If something like this has happened to you, you’re not alone, and it’s actually quite normal.  These skin changes did not happen overnight, although you may notice them all of the sudden on morning.  The American Academy of Dermatology says that about 70 percent of pregnant women develop these blotchy areas of darkened skin. It’s called chloasma or melasma, but is also known as “the mask of pregnancy” (sounds more romantic than it is!).

The blotchy areas usually appear around your nose, cheekbones, and forehead (hence the name Mask of Pregnancy). They may also show up on your upper lip, cheeks, and jawline.  Some women also develop dark patches on other body parts that are exposed to the sun. You may also notice areas of skin that are naturally darker (nipples, freckles, genitals) — becomes even darker during pregnancy. Some women notice a darkened line, called the linea nigra, running from their belly button downward.

Why does it happen?

You guessed it– it’s those lovely hormones at work again!  During pregnancy, hormonal changes cause a temporary increase in your body’s production of melanin, the chemical that gives color to hair, skin, and eyes.

Women with darker skin are more likely that lighter-skinned women to get melasma.  This “mask” may become more pronounced with each pregnancy.

Will it go away?

The good news is that these darkened areas will probably fade within a few months after delivery. In some cases it never completely disapears, but for many women their skin will return to its normal shade.

Can I prevent it?

Although this skin pigmentation  usually disappear on its own after delivery, there are some things you can do to minimize the splotchy factor:

• Stay out of the sun and avoid tanning salons. Cover up or use sunblock if you’ll be out in the sun. More pigment is created when skin is exposed to sunlight.
• Use gentle cleansers and lotions. Irritating products can worsen the condition.
• Use concealer! When all else fails, there’s always the make-up bag.
• After birth: Continue to protect sensitive areas from the sun. Certain contraceptives containing estrogen may also cause melasma.

feature image from The Daily Green

You can watch the family’s CBS News interview here!

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Did you have a birth that progressed so quickly that you couldn’t make it to your planned destination? Tell us about it!

So what should you be looking for?  Here are some Spring 2010 fashion trends for the mom-to-be that won’t have you shuddering in horror!

Sugar Candy Shades: Silky, floating fabrics in soft, feminine colors will definitely breath a sense of spring-time into your wardrobe. Bring on the frills, ruffles, and pastels!

Candy Floss style via Made for Mums

Be Knotty! Knots, drapes, pleats, and other fun shapes reigned on the catwalks, says Made for Mums.

Drop-Waist Peasant Top by Old Navy; Tie Knot dress by Isabella Oliver

Cool T’s: When the weather starts to heat up, you’ll want some fun, comfy T-shirts to brighten up your outfit. The bright colors, draping, and graphics on these T’s keeps them from being boring!

T-shirts from the Gap

Eye-popping Prints: Dress your bump in flashy florals and bright geometric designs.  Let your wardrobe energize you this spring season!

James Jeans Maternity Bootcut Stretch Jeans at Nordstrom; Maternity Jeans by Gap

Although there can be a number of reasons for this trend, experts fear that older women are ditching contraception in the mistaken belief that they cannot get pregnant past a certain age.  Yes, fertility does wane as you age, but women can still get pregnant well into their thirties, forties and even fifties.

So the Family Planning Association (FPA) has a new campaign ‘Conceivable?’ directed at women over 35 years old. It’s purpose is to remind women to stay vigilant about unplanned pregnancy and to keep using contraception until after menopause if they do not wish to become pregnant.

And here I thought it was common knowledge that until you stop menstruating, you can still get pregnant. Silly me.

Just one night of unprotected sex can result in pregnancy, even if you are way beyond your teenage years.  Emily James of Marie Stopes International said: “Many older women facing an unplanned pregnancy are completely shocked to find themselves in this position – many assume that their irregular periods are due to menopause, and are surprised to learn that they are in fact pregnant.”

Bottom Line: Talk to your doctor about age, menopause, and fertility, and be vigilant about unwanted pregnancy, no matter what age you are!

Source: BBC News

This follows another Australian report from 2  years ago saying that researchers have confirmed women do become more forgetful during and after pregnancy.

