Delivering caring, personalized, quality healthcare to women in an environment that is supportive, education-focused and compassionate.

Pregnancy

Pregnancy and Back Pain – Tips from an Expert

The waddling gait, the hands pressed into the small of her back, mama-to-be is uncomfortable.

An aching back is such a common part of pregnancy that the waddling and back clutching is a stereotype of late-term pregnancy. But backaches can start much earlier in pregnancy. The vast majority of pregnant women will experience backaches during pregnancy. For many, it persists after the birth of the baby.

Tim Evens PT of Agility Spine & Sports Physical Therapy gave us the lowdown on why back pain is an issue during pregnancy and what to do to prevent and to treat back pain.

Why do so many pregnant women experience backaches?

As the baby grows and mama’s belly grows, the increased weight, shift in center of balance, and the increased mobility of some of the joints of the pelvis (hypermobility of the sacroiliac joint) all contribute to extra strain on the lower back. This added strain and resulting distorted movements with joints locked at the end range of motion can make daily life painful.

What can you do to prevent backaches during pregnancy?

A strong core and upright posture before and during pregnancy can help prevent backaches.

  • Squats help strengthen legs, abs and pelvic floor, and require balance and can be performed during pregnancy.
  • Balancing exercises, such as through yoga, can provide core strengthening
  • Avoid over stretching
  • Limit how much sitting you do each day
  • Exercise 30 minutes every day

When to contact a physical therapist?

Evens suggests that if back or pelvic pain is limiting daily function do not wait to seek help. Often it is an issue that can be easily addressed. The first port of call is your primary care physician who can rule out other issues. If this is a second or third pregnancy and this is a familiar pain you may wish to check in with your physical therapist’s office.

How can a physical therapist help you if you experience backaches?

A physical therapist can help you return to fully functional movement, and address tissue healing and trauma of back and pelvis pain. As many of these issues can be addressed simply, Evens encourages women to seek help if the pain is limiting their daily function. Don’t let it linger for months when it is easy to fix and can help reduce stress during a time that can be fraught with stress anyway.

At your appointment the physical therapist will evaluate your flexibility, strength, balance and posture. The therapist may manipulate or move your body to address immediate tissue issues, and almost always will provide you with at-home daily exercises to increase strength, mobility and flexibility.

How to perform a squat

Tips on how to perform a squat from Tim Evens Physical Therapist. Particularly important for pregnant women to maintain/develop core/pelvic strengthEvens provided these tips for performing an effective squat:

Hold your lower lumbar spine in a neutral position. As you squat the low spine should not flex (tail should not tuck under)

Make sure your knees do not move in front of your toes. This ensures that the majority of motion is coming from the hips

Remember good squats require good hip strength and flexibility.

 

This post was first shared on May 1, 2014 on TMC for Women

Outpatient lactation services receiving support from TMC Mega Raffle

Little Kailey Nowak decided to enter the world five weeks ahead of her due date. Her mom, Kelly, experienced difficulties with breastfeeding almost immediately. “She wouldn’t latch on, or if she did, it would only be for a few seconds,” she said. “It was awful. I cried every single day for six weeks as I pumped and fed my baby through a bottle. My plan was to breastfeed, and when I couldn’t, it truly felt like I was failing as a mother. People were

The family lives in Sierra Vista and with few lactation support services available there, Nowak’s pediatrician suggested she seek expert advice from the lactation specialists at TMC, where she had previously rented her hospital-grade breast pump. “I didn’t know what to expect, but the lactation specialists solved my problems and had Kailey successfully breastfeeding just two minutes into my session. It was the most magical moment of being a mom. I finally felt like I was doing a good job for her, and I wish I would have pursued this help sooner.”

The Mega Raffle provides funding for new moms to visit the outpatient breastfeeding clinic even if the service is not covered by their insurance or if they cannot otherwise afford it.

 

 

 

This is the fifth of our six-part series of blogs that show how the TMC Mega Raffle is making a difference for patients and the community.

