Pregnancy Preparation Plan (New and Improved!)

(Latest Update: February  2015)


Introductory Comments


It's that time of year, folks! The time when I go through my supplement and diet plan and revise for the coming year. And... here it is! Version 2015, at your service.

This year, I have done several new things:

• I have greatly pared down the information to avoid redundancy.
• I have changed the formatting for easier access.
• I have included a whole new sourcing section for ease of reference and planning. 

The question arises - am I doing all of the things on this plan?

Short answer, no. 

Firstly, this is a work in progress. I'm getting there, folks, but it's a long time in the making. Secondly, there is the small matter of finances. I simply am not able to make all of this work financially right now. (Working on it!) 

I'd say that right now I am maybe, maybe achieving a quarter of the items on the plan. On a good day, if I exaggerate. My goal is to work up to somewhere like 75%. Hopefully that will be possible with time, planning, and work. Right now I'm taking a few supplements, but doing all the supplements isn't possible - and organic, free-range, etc. is completely out of the question. Hopefully some time.

Two things have become extremely apparent to me:

(1) Diet and supplements can have a hugely positive effect on morning sickness and other pregnancy issues, and...

(2) It is extremely important for women to pay careful attention to their health during their childbearing years. (It's always important, of course, but during the childbearing years the negative consequences of neglecting one's health can be particularly dire.)

Thus, I do take my diet and supplement regimen extremely seriously, and I put lots of energy, effort, and time into both developing my regimen and putting it into place. It's a work in progress, but I hope to make consistent progress. 

I'd love to hear any input - and also to see your supplement and diet plans, so do let me know what you're doing!

* sourcing information provided below

PRE-CONCEPTION PLAN

Diet

Very Low Carb (VLC) at 3 months postpartum

Clean (no additives)

Avoid industrial seed oils (cottonseed, soy, etc.) and fake fats (hydrogenated oils, margarine)

Lacto-fermented foods - preferably with each meal

          Kefir* (one-quarter to one-half cup daily)
          Kombucha*
          Yogurt* (small amounts daily)
          Raw sauerkraut*
          Raw pickles*

High in good fats

          Saturated animal fats (free-range organic grass-fed preferred)
          Avocado
          Coconut oil* (2-4 Tbsp. per day)
          Olive oil
          Butter* (2+ Tbsp. per day, preferably grass-fed)

Lemon water (for alkalinity and liver cleansing)

Bone broth (2 cups per day)

Eggs (3-4 per day, preferably organic and free-range)

Some form of healthy meat at each meal

Coconut based snacks like coconut cream*

Unrefined sea salt* (pink or grey)


Supplements*

I am no longer taking vitamin D, as this is provided by fermented cod liver oil

Multi-vitamin (Super Mom* or other) - Since I'm taking fermented cod liver oil and dessicated liver, I believe that the multi is less important. It may go on my optional list.

Fermented Cod Liver Oil * (Preferred dose = 10 mL per day, to provide 1000 mg DHA daily)

Alpha Lipoic Acid (600 mg/daily)

Vitamin B complex*

Probiotics

        Pill form*
        Lacto-fermented foods (see above list under diet)

Dessicated Liver Pills* - For iron and micronutrients

Magnesium

        Oral supplement - Natural Calm or Doctor's Best Chelated Magnesium (or other options)
        Epsom Salts baths* - minimum once per week
        Magnesium oil* or Magnesium Lotion*
        Magnesium water*

Zinc*

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Other:

Finances Permitting (both of these decrease inflammation; turmeric is also anti-microbial)

        Resveratrol (100 mg twice daily)
        Turmeric (350 mg twice daily)

Occasional

        Kelp - occasionally for iodine
        Yearly Liver Cleanse (dates done: May 2011, May 2012)

See my list of pregnancy supplements for other pregnancy-specific supplements (most are third-trimester birth and postpartum prep supplements).


Lifestyle

Exercise - Especially weight bearing exercises, since muscle mass helps with insulin/glucose metabolism.

Sunlight - As much as possible. (I'm terrible about this.)

Sleep - Minimum of eight hours per night.

Self Care - Keeping my house clean so that I'm not a stress-case about it. Doing things I enjoy occasionally. Staying off of the computer. Going for walks. Keeping up with my devotions and Bible study. All of the things that keep me sane, balanced, and emotionally healthy.


Healthcare

Find a naturopath. (I have several recommendations, plus the local naturopathic college.)

Contact acupuncturist. (Done! They recommend starting pre-conception. This will also be a matter of finances.)


Spiritual

Bible verse memorization - I find that having Scripture verses to recite during stressful or panicky times is truly a lifeline, and it's one that I want to develop more fruitfully.

