January is Birth Defects Prevention Month
Written and researched by:
Carolyn Gundell, MS- RMACT Nutritionist
Recent well-researched articles reference that an overall healthy diet prior to conception—not just the addition of folic acid supplementation—may play a significant role in reducing birth defects. Some women prefer to wait until they are pregnant to focus on their nutritional intake, but this may not be the best choice. RMA of CT supports the approach that women and their partners should optimize their health many months prior to pregnancy. Men and women have higher fertility success and pregnancy outcomes when they invest in their own health. Practicing a healthy lifestyle, even 8-12 weeks prior to conception, can also make a significant difference in the health of mother and baby.
Here is a way for you to choose to be proactive in your own fertility treatment. Often women and men in fertility treatment feel a lack of control, but choosing to lead a healthy lifestyle can help you reach your goal; a healthy pregnancy, a healthy mother and a healthy child.
THE IMPORTANCE OF TAKING A PRENATAL SUPPLEMENT
Are you taking your prenatal vitamin everyday?
So many woman have difficulty getting in a balanced diet on a regular basis so Prenatal vitamins can be very beneficial taken daily prior to fertility treatment, pregnancy and preferably 3 months or more before conception. RMA of CT recommends that a minimum of 800 mcg of folic acid should be included in a prenatal supplement. Folic acid is a vitamin that plays a key role in preventing neural tube birth defects, such as spina bifida. The neural tube develops into the baby’s brain and spinal cord within the first 28 days of conception. A birth defect can occur if the neural tube does not close and this is called a neural tube defect. Folic acid has been added to grain food products in the US since 1998 and this fortification, along with a prenatal with folic acid has contributed to a 50-70% reduction of neural tube defects.
Prenatal vitamins are available for purchase at every RMA of CT office. We offer Rainbow Light Prenatal ONE. This prenatal is an excellent quality multi-vitamin and mineral supplement that is vegan, allergy free and easily digested. Also, the Rainbow Light Company donates a portion of their proceeds to offer prenatals to third world women.
OPTIMAL NUTRITION IMPROVES PREGNANCY OUTCOMES
Healthful eating, adequate hydration, physical activity, and appropriate weight gain all improve pregnancy outcomes. A high quality diet provides a variety of nutrients from fresh fruits & vegetables, whole grains, heart healthy fats, low fat proteins and foods rich in calcium, iron, folic acid and other nutrients. Recent studies support the importance of obtaining nutrients from food in addition to folic acid supplementation several months prior to pregnancy. The highest quality diets were associated with up to 51 % lower risk of anencephaly (brain and spine birth defects), 34% reduced risk of cleft lip, and 26% lower odds of cleft palate when compared with low quality diets.
RMA of CT screens all patients for gestational diabetes risk through a simple blood test called hemoglobin A1c. This measures average amount of blood sugar (glucose) in the blood for the past 10-12 weeks. If elevated, blood sugar levels can be lowered, along with diabetes risk with a few simple meal plan, activity, and sometimes body weight changes in a short period of time. If HgbA1c is elevated, it is very important to lower the blood sugar because high blood sugar levels can cause fetal birth defects.
Growing research is supporting the importance of essential fatty acids in pregnancy, especially omega -3 DHA to ensure optimal fetal brain and eye development. Pregnant women should consume 200-300mg minimum of DHA per day. Quality supplements are available at RMA of CT offices--Nordic Naturals Prenatal DHA and Pro-DHA.
All RMA of CT patients’ serum vitamin D levels are tested and supplementation (also sold at RMA of CT offices) is recommended when levels are inadequate or deficient. Vitamin D deficiency in pregnancy may be correlated with preeclampsia, low birth weight, poor postnatal growth, and higher incidence of autoimmune disease in infants. Low mercury fish consumption 2x per week will help increase EPA, DHA, and Vitamin D intake from food sources. High mercury fish--shark, swordfish, king mackerel, tuna steak, marlin, grouper, orange roughy, tilefish--should be completely avoided prior to and during pregnancy.
