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Twenty-one Benefits of Prenatal Massage

Dec 16

Posted by firstpeek in prenatal massage | 8 Comments

If you have ever experienced a prenatal massage during your pregnancy, you will know that a prenatal massage feels good.  But did you know that there are many other benefits as well, including many health benefits?

At First Peek Ultrasound, we are proud to now offer prenatal massage in our very own pregnancy spa located inside our ultrasound studio, by our certified prenatal massage therapist.

Here is a list of twenty-one benefits of prenatal massage.  If you can think of any others, please write to us in your comments below.

  1. Helps ease back pain
  2. Helps with headaches
  3. Decreases pelvic pain
  4. Reduces sciatic pain
  5. Increases circulation
  6. Improves digestion
  7. Reduces fatigue
  8. Helps reduce stretch marks
  9. Helps reduce swelling and edema in the legs
  10. Reduces stress
  11. Improves sleep
  12. Prevents post-partum depression
  13. Relaxes and soothes the baby
  14. May prevent ADHD, PTSD, and anxiety in your baby
  15. More likely to touch and smile at your baby
  16. Reduces nausea
  17. Helps with labor pain
  18. Lower rates of prematurity
  19. Can help you quit smoking
  20. Can help improve your sex life
  21. Helps get the baby to move during your 3D ultrasound

 1.  Prenatal massage helps with back pain

Back pain is the number one reason pregnant women get a prenatal massage.  In many surveys conducted, it has been shown that over half of all pregnant women have back pain at some point during their pregnancy.  10% reported to have severe back pain. And the back pain can start even long before you feel like you’re gaining any weight.  This is because the back pain has more to do with the slight shift in your center of balance than with the actual extra weight placed on your back.  That extra little mass, about the size of a pomegranate, can shift the balance enough for you to feel it.

If you’re not scared of physics, please read this. Otherwise skip the next two paragraphs.

Let’s take a closer look.  If a 1 kg force is applied downwards (what you would expect to gain when you’re 4 weeks pregnant), pushing down on your back, about 10 cm in front of your center of gravity (which is where the center of your belly may be), then that would apply a torque of 10 kg-cm, and you would have to apply an equal force of 10 kg downwards, using the muscles around your lower spine, which is located just 1 cm behind your center of gravity, in order to balance out the torque (10 kg x 1 cm = 1 kg x 10 cm), in order to keep you from spinning forward or falling over.  So that little embryo actually puts a total pressure of 11 kg (or 24 pounds) on your lower back, while you are putting constant tension on muscles that are very rarely used.  No wonder you have back pain!  This is also why some women may have back pain before they even know they are pregnant!

But what happens if you just shift your center of balance forward 8 cm.  Now, your little fetus is pushing down 1 kg at a point 2 cm in front of you (or 2 kg-cm), and your lower back muscles are now 9 cm behind your center of gravity instead of 1 cm behind, and so you will have to push down with a force of 2/9 kg (2/9 kg x 9 cm = 2 kg-cm = 2kg-cm), or 0.2kg, about half a pound.  So you would feel a total weight of 1.2 kg on your back and the weight will be better balanced.  Thus, your back pain is alleviate without pain medication and without any weight loss needed.

Prenatal massage helps alleviate back pain by 1) helping shift your center of balance so that you can utilize the physics of torque to your advantage.  Back pain is also caused by 2) the slight external rotation of your knees, which can also be corrected by alleviating fluid buildup through prenatal massage.  As if that is not enough, during pregnancy, you produce hormones that relax some of the ligaments in your body.  One of these hormones, relaxin, is critical in helping your baby come out through the narrow birth canal by relaxing your pelvic ligament.  But before then, the softening of the ligaments can 3) disrupt your posture and the way you walk, which can promote back pain.  Prenatal massage can help reset your posture, thus alleviating your back pain through this third mechanism.  There are many other additional ways that prenatal massage helps back pain as well, including alleviating stress, anxiety, allowing for the relaxation of lower back muscles, improving circulation in your lower back, and even alleviating the inflammation around the nerves of your lower back.

In a randomized study conducted by the University of Miami, pregnant women who were between 7 and 9 months pregnant were given two free prenatal massages every week. These expectant mothers ended up having less back pain as well as a number of other positive outcomes.

Here are some other ways of alleviating back pain during pregnancy.

