Healthy Practices for Exercising While Pregnant

Healthy Practices for Exercising While Pregnant

By Evan Penrose

Prenatal exercise has been shown to be highly effective in supporting the health of pregnant women. Historically, there have been conflicting answers on who should exercise while pregnant and what conditions can be adversely affected by exercise in the prenatal period. Previously, a variety of medical conditions were outlined where there was uncertainty if exercise would have a negative impact on pregnancy health. However, recent findings identified no evidence to quit prenatal exercise due to 11 common pregnancy conditions (chronic or gestational hypertension; overweight/obesity; recurrent miscarriage; shortened cervix; multiple pregnancies; epilepsy and anemia; orthopedic limitations; history of extremely sedentary lifestyle; history of spontaneous preterm labor; or fetal growth restriction; Meah et al., 2020).  In fact, within those findings, it was shown that prenatal exercise can be beneficial to those with the aforementioned conditions.

This same study, however, found that certain conditions were adversely associated with prenatal exercise. An extensive review of dozens of studies found that prenatal exercise should not be practiced with the following conditions: severe cardiorespiratory disease, placental separation, vasa previa (blood vessel rupture by the umbilical cord), uncontrolled type 1 diabetes, intrauterine growth restriction, active preterm labor, severe pre-eclampsia and cervical insufficiency (cervical weakness/dilation prior to delivery) (Meah et al., 2020). With any one of these conditions, the risk of health complications from prenatal exercise was much higher, and that exercise was discouraged. While prenatal exercise is discouraged while having one of these conditions, you should not modify your daily living activities.

Women who have eating disorders should also not be discouraged from exercising during pregnancy (unless medically-advised to do so). Exercising regularly during pregnancy has been linked to a 67% decrease in the odds of prenatal depression occurring in women (Meah et al., 2020). Prenatal exercise can be useful for improving overall mental health and can potentially mitigate psychological factors associated with eating disorders. In situations where eating disorders are more severe, moderate to intense levels of activity should be avoided. Those with severe symptoms or those who are symptomatic are advised to practice low-intensity workouts provided they have regular guidelines given by their healthcare provider.

Women who have experienced miscarriages or reoccurring pregnancy loss should also know that there is no data that links prenatal exercise and reoccurring pregnancy loss (Meah et al., 2020). While there are few studies on the two items specifically, the underlying pathophysiology shows that is unlikely that prenatal exercise and spontaneous pregnancy loss are related. Prenatal exercise may actually be beneficial to those who have experienced spontaneous pregnancy loss, as prenatal exercise can improve general maternal health. Prenatal exercise can specifically help to mitigate factors attributed to pregnancy loss such as insulin resistance and obesity.

Moving forward, for those who are able to engage in prenatal exercise, the activity is beneficial to both the developing fetus and the woman exercising. Moreover, evidence supports that exercise can be done at varying levels such as high or moderate-intensity while still being safe. Research has shown that blood flow to the fetus was not significantly affected by moderate level exercise routines, as well as birth weight (Bakarat et al., 2010). While there is still more research to do in this area of study, so far, the information shows that exercise does not pose any adverse effects on the health of developing fetuses.

Women with no preexisting health contradictions should still be aware of some caveats that are associated with prenatal exercise. Generally, women with no preexisting conditions should still avoid exercise relating to the following situations: exercising while lying flat after the first trimester; prolonged standing; high risk of contact, falling, or abdominal trauma; altitudes greater than 5250 feet; and scuba diving (Hinman et al., 2015). Women should also be aware that they should stop exercising if they experience any of the following symptoms: vaginal bleeding, dizziness, calf pain or swelling, chest pain, preterm labor, decreased fetal movement, leakage of amniotic fluid, or hyperventilation prior to physical activity.

Overall, prenatal exercise can contribute to a variety of positive factors in general maternal health. Those without restrictions are encouraged to participate in prenatal exercise under the guidance of their healthcare provider. Prenatal exercise can improve health conditions for a woman physically and psychologically, while also being safe for the developing fetus. On the other hand, those with contraindications should avoid exercise unless advised differently by a healthcare provider.

References

Barakat R, Ruiz JR, Rodríguez-Romo G, Montejo-Rodríguez R, Lucia A.

Br J Sports Med. 2010;44:762-764.

Hinman SK, Smith KB, Quillen DM, Smith MS. Exercise in Pregnancy: A Clinical Review. Sports Health. 2015;7(6):527-531.

