Swelling In Pregnancy

Swelling During Pregnancy - Why It Happens And What To Do About It

Swelling during pregnancy can be alarming and uncomfortable. But it’s also totally normal and a healthy sign, especially when mild to moderate and changes based on your activity.

The fluid retention and increased amount of body fluids in the tissue space outside the blood vessels reflect the normal hormonal changes of a healthy pregnancy. 

Many women notice a slight puffiness or swelling in the fingers, hands and face. However, the additional fluid typically congregates in the lower part of the body, namely the feet, ankles and genital area.

This is related to the pull of gravity and the pressure of the enlarging uterus on vessels that bring blood back to the heart. It’s called dependent edema and usually temporarily decreases after rest and elevation or a night’s sleep on your side.

Swelling during pregnancy is made worse by:

• Prolonged periods of sitting or standing

• Carrying a large fetus or twins

• Being overweight

• Hot weather

• Increased perspiration leading to loss of salt

• Inadequate intake of fluids, protein or salt

• Anemia

How To Decrease Swelling During Pregnancy

While swelling during pregnancy is common, many women find it uncomfortable and unsightly (not to mention it can make it hard to get your shoes on!) However, there are a number of ways to reduce the amount of swelling.

DIET

Avoid salt excess, but don’t restrict your intake either. Salt your food to taste, as you need a minimum of 2-3 grams of sodium daily. Sea salt is preferable to table salt that has chemical additives. 

Make sure your diet includes 60-90 grams of protein every day.

Avoid curbing your fluid intake, which will actually aggravate the problem. Drink at least 64 ounces of fluid daily. This should be mostly composed of pure spring or well water - plain, naturally flavored, or sparkling, or herbal tea - between meals (at least 20-30 minutes before or 2 hours after).

REMEDIES

Check if you are anemic. If so, increase your intake of iron with food and/or an herbal supplement like Floradix Iron or yellow dock, and follow this guide here.

Drink 1-2 cups nettles and dandelion herbal infusions each day. To prepare:

1. Soak one ounce of each herb in 1 quart boiling water for 3-4 hours.

2. Strain in a glass canning jar.

3. Add a dash of honey, fresh lemon, lime juice, or mint leaves to taste.

Alternately, take a dropperful of each herb, in tincture twice daily (reputable brands include Gaia, Wish Garden and Eclectic Institute), or the dried encapsulated form, 1-2 freeze-dried caps 2-4 times/day. Professional grade, top quality all natural supplements I recommend are also available in my online holistic apothecary.

Avoid diuretic medications. Safe and gentle herbal diuretics include:  

• Hawthorne berries - Try Gaia, Wish Garden or Eclectic institute’s encapsulated freeze-dried extract 500 mg/day or 1-2 caps 2-4 times per day

• Cornsilk tea - 1 cup 2-4 times/day

• Black tea (if you are not a regular drinker of caffeine)

Consult a professional homeopath to suggest a remedy specific for your symptoms, as there are many homeopathic remedies that are not only safe but also effective for treating this condition. Or you can start by referring to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro.

MOVEMENT

Avoid prolonged periods of sitting or standing, and lying on your back during the third trimester.

Flex or bend your feet back towards your body several times at frequent intervals if you have to sit or stand for a long time.

Do regular exercise like dancing, brisk walking, prenatal yoga, swimming or water aerobics for at least ½ hour 5 days per week. 

Inversions are wonderful yoga postures to reduce swelling, especially helpful, and calming at the end of the day when swelling is usually at its worst.

A great one that is easy to do is Viparita Karini, otherwise known as “legs up the wall.” Lie down on your back, with your buttocks all the way to the wall, flat on the floor or elevated on a folded yoga blanket, bolster or block. Let your legs rest straight up the wall for 10-20 minutes. It is also a great opportunity for quiet meditation, focusing on slow deep breathing and inner gazing between your eyebrows.

A lavender infused eye pillow adds to the delicious relaxation effect.  Use the props to help you feel more comfortable and modify the postures to suit your needs. They are a great asset for your yoga practice, and will help in labor as well.   

An alternative is to lay flat with your head and shoulders supported on folder blankets, and elevate your legs on one, or even better two yoga bolsters.

REST AND COMFORT

Don’t stand if you can sit. Even better, is to squat, and don’t cross your legs while sitting.

Take frequent breaks to lie down on your side, or sit with your back straight and your legs elevated above the level of your torso (ideally for 1/2 hour 4 times daily, depending on how much swelling you have).

Avoid tight restrictive clothing from the waist down, especially socks, knee highs, tight pants and girdles.

Wear comfortable flat shoes instead of high-heeled or ill-fitting ones.

Put on elastic maternity support stockings before you get out of bed in the morning, but raise your legs first to empty them as much as possible from excess fluid.

Get a regular foot and leg massage with arnica oil, while you lie on your left side. Your partner can do this each night!

Soak your legs in a warm bath using 1 cup Epsom Salts, and add a few drops of wintergreen and lavender essential oils. 

If you are overwhelmed and need some guidance,  schedule a consultation with me.

When It Might Be More Serious

Call your midwife or doctor if these suggestions do not help or if the swelling:

• Becomes severe, excessive, or generalized throughout your body

• Becomes pitting, in which pressing the puffy area leaves a temporary indentation mark.

• Increases especially in your hands and face 

• Is only affecting one arm or leg, not both.

• Is as bad in the morning as it is at the end of the day, and does not lessen with rest and elevation.

Seek help if you experience sudden weight gain (5 pounds or more in less than 1 week) not related to diet changes or reduced activity, and if it your swelling is associated with headaches, dizziness or lightheadedness, spots before your eyes or blurry vision, changes in mental status, chest or abdominal pain, shortness of breath or other unusual symptoms.