This time, the researchers analyzed the mental function of a group of women before, during, and after pregnancy, and reported no differences at all.

“I think that people have the tendency to blame the fact that they’re pregnant on normal lapses of memory which happen all the time to us anyway,”  said lead researcher Helen Christensen.  “Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries.”

Well, no one is saying that pregnant women and mommies are dumber than we used to be. We are just slightly more absent-minded and forgetful. I’m not sure that is something that can be accurately measured.

“Women often report problems with memory and reasoning after they become pregnant,” Christensen said. “But the latest findings from our decade-long study, the most in-depth to look at this issue, has proven they do not.”

Blame it on sleep deprivation, hormonal changes, or just normal memory lapses… I still think there’s something to it.  I tend to agree with blogger Kimmama who refuses to believe that “baby brain” was all in her head.  She’s thinking, and I’m thinking too, that clearly none of these researchers have been pregnant before!

The Daily Mail reports mentions research carried out last year by Dr Craig Kinsley, of Richmond University in Virginia, suggesting that giving birth actually leads to dramatic improvements in mental capacity. He says that giving birth actually produces a “surge of memory and learning ability that makes women more vigilant and alert.”

Like I said, we’re not getting dumber… we’re just… what was it I said?

Should men be allowed to witness their children’s birth?  This controversial question seems to be one that depends heavily on each spouse’s temerpament and ability to cope with pain and stress. While many women would never consider giving birth without their husbands, there must be many more who wish he wasn’t there. Conversely, while some dads would be devastated at missing the birth of their child, there are others who would secretly breath a huge sigh of relief at being excluded.

“Barely survived the delivery” Tshirt by Zazzle

I came across a very interesting article by Michel Odent, a top obstetrician, on why men should NEVER be at the birth of their child. You can take a look at it here, and it is an interesting read, whether or not you agree with him.

Dr. Odent states: Having been involved in childbirth for 50 years, and having been in charge of 15,000 births, I have reached the stage where I feel it is time to state what I – and many midwives and fellow obstetricians – privately consider the obvious… That there is little good to come for either sex from having a man at the birth of a child.

Personally, I have delivered two babies in the presence of my husband, and was a wonderful source of support and comfort to me. I also think it was a positive experience for him (although maybe I’ll ask him about that later, just to clarify!).  Then again, I gave birth in relative comfort (I have to say I love that epidural) but I’m sure it would have been a much more stressful experience for both of us if I’d done it without.

Dr. Odent talks about his observations as to why it is better that husbands stay out of the delivery room, and let their wives birth in peace. The phenomena of men being present at childbirth is relatively recent, beginning in the 70’s, as more and more women started to give birth in the hospital. Up until that point, it was mainly a woman’s event, with the mother surrounded by other women including her mother, aunts, sisters, or midwives. The husband was left to boil the water, pace the hallway, and smoke his pipe.

Although there is a lack of scientific study on this subject, Dr. Odent has observed that often men are a hindrance to the ease of his wife’s labor, causing it to be are longer, more painful and more likely to result in intervention.

This may be for two reasons. One, a woman in labour needs to be in a quiet, private world where she doesn’t have to think or talk.  When she tries to “share the experience”, with her husband, the focus is taken off her personal experience and directed toward including, intuiting, and often soothing, her husband.  This complicates the process.

The second reason is that, quite naturally, the sight of his wife in pain causes dad to release the stress hormone adrenaline.  No matter how much he tries to appear relaxed and positive, he cannot help but feel anxious.  And anxiety, even hidden under a reassuring smile, is contagious. His tension prevents the woman from being as relaxed as she needs to be during labor, making the process longer and more difficult.

Then there is the affect that childbirth has on the father. No doubt the miracle of childbirth is something beautiful and uplifting, a family bonding experience that some men wouldn’t give up for anything.

But for others, the experience may be more traumatic than they’ll admit. Dr. Odent  says that over the years he has seen something akin to post-natal depression in many men who have been present at the birth.  This will cause them to exhibit strange behaviors, like take to bed for a week after the baby is born, leaving their wives to care for the newborn. Or, they may try to escape to the golf course or local bar.  In extreme cases, the experience may even cause deeper psychological damage, or lead to divorce or the father abandoning his family.

