Preconception & Pregnancy Care

With the enormous rise in childhood chronic disease such as allergies, eczema, asthma, autism, diabetes and attention deficit disorder, there are steps that future parents can take to help reduce the risk of their child being affected. All of these conditions are complex, and I am not claiming to know a fail-proof way to eliminate risk entirely, but there are steps you can take preconception that make a clear impact. Here are some starting points:

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Naturopathic Prenatal Care

A “Conception Care Program” is offered to follow you through a healthy pregnancy, with regularly schedule appointments to complement your care with a midwife or Obstetrician. There is ample time in your appointments to answer your questions, and also to help with the decision-making process with prenatal testing options, childbirth interventions and post-natal care.

Post-Natal Support

Once your baby arrives, the clinic offers support in many areas including:

improve your energy levels
nutrition support
breast feeding difficulties
postpartum blues or anxiety
sleep issues
losing baby weight
optimal supplements for the post-partum time

This is an important time for rebuilding your health and energy reserves, and this is where naturopathic care can help by offering support to bring you back into strong, vibrant health.

In the first weeks postpartum, phone consultations are available to existing patients to discuss any difficulties in the early days.

Other Clinic Services

Our clinic also has practitioners who would love to support you through pregnancy.

1. Pelvic Floor Physiotherapy

A pelvic floor physiotherapist has completed post graduate certification in and treating your pelvic floor muscles which are a part of your core (pelvic floor, diaphragm, transversus abdominis, multifidus). The gold standard for knowing how your pelvic floor is working is with an internal assessment since these muscles exist inside your pelvis. Your pelvic floor is the exactly what it sounds like – the floor of your pelvis which has many key jobs- stopping you from leaking urine (common but NOT normal before, during or after pregnancy) and stool/gas, supporting your tailbone, pelvis, low back, pelvic organs and baby, sexual functions and lymphatic flow in your pelvic region. Finding out if these muscles are tight/weak or loose/weak are key in guiding you through pregnancy, childbirth and beyond. Many women assume these muscles are loose BUT they can actually be tight just like any other muscle in our body. If this is the case it is important to release these muscles through manual release, breathing techniques and stretches since when childbirth time comes, if these muscles are still tight this can contribute to vaginal tearing plus you can still continue or begin to have incontinence or pelvic organ prolapse. Pelvic floor physiotherapists also check if you have a diastasis (abdominal separation) which happens by the end of pregnancy for most women if it is your first child but if it is a subsequent pregnancy you may be entering pregnancy with already having a diastasis.

2. Acupuncture

Acupuncture treatments are safe and effect to reduce nausea, reduce back and hip pain in pregnancy, and also to help initiate labour if you go past 40 weeks as a form of natural induction.

3. Osteopathy

Osteopathic care is very helpful for aches and pains as your body changes and grows, and to support optimal alignment in pregnancy.

4. Mental Health Therapy

Anxiety and fear can be a part of the prenatal experience. These feelings can arise from many situations, including, but not limited to, a prior miscarriage, anticipating labour and doubting your competency as a mother. If there has been a loss in the family a pregnancy my stir up feelings of grief. Pregnancy is a time of process and psychotherapy can help you find trust and patience for your body.

Creating Healthy Babies

Nutrition:

Nutrition is key, especially minimizing any deficiencies of key nutrients. This means eating sufficient dietary protein, a diet rich in colourful fruits and vegetables, lots of dark leafy greens as a source of natural folate, DHA and omega-3 fats, and minimizing sugar and foods made with white flour.

Another factor with nutrition is to address food intolerances and sensitivities, as they cause inflammation and immune system stress. This may affect the ability to conceive, can definitely aggravate any inflammatory conditions (for example, endometriosis, inflammatory bowel disease, joint pains), and inflammation in pregnancy can affect the health of your future baby.