Keep in mind that for most people, swelling in pregnancy is just a common nuisance that will quickly be relieved with the birth of your beautiful baby.

Check out my number one international best selling book Natural Birth Secrets and my Love Your Birth course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything! It is now recommended by midwives, physicians, health care professionals around the globe, and doulas take it for their certification training.

Leg Cramps In Pregnancy

How to Deal With Leg Cramps During Pregnancy

Leg cramps during pregnancy are quite common. They’re usually felt as a sudden, painful contraction or spasm of the leg muscles, and often occur at night or early in the morning. They may also be associated with a sense of uncomfortable restlessness in your legs. 

Leg cramps are thought to be caused by:

• A diet too low in calcium and/or magnesium

• A diet too high in phosphorus

• Compression of nerves or impaired circulation to the area from the growing uterus

• Inadequate fluids and salt intake

• Iron deficiency

• Muscle fatigue from too much strenuous activity

• Sedentary living without adequate exercise

Dietary Considerations for Leg Cramps During Pregnancy

Leg cramps during pregnancy are often caused by dietary factors.  

Make sure you are drinking at least 64 ounces of pure spring or well water - plain, naturally flavored or sparkling - and/or herbal tea daily between meals (at least 20-30 minutes before or 2 hours after you eat.)

Anemia due to lack of iron is very common in pregnancy, and should perhaps be your first consideration. Follow this guide if anemia is suspected.

CALCIUM

Make sure your diet contains at least 1200 mg of calcium every day. Best food sources include:

• Dairy products (organic fresh raw goat or sheep are best)

• Fish tested free of pollutants or from non-polluted waters like sardines, wild Alaskan or Norwegian salmon and mackerel

• Fresh dark green leafy vegetables such as kale, seaweeds like kelp, broccoli, watercress, parsley, collards, bok choy, turnip and mustard (but not spinach)

• Ground sesame seeds (tahini)

• Blackstrap molasses

• Dried fruit (like dates, figs raisins and prunes)

• Nuts

• Organic tofu and tempeh

• Bone broth

Certain herbs can also help as they supply a rich source of calcium and many other nutrients in a highly absorbable form. To make an infusion:

1. Combine 1 ounce each of nettle and red raspberry leaf in one quart boiling water, cover.

2. Soak them in a glass canning jar for 4-8 hours, strain.

3. Optional: add fresh lime or lemon juice, mint leaves or a dash of honey to taste.

4. Drink 1-4 cups daily.

For an additional nutritional boost, mix in 1 ounce of dried dandelion, ½ ounce alfalfa and/or oatstraw. 

When making soup stock from bones, add 2 tablespoons of apple cider vinegar during the boiling process. This releases the calcium out of the bones and thus makes a broth rich in absorbable calcium.

Avoid alcohol, caffeine, chocolate and an EXCESS amount of salt and protein foods which interfere with the absorption of calcium or increase the amount of calcium excreted in the urine. You need NOT LIMIT salt or protein as these are essential in pregnancy – just modify your intake if its grossly excessive and use sea or earth salt to taste.

If you cannot consume a sufficient amount of calcium by diet alone, consider a calcium supplement like 500 mg calcium citrate once or twice a day with meals to enhance absorption. The amount you need to take depends on the amount that is missing from your diet. 

If you take a calcium supplement, you should also supplement with equivalent amounts of magnesium, which happens to be calming and helps with other common discomforts of pregnancy like insomnia and constipation. If you experience excessively loose bowel movements, you can cut the magnesium to ½ the calcium dose. A great liquid absorbable supplement is called Natural Calm with Calcium, as it has both the magnesium and the calcium together (raspberry lemon flavor tastes yummy). Professional grade, top quality all natural supplements I recommend are also available in my online holistic apothecary. 

Also, reduce your phosphorus intake by reading labels and avoiding highly processed foods (like sodas, party snacks, and lunch meats) that contain phosphates.

Try eating raw foods high in vitamin E such as cold pressed oils, whole grains and wheat germ, nuts (especially almonds), seeds (especially sunflower). You may need to supplement with up to 200 IU per day as long as you are otherwise healthy and your blood pressure is normal. 

Eat foods high in vitamin C, which include raw fruits and veggies, especially green leafy vegetables such as kale and collard greens, strawberries, citrus fruits, peppers, tomatoes and alfalfa sprouts. Herbal sources include nettle, dandelion, rose hips, watercress, red clover and burdock. You can supplement vitamin C with up to 1000mg twice a day until 36 weeks gestation, then decrease to 500 mg per day.

Posture and Movement

 Regular moderate exercise like swimming, walking, prenatal yoga or dancing helps prevent leg cramps, as well as periodic leg elevations and stretching.

Maintain a good straight posture using proper body mechanics during daily activities such as carrying, pushing, pulling or reaching for something. This involves engaging your abdomen (corset your ribs inward, bring your front pelvic bone toward your breast bone, your belly towards your spine), and using your leg and arm muscles instead of your back.

Refrain from prolonged sitting or standing by periodically taking a break to exercise your legs. 

Avoid completely extending your foot while pointing your toe, as this can trigger a leg cramp. Make sure your foot is dorsiflexed while extended, especially during leg stretching and exercise, and make your bed loosely so your toes are not pressed down by the sheets.

Keep your legs warm with knee socks or leg warmers, especially during exercise and at night during sleep. Support stockings may help in the day.

For Immediate Relief of Leg Cramps During Pregnancy

Take a deep diaphragmatic breath, by inhaling deep into your belly, expanding your ribs and chest - really stretch the inhale to your fullest capacity. Then take a huge automatic sigh of relief on the exhale, while consciously relaxing all tension. Keep up the deep breathing, and release more with each exhalation. Send breath and its healing energy to your leg cramps when you exhale. Stay very calm, present, and mindfully focus on all the details of your sensations without a mental story about them, without resisting and fighting with what is, which makes it worse. Practice consciously embracing and even intensifying the cramping, which actually helps alleviate it. See this as an opportunity to train yourself to surrender and relax with intense discomfort. It is great practice for labor and life. If you need guidance mastering the healing and transformative power of breathwork, schedule a session with me.

