A Modern Day Village: The Birth Worker’s Inspiration

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I recently had a conversation with a client who is about to be a first time Grandmother. As I listened to her speak about her worries about her daughter’s upcoming birth, her struggles during pregnancies with depression and Hyperemesis Gravidarium, I was completely struck by the feeling of isolation that she was describing in her daughter. She is the only one of her friends pregnant, and although she does have a Fiance, he is  not operating on the helpful wavelength that she needs.

Immediately, my head swirled with questions to find out more.

“Who did this new soon-to-be-mama have to ask questions to other than the doctor she sees once a month?

Why is no one there for her other than her mother? Is the doctor leading her to support groups, mothering circles, moms with prenatal or postpartum depression? What will she do when she actually HAS the baby? If she’s struggling with depression now, who will watch out for the signs/symptoms of it in the postpartum months? Who will help this woman!!!!!!!??????”

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A little voice in my heart spoke up right then.

You, silly. You’re a birth doula. You have all she needs. Help her.

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Almost moved to tears, the words fell out of my mouth reflexively. “I remember those feelings all too well in both of my pregnancies,” I said sympathetically. “It sounds like she could use a birth and postpartum doula.”

The only difference between this mama and me when I was going through those same terrible feelings while pregnant was, I wasn’t actually alone. I had my doula there one phone call away at any moment. I had the cohesion of care between my amazing midwives, my doulas, myself, and my team. I had created my village.

After explaining what a doula is and does to her, (if you still want to know what that is, reference my Demystifying Doulas post here) it occurred to me that in some cases, women have no idea of the need for a village.

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Photo Cred Doulamatch.net

Back in the day, we lived in literal villages that would commune together for the birth of a new village member, and either call the midwife or have one on hand. 9 times out of 10, the birthing mother had a sister, mother, friend, neighbor, SOMEONE, with her until the midwife could arrive to her. Thus, the doula is born. Even female elephants know the importance of gathering around to form an impenetrable barrier of support for the birthing mother. I frickin’ love elephants.

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While modern-day women and birthing communities are certainly bringing doulas back, there is still too large a proportion of women who go unsupported during the pregnancy, birthing, and postpartum process. Why, you ask? Mostly because, they do not know we exist. It is the lack of conversation, or the lack of clarity on our exact role, that I sadly have to believe is one of the main reasons that birth has the potential to be such a traumatic experience for some women.  Having the guidance of your doula to shepherd you into the parenting life with grace, provide you with materials to support you every step of the way, can provide you with your lifeline if when you need it.

A glorious benefit in making the choice to hire a doula is that he/she may in turn lead you to your permanent, modern village.

Truth is, the years of preconception, pregnancy, transitioning to becoming a mother of one, two, three, multiples, etc., can come with many mixed emotions. No matter what your situation turns out to be when you find out you are pregnant, the feeling of isolation can be sudden and agonizing. When hiring a doula, you’re not only receiving the personal care of a hands-on teammate in your birthing journey, you are also DSC01327choosing an expert in community, local resources, birth education, knowledge of primary care givers specific work, and access to birth related evidence, articles, and, yes, even a postpartum sounding board. The doula will, in essence, be your trail guide for navigating the rough and unknown waters of this new chapter.

It is time, now, that we stop isolating ourselves as mothers. Let’s remind our world that we have been supporting each other proudly and strongly for…well…since the dawn of humankind. We do not need to do it alone. It may feel too daunting a task going to these mothering circles full of strangers, organizing birth class dinners at your house, or even seeing a therapist to get the necessary prescriptions to aid you. What if, in lieu of uncertainty of the support you need, you could Call. Your. Doula.

We can support this adventure every step of the way. We are here, so that you can be here and present through the whole process.

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Now that I have you convinced of the awesomeness of unconditional education and no-judgement support during your birthing years, let me illuminate the steps necessary to finding your perfect doula.

  1. Ask a friend: Ask around for a connection or connect with the doulas in your area by using the ultimate doula search engine: Doula Match  
  2. Interview a few: Find the right candidate by sitting in the energy of several different people.  Remember, you are hiring for a job, so the right fit is important. Birth is a vulnerable experience, so pick someone who will make you feel completely safe, who makes you feel confident, and someone by whom you and your birth partner feel empowered.
  3. Ask all the questions: Make sure you understand their vision of care, fees, and schedule and those align with what you had in mind for your birth vision. After all, it is your birth, the team you hire should complement it in every way with encouragement and advice that makes you feel informed. Do you want a doula just for prenatal education and birth? Do you know you’ll need postpartum care? Do you even know what that means? Does this person have the resources for all of that?
  4. Contract: You should always enter into a contract with your doula. That way there is an expectation of care that is agreed upon by all parties. This agreement is key, as mentioned above, it will be the catalyst for your new life as a mother.
  5. Get excited: Your doula should help you feel connected to birth classes, books, and other materials to prepare you for your upcoming experiences and all outcomes!