Much more information on preconception health for both partners can be obtained by attending one of RMA of CTs preconception wellness classes held on Saturdays at our Norwalk office. Topics discussed include men’s health, pre-pregnancy weight of both partners, activity, stress, smoking, alcohol, nutrition, and more.
WHAT IS RMA of CT OFFERRING FOR FERTILITY & PREGNANCY WELLNESS?
Pre-pregnancy & pregnancy care is a shared responsibility between healthcare providers and their patients. RMA of CT offers several opportunities for patients to obtain information on optimizing their health, and also to participate in services, such as seminars and workshops. Classes/groups for preconception wellness, pregnancy, cooking, Fertile Yoga, PCOS, and general support are posted on the events calendar at www.rmact.com.
First, you need to want a baby.
I know that sounds kind of silly, rather obvious.
Except that some of us start this process not quite sure.
True confessions here. Something I've never spoken about here or anywhere else in public.
This is something that I've never actually talked about before, with anyone.
When I first wanted a baby, there was a definite sense that it was the next step. We met young and got married young.
We both had established careers and had advanced degrees in education.
Even though we were still young, babies seemed like the natural next step. The natural next step also, according to society. In other words we were hearing the questions that many of you are familiar with.
"When are you going to start a family?"
"Do you think you might have good news by the holidays?"
"How long are you thinking to wait for children?"
And on and on.
Here's the point though, for me.
Was I ready for children or was it really just the next expected step?
Secretely, I think I wasn't so ready.
Infertility though, then made me feel hyper ready. I went from wanting a baby, in a relaxed way to wanting a baby in a far, far less relaxed way.
Was it because it was proving to be difficult and therefore was more alluring?
I don't mean to minimize any of this. Alluring, appealing, inviting; none of those words express the depth and strength of my desire for a child once it became difficult. Once it became obvious that conceiving wasn't coming easily, my feelings became so much more intense, almost obsessed.
I wonder whether that was because infertility led me to understand how important having a child was to me or because it was something that maybe I wasn't going to be able to have.
It's possible that this is the place where I stand alone. Maybe I am the only one who only kind of, sort of was ready to have a baby. Maybe you all are more committed and have looked at your feelings more closely.
Maybe, though, there are one or two of you out there that were like me. Not quite sure.
Not quite ready.
Infertility Basics would have to start there.
Are you really ready? Is this what you really want?
If infertility becomes part of your path to a child, being truly ready makes it an easier path. And if you're not truly ready, infertility may help get you there.
I'm blessed to be able to speak to fertility patients and Fertile Yoga students all the time.
I hear you all wondering about these things. Taking breaks to have your "real life". Asking out loud about adoption. Considering childfree.
I applaud you. All of you.
There's a lot of conversation going on in the fertility world these days about having your own child. Or having a child "naturally".
Science, medicine and technology are all amazing things. I am awestruck when I realize what we can do with eggs, sperm, embryos and genetics.
We can separate one sperm from millions of others (ICSI) and insert it into an egg and see it fertilize and become an embryo. We can then remove cells from that embryo and test them to see if the chromosomes in that embryo are healthy and viable. We can then transfer that healthy embryo back into the uterus, knowing that the chances of pregnancy occuring are very high.
If necessary, we can use sperm from a donor, eggs from a donor and a gestational carrier to carry the pregnancy to term.
Maybe some would say that there's something unnatural about all that.
I get that it's more complicated than having sexual relations and becoming pregnant.
But there's nothing unnatural in using human eggs and sperm and creating a baby that is wanted so much that adult human beings are willing to go to such lengths to help bring into this world.
We're not talking about manufacturing eggs or sperm.
Every human being in this world who has ever lived has been conceived from a cell from a male and a cell from a woman.
Including the babies described above.
Those babies too, come from one cell from a man and one cell from a woman.
Nothing at all high tech about that.
Nothing at all unnatural about that.
And in case I haven't convinced you, look carefully at these babies.
Are they loved?
Are they cherished?
Is there anyway at all that you could pick them out from any other babies?
One female cell. One male cell.
Recently I've had the job at looking at and buying new images for the RMACT website, blog and fliers.
It's amazing what happens when you type in infertility to the photo site that we're using.