One last point that Dr. Odent makes, is that there are some things we prefer to do in private, in order to preserve a degree of modesty and mystery.”And,” adds Dr. Odent, “For the benefit of our sex lives, it may be worth adding childbirth to this list.”  I don’t think I need to elaborate on this point…

He sums it up by saying, “It is time to go back to basics, and turn modern convention on its head.  When it comes to the delivery suite, men would be well advised to stay away.”

These observations are based on one man’s personal experiences, and not on large scientific studies. But it doe give you something to think about! What’s your opinion?

Benefits of Vigorous Exercise

The book “Exercising Through Your Pregnancy” by James F. Clapp M.D. cites over 20 years of research into the pregnancies of competitive athletes. Dr. Clapp found that exercising at a fairly high level throughout your pregnancy, including full weight bearing exercises, is safe and actually has many positive effects. Some of theses outcomes are obvious, such as reduced maternal weight gain and fat accumulation,  and improving your mood, energy levels, and muscle tone. But some are more surprising, including:

• reduced pregnancy-related symptoms
• Helps reduce backaches, constipation, bloating, and swelling
• May help prevent or treat gestational diabetes
• good placental growth
• fewer big babies
• increased chance of delivering close to due date
• shorter and less complicated labors
• more rapid recover after delivery.

Changes in Your Body

Your body is changing in many ways during pregnancy. You should be aware of these, as they will affect the way you move and exercise.

• Joints: Pregnancy hormones cause the ligaments supporting your joints to relax. This puts them at increased risk of injury, so you should avoid jerky, bouncy, or high-impact motions.
• Balance: The extra weight you’re carrying causes your center of gravity to shift. It also puts stress on your joints and muscles, specifically those in the pelvis and lower back. This puts you at risk of back pain, loss of balance, and falls.
• Heart Rate:  Growing a baby is hard work, and your body is working extra hard to deal with the weight gain and other changes.  Exercise directs oxygen and blood flow to the muscles being worked, and thus away from other parts of your body. It’s important not to overdo it if you begin to feel short of breath, faint, or exhausted.

What’s Safe and What to Avoid

This may come as news to your Grandma, who has probably told you to stop carrying the groceries into your house, and to lie down and put your feet up. But there are, of course limits to how much your pregnant body can handle.  The American Congress of Obstetricians and Gynecologists (ACOG) recommends walking, swimming, cycling, and aerobics.  Other activities, such as running, racket sports, and strength training are good if you’re body is already accustomed to these exercises.

Activites that should be avoided during pregnancy include:

• Downhill snow skiing: Your changing center of gravity can throw off your balance and cause falls and sever injuries. High altitudes with less oxygen may not be the best idea, either.
• Contact sports can result in injuries to you and your baby as well.
• Scuba diving: The water pressure can put your baby at risk for decompression sickness.
• Excessive weight lifting.
• Yoga poses that have you lying on your back or hanging upside down.
• Activities that increase your chance of falling and injuring yourself, such as horseback riding, water skiing, and gymnastics.
• Standing still for long periods of time should be avoided.

If you haven’t been exercising much before you became pregnant, start slowly and carefully. It’s a good idea to consult your doctor about what types of exercise are best.  You should also expect that physical exertion will become more difficult during the last trimester, and respond accordingly. Always incorporate a warm-up and cool-down stage for 5-10 minutes each.

Things to Watch Out For

Women with the following conditions will be advised against exercising during pregnancy:

• Risk factors for preterm labor
• Vaginal bleeding
• Premature rupture of membranes

The ACOG recommends the following guidelines for a safe and healthy exercise program:

• After the first trimester of pregnancy, avoid doing any exercises on your back.
• Avoid brisk exercise in hot, humid weather or when you have a fever.
• Wear comfortable clothing that will help you to remain cool.
• Wear a bra that fits well and gives lots of support to help protect your breasts.
• Drink plenty of water to help keep you from overheating and dehydrating.
• Make sure you consume the daily extra calories you need during pregnancy.