We all need the help. It is up to us to choose, in this modern world, just what our helping hand will look like. Most of us consider this calling a service to womankind alike. I am here to let you know it’s out there. I am writing to speak aloud that we are everywhere. We are your friends, neighbors, sisters, mothers, co-workers and colleagues, gym members, professionals, and tradeswomen.nature.jpg

We are your village, and we are here for you.

Kristy is a doula, massage therapist, energy worker and mom of 2 in Virginia.

 

Pregnant, MD: First Trimester Woes

Whether you’re an experienced mama or a first-timer, there is always a bit of a rollercoaster that ensues between pregnancy test turning positive and the onset of pregnancy related symptoms. Every single person has a different experience, but lucky for me as a doctor, I’ve had the majority of “usual pregnancy symptoms” happen to me in one of my 3 pregnancies – giving me insider knowledge that I appreciate as it can help me help others… even if I curse them in the moment.

I’ll give a little run-down of the most common things, how to deal and when to worry here. More in depth posts will follow! And, as always, this is not personalized medical care here – ask your own health care provider for help on any issues.

Nausea

There are women out there – I know because I’ve seen them in my clinic – who do not experience pregnancy-related nausea. If this is you, move on, you magical unicorn being, you. For the rest of us the nausea, oversensitivity to smells, food aversions and cravings and sometimes vomiting usually hits between 6-8 weeks of pregnancy and lasts until 14-16 weeks… or until birth for some of the really special ones of us.

Some simple tips can help minimize how bad it is, but by far, the most important thing, is to STAY AHEAD OF IT! The nausea feeds off itself. Do NOT try to tough this one out – the worse it gets, the worse it will get. Oh, ps. even though you’re not eating real meals, you may start to look like you just had a Thanksgiving feast thanks to the bloating – hooray!

  1. Eat all. the. time. Seriously, you should put some little bit of caloric intake in your mouth every 1-2 hours while awake. Avoid big meals – split them up into basically constant grazing throughout the day. The empty stomach is your enemy.
  2. Start keeping easy-to-access snacks everywhere – baggies of whole-grain crackers, applesauce pouches, dried fruit, cheese sticks and nuts make healthy options, but really this is the time to least worry about nutrition. If you are getting bad morning sickness, try to eat a snack in the middle of the night or have one on your bedside table for before you get out of bed. This is your most important and first line of defense, take it seriously!!
  3. Try the different natural aids. Some people do well with ginger, others with citrus, others with mints. I’m a big fan of Preggy Pop Drops as an emergency purse go-to. Others swear by Sea Band Mama acupressure bands. See what works for you.
  4.  Avoid places you know you’ll be assaulted by strong smells. If they are unavoidable, consider an aromatherapy necklace or a scarf spritzed with a light fragrance for defense.
  5. Do not, and I mean DO NOT try to force yourself to eat something you know doesn’t sound good out of politeness. You will regret it. I don’t care if grandma slaved away on the chicken piccata for hours. Not worth seeing it again later in reverse. You can always go with “my doctor said I can’t eat that” ;^)
  6. Distract yourself. Dwelling on the sensation of nausea will get you one thing: more nausea. This is the time to give yourself some grace about catching up on Netflix, flipping through magazines or scrolling social media during the difficult moments. The more you can keep your mind off the sensation, the less severe it will get.
  7. Take your prenatal vitamin at NIGHT, not in the morning.

When to worry: If you are vomiting multiple times per day or unable to keep nourished or hydrated, contact your doctor right away. You may need to start on Diclegis (doxylamine and vitamin B6) to help prevent nausea or need a prescription anti-nausea medicine to take.

Boobs

I will never forget reading The Girlfriends’ Guide to Pregnancy when I was gestating for the first time and bursting into hysterical laughter as she describes the “titty fairy” coming to visit. One of the first signs of pregnancy many women experience is a rapid, and often very painful expansion of one or multiple cup sizes in your breasts.