Meah VL, Davies GA, Davenport MH. Br J Sports Med 2020;54:1395–1404.

Postpartum Body Image With Eating Disorders

Postpartum Body Image With Eating Disorders

By Kamryn Bedore 

Postpartum occurs after giving birth and can last anywhere from a couple days to a year (MediLexicon International). This postpartum period has a variety of different symptoms, but the main focus of this article pertains to eating habits. Postpartum has the ability to take a toll on mental health and make you into someone you are not. 

The postpartum period can also be accompanied by what is commonly referred to as the “baby blues”, but this is a much more mild version. Feeling overwhelmed and unsure of what is to come is always normal, but the postpartum period can amplify these feelings. Many also refer to this period of time as the “fourth trimester”. An individual is experiencing all of the different emotions and uncertainties as they transition back into their non-pregnant state.

Body image is one of the main triggers for an eating disorder to occur postpartum. Pregnancy requires weight gain in order to grow a healthy infant inside of one’s body. Doctors recommend individuals gain on average twenty five to thirty pounds, this can be higher however, over the course of pregnancy (Rogers, 2020). Therefore, during pregnancy people can accurately attribute weight gain to pregnancy and  often avoid social judgment. Once the birth has occurred, however, they  may experience judgment for not losing the baby weight immediately or may be unsure how to healthfully adopt a postpartum pregnancy weight. They may then spiral into doing anything possible to get their pre-pregnancy “look” back. This can lead to the abuse of food consumption and mental health.

Developing an obsession with exercise after becoming a new parent leads to many negative outcomes. The desperation to change their body can sometimes take over and they begin overworking and underfeeding themselves to satisfy their wanted “look”. While it is necessary to have a period of healing and rest after pregnancy and childbirth, a parent with an eating disorder may find it difficult to sit still (Crystal Karges, 2020). They feel as if when they are sitting down relaxing, they are giving up on their body and their desired body image. This leads to an unhealthy amount of workouts, especially cardio, and lack of nutrition to go with it. Parents might feel like they can’t eat unless they have “earned” their food or feel like they have to workout in order to eat anything (Crystal Karges, 2020). Working out too soon and too aggressively can have such a negative effect on mental and physical health.

Abnormal eating behaviors and patterns can be characteristic of a postpartum eating disorder. Erratic eating patterns such as restrictive eating are negative ways to change your body image (Crystal Karges, 2020). Developing these kinds of eating patterns may create a downward spiral into pursuing multiple and becoming obsessive. Food can be a hard topic when adjusting to your new life and body but you cannot let it consume your entire existence. People also shouldn’t tackle these thoughts and motives alone. Have someone else encourage you to try something new everyday and branch out into different types of food and meals. Develop a schedule to consume three meals a day so you know you are not overdoing it or under doing it. Stray away from any erratic pattern that you see yourself developing. 

Individuals with first hand experience regarding postpartum body image issues with eating disorders have spoken out publicly. One being well known Chrissy Teigen, she opened up in an interview after her experience and stated “You just realize you have to give yourself time and understand that you pushed out a baby, and it took this long to put on the weight, and it’s not going to peel right off, and that’s OK” (Ahlgrim, 2019). Everyone goes through these emotions regardless of who you are and it does not make you any less of a parent. Well-known celebrities speaking on their traumatic experiences is very brave and encouraging for people who admire them. This can give an individual the little push they need to overcome their thoughts and negative motives. 

In conclusion, postpartum body image is a serious issue among new parents. Postpartum has the ability to change your eating habits and overall outlook on life itself. Your mental health becomes at risk and you’re likely to turn into someone you are not. Any normal feelings and worries you may have, postpartum amplifies them and turns them into nightmare-like feelings. Individuals need to focus less on their body image, not overwork their bodies, and stray away from abnormal eating patterns. New parents need to take control of postpartum instead of letting it control them.

Sources

Ahlgrim, C. (2019, April 17). 24 times celebrity moms were refreshingly honest about their post-pregnancy bodies. Insider. Retrieved November 5, 2021, from https://www.insider.com/celebrity-moms-talk-about-their-post-baby-bodies-2018-6#chrissy-teigen-wants-moms-to-be-able-to-enjoy-their-babies-and-not-go-crazy-trying-to-lose-weight-4. 

Crystal Karges, M. S. (2020, December 12). 7 revealing signs of a postpartum eating disorder. Crystal Karges Nutrition – Registered Dietitian Nutritionist in San Diego, CA. Retrieved October 21, 2021, from https://www.crystalkarges.com/blog/7-revealing-signs-of-a-postpartum-eating-disorder. 