2. Prenatal massage helps with headaches

Let’s face it. Pregnancy can give you headaches. But there are a lot of causes of headaches, and some may have nothing to do with the actual pregnancy.

  • Different hormones of pregnancy may cause headaches
  • Increase in blood volume that occurs during pregnancy, may cause headaches
  • Pregnancy can slightly alter the shape of the lens of your eye, causing you to have a slight nearsightedness that is virtually undetectable except that you get headaches! 
  • Stress–a major cause of headaches.  What could be causing you so much stress? 
  • Lack of sleep
  • Low blood sugar
  • Dehydration–you’re not only drinking water for two but you also have to keep your amniotic tank full.
  • Caffeine withdrawal–that no coffee rule really starts to hurt right around now
  • Nicotine withdrawal
  • A very mild insidious chronic respiratory failure, caused by a very slight but progressive deficiency of oxygen caused by not getting enough oxygen to your brain, which is caused by decreased blood flow to your brain, due to the weight of your baby resting on your superior vena cava while you are sleeping lying down on your back.  If you wake up with a headache every morning, and it gets better through the rest of the day, this could very well be the cause, and this can be helped by lying down on your left side while you sleep. 

Prenatal massage can help with headaches by alleviating stress and tension, helping you relax, and improving your ability to sleep (your sleep architecture).

3. Prenatal massage helps decrease pelvic pain

Pelvic pain should be distinguished from lower back pain.  Pelvic pain is caused by 1) the actual uterus pushing down on the pelvis, and 2) the effects of hormones on the pelvis and pelvis ligaments.  The hormones relaxin, estrogen, and progesterone, cause softening and widening of the pelvic ligament and pubis symphysis, which can throw off your gait and center of balance and can cause pelvic pain, and then, as a result, the muscles surrounding your pelvis can compensate and then get fatigued or strained, thus causing even more pelvic pain.

Although you may not be able to prevent the normal havoc of the hormones of pregnancy on your pelvis, you can prevent the fallout from the aftereffects from the surrounding muscle.  This is best done by wearing a pelvic belt, much like how you see weightlifters wear in the gym (or on TV, if you don’t go to the gym).  Another thing that helps with pelvic pain caused by this secondary muscle strain is prenatal massage.

Other tips to help with pelvic pain during pregnancy:  Keep your knees together while rolling over in bed by wearing a very large rubber band around your knees (the kind you can get for physical therapy), and taking smaller steps when walking.

On a side note, another cause of pelvic pain in pregnancy can be endometriosis, which may get worse during pregnancy (though it is supposed to usually improve with pregnancy), and some cases may get diagnosed during pregnancy.

4. Prenatal massage can help with sciatic pain

Sciatic pain is a nerve pain caused from swelling, pinching, or some other effect on the sciatic nerve.  This pain can be electrical in nature, but can also be sharp, dull, or throbbing.  The pain is usually intermittent and is worse with walking, but can also be constant, and it may be a combination. For example, someone may have a constant dull pelvic pain, with intermittent sharp pains when standing up from a seated position, with occasional shooting electrical pain originating from the lower back and going down the back of the leg down to the knees or even to the ankles.  Sciatic pain can be caused by prolonged overuse or can be caused by sudden trauma.  In the cases that we are talking about here, sciatic pain can be caused by the weight on the lower back and pelvis from pregnancy and weight gain.

If your weight gain is more than the recommended amount during your pregnancy, then controlling your weight may be the best way to control sciatica.  However, prenatal massage can also help with sciatic nerve pain. 

Sciatic nerve pain is experienced by many women in pregnancy as the uterus pushes down on the muscles of the lower back. The pressure of the uterus adds tension to the muscles of the upper and lower leg as well as the lower back, causing the muscles to swell and put pressure on nearby nerves.  These nerves can then get inflammed. Massage therapy helps heal the inflammed nerves by helping to release the tension of the associated muscles and their pressure on the nerves. Many women have experienced significant reduction in sciatic nerve pain during pregnancy through regular prenatal massage.

 5. Prenatal massage can help increase circulation

6.  Prenatal massage improves digestion

It’s unknown whether massage helps digestion by increasing circulation, by relaxing the muscles associated with the digestive tract, or by alleviating stress and anxiety.