The first time for me, I felt like someone had taken a baseball bat to my poor unsuspecting boobies. Going up stairs brought me to tears with the bouncing. This is (unfortunately) totally normal. It also will get better towards the end of the first trimester for most.

When to worry: The only danger present here is the unwanted attention the newly enlarged chest apparatus might garner from your partner – warn them ahead of time so they don’t unintentionally grab and get karate kicked in self-defense!!

Discharge

Yep, the vaginal kind. You’ll get more of it. It might smell different. This is normal. Not a whole lot else to say about that.

When to worry: A slight amount of pink or brown spotting can be normal in pregnancy, but if you have more bleeding or ongoing spotting or if it comes with any cramping or other new symptoms, you should talk to your health care provider. You should also be checked if you have vaginal pain or discomfort or the vaginal discharge is yellow, green or foul-smelling.

Dreams and Feelings

You are probably going to get some CRAZAY dreams, girlfriend. Some lucky ladies have dreams that include “dream-gasms”, orgasms in your sleep, thanks to the increased blood flow to the lady parts. Some less lucky ladies have very disturbing and vivid dreams.

It has become cliche to talk about the pregnancy hormone emotional rollercoaster, but it’s actually a thing. Many women can be laughing at a joke one moment and balling hysterically at a toilet paper commercial the next. Ups and downs just get a little more extreme thanks to ye olde brain chemistry. Again – give yourself a break here – and also maybe warn those around you.

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When to worry: If your dreams are causing you distress in the daytime, it may help to see a counselor. If you are experiencing consistent anxiety or depressed mood that is impacting your day to day function, talk to your health care provider.

Fatigue

This one hit me hard with this pregnancy. I don’t know if I just had mom-nesia (when you forget how bad pregnancy was after a while because you’re momming), or if it wasn’t this bad the last couple times. I could barely drag myself off the couch for about 2 months straight. This is mainly because of the hormone shift that goes on and your body trying to make 1/3 more blood than it usually keeps on hand in preparation for the rest of pregnancy and birth. You’re functioning like you’re very anemic. You might feel short of breath with relatively little physical activity. You might micro-sleep while at dinner with boring relatives. It’s normal to be tired AF.

Listen to that voice – you NEED rest. Follow the medical school mantra: Don’t stand if you can sit, don’t sit if you can lie down and don’t be awake if you can sleep.

When to worry: If you have family history of thyroid problems, a known history of anemia yourself or might be low on vitamin D (if you aren’t taking a supplement and don’t spend all day in the sun), you might need extra blood tests to make sure your level of fatigue is normal. Ask your person.

Potty Problems

You’re gonna pee a LOT. I went 9 times in 1 night. My husband thinks this is the worst thing about pregnancy because apparently I grunt like a grizzly bear trying to get out of bed at night and wake him up. Guess how sorry I feel for him?

Don’t let this stop you from staying hydrated!! Think of it as a great way to get in your steps, because you’re probably not feeling like doing much other exercise right now.

Bowel movements, on the other hand, tend to have the opposite change. Constipation is a super common pregnancy woe. The gut moves slower (part of the issue with above-mentioned nausea, ahem). Try as much as you can to get in fiber. Prune, pear, peach and plum fruit or juice can also help as do probiotics for many. Simethicone (gas-x) can help with gassiness and is safe. If that’s not getting you a daily or close-to-daily BM, talk to your health care provider about other safe options.

When to worry: If you have pain when you go pee, a history of diabetes in the family or fevers or back pain, you should be checked by your health care provider. If the constipation is several days ongoing or causing significant abdominal discomfort – also check in with them.

Other

So many other things can come up – again, every pregnancy is different. There is a whole cornucopia of options for how to be miserable in the first trimester – yeeha!!

Your skin might get sensitive, decide to rehash teenage acne or have color changes and sprout new moles. You might have strange metallic taste in your mouth all the time. You might have headaches. You might get crazy I-ate-the-habanero-salsa-by-accident level heartburn and reflux. Or maybe, just maybe, you’ll be the unicorn that skates through with nary a complaint. Hats off to you, miracle mama!

Bottom line – ask your health care provider about anything odd for you. We LOVE talking about this stuff – these are the easy questions for us and make us feel smart. Don’t hesitate to bring something up at your visit or between. And remember – this too shall pass.

Dr. Annie is a married mom of 2 with one more on the way and family doctor in the Sacramento area.

Kristy, Au Naturale: Massage is not a Luxury

Show of hands on who is stressed about something right now? Literally, anything. Laundry, money, marriage, kids, work, blah blah blah blah.