Regular prayer and Bible study


Personal and Practical

Make the most of the time! I find that the thought of future pregnancies helps me to treasure my time, and encourages me to use my time wisely - to take every advantage of time with my children, to train my children as much as possible in character and practical skills, etc.

Work on organizational projects as much as possible.

Read as widely and deeply as possible on the topic of health. (See my ever-growing booklist here.)

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POST-CONCEPTION 

Diet

       Strict VLC (very low carb)
       Constant snacking - every hour at least
       Lemon/ACV water - lots of it.


Supplements

       Add more Epsom salts baths (daily)
       Add digestive enzymes
       Consider Protandim (this might also be a good pre-conception supplement)


Healthcare

       Start Vitamin B/Magnesium/Folate shots at naturopathic college
       Contact acupuncturist to let her know in advance


Spiritual

        Pray!


Personal and Practical

        Buy paper supplies (plates, bowls, utensils)
        Easy kid snacks - gold fish, healthy bars, raisins, juice boxes, cheese sticks, dry cereals

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* Sourcing Information:

Kefir
Kefir is easy to make. Just buy grains or get some from a kefir-making friend, and follow easy directions for culturing plain milk. I unfortunately have not had good luck with it, so I buy plain, full-fat Lifeway kefir from Sprouts.        

Kombucha
Kombucha can be purchased, but it's so easy to make! My directions here. The longer you culture, the lower the sugar content.        

Yogurt
Full-fat plain yogurt is also easy to find, but it's pricey. I make a gallon a time in a crockpot. My updated directions here.

Raw sauerkraut
The sauerkraut you buy in the supermarket is not real sauerkraut. It is heat-treated for sterility and not useful from a probiotic standpoint. Look for the words "raw" on the label. Raw sauerkraut is available at Whole Foods, Sprouts, and most health food grocery stores. I buy raw Bubbies sauerkraut from Azure Standard.      

Raw pickles

The pickles you buy in the supermarket are not real pickles. They are heat-treated and not useful from a probiotic standpoint, and if you're buying typical brand-name pickles, they are also loaded with toxic dyes, additives, and aluminum compounds. (For non-toxic regular pickles [non-probiotic], buy at Sprouts, Whole Foods, or Trader Joe's.) For probiotic pickles, look for the words "raw" on the label. Raw pickles are available at Whole Foods, Sprouts, and most health food grocery stores. I buy raw Bubbies dill pickles from Azure Standard.      

Coconut Oil
I buy Wilderness Naturals from Azure Standard or the coconut oil now available at Sam's Club. Coconut oil is also available online from Tropical Traditions.

Butter
The butter I hear most often recommended (organic and grass-fed) is Kerrygold, now available at Costco. I buy the slightly cheaper Rumiano's from Azure Standard.

Coconut Cream
I buy Artisana Coconut Cream from Azure Standard. Coconut cream is available online from Tropical Traditions.

Unrefined Sea Salt (Pink or Grey)
Pink sea salt is available very inexpensively in the bulk bins at Sprouts. Other types (purchased in smaller individual packages) at Sprouts or Whole Foods will be much more expensive.

Supplements
Online, I buy supplements from Amazon.com and Azure Standard (available only in areas to which Azure Standard delivers). I buy herbs locally from Desert Sage Herbs. I buy supplements locally at Sprouts Market, Trader Joe's, and the medicinary at Southwest College of Naturopathic Medicine in Tempe, Arizona.

Supermom Vitamins
The most inexpensive way to purchase that we found was to buy a three-month supply through Amazon. This is not currently available, but we hope it comes back soon! It's much more expensive through the product website.

Fermented Cod Liver Oil
Blue Ice Fermented Cod Liver Oil by Green Pasture. I purchase through Azure Standard.

Vitamin B Complex
See Rachel's recommendations (in general and for specific brand).

Probiotics (Pill Form)
See Rachel's recommendations.

Dessicated Liver Pills
My favorite brand is Radiant Life Dessicated Liver. Because of cost, I currently use a cheaper brand, Solgar, purchased at Nature's Health in Chandler, AZ.

Epsom Salts
Epsom Salts (magnesium sulphate) are available in any pharmacy store (Walgreen's, CVS, etc.) or in the cosmetic/pharmaceutical area of any Walmart or Target. It can get quite pricey - most two pound bags run around $6 each, and you use two cups per bath. The best price I have found is the 50 lb. bag for around $45 from Azure standard. 

Magnesium Oil
Make your own or purchase ready-made. 

Magnesium Lotion
Make your own

Magnesium Water
Make your own

***


Now it's your turn, dear readers! What supplements and/or dietary changes are you using to prepare for possible pregnancy and to improve or prevent pregnancy health conditions?

Hanging Out in Labor and Delivery (And Loving It!)