You get a few decent pictures of fertility doctors (or those posing as doctors), there are even one or two of labs and blood draws.There are about 8-12 images that are reasonable and helpful.
Then what do you see?
First the really politically incorrect and very high on the ick factor ones. Such as, a test tube with a tiny fully formed baby in it. Given how narrow the test tubes are, you can imagine how awful those pictures might be. Rest assured, you will never see that on RMACT's website.
Next up? A scale with a baby on one side and a pile of paper money and gold coins on the other. Pass.
Then it gets really bad. There are pages and pages of dry soil. There were literally, hundreds of images of dry, cracked, barren soil. Of all different colors and textures. All telling the same story though. A place where nothing could grow, where nothing could turn green. A place where all seeds would die, unourished and undeveloped.
Barren. That's what this website turned the word infertile into. Cracked, dry, unfertile soil.
This is infertility basics. So here's what I have to say about that.
We are not barren even if we struggle with infertility. We are not dry, cracked, unfertile soil.
We are men and women who are creative, brave, charming, vulnerable, and GREEN. We are alive, we are creating new cells, new possibilities, new experiences all the time.
We are looking at our problems head on and seeing new ways of managing and even conquering them. Infertility is a challenge, no doubt, a huge one. How alive are we to be challenging what we are given? To find new ways around the problems? To accept and grow into accepting new infertility protocols and treatment? This is far from barren.
I am so blessed in my life to work with RMACT. One of my favorite things about it? Getting to talk to our patients, in Ladies Night In and during peer support before Fertile Yoga.
No way to describe these women as barren. No way to describe these women as dry, cracked, unusable.
Just no way.
P.S. I decided not to show you these awful images. Here's the one that I want to leave you with.
Ripe, delicious, bursting with life.
Ladies Night In- Norwalk this Thursday, August 18, 6:00. Dinner and all. Come talk to and share with a group of women who are anything but barren. We'd love to see you there!
Trying to Conceive? Fertility 101
What you really need to know about human reproduction if you are trying to conceive.
Mother nature gives you about a 20% chance each month of conceiving. If you are under the age of 35, don’t have physical, mechanical problems (blocked fallopian tubes, damaged uterus, immobile sperm, etc.) that will prevent you from becoming pregnant, those are your chances.
Human reproduction is efficient enough, most of the time.
There is that idea that when we’re struggling with infertility that every single thing has to be perfect for us to become pregnant. In fact, that is not even nearly true.
What is true, is that you need to have one egg, one sperm, hormone levels that are appropriate at the right times of the month, and for the egg and sperm to meet at the right time.
Correctly timed intercourse does not mean sex every day each month. Correctly timed intercourse means that you are having unprotected sex slightly before and while you are ovulating.
Ovulation occurs sometime after menstruation. When everything is going well enough, that would be about day twelve through eighteen. If you are not sure when you ovulate or if you ovulate, you can try using an ovulation predictor. An ovulation predictor can be bought at any drugstore.
If you have been trying to conceive for one year, you are ready for some help. Twelve months of correctly time sexual intercourse gives mother nature enough time to have pregnancy occur if there are no underlying problems that need to be addressed.
If you are over 35, six months is a long enough time for you to try before seeking help.
Seeking help is another fertility basic. You probably wouldn't think too long or too hard about seeing a Dermatologist if you were worried about or had a skin condition. There would be no shame or worry about seeing a Cardiologist if you were concerned about your heart.
Board-Certified Reproductive Endocrinologists
Seeing a Board Certified Reproductive Endocrinologist means taking care of your reproductive system. If you are trying to conceive, make an appointment, find out what's going on.
The answers may be more simple than you can imagine.
If I had conceived a child when I first wanted to, what would be different in my life?
Given how young I was, I wonder if my marriage would have survived the challenges of parenthood.
What road would my passion have taken instead of patient advocacy, education and support?
Where would I be living?
Who would my friends be?
Would I be working in a very different way?
How would I have found my connection to working with women?
Would yoga have called me or might I have missed the incredible depth of peace that I find while teaching and practicing?