7.  Prenatal massage reduces fatigue

In addition to being able to get some much needed rest and relaxation, prenatal massage has been shown to improve sleep architecture (the ratio and timing of the different stages of sleep).

8.  Prenatal massage helps reduce stretch marks

There are very, very few things that have been proven to prevent or reduce stretch marks. Yet the stretch mark industry is a multi-million dollar industry.  Cocoa butter and many other creams have been recommended, but they serve more to cover up stretch marks, since lotions and creams generally don’t get to the deep layer of skin, where stretch marks occur.  However, massage has been shown to reduce scarring in general and prenatal massage has been shown to help prevent stretch marks by improving circulation to the skin.  Regular prenatal massage, such as on a weekly basis, before stretch marks occur, in combination with careful weight control during pregnancy, can help prevent or reduce stretch marks during pregnancy.

Another great way to prevent stretch marks is to closely monitor your weight gain to make sure that you do not gain too much weight and that you do not gain weight too quickly.  However, stretch marks are also genetic, and sometimes, there may be nothing you can do to prevent them.

Here are some additional ways to prevent or reduce stretch marks during pregnancy.

9.  Helps reduce swelling and edema in the legs

Prenatal massage helps reduce swelling in the legs and ankles, called edema, during pregnancy.  This swelling can be caused by poor circulation in the legs, increased blood volume, decreased protein in the blood, and obstruction of the veins that come from the legs due to pressure from the uterus causing a backup of blood flow into the legs and feet.  The edema can also be a symptom of pre-eclampsia.  Whatever the cause, many pregnant women notice at least a little swelling in the feet and ankles. If your shoes are getting too tight, you may want to help alleviate some of the strain by resting and relaxing more and spending more time with your legs elevated.

A prenatal massage by a certified prenatal massage therapist can help reduce ankle and foot swelling.  Prenatal massage helps in more than one way.  First, just the time spent in a relaxed position with your feet elevated, doing nothing else, can help wonders.  Second, prenatal massage can help improve circulation to and from the legs.  Third, prenatal massage can even help lymphatic flow, another factor in leg swelling.  Last but not least, by increasing blood flow and circulation throughout your body and by reducing anxiety, prenatal massage can help make it easier for your heart to pump blood throughout your body and reduce the stagnation of blood in the legs, another cause of swelling.

10. Prenatal massage reduces stress

A prenatal massage not only reduces stress and anxiety by forcing you to relax and calm yourself through the sights, sounds, textures, and smells of the massage experience, but the actual physical act of massage has been shown to increase serotonin levels (the neurotransmitter of energy, happiness, and contentment) and decrease epinephrine, norepinephrine, and cortisol levels, the hormones of stress.

Also, the prenatal massage therapist can instruct you on ways of continuing techniques to help reduce stress throughout your pregnancy. By improving the efficiency of your sleep, reducing your aches and pains, and by overall providing a comforting and nurturing environment to fall back on during times of high stress, you will find that your overall anxiety throughout your pregnancy, even when you are not getting a massage, will be much better.

Best of all, women who have less anxiety during pregnancy generally will have less anxiety during labor and childbirth, which helps dramatically with a whole slew of medical outcomes.

 11.  Prenatal massage can help improve your sleep

As stated before, prenatal massage helps you sleep and helps you improve your sleep architecture–the proportion of your sleep that is set for deep sleep, light sleep, and REM sleep.  Pregnancy-related insomnia is a common complaint that can become debilitating, and sleeplessness can aggravate stress, anxiety, and even make minor aches and pains more bothersome.

A common cause of sleeplessness is not being able to “get in a good position.”  This is because when a pregnant woman lies flat on her back, the uterus may be pressing down on her veins (the superior vena cava) and block blood flow to the brain.  This can be sensed as discomfort.  But if you spent your entire life sleeping on your back, then no other position will seem right to you either.  Prenatal massage can help retune and reset your comfort zones and can help you feel comfortable falling asleep on your side

Another cause of sleeplessness in pregnancy is poor oxygenation and circulation. Prenatal massage helps with circulation and oxygenation.

Another cause of sleeplessness in pregnancy is anxiety.  When you are under a constant tension, your body will not let you fall asleep.  Prenatal massage helps you relax and fall asleep in a soothing and stress-free environment.  Your body can then re-learn this ability to relax and fall asleep.  Sometimes, one prenatal massage can help you know what the stress-free mode feels like so you can get back into that mode on your own when you need to at other times.