This past summer, I began a project for the sheer joy of it - touring labor and delivery suites (a.k.a. hospital birth centers, a.k.a. maternity wards) at several Phoenix valley hospitals and making detailed notes of those visits for the purpose of comparing the different options for maternity care within the valley.

Though I am a dedicated homebirther, I love spending time in hospital birthing areas, and this project was a lot of fun for me. I loved getting to hear what tour guides had to say about their hospitals, and it was very interesting to compare the different locations.

In the beginning, my intent was to write a detailed summary of each hospital and then to write a comparison. However, I changed my mind on that and have decided simply to write one summary report of what I learned (see below!).

For this project, I visited three hospitals. I would like to have visited more, but making the time and arrangements to visit three was quite a challenge in itself. Perhaps I'll have the opportunity to visit more in the future.

I will not refer to the three hospitals by name. Although one of the hospitals was pretty much perfect, my thoughts about the other two hospitals did include some criticisms as well as praises, and thus I have decided to keep the names of all three hospitals anonymous.

The reasons for this are several, but primarily, hospital experiences are highly individual. One mother may have a wonderful experience, and another a horrible experience, at the same hospital - because doctors, nursing staff, and unavoidable circumstances may contribute toward very different experiences.

Additionally, hospital tour guides are, it seems, very strictly instructed in what to say (and probably what not to say!). Thus, a hospital tour may or may not be representative of the true experience that a mother or family will have at the time of birth - for better or for worse.

For the record:

- The personnel type giving the tours varied from hospital to hospital. At one hospital, our tour was given by an actual labor and delivery nurse. At another, it was a hospital aide and translator who gave the tour.

- Tours all took place in the latter half of 2014.

- All quotes are paraphrases. I made detailed notes directly after each tour so that my summary would be accurate, so all details should be accurate - quotes, however, are reconstructed paraphrases rather than word-for-word quotations.

- I have a strong preference for Catholic hospitals. I do not want to give birth (or even be) in a hospital that performs abortions, and I like being in a place that (basically) shares my life ethics.

- In my notes, I did not take into consideration various high-risk abilities, such as Level III NICU, etc. In an emergency or a severely high-risk situation, the mother and baby need be where they can get needed care. Period, end of sentence, etc. As my midwife told me, "In an emergency, it doesn't have to be pretty." My notes were simply for the normal birthing family who is looking for a hospital in which to have a non-high-risk birth.


All that being said, here are some of the observations that I gleaned from my experiences touring local hospital labor and delivery departments!


Hospitals Tend to Brag About the Wrong Things

I noticed very quickly that hospitals tend to advertise various amenities that they believe will appeal to birthing families (and which probably will). For example:

• Free WiFi
• Movie channels
• Room service

However, all of those things are absolutely irrelevant to the love, respect, and quality of care that a family will receive during their labor, birth, and postpartum. 

I would much rather hear things like:

• We offer a wide variety of labor tools (birth balls, peanut balls, birth stools, whatever!) and a nursing staff that is trained to help you use them.
• We would love to see your birth plan and want to help you achieve your goals.
• We respect decisions that you make for their newborns without trying to pressure you into hospital protocols. 

And I did hear some of that (especially at one hospital in particular), but on the whole, I think hospitals brag about the wrong things. And perhaps we parents are looking for the wrong things.

On another note, I noticed that hospitals also brag about high-tech things ("machines that go beep"). For example:

• We have full-service monitoring technology that will be tracked at the nursing station at all times.
• We have an anesthesiologist ready at all times.
• We have a full surgery team available at all times. 

Is this a good thing? Yes, if that's what you're looking for. But, to repeat myself, those amenities still have nothing to do with the love, respect, and quality of care that a low-risk family will receive during a normal labor, birth, and postpartum.

All Amenities Are Not Created Equal 

Just because two hospitals offers a certain service does not mean that their quality of care regarding that service is the same. 

Here is one incredibly interesting example:

At two of the hospitals, the question was raised about labor tubs. (Both hospitals had labor tubs available for patient use.) Here are the responses:

Hospital #1:

"Yes! We have labor tubs! They are great for helping you to relax and get non-drug pain relief. Just give us a little bit of notice so that we can get one to your room and set it up for you!"

Hospital #2:

"Yes, we have a labor tub. But nobody ever uses it. They always stay in bed. And nobody here ever goes unmedicated anyway. They always end up begging for drugs even if they say they want a natural birth when they come in."

Enough said.



Don't Assume That Outdated Practices Are Dead

At two of the hospitals, we were strictly informed: "As soon as you are admitted, you are treated as a pre-op patient - no food by mouth, and no fluids except ice chips and IV fluids."

Folks, it's really time to stop this nonsense.