MediLexicon International. (n.d.). Postpartum depression: How long does it last? Medical News Today. Retrieved November 1, 2021, from https://www.medicalnewstoday.com/articles/271217#how-long-does-it-last. 

Rogers, M. (2020, April 19). Pregnancy, body image, and eating disorders. BALANCE eating disorder treatment center. Retrieved October 21, 2021, from https://balancedtx.com/blog/pregnancy-body-image-and-eating-disorders.

Transgender Pregnancy

By Kamryn Bedore & Rachel Yankowy

Pregnancy has been considered something that only women can do but people of all genders can get pregnant and give birth. Medical professionals state that there is a possibility for a transgender woman to have a child with a uterus transplant. In the past there have already been cases of cisgender women having children with a transplanted uterus from donors.

Transgender pregnancy is possible. Transgender men and woman have been mistakenly told by health professionals that the use of testosterone will make them unable to conceive a child. This is not always the case and can result in unplanned pregnancies or a general lack of awareness that pregnancy still is a possibility. Taking testosterone may stop ovulation at a certain point but eggs do not disappear. It is important to be aware of this and not get lost in misconceptions.

In order to make this topic more inclusive we can change the way we talk about birth and the traditional views of it being something only a woman can do.  We can help make a transgender pregnant person’s experience be improved by people not assuming their gender and avoid making assumptions. Some ways we can do that is by using gender-neutral language, for example pregnant people instead of women. Using language specific to the parts used in pregnancy like the uterus and ovaries rather than the female reproductive system. Ask for the person’s pronouns and use the ones they identify with. Use the pregnant person’s preferred name; it may not necessarily be their legal name. Professionals can ask for gender identity, which is different than sex at birth. Healthcare professionals can also ask the staff to check what is written on intake forms before addressing the patient. Establishments can provide single-stall gender-neutral bathrooms. Lastly, all staff can be trained on the practices above to make sure everyone coming in is their most comfortable.

Another way to make pregnancy more inclusive as a whole would be to encourage gynecologists to display their offices as welcoming to all. Everyone, regardless of their gender, should be able to come to a gynecologist office for their obstetric or gynecology health care. Many transgender men and woman miss out on the gynecologist experience due to fear of being judged or rejected. Everyone needs to know they are welcome, and everyone’s goal there is to have a safe and healthy pregnancy. The websites and offices for this establishment should be encouraging all genders to schedule an appointment without any fear and making them like a safe place.

Pregnancy should be spoken about without any label of gender. We need to stop assuming a woman is pregnant every time we hear about pregnancy. This can be very offensive to some, and extremely wrong in many cases. Medical professionals have stated that individuals who are transgender can become pregnant and carry a baby. All genders have the ability to become pregnant with the right care and right procedures. The stereotype that women can only become pregnant needs to come to an end, it is 2022, the world is evolving. 

Trans parents themselves have openly expressed how they feel about the matter and how they are treated by news outlets. A man named Kayden Coleman spoke out about how hospitals are not set up for trans pregnancies. He felt he missed out on all the perks from a pregnancy because no one acknowledged it or made a fuss about him, everyone assumed it was a “beer belly”. Kayden stated “​​ There was a lot of trauma, most of that came from inside the birthing world, with medical professionals. There was a lot of questioning about my identity, a lot of misgendering. Being told I shouldn’t be in spaces I was seeking care from because they were considered women’s spaces. I was offered an abortion a ridiculous amount of times (TodayShow, 2021)”. They made him feel unwelcome, a bother, and like he was incapable of birthing a baby. 

Pregnancy is supposed to be one of the most special and memorable experiences in one’s life.  A person’s gender, sexuality, etc., should not interfere with that experience. Every person deserves to be treated equally, no one is better than anyone else. They are welcoming one of the best gifts into this world, probably a little scared, so being treated unfairly and looked down on will only make them doubt themselves. The mindset that only women can become pregnant needs to be ended now. We are all human, Humans support Humans. 

Sources

TodayShow. (2021, June 2). ‘A lot of trauma’: Trans Parents Say Medical System isn’t set up for their pregnancies. TODAY.com. https://www.today.com/health/trans-parents-say-medical-system-isn-t-set-their-pregnancies-t218691. 