12.  Prenatal massage helps prevent postpartum depression

It’s true.  The following study shows that prenatal massage can help with depression during pregnancy and postpartum depression.

Pregnancy massage reduces prematurity, low birthweight and postpartum depression
Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.
Infant behavior & development.   01/08/2009

13. Prenatal massage relaxes and soothes the baby

Prenatal massage not only can help relax you while you are pregnant, but it can help relax and soothe your baby as well. If your baby is “going crazy,” swimming around and kicking constantly, it can sometimes be due to certain stresses and anxiety that you are feeling yourself.  It has happened many times where a prenatal massage will help soothe the baby.

14. Prenatal massage may be able to prevent ADHD, PTSD, and anxiety in your baby

A wonderful article on the benefits of prenatal massage speaks to the amazing effect of massage on the baby.  The following excerpt was taken from Kate Jordan Seminars, and originally appeared in the August 2007 issue of Massage Magazine.

When women experience stress in pregnancy, blood levels of the neurotransmitters cortisol, adrenaline and norepinephrine surge. Conversely, levels of dopamine and serotonin are suppressed by stress; low levels of these hormones are associated with mood states like anger and anxiety. Not only would Marcy’s continued anxiety fuel more anxiety, it would lead to increased levels of these stress hormones in her body. Recent studies have shown extensive effects on the growing fetus of stress experienced by pregnant mothers. Not only do infants of stressed moms show higher levels of cortisol and lower levels of serotonin and dopamine, they seem to cry and fuss more as babies, and perform less well on such measures of infant development as the Brazelton scale.

Doctors in New York City studied expectant mothers who were in the area of the World Trade Center when it was struck on September 11, 2001. They found that their infants had smaller head circumferences and were more likely to suffer post-traumatic stress disorder.

15.  Women who receive prenatal massage are more likely to touch and smile at their baby

Who knew that prenatal massage can help with bonding of your baby?  The following study, quoted from Kate Jordan Seminars, originally appeared in the August 2007 issue of Massage Magazine. 

Keep in mind that the following study compared two groups, where one group of pregnant women were randomly made to receive prenatal massage. The women did not have a choice as to which group they would be in.  Thus, this can not be explained by reverse causality (as in, maybe the mothers who touch their babies more would have chosen to have more prenatal massage in the first place).

Reva Rubin, a nursing professor at the University of Pittsburgh’s nursing school was able to show that mothers who received what she called “appropriate, meaningful touch” – back stroking delivered by office nurses during prenatal visits – were later able to touch their own babies in a “meaningful, effective and caring” way. Other research has shown that the more touch mothers receive in pregnancy, the more likely they are to stroke, smile, and talk to their infants, and thus to bond with them.

16. Prenatal massage helps with nausea

This may be due to the fact that anxiety has often been implicated as a cause of nausea and vomiting during pregnancy, and prenatal massage can help with anxiety.  Also, nausea can be caused by impaired digestion, and prenatal massage can help with digestion.

17.  Prenatal massage helps with labor pain

Prenatal massage, or perinatal massage, can help with the pain of labor.  This is due the mechanism of distractive pain therapy.  By stimulating the nerves on a different part of the body, the body is distracted and does not process the pain impulses from the other part of the body.

18. Prenatal massage can lower rates of prematurity

The study already quoted above shows that prenatal massage can help reduce prematurity and low birthweight in babies.  This is an amazing discovery.  The mechanism is not known exactly. However, it may be due to improved placental circulation, improved blood flow to the baby through the placenta, thus providing more oxygen and nutrients to the baby.

19.  Prenatal massage can help you quit smoking!

With First Peek Ultrasound’s proprietary method of prenatal smoking cessation, prenatal massage can be used to help you quit smoking. 

During pregnancy, dopamine levels increase–this is one of the reasons why cigarettes can sometimes taste bad to pregnant women who normally smoke.  Pregnancy is the ideal time to quit smoking because not only do you now have plenty of health reasons to quit for you and your baby, you have the biological processes of pregnancy working in your favor!

Prenatal massage has been shown to increase dopamine levels as well as serotonin levels.  Dopamine is the neurotransmitter responsible for addiction (and many other things), and increases with smoking.  Serotonin is the neurotransmitter associated with pleasure, which can be artificially increased with many drugs, including nicotine.