From the article linked above:

"Our study found no difference in the outcomes measured, in terms of the babies' wellbeing or the likelihood of a woman needing a C-section. There is no evidence of any benefit to restricting what women eat and drink in labor."

And:

"There should be no hospital policies which restrict fluids and foods in labor."

But converting evidence into evidence-based practices is easier said than done. Dinosaurs die hard.

Similarly...


Don't Assume That All Practices Are Evidence-Based

At one hospital, I asked the question: "What is your policy on delayed cord clamping?"

The answer that I received was decidedly odd. The tour guide replied, "Um.... people don't really do that any more. You'd have to ask your doctor."

Wait a second. "People don't really do that any more?" The practice of cord clamping over the past century in the United States is moving in the direct opposite direction. The current (and past) standard of practice is immediate cord clamping, now moving (at something somewhat slower than a snail's pace) toward delayed cord clamping, which has all the evidence on its side.

One way or the other, the fact that an experienced labor and delivery nurse had no knowledge of delayed cord clamping is somewhat alarming.


Environment Is Important

Things like noise levels, decor, ambiance are not the most important things about a hospital. Granted, absolutely. BUT - they are important. The ability to relax in a comforting environment is critical for the progress of a healthy labor, and a stressed-out mother is likely to have more trouble relaxing enough to labor effectively.

Here are some of the ambiance-related factors that I noticed in the various hospitals:

• Paint and flooring colors
• Floor plan
• "Hospital feel and/or smell" - Both of these are an incredible turn-off to me.
• Sense of busyness - Also an incredible turn-off.
• Noise levels - Often related to floor plan and general acoustic design.

Some of the hospitals made me somewhat uncomfortable, ambiance-wise, and some (okay, one!) actually felt more like a resort. When a person is in labor, these things can be more important than we know. (And really, this also applies to patients in the hospital who are there for illness, injury, or surgery. Stress-relieving surroundings can be incredibly conducive to healing, and the reverse is true as well.)


The Tour Isn't Everything

Hospital tours are meant to present a hospital's best side to prospective clients. That doesn't mean that a hospital tour accurately represents as to a hospital's true atmosphere and attitude with regard to birthing practices and policies.

Additionally, a hospital tour leaves out two important factors - your doctor (or midwife) and your nurses. One (your doctor) you get to pick, and one (your nursing staff) is a surprise. Both of those are incredibly important components of your hospital birth experience.

When you combine all of the different factors (doctor, nurses, hospital, your specific case), you can easily get many different outcomes from the same hospitals. I have heard both horror stories and "I love this hospital!" stories coming from all three hospitals that I visited.



We're Speaking Different Languages

As I toured these hospitals, I got the strong impression that the hospital staffs love their families, love their babies, and want the best for all involved.

Mothers and fathers also love their babies and want the best for all involved.

But sometimes those two groups (hospitals and families) mean distinctly different things by that statement.

When hospitals want the best for everyone, they want their mamas to follow procedures, adhere to protocols, and not rock the boat.

When I want the best for my baby, I want the complete freedom to make choices that will be lovingly respected, even if they deviate from cultural norms or hospital rules.

The tension between the desires of hospital staff and the desires of families is what can make hospitals a difficult place to achieve desired birth goals or have birth wishes respected by staff. It's what makes homebirth doubly desirable for mothers like me, who do not want to be fighting battles for themselves and their babies during labor, birth, and the postpartum.


Conclusions

I came away from this project confirmed in my preference for home birth. I do hope that I will never see the inside of any hospital as a laboring mother.

However, I am extremely grateful that these hospitals are there in the case of emergency. Here in the valley we are blessed to have several excellent hospital midwifery practices who accept transport cases (as well as providing excellent hospital care for mamas who choose hospital births), and I am thankful that we have supportive care providers to whom we can transfer care when a home birth moves outside of safety protocols and requires transfer.

Each hospital evoked my admiration in different ways, and I deeply appreciated the kindness of their staff in providing detailed and lengthy tours to give prospective clients information and allow them to ask questions.

The take-away message is simply to do your homework if you are planning a hospital birth. Tour the facility and ask questions. Compare hospitals and make a thoughtful choice. Be extremely selective in your choice of doctor or midwife. Take a childbirth prep class. Read, read, read. Do your research. Write a birth plan. Hire a doula. Do your homework.

As for me, I loved touring hospitals and can't wait till we're pregnant again so that I can tour more of them! I had so much fun.


Dear readers, what are your thoughts? Have you toured more than one hospital? How did they compare? How did your hospital tour compare to your birth experience in that hospital?

As always, kindly worded and non-combative comments and questions are welcomed. Impolite comments of any kind will be quietly deleted without comment.

I look forward to hearing your thoughts!