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Close your eyes and feel your body. Feel where it is tense. Is it your shoulders? Your jaw? Your glutes? Is your brow furrowed or your posture slouched?

Now stop reading. Feel it. Take this time.

Now actively release those muscles and become aware that whenever we think about the simplest thing that causes us stress, our bodies produce this physiological response called tension. It is only the most practiced of us (aka, the Buddha) that can be fully aware of these muscular stresses, and actively manage them without the help or guidance of others.

This is exactly why I do not believe that we can call Massage Therapy a “luxury” any longer. We, as the human collective, are just too seemingly stressed out about our lives and the state of the world to recognize how it is affecting our bodes.

What we end up following, is a cycle of tension, and pain, then anxiety and decreased ability to cope with the pain.

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This has a dire effect on us as a whole being. The way our body responds to stress is three fold. It is physiological, emotional, and psychosocial. Most of us turn to medicine to manage the symptoms. Which has its benefits as well, but what if it were more simple than that?

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The Body is Smart

There are over 50 physiological responses to stress. Overwhelmingly and alarmingly, these responses effect our body systems’ ability to function properly. Below are descriptions of different bodily systems as they respond to stressors placed in our lives.

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The Answer is Antique

The power of touch and “healing” touch has been around for 5000 YEARS. Five freaking thousand years people have been using Massage Therapy and healing therapies to ease the symptoms of stress and illness, be it mental, emotional, or physiological. I say, if it ain’t broke……

Massage Therapy is the perfect antidote to most of the stressful situations in which we find ourselves on our daily grind. With frequent (at least once a month, if not every 6 weeks) Massage Therapy, one can benefit GREATLY.  Pictured below are just some of those benefits outlined.

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But what about our psychological health? It is no surprise that stress creates emotional problems such as anxiety, depression, family tension, short temperament, coping problems, and increase use of improper coping mechanisms. Massage therapy can help by increasing self worth, decreasing blood pressure (aka anxiety), boosting energy levels (aka helping with depression) improving sleep (hello resting awesome sleep face) and increasing ones awareness of their bodily tensions. This latter benefit is important so that we can understand our body’s response to stress, and address is as it presents itself before it becomes a reason to create a problem.

The fact is, no matter what you believe, that we are primitively designed to live in the moment. Most of the animal kingdom, when not hunting, do not spend their time worrying about taxes, relationships, promotions, etc.

They spend their leisurely time sleeping, cuddling, BEING.

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I’ve got $5 that she’s not thinking about TPS reports

Massage Therapy is THIS. Not a luxury, but a primitive and necessary reminder that our bodies, brains, and souls need a time out. We need to allow ourselves an hour (or more) every once in a while to tune out from the world and unplug, and tune INTO ourselves.

As mothers, so often when we experience touch in our lives, someone wants something from us. The new baby needs to nurse. The toddler needs comfort. Our spouse needs…. another kind of comfort. Having someone touch you in a healing way is not a regular occurrence for most moms. For other women, whether you’re single or an empty-nester without the kids hanging off of you, touch might be nearly absent. That hour of nourishing touch is even more important in these stages of life.

So, whether you’ve never had a professional massage or it’s just been too long, now is the time to sit down with your budget and find $50-150 per month for this. We are talking about one Target run for a lot of us here. Only, instead of a few bags of (admittedly cute) stuff you were convinced you need, you now have invested in healing every aspect of your life.

You can’t pour from an empty bucket, people. Replenish your needs so you are better able to share yourself with those who matter to you.

18835945_10103938084553859_8628446883750688728_n Kristy is a married mom of 2, doula, massage therapist, and dedicated crossfitter with a passion of healing the human body and mind in Virginia.

Kristy, Au Naturale: Making Fitness Fun Wherever You Are

Alright Alright. I have waited long enough to talk about it. So let’s do it. Guess what? I Crossfit. And what’s the first rule of Crossfit?

               Always talk about Crossfit.

And boy, oh boy, did I ever uphold that rule! I’m pretty sure people ran for the hills when they saw me coming because, “She’s gonna tell us how many pull-ups she did yesterday”

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Yup….that is exactly what I would have done;) But now, I have learned the power of balance and FUN in adapting workouts to fit into the life of all that wish to have fitness be a priority in their lives.

It seems about time that I share some of my hubs’ and my favorite Crossfit Workouts. I do this so you can know that not only is Crossfit for everybody, but it can also be adapted and scaled down for every BODY. 