Supplements:

There is plenty of evidence stating the importance of starting prenatal vitamins 3 months preconception, and most of us are aware of the need to take folate supplements in order to prevent neural tube defects. One study in particular (1) showed that in genetically susceptible mothers who took prenatal vitamins 3 months preconception and in the 1st month of pregnancy, had a 720% decreased relative risk of autism in their child. These stats are quite remarkable, given the fact that the genetic susceptibilities discussed are carried by 10-25% of the population. They included MTHFR, CBS and COMT – more about these will be discussed below.

A high quality prenatal vitamin is recommended preconception, and one that contains adequate support for methylation, meaning the correct forms of folate, vitamin B12 and vitamin B6 especially. Additional supplements may include: vitamin D, omega-3 supplements, and possibly extra zinc and iron if needed. If a woman is over the age of 35, then extra antioxidants to support egg quality would also be recommended, especially Coenzyme Q10.

Genetic testing:

Given the volume of recent research on genetic polymorphisms, especially one called MTHFR (Methylenetetrahydrofolate reductase), which is an enzyme that converts folate into the readily usable form called methylfolate. When someone carries a defect in the MTHFR gene, there is a reduction in methylation by up to 90%. Some general health effects of MTHFR defects include: heart disease, stroke, high blood pressure, anxiety, depression, migraines, cancer, addictions, and high homocysteine levels. If your family history contains many of these issues, especially heart disease presenting at a young age (under 60), testing for MTHFR is highly recommended.

The MTHFR polymorphism can affect the following related to pregnancy and conception:

Neural tube defects (spina bifida, anencephaly)
Cleft lip and cleft palate
Congenital heart disease
Pregnancy induced hypertension
Miscarriages related to blood clots
Infertility
Autism (2)

Gastrointestinal health:

An additional factor to address preconception is maternal gastronintestinal health, especially the balance of organisms in the gut. Dysbiosis or imbalance of digestive flora has been associated with type II diabetes, obesity, inflammatory bowel disorders, mood disorders, among others. Given that the newborn baby’s gastrointestinal tract is first ‘seeded’ with bacteria through vaginal birth, maternal balance of flora is very important to a newborn’s health. Having an improper balance of organisms can also affect the progression of pregnancy: dysbiosis and too much of the ‘wrong’ bacteria has been linked to premature rupture of membranes and premature birth (4).

Supporting digestive health can also reduce the risk of allergic disease in children. For example, taking probiotic supplements in pregnancy reduces the risk of allergies by 12% (3).

Other factors to address:

There are many other factors to address in a preconception plan, with the aim being to have both parents in optimal health first. Here is a short list of considerations:

Alcohol intake (maternal and paternal intake preconception are relevant).
Infections – certain infections can affect fertility and pregnancy outcome (chlamydia, trichamoniasis, and others).
Stress levels.
Autoimmune conditions.
Being optimal body weight.
Blood sugar metabolism / insulin resistance and pre-diabetes (All can increase your risk of gestational diabetes, and can also affect future child’s susceptibility to blood sugar disorders later in life).
Medication use – maternal and paternal.
Toxin exposure.

This is an exciting topic, as we learn to take more proactive approach to preconception. It is amazing how small changes before conception, and spending time focusing on parental health can have such a great impact to reduce health risks in our children.

References:

Schmidt, Rebecca, Hansen, Robin, Hartiala, Jaana, et al., Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk of Autism, Epidemiology, Vol 22, No. 4, July 2011; 476-485
James SJ, Melnyk S, Jerginan S, et al. A functional polymorphism in the reduced folate carrier gene and DNA hypomethylation in mothers of children with autism. Am J Med Genet B Neuropsychiatr Genet. 2010;153B: 1209-1220
Elazab N, Mendy A, Gasana J, et al. Probiotic Administration in Early Life, Atopy, and Asthma: A Meta-analysis of Clinical Trials. Pediatrics. August 2013.
Fortner KB, Grotegut CA, Ransom CE, et al. Bacteria Localization and Chorion Thinning among Preterm Premature Rupture of Membranes. PLOS One. January, 2014