Also, try sitting while straightening your leg and actively flexing your toes back towards your head, using your hands or a yoga strap to help you flex your feet. This is not about bending forward and touching your head to your legs or resting it on a yoga block between them, although if you already have a practice it fells nice and calming) . It may help to exert steady pressure against your bed board or partner’s hand, or to simply stand up with your foot flat on the floor or flexed up towards your body.

If the cramp is in your foot, roll it over a roller, baseball bat or unbreakable bottle 3 inches in diameter. Some say standing on ice is effective.

Deeply massage your lower legs and feet with arnica oil, mixed with a few drops of chamomile, ginger, lemon balm, St. John’s Wort and/or lavender. 

Other Healing Modalities

Herbal epsom salt foot baths - Soak your lower legs in very warm water with 1 cup Epsom Salts, and add a few drops of wintergreen, lavender, camphor and/or chamomile essential oils. 

Heat - Apply a heating pad or hot wet compress, infused with a few drops of the above mentioned essential oils, to the area of cramping. 

Homeopathy - Take homeopathic 6X of Magnesia phosphorica alternating frequently with Calcarea phosphorica several times a day until you feel relief. If this is a chronic problem among other pregnancy discomforts, it may be better to consult with a professional homeopath who can prescribe a safe, natural remedy specific to your individual symptoms.

Herbs - Black haw or crampbark can be taken to decrease leg cramps. Take a dropperful of either tincture as needed, up to 4 times daily. Herbal teas and tincture combinations that include ginger, catnip, chamomile, lemon balm and skullcap, taken as directed on the bottle, can also help. Reputable brands include Wish Garden, Eclectic Institute and Gaia. Aviva Romm remains one of my favorite resources for safe effective use of herbs in childbearing. She is an integrative physician, midwife and herbalist who has done extensive research and compiled the most comprehensive, evidence based reference guide I have come across called Botanical Guide For Women’s Health. She wrote a more accessible resource for moms in The Natural Pregnancy Book - which has some wonderful home made recipes, if you like to make your own remedies. 

Acupuncture can work wonders. Consult an experienced acupuncturist. 

Avoid commercial medications like muscle relaxants and quinine as they are not safe during pregnancy.

When Nothing Helps

If your leg cramps are extreme or persist in spite of following the above guidelines, consult your physician or midwife or schedule a consultation with me. If you are feeling overwhelmed, or do not even know what questions to ask, I can help you! Consult your local practitioner if cramps become increasingly severe or frequent, the above suggestions do not help, or if you notice an area of leg warmth, redness, swelling and/or pain. Sometimes other metabolic imbalances can be the culprit, and these may need to be investigated.

Check out my number one international best selling book Natural Birth Secrets and my Love Your Birth course- an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything! It is now recommended by midwives, physicians, health care professionals around the globe, and doulas take it for their certification training.

Natural Remedies For Nausea During Pregnancy

Nausea during pregnancy will resolve on its own by the third or fourth month for most people. In the meantime, there are several methods for dealing with it naturally.

Nausea is one of the most common complaints of pregnancy. It seems to be related to the massive increase in hormones to support the pregnancy, and an individual’s unique sensitivity to the physical and emotional changes that result. 

Consider keeping a diary of what makes your symptoms worse and better, to increase your awareness of what to avoid and how you can help yourself. Nausea is often made worse by fatigue, stress, unresolved emotional issues, sedentary indoor living, nutritional deficiencies, inadequate diet, an empty stomach, and offensive odors. Plan accordingly!

Dietary Recommendations for Reducing Nausea During Pregnancy

A drop in blood sugar from the added work of making a baby can make nausea worse, so it is important to eat small amounts of whole food with complex carbohydrates, protein and healthy fat, at least every 2-3 hours, and eat real, local, organic food products as much as possible. Include in your daily diet small frequent servings of:

• Protein and fat like nuts, nut butters, seeds, tofu/tempeh, whole eggs, turkey or chicken, beef, lamb, wild Alaskan/Norwegian salmon, and fresh raw whole dairy (ideally sheep or goat).

• Unrefined complex carbohydrates such as brown rice, quinoa, millet, barley, oats, kasha, beans, sweet potatoes, squash, and whole multi-grain sprouted bread like Ezekiel. Combine with protein and fat like toast with avocado or sliced turkey, oatmeal in milk, or granola with yogurt.

• Fresh fruits with protein and fat like pure peanut butter or a handful of almonds.

• Plenty of fresh vegetables with protein and fat like hummus or cheese.

• Healthy fat for cooking. Good options are cold expeller-pressed extra virgin olive oil, coconut oil or butter.

Stay away from refined white flour foods and sweets, as they lead to a rapid rise then fall in blood sugar - this actually worsens nausea and causes other symptoms like fatigue, dizziness, headaches, brain fog, anxiety and depression. Avoid letting your stomach become empty or stuffed, and try to separate eating solids and drinking liquids by about 15-20 minutes. Try to eat a small portion of food that you tolerate after vomiting. Eat what agrees with you for now from the above foods, as baby will take nutrients from you. You can replenish when the nausea resolves.

Keep some healthy snacks by your bedside to eat before rising in the morning and going to bed at night. Always carry an assortment of your favorite foods when out.

In general, plain foods are usually better tolerated than hot, spicy, rich, greasy, overly sweetened or processed junk foods. Avoid coffee, alcohol and cigarettes, as they irritate the stomach, in addition to causing health problems for you and your baby.