I’ll give y’all (that’s right I am a Virginian) two versions for these adapted workouts. The first version will be the Crossfit prescribed workout. The second will be adapted for the at home motivated fitness junkie.

You should of course only do these if you know you are medically safe to do so – if you’re not sure, ask your healthcare provider. And for Pete’s sake, use good form!!!! Not sure what good form is? Invest in a few personal training sessions or CrossFit Gym sessions (you might just get hooked like me).

Kristy’s Most Favoritest Crossfit WOD Ever

“Annie”

download (5).jpegWhat you’ll need: A jump rope and a yoga mat. Oh and some Chamois Butter  just trust me and buy it. High Reps=hello sit-up chafe. 

Oh and also if you’ve had kids……..These little life saver Poise Impressa protection things are Ah-May-ZZZING protection for those 150 reps of jumping. And yes, you will probably pee on yourself if you aren’t using them, let’s all just be real.

The point: We do these repetitions on a metabolic conditioning scale. The way it works is the clock starts, and you want to get in 50 reps of double unders then sit-ups. Then, you do 40 and 40, 30 and 30, and so on…..FOR TIME.

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You said do what?

Don’t have double unders? No problem, just triple the amount of single unders (standard jumping rope) you have to do.

50-40-30-20-10 reps of

Double unders

and sit-ups

Annie at home”

What you’ll need: Your body and a yoga mat

50-40-30-20-10 repetitions of:

High Jumps

and Sit-ups

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Record your time. And repeat in a couple of months and see if you can can get a faster time!

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My Husband’s Choice

“Nancy”

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We are back into the METCON here, but this sort of run/weight training is amazingly efficient in reaching your anaerobic thresholds. Threshold meaning the point when you “feel the burn” but you keep moving through anyway, fighting the urge to quit!

5 Rounds for Time:

400-meter run (roughly a quarter mile)
15 overhead squats

Men: 95 lb (with weight plates and a barbell)
Women: 65 lb (weight plates and barbell)

Crossfit.com explains this workout of the day, or WOD, perfectly.

“This benchmark couplet is meant to be light and fast. Reduce the load on the overhead squat so you can perform all the reps unbroken and still run fast.

Intermediate Option
5 rounds for time of:
400-meter run
15 overhead squats

Men: 65 lb.
Women: 45 lb.

Beginner Option
4 rounds for time of:
400-meter run
10 overhead squats

Men: 45 lb.
Women: 35 lb.”

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“Nancy at home”

What you’ll need: A 1/2 mile route and free weights (you choose the load)

NO weights?

Find a heavy object in your house or use your baby/toddler for Mom/Dad-ercise!

5 rounds for time of:

1/2 mile run

15 air squats

OR

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OR 15 baby thrusters (shown below)

These are some fun ways to “dip your toe” into the world of High Intensity Interval Training to see if it is for you. But trust me, it is.

Enjoy rocking out and sweating massive amounts of High Intensity Awesomeness!

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I mean, who can argue with that?

Friday Faves: Summer Smoothies

Summertime is coming in hot across the country right now (see what I did there, hehe) and that means breakfast and snack time need refreshing makeovers. We love smoothies all year round, but especially when it’s 80 degrees already at 9 am, ain’t nobody wanna be slaving over a splattering pan of bacon and eggs.

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Photo by Suzy Hazelwood on Pexels.com

Smoothies offer densely packed nutrition, portability and refreshing yum-factor, it’s a win-win-win. It helps to do a little on-the-fly prep as your week goes by. Whatever extra fruit you have lying around about to go bad, chop it up and freeze it. Bananas (obvi), melon, berries, pineapple, mango and watermelon are all great frozen additions. OJ been sitting around for a while? Toss it in an ice-cube tray for future smoothies.

Here are some faves! Fire up that blender and enjoy.

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Photo by Kaboompics .com on Pexels.com

PB&J Smoothie

This is Annie’s OG smoothie from back in medical school and is still her go-to for a filling breakfast. You can make it thicker and have it as a smoothie-bowl with some nuts and fresh berries on top also. All measurements are super-approximate, I don’t actually measure anything.

3/4 Cup Frozen Organic Mixed Berries (I usually get from Costco)
1 small frozen banana
1.5 C spinach or kale
1 C Cashew milk (or any other creamy substance you like)
1 heaping TBS cashew, almond or peanut butter
Optional 1/2 C plain whole-fat yogurt
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Photo by Oleksandr Pidvalnyi on Pexels.com

Watermelon-Cucumber Refresher

Ultimate afternoon pick-me-up right here. Not super filling – great for after workout or if you didn’t quite eat enough of your kids’ leftover dino-nuggets at lunch to get you through till dinner 😉 It’s super hydrating and also packed with great vitamins with the watermelon and cucumber combo.