During your prenatal massage, dopamine and serotonin increases in an environment not associated with smoking, thus allowing you to fulfill the craving of cigarettes in an alternative way.  This association of the relief of the craving of smoking with something else besides cigarettes can retrain the body and mind to stop its dependence on smoking.

With our prenatal smoking cessation program, you would come in for your first prenatal massage appointment during a time when you know you will have a craving to smoke.  Basically, you would not smoke during that day and you would come in that morning or afternoon to our 3D ultrasound studio.  You may feel irritable, anxious, nervous, but instead of reaching for a cigarette, you alleviate the nervousness and anxiety with a prenatal massage.  The first time will be the most difficult.  Then, you repeat this step a few more times, either with scheduled appointments, or coming in as a walk-in on Saturdays right at the time that you feel the craving for cigarettes.  The prenatal smoking cessation program comes with four prenatal massage appointments.

Another weapon in our arsenal of the prenatal smoking cessation program is the 3D ultrasound service we offer.  When you see your baby for the first time in 3D, pregnancy will be more real for you.  Some mothers have expressed to us that seeing their baby in 3D ultrasound has helped motivate them to quit smoking.  So the prenatal smoking cessation program also comes wth a Premium 3D/4D ultrasound package.

You will also get a smoking cessation discussion session led by a First Peeker specifically trained in smoking cessation.  This member of our team has a degree in psychology, experience in counseling and stress management, and specifically trained in smoking cessation.  More importantly, she does not talk down to you or lecture you.  Instead, there is a one-on-one discussion on practical ways of changing smoking behavior.  If you require more than one discussion session to complete the conversation and strategies, then this will be included in the total package.

The final weapon that we use is purely behavioral–using reward and punishment.  Our prenatal smoking cessation package will be charged up front at a price of $350.  But if you actually quit smoking, you will get a $50 check back at the end of your pregnancy (two months after your baby is born).  You can use this money to buy diapers, take your friends out to eat to celebrate, or even get a massage with us.  But by this time, you will not want to use the money to buy cigarettes.

In summary, the First Peek prenatal smoking cessation program comes with four prenatal massage therapy sessions, timed specifically to your needs, one Premium 3D/4D ultras0und package, one smoking cessation discussion session (more if needed).  The cost of this total program is $350.  You also will get a $50 check back at the end of your pregnancy, approximately 2 months after your baby is born, if and only if you have successfully quit smoking and have not returned to smoking by that time, so that the total amount you have invested to change your life will be just $300 in total.

You can purchase this package online by visiting our website, www.OakParkUltrasound.com, and scheduling your first prenatal massage online and typing in “prenatal smoking cessation program” in the Special Instructions box.  Or you can call us to set up this package for you, at 708-870-0808.  Due to the investment of setting up the program, the entire payment is due when you first sign up for the program.

Note: We can not prescribe medications as we are not a medical facility.

20. Prenatal massage can help improve your sex life!

The following is taken, somewhat out of context, directly from the blog, Sheknows.com, and the full article can be found here.

The best sex of your life: 4 Tips to improve your sex life

Elizabeth Cullen

Not only do massages feel good, but, as an added bonus, they warm up your skin and connect you with your partner.

Finally, last but not least…

21.  Prenatal massage can help get the baby to move during your 3D ultrasound

At First Peek Ultrasound, when you get the prenatal massage with your 3D ultrasound, if your baby is not in the best position, you can try your 3D ultrasound again after your prenatal massage.  Many pregnant moms say that the prenatal massage relaxes their baby and gets them to shift position, almost like they are getting comfortable.  Sometimes, this is just enough to be able to capture the perfect memento of your baby on 3D ultrasound.

So there you have it.  21 benefits of prenatal massage, courtesy of First Peek Ultrasound.

Is there a benefit of prenatal massage that you have experienced yourself which was not mentioned here?  We would love to hear about it.

Add to this list and get $10 off your next prenatal massage at First Peek Ultrasound.