Stop exercising and call your doctor if you get any of these symptoms:

• Vaginal bleeding
• Dizziness or feeling faint
• Increased shortness of breath
• Chest pain
• Headache
• Muscle weakness
• Calf pain or swelling
• Uterine contractions
• Decreased fetal movement
• Fluid leaking from the vagina

Bottom Line: It’s good news for pregnant sports lovers and exercise enthusiasts! Exercise during pregnancy can help prepare you for labor and childbirth, in addition to staying fit and feeling good. And exercising afterward can help you get back into shape.  So put on those running shoes, get out your tennis balls and rackets, or head to the gym or nearest hiking trail. If there’s something you loved doing before pregnancy, chances are you may be able to continue in almost the same way that you always have!

feature image from Hello Beautiful

It’s important to realize that prenatal vitamins are not meant to be your sole source of nutrients. They are meant to supplement!  Pregnant women need more of almost every vitamin and mineral than non-pregnant women. Some say that most of these increased nutrient requirements can be met through a carefully planned, nutritious diet.  You should try your best to eat lots of fresh, non-processed foods. However, a supplement is important if you are NOT getting the required amounts from what you eat (and most of us probably are not!).

Not all prenatal vitamins are created equal. If you are unsure about the best one for you, do some research and talk to your doctors. Avoid artificial preservatives, flavors, colors, and sweeteners. You may want to follow this advice and purchase your vitamins at a health food store, instead of a drug company that “loads them with plenty of of low-quality, synthetic vitamins.”  Here are some other aspects to consider:

Iron
If you’re suffering from extreme exhaustion, you’re not alone. March of Dimes claims that anemia caused by lack of iron affects half of all pregnant women!

Your multivitamin won’t contain the 27 milligrams of iron that pregnant women need, so you can add to your levels by eating iron-rich foods like red meat or fortified cereals.

You may also be prescribed a supplement if you have low iron levels, or have pernicious anemia, sickle cell disease, or uterine fibroids. If iron makes you nauseous, try taking it in the evening, and improve your body’s ability to absorb it by avoiding coffee, tea, egg yolks, milk, fiber, and soy with your tablet.

Calcium
Calcium is so important for your baby’s bones that your body will steal your stores and give them to baby, if necessary – putting you at risk for osteoporosis. Prenatals don’t contain anywhere near the recommended 1,000 milligrams (and women carrying multiples need even more). So add calcium-rich foods to your diet, or ask your doctor about a supplement.

The World Health Organization recommends that in order to reduce the risks of preterm birth and eclampsia, pregnant women should consume 1,500 milligrams of calcium.  (Note that anything beyond 250 mg of calcium, or 25 mg of magnesium, should not be taken at the same time as supplemental iron since both calcium and magnesium interfere with the absorption of the iron.)

Vitamin D
Sunshine is the body’s leading source of vitamin D. There are many reasons why vitamin D is vital during pregnancy. Women with darker skin and those who get little sun should be tested for vitamin D, says the American Academy of Pediatrics. If you’re deficient, you should consider a supplement.

Omega-3s
Studies have shown that DHA, found in omega-3 fatty acids, improves baby’s visual-learning ability and attention span, and may help stave off postpartum depression. You can get enough DHA with two or three servings of salmon, herring, or sardines a week, but to be on the safe side, you might take a DHA supplement. The American College of recommends that pregnant women get 300 milligrams a day.

Iodine
Iodine is critical for your baby’s brain development, says Donnica Moore, M.D. You should use table salt that specifically says, ‘iodized.’  If you are on a low-salt diet or have trouble with water retention, it may be better to find a prenatal supplement with iodine.

Choline
Choline helps develop the hippocampus, the brain’s memory center, but is not included in many prenatal supplements. Eating two eggs a day can help you meet the 450-milligram daily choline requirement.

Folic Acid
Most moms have heard about the importance of folic acid in preventing pina bifida and other defects. The recommended dosage is 400 to 600 micrograms a day, but you need more if you’re carrying multiples, have anemia, sickle cell disease, or who’ve had a child with a similar brain defect.  (I did find one source saying that eating green, folate-rich foods is safer than taking folic acid, but I don’t know enough to comment on that.)

