute, rest for 30 seconds in Wu Chi, and go into the next move. As you progress, move in a "flow" sequence without resting. Finish with a final Dan Tien Connection (pg. 82). For tips on fornt, see pg. 86.
| AVOID COMPLICATIONS |
Good news: Research is indicating that simple lifestyle factors such as exercise and diet can help prevent three growing pregnancy complications. The following are the best ways to do this, according to Siobhan Dolan, M.D., M.P.H., assistant medical director of the March of Dimes (MOD):
1) PREMATURE BIRTH Prematurity is the top cause of newborn death, and you can reduce your risk of early delivery by being in good health before you conceive. Have infections (including gum disease and sexually transmitted diseases) treated; get chronic health problems such as hypertension or diabetes under control; tell your doctor what medications you take; be in the best physical shape possible; try to achieve your ideal weight; stop smoking, drinking alcohol and/or using recreational drugs; and start taking folic acid supplements (400 micrograms daily).
Uterine infections are commonly associated with preterm birth, and new research reported in the Journal of the American Medical Association has identified proteins in a pregnant woman's blood that can indicate the presence of such an infection and allow for early treatment with antibiotics.
Some herbal remedies traditionally considered a natural way to relieve pregnancy discomforts are now under suspicion and should not be used without your obstetrician's approval. For example, large amounts of some herbal teas, including peppermint and red raspberry leaf, may cause uterine contractions, increasing the risk of miscarriage or preterm labor, according to the MOD, which also warns against using herbal tablets, capsules and extract.
NEW THINKING ON PREMATURITY
Doctors long have performed cerclage--stitching up a short or damaged cervix--to help prevent premature delivery in high-risk women. However, a recent large study published in The Lancet found that cerclage did not reduce the chance of preterm birth.
2) GESTATIONAL DIABETES Developing diabetes during pregnancy can lead to a large, difficult-to-deliver baby, increasing the risk of delivery complications and a C-section. Such rising rates go hand in hand with Americans' increasing tendency to be overweight. Starting pregnancy at a healthy weight and gaining no more than the recommended 25 to 35 (see "How Much Weight Should You Gain?" on pg. 148) can help lower your risk for gestational diabetes. And a new study in the American Journal of Epidemiology found that women who exercised before and during pregnancy had a 70 percent lower risk of gestational diabetes.
NEW THINKING ON PREECLAMPSIA
Preeclampsia is a potentially life-threatening complication also known as pregnancy-induced high blood pressure. A protein "marker" that is sharply elevated approximately five weeks before its onset could provide a warning that would allow doctors to diagnose and treat it earlier, improving survival odds for both mother and baby, according to a study in The New England Journal of Medicine.
3) CESAREAN SECTION Choose a hospital and/or obstetrician with a low Cesarean-section rate (15 percent or less); consider a midwife-assisted delivery; wait until you are in active labor before going to the hospital; work with a trained doula; get good prenatal care and avoid excess weight gain during pregnancy. Also, keep hydrated and change positions often during labor so you can stay comfortable and energized in case labor is long.
STAY EmOTIONALLY HEALTHY
For some women, hormone shifts, relationship problems, a negative body image, financial pressures and other reasons make pregnancy stressful. Be sure to watch out for the following:
DEPRESSION If you're feeling blue, check in with your doctor. During pregnancy, depression is treated with talk therapy or, if that fails and the depression is serious, with medications such as Zoloft and Prozac, according to Petra M. Casey, M.D., an obstetrician at the Mayo Clinic in Rochester, Minn. "These drugs should be used with caution, but depression has major risks also--even suicide--so we must balance that with the potential risks of antidepressants," Casey says.
STRESS Although some studies suggest that sky-high stress levels contribute to preterm delivery, low birth weight, and behavior and learning problems in toddlers, other research fails to show a link. "We don't have any clear answers on this issue," says Kimberly A. Yonkers, M.D., an associate professor in the psychiatry department at Yale School of Medicine in New Haven, Conn. In any case, it's wise to reduce stress as much as possible during pregnancy, particularly if it causes you to lose sleep, eat poorly or reach for cigarettes or alcohol for relief. If something is causing you stress, make a change if you can, since stress can, at the very least, contribute to fatigue, headaches and backaches.
NEW THINKING ON DEPRESSION
Pregnant women are as prone to depression as those who aren't expecting. In fact, 5 percent to 15 percent of pregnant women suffer from depression. "Not every woman is happy during pregnancy," says Yale psychiatry professor Kimberly A. Yonkers, M.D.
RULES TO EaT BY
Here are three up-to-the-minute rules for the healthiest possible diet for you and your growing baby.
1) SAY NO TO LOW-CARB "Forget low-carbohydrate diets when you're pregnant," says Marilyn Tanner, R.D., a spokeswoman for the American Dietetic Association. "Smart, or complex, carbs are the way to go." That's because they provide energy, vitamins, minerals and fiber. Limit refined, processed "white" foods (bread, crackers, pasta, etc.). Instead, choose whole-grain products, including brown rice, along with fruits, vegetables, beans and nonfat dairy products.
2) KNOW WHERE YOUR FISH COMES FROM Some farm-raised fish contain high levels of industrial pollutants known as PCBs. When possible, eat fish that has been caught in the wild, suggests Suzanne Havala Hobbs, Dr.PH, a registered dietitian who teaches in the School of Public Health at the University of North Carolina at Chapel Hill. But even wild fish can be contaminated--for example, pregnant women are warned not to eat fish from Lake Michigan. Check local advisories for safety information about fish caught in your area. (For more information on fish safety, see "Eating Do's and Don'ts" on pg. 46).