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Eating for two? Maybe you shouldn’t–Battling obesity in pregnancy

Nov 24

Posted by firstpeek in Pregnancy | 4 Comments

Pregnancy has always been a good excuse for gaining weight.  It seems like this is the one time where you don’t have to worry about what you eat or how much weight you gain.  And other people also do not bat an eye at any amount of weight you gain as long as you can look them straight in the eye and say that you are pregnant.  Yet recent studies have shown that maybe pregnancy is the time when women should be the most concerned about their weight and how much weight they gain. 

And women who are already overweight or obese tend to gain even more weight than what is recommended during pregnancy.  This is not surprising. If someone is having a hard time with their weight as it is, it will be even harder to control weight when you add pregnancy plus the stresses that go along with pregnancy with it.  Also, this excessive weight gain may be especially hard to lose after you have the baby.

The solution? Start healthy eating habits, exercise habits, lifestyle habits, and thinking habits long before you become pregnant.

This issue is so important that I have included the recent article from MSNBC news in full below.  You can also find the article here, called Obese and Pregnant?

WASHINGTON – Eating for two? New guidelines are setting how much weight women should gain during pregnancy — surprisingly little if they’re already overweight.

The most important message: Get to a healthy weight before you conceive, says the Institute of Medicine in the first national recommendations on pregnancy weight since 1990. It’s healthiest for the mother — less chance of pregnancy-related high blood pressure or diabetes, or the need for a C-section — and it’s best for the baby, too. Babies born to overweight mothers have a greater risk of premature birth or of later becoming overweight themselves, among other concerns.

Meeting the guidelines could be a tall order, considering that about 55 percent of women of childbearing age are overweight, that preconception care isn’t that common and about half of pregnancies are unplanned.

Once a woman’s pregnant, the guidelines issued Thursday aren’t too different from what obstetricians already recommend, although about half of women don’t follow that advice today.

Among the new recommendations:

  • A normal-weight woman, as measured by BMI or body mass index, should gain between 25 and 35 pounds during pregnancy. A normal BMI, a measure of weight for height, is between 18.5 and 24.9.
  • An overweight woman — BMI 25 to 29.9 — should gain 15 to 25 pounds during pregnancy.
  • For the first time, the guidelines set a standard for obese women — BMI of 30 or higher: 11 to 20 pounds.
  • An underweight woman — BMI less than 18.5 — should gain 28 to 40 pounds.

What if a mom-to-be has gained too much? On average, overweight and obese women already are gaining five more pounds than the upper limit.

But pregnancy is not a time to lose weight, stressed guidelines co-author Dr. Anna Maria Siega-Riz of the University of North Carolina, Chapel Hill.

“It’s not, ‘Hey you gained enough, now you need to stop,’ ” Siega-Riz said. “Let’s take stock of where you’re at and start gaining correctly.”

A pound a week
Indeed, underweight and normal-weight mothers should put on a pound a week for proper fetal growth in the second and third trimesters, the guidelines say. The overweight and obese need about half a pound a week.

Hopping on the scale during prenatal checkups makes for a sensitive moment, especially in a culture that cherishes the stereotype of late-night ice cream-and-pickles snacks.

Implementing the guidelines may take a move “to change the whole culture about pregnancy” and eating, Siega-Riz said. She noted that in studies of the overweight, “most of these women will tell you that they’ve never been told how much weight to gain.”

The guidelines call for increased nutrition and exercise counseling during pregnancy, saying doctors or midwives may need to consult a dietitian to tailor a woman’s care no matter her starting weight. Also, providers should discuss whether a woman plans to breastfeed, which not only is optimal for the baby but helps the new mother shed pounds, too.

“It’s really a teachable moment,” said guidelines co-author Dr. Patrick Catalano, obstetrics chairman at Ohio’s Case Western Reserve University. “When women are pregnant, they may be more accepting” of weight discussions “because it’s also in the best interest of their babies.”

Obstetricians, who have struggled with how to advise heavier women as U.S. obesity rates have soared over the past two decades, welcomed the guidelines — especially the recognition that babies born too large tend to grow into overweight children at risk for their own health problems. Not too many years ago it was rare to see a 9-pound, or larger, newborn.

“Pregnant women should not be eating for two,” said Dr. Ellen J. Landsberger, who specializes in high-risk pregnancies at New York’s Montefiore Medical Center. “You want a healthy baby? On both ends, you have to eat the right amount.”

Nutritional needs
But is it realistic for obese women to gain as little as 11 pounds?