I can tell you, that drink is pretty nasty. It makes some pregnant women feel downright nauseous. Some women add ice or lemon juice, so it’s more of a lemonade-type beverage. I just gulp it down as fast as I can, and try not to think about it!

What is the Test For?

This is a routine test that is done to check for Gestational Diabetes Mellitus (GDM).  This is different than regular diabetes. In GDM, the hormones secreted by the placenta alter how insulin is used in the pregnant body. If untreated, a pregnant woman with GDM may experience problems with ecclampsia, blood pressure, urinary tract infections and an increased risk of Type II Diabetes later in life. The newborn may experience problems of the heart and kidney, and respiratory distress syndrome.

When is the Test Done?

The test is usually offered to most women around 28 weeks gestation. However, if you have a family history of diabetes or had gestational diabetes in a previous pregnancy they may test you earlier.  There are no risks involved, although some women are concerned about the effects that this blast of glucose has on a baby who is not used to receiving it is such quantities.

If you “fail” the one hour test, there’s another 3-hours glucose test. (It is important to note that only about a third of women who test positive on the first test are found to have diabetes upon further diagnosis.) You will be asked to drink or eat something with sugar and will be tested at 30 minutes, one hour, two hours, and three hours. You must pass in three of these tests to “pass” the entire test.

Treating Gestational Diabetes

If you are found to have Gestational Diabetes Mellitus (GDM), you will more than likely be sent to a nutritionist to learn ways that you can control your glucose levels through diet. You will also have a plan for monitoring blood sugar levels to assess your progress. Glucose intolerance during pregnancy affects about 100,000 women every year. The condition usually ends with the pregnancy. However, a small number of women will continue to be diabetic after delivery, so you’ll have to take another glucose test six weeks postpartum.

Do You Need to be Tested for GDM?

A friend of mine was just complaining that her doctor wants her to “redo the whole stinkin’ test.” Somehow they lost her lab results, and she’s tempted to just skip the whole thing, rather than drink the nasty glucose and take another blood test. “Is that crazy??” she wants to know (this is actually her 3rd pregnancy, and she’s never had a glucose problem in the past).

Well, no. It seems she wouldn’t be all that crazy, considering her current situation.

Although GTT  is routine in many places, the American College of Obstetrics and Gynecologists (ACOG) has actually stated that many women are tested unnecessarily. You may not need laboratory testing to screen for GDM if you meet all of the following criteria:

• Less than 25 years old
• Not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
• A body mass index (BMI) 25
• No history of abnormal glucose tolerance
• No previous history of adverse pregnancy outcomes usually associated with GDM
• No known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

• age
• ethnicity
• obesity
• family history of diabetes
• past obstetric history

It can’t hurt to take the test, but if you can talk to your doctor about whether or not it is really  necessary for you.

The Jelly Bean Alternative

I thought it was interesting to note that several years ago some studies were done showing that eating 18 Brach’s® jelly beans worked just as well as the glucola. This definitely sounds a lot more pleasant, and supposedly has few stomach side effects than the glucola. Some women are just told to eat certain sugary foods before the test, which also seems to make sense.

feature image from the mommy diary

What is Vitamin D?

Vitamin D, sometimes referred to as the “sunshine vitamin,” is technically not a vitamin! It is a “steroid hormone precursor” that is NOT naturally present in food. Your skin produces vitamin D when exposed to sunlight (sans sunscreen). Its major role is to increase the flow of calcium into the bloodstream, and is also necessary for bone growth.

What do we need vitamin D for?

According to Medical News Today, there are many reasons your body  needs adequate levels of Vitamin D:

It is crucial for the absorption and metabolism of calcium and phosphorous, which have various functions, especially the maintenance of healthy bones.

It is an immune system regulator.

It may be an important way to arm the immune system against disorders like the common cold, say scientists from the University of Colorado Denver School of Medicine, Massachusetts General Hospital and Children’s Hospital Boston.

