Girls and women of childbearing age who may become pregnant can give themselves and their babies the best chance for a healthy pregnancy if they are within a normal weight range, take a daily prenatal vitamin and exercise regularly. That often means planning and a change in personal habits, which is something certified nurse-midwives can help pregnant women work toward even when they aren't in ideal shape.
Questions about issues every expectant mother should be aware of will be answered on Saturday from 10 a.m. to noon during the monthly Deseret News/Intermountain Healthcare Hotline. Angela Anderson and Angel Murdock, both certified nurse-midwives at Intermountain Medical Center, will answer calls.
From the Salt Lake area, call 236-6061. Elsewhere, the toll-free number is 1-800-925-8177.
While both women would like to see all their patients at a normal weight and exercising before they get pregnant, the fact is that "in our practice we deal with more overweight or obese moms," said Murdock. Being underweight — with a body mass index of less than 18.5 — is also an issue, but more women are too heavy when they get pregnant, she said.
"In that case, we recommend a weight gain goal for them and those recommendations are evolving," she said, noting every pregnant woman will gain weight, but some should gain less than others.
"The past recommendations of 25 to 35 pounds for a normal-weight woman going into pregnancy" has been revised, and those women "may want to aim more for the 20- to 30-pound range." Obese women should keep their weight gain to about 15 pounds, Murdock said.
While that may seem scanty, she said if heavy women are aware of what they are eating and they exercise regularly, "they have the nutritional and fat stores to provide enough energy for pregnancy so their babies are not underweight or malnourished."
In assessing diet, the midwives urge women to eat more nutritionally dense food like fruits, vegetables and lean meat. They ask patients to keep a three-day food journal listing everything they eat and in what amounts, so caloric intake can be determined and adjusted, if necessary.
The number of calories needed is individualized, based on the expectant mother's height and weight.
"We universally advise our patients to stay away from soda. There are some other foods they should avoid, like raw fish and very soft cheeses that may not have been adequately pasteurized."
She also tells women who plan to eat fish caught in local lakes, rivers or streams to check the mercury content of those waters before consuming the trout to make sure they are not inadvertently poisoning their baby.
Another big component for a healthy pregnancy is exercise, she said. "Many of our obese women are pretty sedentary. We get them on exercise regimens starting with 15-30 minutes of walking per day and working up to an hour." The women are instructed to monitor themselves to be sure they're able to carry on a conversation and are not feeling light-headed or dizzy.
Water aerobics and swimming are also recommended for those who have not previously had a firm exercise regimen.
Athletic women who are well-toned and in excellent shape can continue to run early in pregnancy as long as they're not having joint pain or light-headedness, she said. The midwives discourage skiing, water skiing and other sports during pregnancy to eliminate the risk of falling.
"As midwives, we're very big on being pro-active with your health. We feel like an ounce of prevention is worth a pound of cure."
Issues women should be aware of before and during pregnancy is the topic of Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Angela Anderson and Angel Murdock, both certified nurse-midwives at Intermountain Medical Center, will answer questions from callers. From the Salt Lake area, call 801-236-6061. Elsewhere, the toll-free number is 1-800-925-8177, only operational during hotline hours.