Complications around Breastfeeding with an Eating Disorder

By: Rachel Yankowy

West Virginia University

Breastfeeding is an important time for mothers after having a child for many reasons such as bonding and the benefits of protection against illnesses or diseases. Women with an eating disorder or a history of one may have concerns or complications when it comes to breastfeeding their new child. Eating disorders can occur at any age, but do affect women during their peak reproductive years which can lead to problems with their ability to breastfeed compared to individuals without eating disorders. Eating disorders can be associated with both psychological and physical aspects that may affect breastfeeding. Please note that most of the research done on this topic focuses on anorexia nervosa (AN)  and bulimia nervosa (BN) and every mother may have a different experience. 

Studies have shown that breastfeeding for six months to a year is the most optimal amount of time to ensure all the benefits are given to a mothers baby(Claydon & Zerwas 11). Some research has found that women with AN or BN will breastfeed their babies just as long or longer than the rest of the general women. Further investigation has shown that women with AN are two times more likely to stop breastfeeding early compared to the general population of mothers. 

Mothers with eating disorders often fear their breast milk will not have enough nutrients for the child. What a woman eats depends on the quality of the milk they produce. For mothers with eating disorders this can be difficult causing them distress which could be projected onto the baby. The pressure of the infant becoming accustomed to a specific feeding schedule can also cause anxiety when they signal hunger outside of the window for feeding. 

There are also psychological reasons behind why mothers with eating disorders shorten or do not breastfeed. Some studies have shown that women with AN often feel like it is an embarrassing act. Women may worry that it can alter their appearance causing them to make their decision based on these feelings. 

Every woman’s journey with motherhood and approach to how to parent is different. Multiple studies have suggested that eating disorders can have an effect on not only the infant but also the mother. Although the decision and choice on whether to breastfeed is unique to each mother, there is research to suggest that stopping breastfeeding early can be associated with more digestive or immune problems for the child. When the mother has an eating disorder or history of an eating disorder, breastfeeding can be an even more difficult decision to make. The research and associations of eating disorders with breastfeeding are complex but continue to be researched to find additional information.   

References: 

Zerwas, S. & Claydon, E. “Eating Disorders Across the Life-Span From Menstruation to Menopause: Breastfeeding and Infant Feeding.” Women’s Reproductive Health Across the Life-Span, edited by D.L. Barns, Springer International Publishing Switzerland 2014, 11-12.

Torgersen, L., Ystrom, E., Haugen, M., Meltzer, H.M., Von Holle, A., Berg, C.K., Reichborn-Kjennerud, T. and Bulik, C.M. (2010), Breastfeeding practice in mothers with eating disorders. Maternal & Child Nutrition, 6: 243-252. https://doi.org/10.1111/j.1740-8709.2009.00208.x

A Toxic Relationship: Eating Disorders and Violence

By Hattie Rowe

West Virginia University

*Trigger Warning. Discussions of Intimate Partner Violence, Sexual Assault, and Eating Disorders*

You may have heard of the nature vs. nurture debate. Some people say that our genetics and biology are what make us who we are. Others say that our environment shapes us to create the person we are. Researchers have applied this theory to the development of eating disorders.

The roots and causes of eating disorders are a widely debated and researched subject. While there is evidence that a person’s genes can predispose them to an eating disorder, there is also evidence that shows how disordered eating problems could occur as a response to sexual abuse (Chen, et al., 2010).   

What is sexual violence? And what does it have to do with eating disorders?

Sexual violence means that “someone forces or manipulates someone else into unwanted sexual activity without their consent,” as defined by The Rape, Abuse & Incest National Network (RAINN) (rainn.org).

Studies have shown a relationship of eating disorders forming as a result of sexual violence. Sexual violence can happen to anyone, but most frequently occurs to women between the ages of 18 to 34 (rainn.org). This is a similar age bracket to the average population of people with eating disorders, which typically affects women in their early teens into young adulthood (National Institute of Mental Health, 2016).

What is Intimate Partner Violence (IPV)?

Intimate partner violence (IPV), sometimes known as domestic violence, is a common

threat to men and women. The Centers for Disease Control and Prevention in the United States defines Intimate Partner Violence as: “abuse or aggression that occurs in a close relationship.” An intimate partner refers to both current and former spouses and dating partners (CDC, 2019). IPV can vary in how often it happens and how severe it is. “It can range from one episode of violence that could have lasting impact to chronic and severe episodes over multiple years.” (CDC, 2019)

Crimes committed by intimate partners often go unreported. As for the information that has been contributed to our base of knowledge over the years, the statistics offer alarming insights. Over half of reported female rape victims said that an intimate partner was responsible (CDC, 2011). Nine percent of homicides are committed by intimate partners (NCRJS, 2018). The psychological and behavioral consequences of these experiences are numerous. One of these consequences is that victims of IPV have reported experiencing disordered eating patterns (Wong et al., 2016).

