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September 17, 2014
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Taking Care of Mom: Why Women’s Health Matters Most

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“Tulsa County has a higher rate of premature births and infant deaths than the State of Oklahoma or the nation.”(source Healthy Women, Healthy Futures, OU-Tulsa)

It really is all about Mom. For generations mothers have been blamed and credited for everything. It turns out that biology may support that claim. While the scientific research is relatively new, the implications of what we now know about the impact of a woman’s environment on the health of her baby before, during and after pregnancy may dramatically change the way we look at women’s health.

Last October Michael Lu, M.D., MPH, a national expert on maternal/child health from UCLA was the keynote speaker at a conference on maternal health hosted by OU-Tulsa.  Dr. Lu, author of “Get Ready to Get Pregnant,” Dr. Lu has been recognized for his work using the Life Course Perspective, which addresses the influences of the biological, social and environmental impacts on a woman throughout her life, not just during the 9 months of pregnancy. Dr. Lu was recently named Associate Administrator of the Maternal & Child Health Bureau (MCHB), which oversees the Block Grant Program of Title V of the Social Security Act, the Healthy Start Program, Universal Newborn Hearing Screening, Emergency Medical Services for Children, Sickle Cell Services and Family to Family Information Centers.

The Life Course Perspective

In light of new science, OB-GYNs and other medical and mental health professionals now know that even the point of conception is too late for women to plan for the best outcome for their babies. And, because over half of all births in the United States and 65 percent locally are unintended, it is critical that women of childbearing age receive information about prenatal care long before they have children.

“We’re pushing reproductive life-planning,” Dr. Lu said. “Doctors need to ask their patients at every visit if they [patients] have a reproductive life plan, about their personal goals about having children, and under what circumstances they want to have children before they get pregnant.”

Such things as high blood pressure, being under or overweight, medications, social and mental health, inflammation and nutrition can all affect a developing fetus. Dr. Lu believes that these issues must be addressed throughout a woman’s life rather than at the point of conception.

Dr. Lu says that pregnancy is too late to begin prenatal care. “Doctors should target every woman, every couple, every time they see them. The fate of the pregnancy has been written in implantation. A baby’s vital organs are being programmed inside the womb.”

Everything from the mother’s nutrition to her stress level can affect her developing child, not only at birth, but throughout life.

Su An Arnn Phipps, Ph.D., RN, CNE, is the director of Healthy Women, Healthy Futures and assistant professor in the College of Nursing at OU-Tulsa. She said that a reproductive life plan should take into consideration all areas of a woman’s life. “We tend to think of [reproductive planning] as just birth control,” she said. “But women need to ask, how will this pregnancy impact the rest of my life?”

Part of the plan should include careful spacing of children with pregnancies being no closer together than 24 months.

“I hear women say that they want their children to be close together so they’ll be close friends,” Phipps said, “but women don’t realize the toll having a baby has on their body. You want your body to be as healthy as it can be when you get pregnant.”

Women of childbearing age should also be taking a multivitamin every day to ensure that they get enough folic acid, which is crucial to preventing spinal chord abnormalities. The spinal chord forms within the first three to six weeks of pregnancy, often before a woman knows she’s pregnant.

Nutrition

Pregnant women should be eating for quality rather than quantity, with the first trimester caloric needs being about the same as non-pregnant needs said Dr. Lu. After that, women can add 350 calories a day during the second trimester and about 500 calories during the third.

According to Jennifer Hays-Grudo, Ph.D., George Kaiser Family Foundation Chair in Community Medicine and professor of medicine in the OU School of Community Medicine, pregnant women need to stay within the recommended weight guidelines, which is relatively new thinking for this generation of pregnant women.

“If you’re overweight, you’re not supposed to gain more than 15 or 20 pounds,” she said. “Mothers who are overweight or obese, or mothers who gain more than the recommended amount of weight are more likely to have children at risk for diabetes and obesity, and this has been found in children as young as 7 years old.”

Moreover, the risk doesn’t stop with one generation. Hays-Grudo said that animal studies show that when mothers have too much glucose in their bloodstream and are producing too much insulin, the metabolic regulatory genes of the children actually become permanently altered.

“The gene that is switched off [by the mother having too much glucose] actually gets passed along in that switched off state to subsequent generations,” she said.

While not every overweight mom will have an overweight child, “knowing that pregnancy is a critical time because of the response of the fetus’s DNA to the mother’s environment” means that women should monitor how much weight they gain during pregnancy.

In order to maintain a healthy weight and get good nutrition, Dr. Lu recommends that pregnant women eat more whole foods such as whole grains, vegetables, fruits, beans and nuts and less processed foods. Top brain foods include beans, eggs, nuts, olive oil, wild salmon, yogurt, whole grains, spinach, kale, prunes, berries, oranges and red bell pepper. Toxic foods include swordfish, mackerel, soft cheeses and unpasteurized milk, hotdogs, luncheon meats, raw or uncooked meat, liver (vitamin A overdose), saturated fats, transfats, partially hydrogenated vegetable oil, added sugar and refined flour.

And, for optimum maternal and fetal health, women should maintain a healthy weight for three to six months prior to pregnancy.

Outside Environment

“Detoxify your home,” he said. “Get rid of anti-bacterial soap, air fresheners, glass cleaners with ammonia, vinyl wallpaper and blinds and #3, #6 and #7 plastic bottles.”

While you may think that bar of anti-bacterial soap in your shower is benign enough, Dr. Lu said that you should get rid of it. And that plastic office water cooler jug? Don’t use it. Most office coolers are #7 plastic.

“Detoxify your home,” he said. “Get rid of anti-bacterial soap, air fresheners, glass cleaners with ammonia, vinyl wallpaper and blinds and #3, #6 and #7 plastic bottles.”

During pregnancy, avoid dry cleaning, too. Dr. Lu said that the chemicals are a proven reproductive toxin. If you must pick up the dry cleaning, open all your car windows and air out the clothes for at least one hour once you get them home.

Smoking, drinking and substance abuse are also damaging to a baby. “Smoking and drinking during pregnancy sets a child up for learning difficulties,” Hays-Grudo said. “It affects the way the brain is structured.”

 

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