Who would my friends be? My neighbors?
Where would I have found the compassion that I have about other people's pain?
What would my travels and adventures have been like?
How would I have discovered how deeply important it was to me to have children?
If I had conceived a child as soon as I wanted to, what would I have missed?
FYI for tomorrow:
Peer Support Group from 9:30-10:00
Fertile Yoga from 10-11:00 in Norwalk- 20 Glover Avenue- Free of Charge
Fertile Yoga-YogaSpace- New Time! 5:15-6:30 at 777 Federal Road, Brookfield CT
Nutrition & Lifestyle Tools for Fertility Success
Spring into a healthy and fertile lifestyle with knowledge learned in this seminar, led by Carolyn Gundell, RMA Nutritionist and Monica Moore, MSN, RNC. Come join us for an interactive nutrition discussion on The Fertility Diet, fertility secrets for meal planning, and shopping for fertile foods. We will also discuss how lifestyle behaviors, such as activity, sleep and stress can affect fertility.
Norwalk: Saturday March 26th 8:30 AM – 9:45 AM
10 Glover Avenue, Norwalk, CT
Please call Nina to reserve a seat at 203-750-7484
* Please visit our website or call to confirm date, time and/or location as they are subject to change.
Reproductive Medicine Associates of Connecticut: www.rmact.com
How children come into our lives is often straightforward; sometimes surprising and sometimes even mysterious and unexpected. Infertility makes the path to having our own children bumpy and unpredictable at best. Yet most of us have children in our life in other ways. Here is my story.
I know for myself, how much I appreciated the preview that I got from a very dear friend, who I met in the midst of my struggle to create my family. Tanya had three young daughters, 13, 11, and 6 when I first met her. My fertility path, at that time, was full of injections, blood draws, possible diagnoses, ultrasounds, surgical procedures, and all the other not so glamorous pieces around infertility treatment and conception.
Ever meet a friend who becomes an old friend immediately? I have had the honor and pleasure of having had that happen several times in my life. Tanya may have been the first adult friend that happened with. We clicked immediately, had much in common, and found respect and interest around those things that we did not have in common. She was and continues to be one of my dearest friends, a person that I rely on for support and love.
Thankfully, she didn't have babies, wasn't pregnant, didn't want another baby. For me, I was truly grateful about that as I believe that my vision of my family rarely extended past getting pregnant, giving birth and having a very young baby in my arms. Therefore, the children that she had were past the age that made my heart sore or resentful or simply full of longing.
These children were real people, they had weight and bulk and mass and most of all, minds and hearts. They were all beautiful, talented, challenging, and engaging in remarkably different ways. Vela, the eldest was moving into her teens with a vengeance, finding her own voice, defining her own presence. Banyan was easily the most capable eleven year old that I have ever known, a very calming sense came from her, everything was always manageable, and she could always do far beyond what anyone expected of someone her age. Kether was simply the most delicious, curious, fun, loving, imp that I ever met, before or since.
And instantly I had a family that I was involved in. Not their mother, not their aunt, still, we became family. Experiencing the joys and struggles along with them, as a young adult, I saw just how much there was to parenting. It was a little scary. Experiencing their family was the first time that I saw beyond the baby I wanted in my arms. I saw the six year old, eating M & M's, wanting to play, not do her homework. The eleven year old, capable of so much, pushing against rules and restraints of the family, asking for more freedom. The thirteen year old needing more support than she or any of us realized, evolving into a force to be reckoned with. Yeah, it was scary. Not the picture perfect vision I had of motherhood and cuddling a baby.
It was my peek into the future, my preview, past pregnancy, past birth, past babyhood.
They are still family. These days though, I go to visit and Vela (thirty four years old, with children of her own) picks me up from the airport and takes me for lunch, a bon fire on the ocean. Banyan takes time out of her busy schedule and creates meals for all of us, bringing us together and keeping us organized. Kether, still a fun loving imp, gives me a facial, eyebrow wax and haircut. I shower them with love, heart felt compliments and most of all, I listen.
A real family. Not of my body, not even in my home, but absolutely in my heart.
What's your story?