Hydration is Key

Keep well hydrated by drinking at least 64 ounces of liquids away from food. Good options are:

• Pure spring or well water with a splash of lemon, lime, orange or grapefruit juice.

• Seltzer or sparkling water (plain or naturally flavored).

• Herbal teas of ginger, peppermint, spearmint, chamomile, raspberry leaf, cinnamon, peach, catnip, lemon balm, anise or fennel seeds with honey, agave or fresh mint leaves to taste.

• Warm milk with lemon juice or honey as soon as you get up in the morning.

• A small glass of grapefruit juice before meals.

• Sipping natural ginger ale throughout the day.

• Soup broth (vegetable, bone or miso are excellent choices).

If you are vomiting, try to drink a small amount of liquid each time you throw up. One quarter cup of fluids every 15-30 minutes is crucial to keep hydrated.

Try to drink the health food alternative to Gatorade or Pedialyte (which is full of chemicals), called Third Wind or Recharge to replenish lost fluids and electrolytes. Another option is electrolyte infused water like Smart Water. Fresh or all natural coconut water is nature’s rehydration drink. Eating watermelon is also great for hydrating yourself and is well tolerated. You can also make your own concoction by combining:

• 1/8-1/4 tsp sea salt

• 1/4 tsp baking soda

• 1 tsp calcium/magnesium powder

• 1-2 Tbsp honey

• Juice of 1 fresh lemon or lime to taste

• 1 qt spring or coconut water.

• Drink a cup slowly every 1 - 2 hours. Even if you vomit it up, you will still get some and it often reduces the number of vomiting episodes.

Take Time for Self-Care

This is a very sensitive period. You need to find extra time for your own much needed pampering, and remind close friends and family that you need lots of additional love and understanding.

SELF-CARE STRATEGIES

Soak in a warm bath with a few drops of essential oils of lavender, sandalwood, peppermint, citrus or rose. You can also bathe in a few tablespoons of fresh ginger juice - made by juicing a few inch piece of ginger - or 1/2 cup of grated ginger to the bath.

Get more sleep by going to bed earlier or sleeping later, and taking a nap or frequent rest periods during the day. Allow more time to get out of bed in the morning.

Get plenty of fresh air and sunshine. Open windows when inside, weather permitting. Every day, try to spend at least 20 minutes outside with nature in the early morning or late afternoon sun. This does wonders!

Engage in regular moderate exercise such as brisk walking, cycling, dancing or swimming for ½ -1 hour 5 days per week. Even though you may not feel like doing this, it helps immensely and you will feel better afterwards.

Practice the following breathing exercises twice per day (like before rising in the morning and going to sleep at night) and whenever you feel very nauseous or stressed. 

Exercise 1. Simply focus your attention on your breathing for a few minutes. Then, after a normal breath, try slowly squeezing out as much air as possible using the muscles in your chest. Next, allow air to come in naturally and deeply, but automatically. Repeat the cycle for at least eight breaths.

Exercise 2. Take a slow deep inhale, drawing your breath deep into your belly and expanding the inhalation to your fullest capacity. The exhale happens naturally. But let it be through your mouth with an audible sigh of relief, releasing and relaxing all tension. Inhale slowly through your nose for a count of 4, hold for a count of 7, and exhale through your mouth for a count of 8. Repeat this cycle for at least eight breaths.

Exercise 3. Play with the counts of inhaling, pausing, exhaling and another pause before the next inhale to see what feels best for you. Try triangle breathing: inhale to a count of 4, exhale to a count of 4, then pause for a count of 4, continuing for 5-10 minutes. Alsp try box breathing: inhale to a count of 4, pause for a count of 4 while focusing on relaxing, exhale to a count of 4, pausing again for a count of 4 and repeating that cycle for 5-10 minutes.

Breathwork with extended slow exhales, such as inhale for a count of 3-4 and exhale for a count of 6-8, tend to be extremely calming as well. Rapid forced exhaling through the nose as in the yoga breath of fire, as well as conscious connected circular breathing through the mouth with full capacity enthusiastic inhale and relaxed quick exhale, is more activating and energizing. I love to guide people in mastering transformative life-changing Breathwork practices not only for healing, but also for optimal health and well-being.

Try to relax with yoga, meditation, progressive muscle relaxation techniques (yoga nidra), visualizations and imagery work. There are many phone apps like Calm and Breathe to help you establish a regular practice.

Enjoy a light distraction like watching an engrossing drama, comedy or musical, reading a good book, or listening to music that you love.

Get a change of scenery by unplugging from your smartphone or computer and spending a day in the park or at the beach, hiking in a beautiful place, getting a spa treatment, exploring a museum or a local town, going to the theater, taking an art or music class, volunteering for those in need, getting together and connecting with those who support and encourage you, going on a mini vacation with a family member or friend to a place you love.

Natural Remedies for Nausea During Pregnancy

HERBS

If you are interested in herbs, there are several options to try alone or in combination. Go for high-quality sources like Gaia, Wish Garden or Eclectic Institute, or professional grade brands like those in my online holistic apothecary.

Peppermint. Place 1 or 2 drops essential oil of peppermint in a spray bottle and spray it near your nose periodically. You can also put the drops on a piece of cloth, or in an essential oil diffuser, and smell it as often as needed.

Red raspberry leaf. Take 1-2 capsules or 1 ml tincture 1-2 times per day.  

Wild yam tincture. Take 20-30 drops 3-6 times a day, or 1 dropperful up to every few hours depending on the severity of your symptoms.

Dandelion tincture. Can be taken on it’s own, but is especially effective in combination with wild yam. Take 20-30 drops 3-4 times daily.

Ginger root powder. If no history of 2 or more miscarriages, take 250 mg capsules up to 4 times per day.

New Chapter’s Ginger Honey Tonic. Can be taken in 1-2 tsp doses as often as needed, as can all natural ginger lozenges, ginger sucking candies and dried crystalized ginger pieces.