This one also makes a great alcoholic slushie if you cut out the yogurt and add a shot of vodka or gin instead.

1 C frozen watermelon chunks

1/2 C roughly chopped cucumber – if bitter, skin mostly removed

1/2 C plain whole milk yogurt

1 TBS fresh mint

Enough OJ or pineapple juice to be able to blend – the watermelon has a lot of water, so you won’t need much, start with 1/2 C.

Bonus Boosts

For added protein boost to any smoothie, consider throwing in a scoop of healthy protein powder.  Annie’s fave is NanoPro Vanilla Protein powder, Margo’s prefers Arbonne Vanilla Protein and Kristy’s go-to is Ascent Native Whey Protein Powder.

You can also add a super-food powder such as Youth Factor powder by Nerium or Lifeguard Greens to get a huge boost of anti-oxidant power.

Hope you all have fun getting your blend on this weekend! xoxo, Lockers To Littles crew.

Dr. Annie Answers: Getting Pregnant

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It’s kinda crazy to me that a lot of us spend so much of our lives worrying about NOT getting pregnant and then you go straight from that to worrying about getting pregnant. This, like many issues addressed here, can be influenced by many personal health issues. Talk about it with YOUR doctor. I’m just here to give some basic info. This advice also is less applicable if you’re using a sperm donor or other fertility treatments for any reason, but some of it still applies.

So you think you want to get pregnant…

Number 1: Start a prenatal vitamin. *Ideally* you’re already taking one if you are of childbearing age (aka teens through 40s). If not, start NOW. You should be on a prenatal vitamin at least 3 months, and ideally 1 year before you conceive. What if you’re already trying to conceive? Start now. Better today than next week. Just, the sooner the better.

Which prenatal vitamin is right for me? There are lots of brands, gummy options, drinkable options, etc… to choose from. Find one that you can tolerate taking. The basics it needs to have are 400-1000mcg of folate, 27mg iron, 1000 units vitamin D, and 100mcg iodine. If your diet does not have a lot of healthy omega oils, also get a 1000mg daily DHA/EPA supplement. I personally use Honest company prenatal and DHA.

Talk to your health care provider about any medications you’re taking and if they are safe while trying to conceive. Make sure any chronic health issues such as thyroid problems, diabetes, or high blood pressure have been checked and are in good control. Plan ahead for these!

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This depends a little on what you were using. You CAN get pregnant the month (or week) you stop any form of birth control. So don’t stop using anything unless you are A-OK with being pregnant right away. That being said, hormonal birth control is more likely to have a “wash-out” period where you don’t ovulate regularly and are less likely to conceive. DepoProvera, oral pills (especially if you’re skipping periods), the patch, the nuva-ring and Nexplanon/Implanon all have a 3-6 month expected wash-out. I have seen it take up to a year with Depo. IUDs are less likely to have wash-out, but we wouldn’t be surprised if it took 3 months or so.

So, let’s say you want to get pregnant “sometime in 2019”. Easy. Go off birth control after you have that New Year’s blow-out party. What if you have a more specific window? You can plan to go off birth control 3-6 months in advance of that window, but use condoms to prevent pregnancy until then. Know that condoms are only 85% effective at best and you could still get pregnant earlier than you think. So, if, for example it would be devastating to get pregnant in February (calculate due date from theoretical conception date out here), don’t stop birth control until after that.

How to get pregnant….

SO, um, there are of course some basics here I’m assuming everyone knows about human reproduction. If you’re confused on the what goes where, may I refer you back to wikipedia under “birds and bees”. If you’re not in a relationship where sperm is readily available or you can’t have intercourse for any reason – see a fertility specialist about how to get that all going.

If those exceptions above don’t apply to you… the most reliable way to get pregnant is also the simplest. Have unprotected intercourse every other day from right after your bleeding stops until you start bleeding again. Every. Other. Day. Not every 3 days. Not twice a day (but good for you if this is your issue!). This gives you optimal semen volume and you will never miss your fertile window because it lasts 2-4 days. Boom.