“We think it’s possible. We also think it will be a challenge,” said Cornell University nutrition specialist Dr. Kathleen Rasmussen, who chaired the Institute of Medicine committee.

In the Bronx, Nyree Paten illustrates that challenge: She had been putting on weight for three years and discovered she was pregnant at her peak, just over 300 pounds, seriously obese even for someone 6 feet tall. Her doctor diagnosed diabetes at her first prenatal checkup. Landsberger found Paten, 35, a nutritionist and prescribed insulin for the diabetes. Paten said she’s gained only about 2 pounds by week 24, while regular ultrasounds show her baby is growing well.

“Thank God I’ve been doing good,” says Paten, who feels more energetic because she’s eating better. So is her 8-year-old son. First to go: sugary sodas and juices in favor of water.

“It’s all about knowing and being educated on how to eat,” adds Paten, who’s lined up the nutritionist to help her lose weight once her baby is born.

The guidelines say women expecting twins can gain more: 37 to 54 pounds for a normal-weight woman, 31 to 50 pounds for the overweight, 25 to 42 pounds for the obese. There’s not enough information to set recommendations for triplets or more.

The institute stressed that the guidelines are aimed at U.S. women, not for parts of the world with different nutritional and obstetric needs.

Gaining too much weight during pregnancy is not just an issue of physical appearance.  There are many medical complications for the mother.  But more recently, there have been studies showing medical complications for the baby as well.  The following list has been taken from www.pregnancy-info.net:

Complications For Mom
If you are obese during pregnancy, you are at risk of several serious health complications, including: 

  • Preeclampsia: Preeclampsia is a condition which causes high blood pressure, fluid retention, and swelling during pregnancy. When serious, preeclampsia can restrict placental blood flow, endangering baby.
  • Gestational Diabetes: Gestational diabetes is a form of diabetes that develops during pregnancy. It prevents your body from breaking down sugar and can put your baby at risk for gaining too much weight in utero.
  • Cesarean Section: Women who are obese during pregnancy have an increased risk of experiencing problems during delivery. Labor is more likely to be slow and prolonged, increasing the likelihood of cesarean section.
  • Postpartum Infection: Obesity during pregnancy also makes you more vulnerable to experiencing a difficult postpartum recovery. In particular, if you have had a C-section, you are at risk for developing dangerous postpartum infections.

It is not certain why obesity is associated with pre-eclampsia, although obesity has always been known to be one of the causes of high blood pressure. There is one study that explores this association between obesity in pregnancy and preeclampsia.

Complications for Baby
If you are obese during your pregnancy, you baby is also at risk for developing some dangerous health issues.

  • Macrosoma: Macrosoma is a condition in which your baby puts on too much weight during development. This can complicate labor and delivery, making it difficult for your baby to enter and exit the birth canal. Some large babies have their shoulders injured during birth. This is known as shoulder dystonia.
  • Neural Tube Defects: Babies born to obese mothers are also at increased risk of suffering dangerous neural tube defects during development. Neural tube defects, like spina bifida and anencephaly, are often associated with low levels of folic acid during the first trimester. These defects can frequently be detected early in pregnancy through the use of ultrasound imaging. However, women who are obese often produce poor ultrasounds. Because the ultrasound waves have trouble penetrating extra layers of fat, blurry images are produced. As a result, neural tube defects aren’t always detected in these babies.
  • Childhood Obesity: Studies show that babies who are born to obese mothers are more likely to suffer from obesity by the time they reach the age of four. In one recent study, 29% of children born to obese mothers were also obese by the age of four, compared with only 9% of babies born to mothers of normal weight.

Admittedly, adding neural tubes defect to this list of complications of obesity during pregnancy is a stretch.  The actual issue is that obesity can lead to not being able to get good ultrasound images of the baby, which can lead to a missed diagnosis of neural tube defects, such as myelomeningocele.  Basically, this can lead to an increased risk of having neural tube defects only if you are working on the assumption that if your baby was diagnosed with a neural tube defect, then you definitely would have had an abortion. 

However, this article speaks to the fact that there is in fact a true direct link between obesity in pregnancy and neural tube defects, cleft lip and palate, and hydrocephalus.  This may be due to the association of obesity with other nutritional deficiencies, including a deficiency in folic acid (folate deficiency), which is a known risk factor for neural tube defects, cleft lip and palate, and hydrocephalus.