Slippery Elm. Can be taken in lozenge form or as a thin porridge, by adding water to the powder and honey to taste.

Umeboshi (sour plum). Can be taken as sucking or chewable candies, and are available in most health food stores.

CBD from hemp oil. This is the new rage, as it relieves morning sickness without the potential risks of the THC component of cannabis on the developing fetus. Results from anecdotal evidence and preliminary research, although sparse (as is common with most natural remedies in pregnancy), are promising. Make sure it is absolutely pure, and from a reputable source who can recommend proper dosing or from pharmacies licensed to dispense it, as it is largely unregulated. It is usually taken as several drops under the tongue.

Fresh homemade herbal teas can work wonders for nausea during pregnancy. Do some experimenting to find what is most helpful to you:

• Immerse a tiny piece of fresh ginger, or 1 tsp grated ginger in a cup of boiling water for 5-15 minutes. Strain into a glass and sip up to two cups throughout the day.

• Dandelion root can be taken with or without the ginger. Add approximately 5 Tbsp dried root or about 10 Tbsp fresh root to 1 quart boiling water. Let it brew for 3-4 hours, strain into a glass canning jar, and periodically sip totaling up to 2 cups per day.

• Add 1 Tbsp dried chamomile to 1 cup boiling water and steep covered for 10 minutes. Strain into a glass and sip periodically, up to 2 cups daily.

• In 1 cup boiling water, add a tsp of dried or 2 Tbsp fresh leaves of peppermint or spearmint. Immerse covered for 15 minutes and drink as often as needed. You can make your own mint smelling remedy, by placing fresh mint leaves in a covered container, crush the leaves each time you open it, and smell throughout the day as often as you need.

• You can add a dash of honey, lemon or lime juice to any of the above teas to taste.

• Try making ice cubes of strong ginger, peppermint or red raspberry tea and suck on them every few hours.

• You can make your own mint smelling remedy by placing fresh mint leaves in a covered container, crushing the leaves each time you open it, and smelling throughout the day as often as you need.

SUPPLEMENTS

Take a good whole food all-natural prenatal vitamin like New Chapter, Innate Response, or Vitamin Code. Add an additional supplement of 25-50 mg Vitamin B complex 1-2 times per day, depending on how much nausea, vomiting and fatigue you are experiencing. A whole food or herbal iron supplement can also be taken, after meals as needed if you are anemic. It tends to be well absorbed and better tolerated than the pharmaceutical formulations, especially ferrous sulfate that actually upsets the stomach.

If your symptoms are severe and you cannot tolerate taking supplements, just take 25 mg Vitamin B6 three times per day. If even that is too much and your nausea is accompanied by the great exhaustion of early pregnancy, consider a Vitamin B injection from a compounding natural pharmacy. 

Another option when dealing with severe symptoms is to combine Vitamin B6 with a rather safe over-the-counter antihistamine medication doxylamine, known as Unisom, which is available in most drug stores. Take 1/2 tablet or 25 mg before sleep with 25 mg of vitamin B6. You can take the other half in the morning with your first B6 dose but it may make you drowsy. And do not forget the midday 25 mg dose of B6. The combination of Vitamin B6 and Unisom or the prescriptive version called Bongesta can be phenomenally successful at reducing severe nausea during pregnancy, and is considered the best pharmacological treatment around.

ADDITIONAL REMEDIES

While there are many herbalists and holistic midwives whose books line my shelves, with now a plethora of recipes and recommendations used effectively around the world for countless years all over the internet, Dr. Aviva Romm remains one of my favorite resources for safe effective use of herbs in childbearing. She is an integrative physician, midwife and herbalist who has done extensive research and compiled the most comprehensive, evidence based reference guide I have come across called Botanical Guide For Women’s Health. In The Natural Pregnancy Book she advises a wonderfully effective Japanese treatment if you feel like a bout of vomiting is coming on or if you have been already vomiting multiple times:

• Heat ½ cup sea salt in skillet for 3 minutes. 

• Put the salt in a pillow case or other suitable sack.

• Fold into a rectangular pad or small square and wrap it in another towel if too hot.

• Apply pack directly to your stomach in your upper right abdomen (not lower belly). 

Wear acupressure wristbands, or Seabands, which place constant pressure on the acupressure points related to nausea. These can be purchased in most health food stores and some pharmacies, have been very effective for some women. Or get regular acupuncture treatments.

Homeopathic remedies are safe and amazingly effective in treating nausea and vomiting during pregnancy. You can consult with a classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro. Some women report much success with Weleeda’s homeopathic combination Nausin (7 – 10 drops four times per day). 

Do not take over-the-counter medications without checking with your health care provider, as many are not safe during pregnancy, especially during the first trimester.

Please call your health care provider if you have severe persistent vomiting such that you can not keep anything down for more than 24 hours, you are losing weight, dehydrated, and/or you feel faint, as you may need medication, or even intravenous hydration.

Final Consideration: Your Nausea May Have an Emotional Component

Mental conflict and emotional turmoil can greatly contribute to nausea and vomiting, as does ambivalence about your pregnancy. Make a conscious effort to work on increasing feelings of forgiveness, appreciation, love, joy, optimism, and healing. Likewise, try to let go of anger, resentment, fear, sadness, and other negative thought patterns that are not serving you. Conscious connected breathing as in Clarity Breathwork is a highly effective way of doing this naturally, without much effort.

Try to avoid things, thoughts and people that agitate your mind and raise your internal tension. Surround yourself as much as possible with calm, centered people, things, sounds and places that inspire, relax you, cause you to feel at ease and restore you to inner peace and serenity.