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Now we get to the people who are absolutely opposed to having sex every other day. For some couples, that’s not sustainable over the several months it can take to get pregnant. That’s totally fine! If that’s the case, I usually recommend the Glow Ovulation, Period Tracker App. This lets you track cervical mucus, basal body temperature, ovulation sticks and pregnancy tests, sexy time and everything else about your cycle. Take at least 1 month to track everything while still using condoms so you get some understanding of your cycle.

Then, go for that fertile window! Again, sex every other day or daily. What kind of sex? Pretty much whatever. Position doesn’t matter. Ideally, the person trying to conceive should have an orgasm during or after (though there isn’t evidence that this is necessary, it has little down side!). And if you’re gonna use lube, use this lubricant. Chill out for 5-10 minutes after sperm gets in there then go about your business.

Did you say cervical mucus? Sounds so gross, but is actually the easiest way to check if you are fertile. Just look at the TP after you wipe when you go pee. When you’re approaching fertility and fertile, you’ll notice a clear discharge like egg white. When this is super gooey/stretchy – that’s peak fertility. More nitty gritty here.

How long is this going to take?

If you’re under age 35 it is normal to take up to 1 year to get pregnant depending on your health and the health of your partner. Most couples will get pregnant within 3-6 months. If you’re over 35, the timing gets a little more pressured because fertility starts to decline significantly around age 37. In this case, we would usually only give you 6 months before further testing. If you’ve already been trying to conceive for that long – go see your doc.

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Photo cred: FionaMargoPhotography.com

Final note: Don’t sabotage your efforts.

If you’re in the exciting phase of ‘trying to conceive’, don’t do things that are going to stress you out and make it harder or threaten an early pregnancy. Ask your health care provider if any medications you’re taking are safe. Don’t go binge drinking. Don’t smoke marijuana. Don’t smoke anything for that matter. Have your sperm provider avoid hot-tubs, tight underwear and long bike rides. Eat lots of healthy fruits and vegetables and proteins and fats (first trimester is ROUGH ya’ll, you will need those nutrients stocked up). Exercise regularly. Avoid over the counter medicines other than tylenol and tums without asking your healthcare provider. And… enjoy the ride!

ps. Make sure you follow us for an update on my own adventure trying to conceive baby #3 coming soon 😀

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Dr. Annie is a family physician and married mom of 2 in the Sacramento Area.

Dr. Annie Answers: Good fat, bad fat

 

In case you clicked on this post thinking it had to do with body shapes or positive body image – that’s not the fat I’m talking about here. Although, I do fully believe that there is a wide range of healthy body shapes out there and that no person should feel shame about theirs. I digress…

What I’m actually writing about here is the fat we eat. Unless you’ve been living under a rock for the last decade, you should be at least a bit aware that ‘trans fats’ are BAD and ‘omega-3 oils’ are GOOD. I’m going to both give you a bit more detail and also simplify it at the same time. **As always, this blog post is meant to give you information and not as personal medical advice since I am not your personal doctor. **

For decades, people with high blood pressure, high cholesterol, diabetes or obesity have been told to follow a “healthy low-fat diet”. That is an oxymoron. It turns out, that exact advice has been a huge driving force in the EPIDEMIC rise in all of the above conditions.  We are just now starting to get a grip on the actual data and the conclusion is undeniable: a diet very high in healthy fats and very low in carbohydrates can prevent and reverse that damage. There are a tiny handful of people with specific health conditions in which they have to limit fat intake. You are probably not one of them.

Good fats go into your body and provide steady energy, a vehicle to transport important nutrients and hormones around, and keep your blood vessels and nerves healthy. Bad fats get in there and gum up the machinery, clog those arteries and often carry harmful things in with them. Your body needs a LOT of those good fats, probably more than you think.

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I have to admit, I too was a skeptic for a time. Enter Whole30 diet in which you eat only vegetables, fruits, meats (SO much meat), nuts, seeds and eggs for 30 days and NO grains, legumes, dairy, sweeteners of ANY kind, alcohol, soy or chemical additives. You aren’t supposed to track calories but I was curious – on average I was eating about 100-120 grams of fat per DAY, lots of it saturated. And you know what? I lost 15 pounds and 2 pant sizes and felt like a freaking super-hero by the end. Depression better, sleep better, skin better, energy better. It just works.

So, how is one to navigate this?? There are a few simple rules.

  1. No reduced-fat versions of foods.
  2. Not all fats are created equal, increase the good, limit the bad
  3. If something is high-fat, try to choose the highest-quality.

Want a little more detail? Read on, my friend!