What is very interesting is the fact that if a woman is obese just during the nine months of her pregnancy, this can effect the entire life of her child!  If she is having a girl, her daughter may end up staying obese until she is pregnant, and then have another obese child.  This can continue on for generations. This shows that in addition to genetic influences and environmental influences, there is this third cause of obesity that can appear to be genetic in origin but is in fact caused environmentally in the womb.

To this list of complications of obesity during pregnancy, you can also add other problems with being obese during pregnancy, including:

1. Congenital heart defects.  A recent study has shown that women who are obese when they become pregnant are 30% more likely to have children born with congenital heart defects.

2. Post-partum depression - A study conducted by the University of Utah in 2008 showed a link between being obese in pregnancy and having post-partum depression.  You can see a summary of the study here. 

This makes a lot of sense, since there are many underlying causes that can lead to both obesity and post-partum depressions, such as negative thinking, poor coping skills, a stressful environment, poor social support, and poor self esteem.  Also, increased fat tissue can itself cause depression in a purely physical way, since fat cells can convert estrogen into testosterone, leading to hormonal and emotional imbalances.  This is the same reason that depression has been associated with women with polycystic ovarian disease.

3.  ADHD – Being overweight or obese during pregnancy may be associated with ADHD in the child, at least the inattentive type.  This article, called Maternal Obesity During Pregnancy Increases Risk for ADHD, is rather convincing. 

4. Autism – The link between obesity during pregnancy is one of a few prenatal factors associated with autism, including having an older mother or father and having a mother being born abroad.  This association was discovered and discussed in a research paper conducted by American researchers in the British Journal of Psychiatry, in July, 2009.  A summary of this intriguing research paper is presented here.  Could the rise in obesity in pregnancy be the real reason for the recent rise in autism rather than the use of vaccines, I wonder?

5.  Blurry 3D ultrasound images.  Yes, obesity in pregnancy can lead to poor, blurry, and unclear 3D ultrasound images.  With the latest craze of 3D and 4D ultrasounds, pregnant women are now doing whatever it takes to get the best 3D ultrasound images for their baby album. If this motivates you to avoid obesity during your pregnancy, then I am all for it!  Not gaining excessive weight during pregnancy can prevent a whole slew of medical problems for you and your baby.  But the beautiful 3D ultrasound images can be a great reward for your efforts.  If you are in the Chicagoland area, feel free to reward yourself for not gaining too much weight in pregnancy by getting a 3D ultrasound at First Peek Ultrasound.

So what can you do as a pregnant woman to avoid obesity in pregnancy?  The following suggestions say it best, taken from www.pregnancy-info.net:

  • Lose Weight Before Pregnancy: If you are planning on getting pregnant in the near future, get your weight evaluated by your health care provider. If you are obese, consider losing weight through proper diet and exercise. Even minimal weight loss can help to radically reduce your risk of pregnancy complications. Those that are severely obese may want to consider obesity surgery.
  • Watch your Weight Gain: Even if you are obese, you should never try to lose weight during pregnancy. Weight loss or changes in diet can prevent your baby from getting the calories and nutrients she needs to grow properly. Instead, focus on gaining weight in moderation. Most obese women need to gain between 15 and 25 pounds, putting on the majority of the weight during the third trimester.
  • Exercise: Exercise should be continued throughout your pregnancy. Talk with your health care provider about exercise levels that would be appropriate for you. Even if it’s just walking around the block a few times, exercise can really help to reduce your risk of potential health complications.

More recently, the suggested weight gain during pregnancy for obese women has been seriously modified than what was even mentioned above.  In the MSNBC article mentioned first, the recommended weight gain for obese women, with a BMI greater than 30, is 11 to 20 pounds for the whole duration of your pregnancy.  In other words, basically, you should just try to not gain any weight at all and just hope that your existing weight rounds off and goes where it needs to go!

Eating for two? If you are obese, then maybe you shouldn’t.

Is anyone out there struggling with obesity in pregnancy? We would love to hear from your perspective.

Also, I apologize in advance if I offended anyone out there who is struggling with this issue of obesity in pregnancy.  Although I am not here to judge, as a pediatrician, I feel I have to speak out on anything that has this much of an impact on children which is preventable.  If you know anyone who can benefit from this article, please forward it to them.

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