Eating Disorder Effects

Use of food is a common coping mechanism used by victims of sexual violence. Strictly managing food intake is a way that a victim can feel in control over their body. Or possibly bingeing on large amounts of food falsely eases psychological burdens for a brief moment. Obsessions with food and body become a problem that impedes on the everyday life of a victim. 

Victims of sexual violence often undergo a process of healing physically and mentally. Due to the physical toll that eating disorders take on the body, eating disorders may cause a disruption in the healing process. 

Physical consequences of eating disorders include, but are not limited to:

• Tooth decay
• Sore throat
• Sleep problems
• Lowered sex hormones
• Dropped body temperature
• Constipation
• Stomach rupture
• Esophagus rupture
• Bone loss
• Decrease in white blood cell count 
  • (NEDA Health Consequences)

The mental effects of sexual violence and IPV can include:

• Eating disorders
• Trauma
• Depression
• Dissociation 
• Sleep disorders 
• And more 
  • (rainn.org/effects)

Getting professional care for the psychological effects of abuse is just as important as

healing from physical abuse. This can help prevent the onset of eating disorders and other mental health problems that occur as a result of sexual abuse. Seeking helpful services can include receiving trauma informed care/practice and becoming aware of resources for eating disorders, IPV, and sexual violence available in your area.

Pregnancy and Abuse

A 2015 study found that women who have eating disorders are at an increased risk for IPV during pregnancy (Kothari, 2015). Further research is needed on this subject, but it is important to note that rates of perinatal IPV range from 3.7% to 9% and are associated with mental and physical problems for both the parent and child (Hahn, Gilmore, Aguayo, and Rheingold, 2019). Sometimes pregnancy may occur from reproductive coercion. For instance, if one partner wants to have a child and the other does not. Pregnancy can also occur as a result of sexual assault.

Whether it was an isolated event, or if your partner is currently or has a history of being abusive, it is important to have a plan moving forward. Making a plan for maintaining good physical and mental health during pregnancy is crucial. The changes happening to the body and healing after sexual violence are a lot to handle at once. Preparing helps keep you focused on your goals throughout and after your pregnancy and also can help keep you and your baby safe. 

Visit https://www.thehotline.org/is-this-abuse/pregnancy-abuse/ for detailed information on safety plans during pregnancy.

Resources for help: 

• National Sexual Assault Hotline: 1 (800) 656-HOPE (4673)
• National Domestic Violence Hotline: 1 (800) 799-7233
• National Eating Disorder Helpline: 1 (800) 931-2237

References

Black, M. C., Basile, K. C., Breiding, M. J., Smith, S .G., Walters, M. L., Merrick, M. T., Stevens, M.

1. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 

summary report. Retrieved from the Centers for Disease Control and Prevention, 

National Center for Injury Prevention and Control:

http://www.cdc.gov/ViolencePrevention/pdf/NISVS_Report2010-a.pdf

Brewerton, T.D., Alexander, J., Schaefer, J. (2018). Trauma-informed care and practice for eating disorders: Personal and professional perspectives of lived experiences. Eating and Weight Disorders, epub ahead of print.

https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html

Chen, L.P., Murad, H., Paras, M.L., Colbenson, K.M., Sattler, A.L., Goranson, E.N., … Zirakzadeh, A. (2010). Sexual abuse and lifetime diagnosis of psychiatric disorders: Systematic review and meta-analysis. Mayo Clinic Proceedings, 85(7), 618-629. 

Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, National Crime

Victimization Survey, 2018 (2019).

https://www.thehotline.org/is-this-abuse/pregnancy-abuse/

Christine K Hahn, Amanda K. Gilmore, Rosaura Orengo Aguayo, Alyssa A. Rheingold. (2018). 

Perinatal Intimate Partner Violence. Obstetrics and Gynecology Clinics of North America,

45(3): 535–547. doi: 10.1016/j.ogc.2018.04.008

https://www.nationaleatingdisorders.org/health-consequences

https://www.nationaleatingdisorders.org/help-support/contact-helpline

https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml

https://www.rainn.org/about-rainns-statistics

https://www.rainn.org/articles/eating-disorders

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