Talk through ambivalent or troubling feelings with your partner, close friend or therapist as needed. Don’t be afraid to seek counseling if you need help with this, as it is not only helpful to express your feelings with a sympathetic ear, but also to develop skills of self mastery and empowerment. Breathwork however will release issues that can not be resolved through thinking and talking, and shave off years of therapy.

If your nausea is extreme or persists in spite of following the above guidelines, consult your physician or midwife or schedule a consultation with me. If you are feeling overwhelmed, or do not even know what questions to ask, I can help you!

Check out my number one international best selling book Natural Birth Secrets and my online course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

Battling with low back or pelvic discomfort? Having common pregnancy aches and pains and need some additional support? Try Bellefit’s prenatal support wear. I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.

Fatigue During Pregnancy

How to Deal With Fatigue During Pregnancy

Fatigue during pregnancy is a very common experience. Growing a baby is an enormous task and requires a tremendous amount of physical and mental energy.

There are a number of factors that can contribute to fatigue during pregnancy:

• The increased demands on your body, mind and spirit.

• Lack of quality sleep or rest periods.

• Overworking yourself inside and/or outside of the house.

• Short pregnancy spacing, breastfeeding and caring for other children

• Too much time on computer or cell phone.

• Inadequate diet.

• Sedentary living.

• Unexpressed or unresolved emotional difficulties.

• Depression or anxiety.

• Anemia.

• Acute infection or illness.

• Under-active thyroid function.

• Other health problems.

• And even boredom.

Resolving Fatigue During Pregnancy

Look at the whole picture. Consider what in your life could be contributing to your fatigue, and take common sense measures to take care of yourself.

LACK OF REST
Get more sleep by going to bed earlier, sleeping later in the morning and/or taking a nap during the daytime. Getting enough sleep is especially essential during pregnancy.

Take frequent breaks or “healing intervals” throughout the day to simply sit down, rest, center and calm yourself. You can do this by sitting quietly with your eyes closed, slowing down your thoughts by focusing on slow deep breathing while gazing internally between your eyebrows.

Meditation, breathwork, visualization, and yoga nidra/progressive muscle relaxation are all great ways to relax the body. There are many books, audio CDs and hypnobirthing MP3s for pregnancy to help you learn these important life skills, and now there are wonderful phone apps like Breathe and Calm. Make it a regular part of your daily routine to practice them - even just for 15 - 20 minutes.

INADEQUATE DIET
Paying close attention to your diet can go a long way in avoiding fatigue during pregnancy, as your nutritional needs soar during this time.

Make sure you’re drinking 8-10 glasses of filtered, spring or well water daily. Try to drink water away from meals (at least 20-30 minutes before or 2 hours after). Include in your daily diet plenty of fresh organic fruits, vegetables, whole grains., lots of protein and healthy fats.

Eat 20-30 grams of protein three times daily such as:

• Beans

• Nuts and nut butters

• Seeds

• Tempeh

• Organic whole eggs

• Wild Alaskan Salmon

• Turkey or chicken

• Beef, Lamb and Buffalo

• Organic fresh raw whole dairy - ideally goat or sheep

When eating fruit and whole grains, combine it with a protein or fat like avocado, nuts or nut butters, eggs, or a piece of organic cheese. If eating whole-grain carbohydrates makes you tired, reserve them for your evening meal.

Use cold expeller pressed extra virgin olive and/or coconut oil, and butter (goat is best) as your primary fat for cooking.

Eat small amounts several times throughout the day rather than heavy infrequent meals.

Products containing refined white flours and sugars or high fructose corn syrup will give you a temporary energy boost, followed by greater fatigue once the effect wears off. These should be avoided.

Also avoid highly refined processed foods, as these are usually void of nourishment and contain all sorts of chemicals, unhealthy fats, simple starches and sugars that can also make you feel more tired after an initial brief boost in energy.

VITAMIN AND MINERAL DEFICIENCIES

If you are anemic (which is very common in pregnancy, especially during the second and third trimesters), eat iron-rich foods. Good options include eggs, dark green leafy vegetables, seeds, nuts, beans and split peas, dried fruit, iron fortified cereals, red meat and poultry, blackstrap molasses, and brewers yeast. Take natural herbal sources of iron, such as Floravital Iron & Herbs - it comes in liquid and tablet form, as needed. There are other wonderful natural remedies to boost iron in my online holistic apothecary.

If your vitamin B 12 levels are low (common in women who have had several successive pregnancies or are breastfeeding), supplementing with 1000 mcg will be needed and can really make a huge difference in how you feel. It is also in the apothecary.

Also, be sure to take a good all natural whole-food based prenatal vitamin and mineral supplement.

A daily nutrition-rich fresh juice made with a combination of veggies and superfoods like spirulina, kelp or wheatgrass can help you feel more alert and energized. Start slowly with 1-2 tablespoons of the superfoods and build up to 1-2 ounces. Drink first thing in the morning on an empty stomach. Superfoods also come in all natural powdered mixes that can be added to your daily smoothie. Note: if you have a lot of accumulated toxins in your body, wheatgrass may cause slight nausea at first as it cleanses your system. This is harmless and eventually passes.

NATURE AND MOVEMENT
Get plenty of fresh air and adequate exposure to sunlight on a daily basis. Try to spend at least 20 minutes outside with nature in the early morning or late afternoon sun each day without sunscreen. If spending a lot of time indoors, at least open the windows – even and especially in the winter.

Engage in moderate exercise for 30 minutes at least 5 days per week. Good options during pregnancy include swimming, brisk walking, cycling, dancing, or low-impact aerobics. Even though you feel tired, exercise creates energy and does wonders to minimize fatigue, depression and anxiety. Incorporating yoga (especially prenatal, Yin, gentle, and restorative) as a regular part of your daily routine can also be very powerful.