It may reduce the risk of developing multiple sclerosis. Multiple sclerosis is much less common the nearer you get to the tropics, where there is much more sunlight, according to Dennis Bourdette, chairman of the Department of Neurology and director of the Multiple Sclerosis and Neuroimmunology Center at Oregon Health and Science University, USA.

Vitamin D may have a key role in helping the brain to keep working well in later life, according to a study of 3000 European men between the ages of 40 and 79.

Vitamin D is probably linked to maintaining a healthy body weight, according to research carried out at the Medical College of Georgia, USA.

It can reduce the severity and frequency of asthma symptoms, and also the likelihood of hospitalizations due to asthma, researchers from Harvard Medical School found after monitoring 616 children in Costa Rica.

It has been shown to reduce the risk of developing rheumatoid arthritis in women.

A form of vitamin D could be one of our body’s main protections against damage from low levels of radiation, say radiological experts from the New York City Department of Health and Mental Hygiene.

Various studies have shown that people with adequate levels of vitamin D have a significantly lower risk of developing cancer, compared to people with lower levels. Vitamin D deficiency was found to be prevalent in cancer patients regardless of nutritional status, in a study carried out by Cancer Treatment Centers of America.

The Vitamin D Council adds that current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

Vitamin D and Pregnancy

Vitamin D deficiency during pregnancy has effects on both the mother and fetus. The Vitamin D Council implicates it in cases of c-section, preeclampsia, gestational diabetes, and bacterial vaginitis.

During pregnancy, the active form of vitamin D increases significantly, according to Mayo Clinic, particularly in the second and third trimesters. During this time, the baby’s bones are developing, as are the brain, the nervous system, and the other organs.Your levels of vitamin D also play a role in determining your baby’s health later in life. Vitamin D deficiency been linked with low birth weight. It also appears that sufficient vitamin D in early life may decrease the risk of serious health problems such as newborn lower respiratory tract infection, diabetes, asthma, weak bones, schizophrenia, autism, brain tumor, heart failure, and a host of other maladies. (Read more here.)

The American Academy of Pediatrics (AAP) recently recommended that all pregnant women have a 25(OH)D blood test, because Vitamin D is vital  for normal fetal development .  If your obstetrician has not referred you for this test, you may want to consider asking that he/she does.

The Sun Exposure Quandary

For decades dermatologists have been warning about the hazards of sun exposure and skin cancers. We know that excessive sun exposure is dangerous, and have been cautioned to stay out of the sun,  wear sunscreen, and protective garments if we will be outdoors. At the same time, Vitamin D deficiency is at epidemic levels in the US (80-90% according to one expert). Getting just enough daily sun exposure to produce necessary levels of Vitamin D may actually be important for your health.

Further studies are required to address this dilemma. However, some health authorities are starting to change their recommendations. Medical News Today quotes the Cancer Council, Australia (2009):
“Sun exposure is the cause of around 99% of non-melanoma skin cancers and 95% of melanomas in Australia. However, exposure to small amounts of sunlight is also essential to good health. A balance is required between avoiding an increase in the risk of skin cancer by excessive sun exposure and achieving enough exposure to maintain adequate vitamin D levels.”

Getting Enough Vitamin D

The current U.S recommended daily allowance is 200 international units of vitamin D, however the current “tolerable upper limit” is 2000 IU. The Canadian Pediatric Society and other Vitamin D advocates suggests that this level may be appropriate for winter pregnancies. (Mayo Clinic) Some experts suggest that pregnant women need even higher levels than this, up to 5000 IU.  Speak to your doctor, as too much Vitamin D can be toxic.

The Vitamin D Council recommends 3 ways for adults to ensure adequate levels of vitamin D:

• Regularly receive midday sun exposure in the late spring, summer, and early fall, exposing as much of the skin as possible (being careful to never burn).
• Regularly use a sun bed (avoiding sunburn) during the colder months. (For more info on this topic: Are Tanning Beds Safe?)
• Take 5,000 IU per day for 2–3 months, then obtain a 25-hydroxyvitamin D test. Adjust your dosage so that blood levels are between 50–80 ng/mL (or 125–200 nM/L) year-round.