I’m struggling to get pregnant. What types of fertility treatments should I look into?
That is a very good question because the ability to get pregnant is way beyond just jumping towards what fertility treatment you need. A thorough examination needs to be done. You have to keep in mind that 30% of the infertility that occurs is women. 30% is men. The other 30 - 40% is either both the binaries, or some unknown reason. So you can't just jump to fertility. A thorough workup needs to be done of you and your partner before we can find out what the cause is, and then address that cause.
How many days after my period am I the most fertile?
The days after your period that you are most fertile depends on what your period cycle is. The average is 28 days. So that's what people think is what your periods should be, but each person has their own cycle. So for instance, if your period is 32 days, that is your cycle, as long as it's regular and it's repeatable. When you know when your period is going to come, take that as your cycle. The thing with ovulation is it’s 14 days from the end of your cycle date, backwards. So you don't go forward. You actually go backwards on this one. I'm going to show you a picture of what that looks like, what our body does and the hormones that occur during ovulation and during our cycle. So what you're going to see here is a spike in estrogen and then a spike in the Luteinizing hormone. This is the hormone that you're going to be testing when you do your ovulation prediction kits. Ovulation occurs, then should you not get pregnant, the hormone levels drop and you get a period. But this time from here is very predictable. 14 days to here. This varies depending on your own personal cycle.
I’m trying to get pregnant. Should I start taking prenatal vitamins now or wait until I am pregnant?
Pre-natal vitamins are essential in pregnancy. The main reason, especially in the beginning of pregnancy, is folic acid. So let me go a little bit backwards on that one. If you decide to get pregnant, you should be taking the prenatal vitamins at least a month before pregnancy. We sometimes even say up to three months. There's been data to show that a year has even decreased the risk of other disorders like preeclampsia and preterm later. But that one month is essential. You have to increase your folic acid level. And the reason why is baby's neural tube defects. If you look here, you can see the neuro tube is the entire spinal cord. It starts from the head and goes all the way down. So this is an example of a spine bifida. If you do not have the folic acid in your body, you have an increased risk of developing a disorder. This spinal cord in the neural tube defects are completed by 26 to 28 weeks. So that's why it's important to have it on board beforehand because by 26, 28 weeks it is completed.
What other supplements should I take to ensure a healthy pregnancy?
It is very important that you take other supplements to ensure a healthy pregnancy. The ones that come to mind the most to me are what I see very common deficiencies of. And those are calcium, iron, vitamin D and vitamin C. Those are all important. The good thing is, if you take a normal pre-natal vitamin, it doesn't have to be anything special. You will get most of those vitamins in there, but what you won't get is calcium. Calcium is a large molecule. You will have to take that separately. So during pregnancy it's recommended that women over 18 get 1000mg a day. If you are under 18, you need 1300mg a day. And this continues throughout pregnancy and into the postpartum period as well. And the importance of that is that calcium is needed for our bones and most muscular activity to perform normally. If you don't have enough of that, your body will literally feed the baby. So what I'm saying is, baby comes first. God has designed this perfectly, that the baby is the primary person who comes first. So we will literally break down your own bones to give me [baby] what it needs.
What types of foods and nutrition are best for me and the baby during pregnancy?
Food and nutrition that you need during pregnancy is very interesting. And I actually put an article together (below) for that because what I find very common questions are, is what about fish? I love to eat fish. One thing that I have seen in various locations is that if you're going to fish yourself, please look to see what the mercury air content is in that area. Mercury is the problem with fish. Some fish have much higher levels than others. And I have put that together in this article, showing you the different types of fish and which ones are causing you problems. It tells you how much take and what not to take. That is important because the DHA that you're going to receive from this is essential to the baby's development as well. Other foods that are going to cause problems in pregnancy tend to be unpasteurized milk, which is not that common in this country. And people worry about, well, can I go to subway and get a sandwich? Honestly, the answer is no, unless that meat has been heated to above 165°, it can contain a bacteria called Listeria that is both dangerous to you and the baby. There are drinks that you shouldn’t have - of course, avoid alcohol. There is no minimum level of alcohol that you can take in pregnancy. They used to say drink one glass a day; that used to be the old saying on that one. We know now there is no level. We don't know if that one glass will cause fetal alcohol syndrome. So just avoid it altogether. There are certain drinks. So we will say “drink an herbal tea”. Well unfortunately, herbal tea can actually deplete your folic acid level and cause some problems. So please read up on this before you go and consume something if you are not sure if it’s safe or not.
Resources on nutrition during pregnancy - need pdf from DiMichele
Is it true that having an occasional alcoholic beverage, like a glass of wine, is okay to consume while pregnant?
No, there's just no safe limit. This is coming from the American college of OB/GYN. So they build the guidelines that we follow because they have tested all this information. The guidelines state that there's no safety limit.
What types of bodily changes should I expect (from head to toe) from early pregnancy until the baby arrives?
I’m going to discuss some of the more common ones. So when you first get pregnant, you will notice changes that are obvious. Like for instance, you'll notice expanding in your belly. You might notice some cramping in the uterus as blood supply increases to the uterus. You will notice breast changes. You'll notice a darkening of the areola, which is the area around the nipple and breast tenderness and largining of the vessels in that area. Nausea and vomiting are very common. This is about 70% of all women and it's not just morning. It could be all day and all night. It usually occurs at six weeks, peaks at nine weeks and it's usually done between 12 and 13 weeks. Although unfortunately, there are women out there that this continues the entire time. As we progress, of course, you will notice that your belly will enlarge. And with that, you'll have a lower back strain because of the curve of your back, trying to compensate for the weight in front of your belly. This will cause back pain in about 70% of women.
Our body releases a number of hormones, one of which is called relaxin. This causes ligaments in our body to literally relax. So you are more prone to straining and spraining things. You are more prone to having hip issues because literally that hormone is meant to open up our hips so that baby can easily pass through. Swelling is very common, especially in the summertime and especially if you're sedentary. We do have compression socks that can help that. Unfortunately, hemorrhoids are very common. A lot of this is due to the baby's pressure on our major vessels – the aorta and the vena cava. Because of that pushing on those vessels, it's not allowing a lot of fluid in the lower extremity to get back up. And so it's causing engorgement of those vessels. Also, varicose veins – those are more common ones. There is a whole slew of them that can occur. So if you have any questions, please come to one of the three of us and ask us because most likely a lot of this is just your pregnancy.
What are some safe workouts and physical activities I can and should do while pregnant?
That’s a very good question because they used to believe that you should do little when you're pregnant. The answer now is actually the opposite. We want you to be active in pregnancy. We have shown that if you are active during pregnancy, you have a decrease in c-sections, a decrease in gestational hypertension and gestational diabetes. You will have an increase in your vaginal deliveries and actually quicker, easier vaginal delivery because your body is toned. But don't just jump into an exercise regimen. If you're already in one, continue that one and elevate it slowly through pregnancy, once you’re at moderate-intense. There is no heart rate determination.
Once again, that is a past belief. So we want you to look for symptoms such as “my belly hurts” or “I'm bleeding”, or “I'm having repetitive contractions”. And of course, if your water breaks - anything that is concerning. Again, I have this in a paper form for you (below) so that you can see what is concerning, what can I do and what are the parameters for which I should be doing exercise. These are to continue after postpartum. So if you have a C-section, obviously you're going to avoid the abdominal muscles, but if you have a vaginal delivery, you are welcome to day-one, day-two, start going out there and exercising at any pace you would like.