Try to maintain correct posture and body mechanics. Use your abdominal muscles to straighten your upper back and tuck your pelvis in to straighten your lower back. Engage your core by bringing your breast bone and lower ribs and belly toward your back, and bringing your front pelvic bone towards your breast bone. Use your arm and leg muscles instead of your weaker back muscles to lift, carry, pull, and push things.

EMOTIONAL HEALTH
It is important to be open and honest about your feelings to yourself. Some women find it helpful to keep a journal or diary to increase self-awareness and understanding. Share your feelings with your spouse, close friend or family member. Periodically release pent up emotions with a good cry, followed by a hug.

Move strong emotions through your body. If you are angry or overstressed, play an angry song, if you feel grief, play a sad song, or simply play a track of African drumming and let your body move to the music, while making the sounds you need. Our little ones have their temper tantrums, move and release their emotions so they are not repressed and stuck in their bodies. Then they get up and play. Indigenous cultures dance their grief, anger, joy and celebration in community drum circles. We have much to learn from them. Invite friends and have your own drum circle to express and release emotions - you might just feel so exhilarated by it you will want to do this regularly.

Avoid overexertion and trying to be “super mom” by re-examining your priorities, limiting unessential activities, and learning how to say “no.” Delegate tasks to others and let friends and family help.

Try to allow yourself regular time each day without guilt to do something that you fully enjoy, that inspires and uplifts you. Make it easy and fun. Some ideas are:

• Watching a musical, romance, comedy or inspirational drama

• Reading a good novel

• Taking a stroll through the park or in a beautiful spot in nature

• Gardening

• Going on an outing with your partner or good friend

• Cultivating a hobby you desire

• Learning something new that interests you

Add more laughter and play to your life. Many women are surprised to find how health-enhancing and energizing this can be.

Seek out a transformational life coach or, if needed, a professional holistic therapist if the above ideas do not help and you are troubled by psychological distress or emotional discomfort. Suppressed feelings can worsen fatigue as well as cause all sorts of other problems if not properly dealt with.

HERBS AND OILS

Take an invigorating bath with a few drops of essential oils of peppermint or eucalyptus, lemon, wild orange, grapefruit and/or rosemary. You can add a few drops of these essential oils to a bowl or spray bottle of cool water and splash or spray yourself with the uplifting scents throughout the day.

Nettle is a great herb to be taking in pregnancy as a nourishing tonic. It also has the added benefits of blood sugar regulation, adrenal support, improving nutrient intake, and building iron levels. Make a strong infusion by steeping a handful of dried herb in 1 quart of boiling water for 3-4 hours and strain into a canning jar. Drink 1-3 cups daily (with fresh lemon or lime juice, mint leaf or a dash of honey to taste). A fresh spearmint or peppermint tea can also provide a lift of spirit and energy.

If interested in other herbs to improve energy, combine equal amounts of herbal tinctures of schisandra, eleuthero, and American ginseng, and take 1/4 to 1/2 tsp once or twice per day. Start with the lowest dose and work your way up as needed. Reputable herbal companies include Gaia, Eclectic Institute and Wish Garden.

Minimize or avoid caffeinated coffee. It is addictive, too much is harmful, the energy boost is artificial, and it can be agitating and impair sleep. Many feel more tired when its effects wear off.

Avoid stimulant drugs (including diet pills) and sleeping medications, as most have side effects for you and your growing fetus, and can cause you to become dependent on them. Many substances, such as cocaine, are outright dangerous to you and your baby. You must seek professional help if you cannot stop using them.

OTHER RESOURCES

Homeopathy and acupuncture can both be great for soothing stress and increasing energy. Also, check out Clarity Breathwork and/or read The Journey. - for extremely effective, mind-body, cutting edge methods that have lead to transformational healing for thousands of people around the world.

If you experience any sort of chronic fatigue and exhaustion in which serious causes have been ruled out and none of the natural and allopathic remedies help, consider reading the book “The Mindbody Prescription” by Dr John Sarno, MD, an amazing pioneering physician whose brilliant approach has helped hundreds of thousands of people without drugs, physical measure or surgery.

If your exhaustion is extreme or persists in spite of following the above guidelines, consult your physician or midwife or schedule a consultation with me. If you are feeling overwhelmed, or do not even know what questions to ask, I can help you!

Check out my number one international best selling book Natural Birth Secrets and my online course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

Battling with low back or pelvic discomfort? Having common pregnancy aches and pains and need some additional support? Try Bellefit’s prenatal support wear. I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.

Anemia in Pregnancy - Prevention and Treatment

Many of the pregnant women I work with are concerned about anemia. They want to know whether they’re getting enough iron in their diets, and whether they should be supplementing.

Physiologic “anemia” in pregnancy is healthy and natural.  Increased amounts of iron are needed to make additional red blood cells for your developing baby, and for your body’s preparation for blood loss at delivery. Anemia also results from the dilution of red blood cells as the fluid volume expands to nearly double the amount normally present before you were pregnant. It is evidenced by a gradual 2 gram drop in hemoglobin by the seventh month, followed by a gradual return to prepregnancy levels by 3-4 weeks postpartum. Iron stores (ferritin levels) also tend to drop.

While iron deficiency anemia is the most common type, it’s important to note that anemia can be caused by a number of factors. Also, vitality is a great gauge of well-being. If your hemoglobin is a little below normal but your iron stores are fine and you feel fit and healthy, you need not worry. Just make sure your diet is rich in foods high in iron and vitamin C.

Symptoms of Anemia

If you are truly anemic, you may experience the following symptoms.