Rule 1: Choose the full-fat version

“Whaaaaaaaaat?”, You say. Not even low-fat yogurt?? No. We are evolved to like the taste of fat. When fat is removed from foods, food manufacturers have to replace it with something – both for the volume lost and also for the flavor. The answer in most cases is carbs/sugar and salt – both of which have a huge body of evidence to show they are harmful. Diabetes, obesity, hypertension, and multiple cancers included in the ‘harm’.

Moreover, when you have less fat, you have to eat more to feel satisfied because of the way hunger signals translate from stomach to brain. That big old bolus of sugar/carbs you ate instead causes an insulin spike that stores away fat in your body (no thank you extra stored fat!) and then crashes into hunger soon after. Higher fat foods, however cause almost no insulin spike. Check out the difference:

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Insulin over time after eating pure carbohydrate vs pure protein vs pure fat.

So, does this mean I can eat bacon and eggs for breakfast, a steak with butter on it for lunch and breatwurst wrapped in more bacon for dinner as part of this healthy low-carb, high fat diet? Um, no. (though there are some interesting studies in which people did just that…). Most people would still say your diet should include plenty of non-starchy plants (aka not potatoes, corn, peas or carrots). Half or more of your plate should be vegetables like broccoli, cauliflower, greens, bok-choy, asparagus….. or sometimes fruits like so:

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Rule 2: Know Good vs Bad fats

So which are which? Nuts, seeds and fruits tend to have healthy fats and should be the largest source of your fats. Newsflash: corn (aka Canola), soy, cottonseed, palm fruit and peanut oils do NOT fall in this category. Coconuts, tree nuts, sunflower seeds are great for eating and their oils for cooking.

And, yes, I said fruits. Avocados and olives are fruits with hella good fat content (California joke). Good fats can also come from fatty fish such as salmon, tuna and trout – or for the more adventurous palate, sardines and mackerel. Good quality meats and dairy can also be a great source – more on what “good quality” means below. If you have to buy the cheap cuts – limit these a bit.

The worst fats are the ones humans have done something ‘advanced’ to that alters them. Ask yourself: Is it is a processed ‘food product’ like margarine or Doritos? Bad. Did the animal or plant it came from have it’s natural lifestyle disrupted for mass production? Bad. Did it come from a lab – aka trans fats and hydrogenated oils? SO SO BAD.  Avoid, avoid, avoid. Also, avoid heating liquid oils (canola, olive, avocado, etc..) to high heat as this can create carcinogens (cancer-causers). Better to use coconut, ghee (butter), or animal fat.

Rule 3: Choose High Quality Fats

Some of you might be thinking at this point… is this what that Atkins Diet was saying? Yes and no. The Atkins Diet skims over the high-quality vs low-quality fat delineation and just says: increase fat, lower carbs. This is a good step in the right direction. However, the quality of the fat also matters, and I’ll tell you why.

Most things that we put into our bodies can be categorized in one of 2 ways – fat soluble or water soluble. In a huge simplification, that means that it can get through your gut and into the rest of your body by ‘riding’ on a fat or with water. Vitamin D, for example, is fat-soluble. So you want to take it after eating some fat. Vitamin C, however, is water soluble so can be taken with just water. This also goes for nasty stuff you don’t want in there. Many chemical pesticides, growth hormones, antibiotics and even heavy metals like mercury are concentrated in fats. Furthermore, the good fat to bad fat ratios change dramatically when we take an animal and feed it an ‘unnatural’ diet.

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Happy, healthy cows.

If a cow is fed grass, as nature intended, the fat profile in those rib-eye steaks and that delicious milk is WAY healthier than if they are corn fed. Not only that, because that corn-fed cow was on a diet it’s body wasn’t made for, they are loaded up with hormones and antibiotics which ride on in to your system with that fat. Note: organic doesn’t mean grass fed, but is still better than non-organic.

Where your budget allows, buy these top quality fats. Organic olive oil and avocado oil are cheaper at Costco. Search out the deals on grass-fed beef. Then cook it in some organic ghee and top off with organic Bechamel served with some broccoli roasted in coconut oil. Then tell me how “deprived” you feel on this diet 😉  It’s really not as hard as you think!

Take home point: Eat LOTS of fat, don’t worry about how much but do worry about what kind. Choose organic plant oils and aim for organic/free range animal products.

Resources:

There is a lot of emerging information about this (finally!!), here are some ways to learn more:

 

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Dr. Annie is a family physician, wife and mom of 2 girls in the Sacramento Area who, yes, cooks everything in butter.