• Extreme exhaustion and weakness

• Shortness of breath

• Heart palpitations

• Dizziness or faintness

• Headaches

• Irritability

• Poor concentration and confusion

• Feeling weary and run down with a lowered resistance to infection

• Poor appetite and unusual cravings for non-food items
  
  

Iron Deficiency Anemia is Common

Whether or not you have the above symptoms, you are smart to be paying attention. The formation of additional red blood cells for both momma and baby, coupled with their dilution by increased fluid in the circulation, can often lead to iron deficiency anemia during pregnancy. It can be especially aggravated by:

• A diet low in iron both before and/or during pregnancy

• Severe nausea and vomiting

• Being pregnant with multiple fetuses

• Closely spaced pregnancies

• Alcohol or drug addiction

• Severe or chronic infection

• Significant blood loss

• More serious medical conditions

Treatment Options for Anemia in Pregnancy

Untreated anemia in pregnancy that becomes severe may increase the risk of harm to your baby. You may be more susceptible to infection, less likely to handle the stress of labor, the normal blood loss at delivery, and the needed healing during the postpartum period.

Treating iron deficiency anemia can be tricky because many sources of iron are not easily absorbed into your system and some products like coffee, soda, black tea, dairy foods, bran, antacids, calcium and magnesium supplements, and certain medications actually inhibit iron absorption. However, careful attention to diet and use of natural easily assimilated forms of iron have produced excellent results without the detrimental side effects of the commonly prescribed ferrous sulfate.

Ferrous sulfate is not only poorly absorbed, but also very constipating, can cause indigestion, black tarry stools, skin rashes, and is said to be hard on the digestive tract, liver and kidneys. Too much ferrous sulfate has been associated with serious complications and can produce the same deficiency state that it was prescribed to correct.

There are a number of ways anemia in pregnancy can be addressed without ferrous sulfate. I recommend combining several of the suggestions below to increase your chances of successfully increasing your hemoglobin and keeping it at a healthy level.

High-Iron Diet

Get as much iron you can from your daily diet. Good food sources for iron (as well as other needed nutrients) include:

• Organ meats like beef or chicken liver

• Red meat and poultry

• Shrimp, oysters and clams

• Egg yolk

• Dark green vegetables like spinach (ideally boiled briefly to increase absorption), watercress, alfalfa, parsley, seaweed, collards, kale, turnip and dandelion greens

• Seaweeds (kelp and dulse/kombu)

• Beets and fresh raw beet juice

• Jerusalem artichokes

• Fermented soy like tempeh

• Legumes like red beans, chickpeas, lentils and split peas

• Whole grains and fortified cereals

• Blackstrap molasses

• Seeds and nuts

• Dried unsulphured fruits fruits like raisins, apricots, cherries, black mission figs and prunes

• Black cherries and pomegranate

• Prune juice

• Carob powder

• Brewers yeast

To further enhance iron absorption, eat iron-rich foods with foods high in vitamin C. For example, fresh organic uncooked grapefruit, oranges, vegetable or tomato juice, strawberries, blackberries, raspberries, mango, cantaloupe, papaya, tomato, red or green pepper, cabbage, broccoli, cauliflower, and leafy greens. Regular exercise will also help with absorption, as will cooking in cast iron.

Herbs and Tonics

Choose one or two of the following natural sources of iron to prevent iron deficiency, or alternate between a few.

Vegetarian Iron Tonic - Mix 1 Tbsp blackstrap molasses, 1 Tbsp brewers yeast, 1 Tbsp wheat germ, 1 Tbsp canola or coconut oil, and 4 oz orange, grapefruit or pomegranate juice. If you like warm drinks, try 2 Tbsp blackstrap in 1 cut hot water with fresh lemon juice. Drink 1-3 times daily.

Fresh Juice - Fresh beets and apples make a yummy absorbable, iron-rich juice. Drink 2 cups twice daily. You can add  1/2 to 1 ounce wheat grass juice, ½ cup of fresh parsley and/or other green leafies (except raw spinach) to boost the iron content.

Wheat Grass - Take no more than one ounce per day. If causes stomach upset, half the dose or add it to beet, carrot or other vegetable juice for the first week then take the full ounce by itself or in the vegetable juice.

Herbal Infusion - Steep up to 1 large handful of dried nettle leaf and/or red raspberry leaf in a quart of boiling water for at least 4 hours. For increased iron, you can add a pinch of dandelion root and/or a pinch of yellow dock root. Strain, and drink several times throughout the day. You can add a splash of  lemon or lime juice, fresh mint, 1-2 Tbsp of blackstrap molasses or a dash of honey to taste.

Capsules - Take 3-4 capsules of freeze dried nettles or 8 capsules of seaweed daily.

Tinctures - For prevention, take a dropperful of yellow dock root or dandelion root tincture in orange juice. For treatment, take up to three dropperfuls 1-3 times daily.

Liquid Chlorophyll - Take 1-3 Tbsp per day depending on your individual requirements.

If You Decide to Take an Iron Supplement

If an iron supplement is needed, I recommend taking a non-sulfate whole food variety like ferrous gluconate or fumarate combined with vitamin C. 30-60 mg of elemental iron daily should suffice for those with normal iron stores, while higher doses may be needed if your iron stores are depleted. Your dose should be adjusted according to your lab results and individual needs. Take your supplemental iron daily until 2-4 months postpartum.

Find the best supplements that have gone through my thorough screening process at the Holistic Apothecary.

For optimal absorption, it is best to spread supplemental iron intake out over the course of the day to avoid stressing your system with the unabsorbed portions. Do not take with dairy foods, caffeine or soda with phosphates. Be sure to take it between meals on an empty stomach with 500 mg of vitamin C and bioflavonoids

Although it can take a few months to correct iron deficiency anemia, you should start to see an improvement in the lab values within two weeks of treatment. If not, try a different combination of natural iron sources. If there is still no improvement after another 2-4 weeks, your anemia may not be related to low iron and a more thorough medical evaluation is needed. If you are feeling overwhelmed, or do not even know what questions to ask, I can help you! You can just schedule a consultation with me here.

Check out my number one international best selling book Natural Birth Secrets and my online course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!