 

19 lives saved, and counting: Cord Blood Awareness Month draws attention to benefits of Arizona Public Cord Blood Program

proclamation cord blood awareness month ArizonaArizona Governor Doug Ducey has signed a proclamation making the month of July Cord Blood Awareness Month. The proclamation generates attention about stem-cell-rich umbilical cord blood and how the Arizona Public Cord Blood Program, which Tucson Medical Center is a part of, is saving lives.

Each year, thousands of patients in the United States are diagnosed with a blood cancer or other life-threatening disease. Umbilical cord blood is a prime source of blood stem cells and can be a precious resource to a patient in need of a stem-cell transplant, since the cells can renew themselves and grow into mature blood cells. The advancement has proven to cure and treat as many as 80 diseases. The blood can be collected, stored and made available for transplant to children and adults with life-threatening diseases such as leukemia or lymphoma.

TMC is one of four hospitals in the state, and the only hospital in Southern Arizona, to offer this option to expectant parents as part of this program. The program also partners with the Tucson-based, nonprofit Save the Cord Foundation, which provides education. The Arizona Public Cord Blood Program is funded by the Arizona Biomedical Research Commission. There is no cost to families who choose to publicly donate their baby’s cord blood through this program.

“This proclamation highlights a special program that provides a lifeline to patients in need,” the governor said. “The generous gift of cord blood increases the odds of survival for cancer patients and gives researchers a chance to find a cure for genetic disease.”

Collecting the blood does not hurt the mother or the baby or change a woman’s labor or delivery. “This is a way for parents to give the gift of health to others in need,” said TMC Cord Blood Coordinator Kristen Wilt. “It’s one of the easiest ways to make a positive impact on the lives of others.”

One Arizona mom calls the decision to publicly donate a baby’s cord blood, “The best gift a mother can give another mother.”

Since the program’s inception in 2011, 19 cords have been selected for transplant in Arizona, meaning 19 lives have been saved. Since TMC for Women signed on to the program in October 2014, roughly 600 units of cord blood have been collected.

For more information about how to donate your newborn’s cord blood at TMC, please click here.

Togetherness for Mom & Baby Health – Why we promote rooming-in

Rooming in brings benefits for Mom & BabyIn a scene in the PBS series “Call the Midwife” , Nurse Jenny Lee (the main character) risks getting into trouble to sneak a newborn baby into an open ward so that a desperate mom can hold her child for the first time. It seems shocking today, but not so long ago, babies were kept in the nursery under observation while mom recovered in an open ward with other moms. Family and visitors would clamor for prime viewing spots outside the nursery window to see baby who lay swaddled and isolated beyond reach and comforting touch.

In recent years, as hospitals moved from open wards to private rooms, the practice of ‘rooming in’ has become common place, allowing moms and babies to stay together. Still, the practice of taking baby to the nursery to ‘give mom a break’ or a good night’s sleep continues. And indeed it would seem to make some sense, but research studies have shown that sleep patterns and breastfeeding are often better established when baby stays with mom and mom with support learns her child’s cues. For this reason we promote 24 hour rooming-in for new moms.

Mom to near 2 year old Felix, Cindy shares her experience rooming-in at TMC for Women,

I was going to the El Rio Birth Center and wanted to have a natural birth experience, but that wasn’t in the cards for me. At 41 weeks, it was time to go to the hospital. I was at TMC for two days before Felix was born via C-section. He was 10.5 lbs and a bit of a celebrity for the short time I was there. There hadn’t been such a big baby born in quite awhile. After the C-section, our midwife gave Felix to me right away…

Placed on Cindy’s chest immediately, Felix stayed with mom except for testing and a short time when Cindy cleaned up following the C-section.

The nurses at TMC were very kind and supportive and respectful of my need to have Felix with me at all times. I was there after the surgery for 3 days…It was amazing to have that little guy close to me, I wouldn’t have traded that experience for anything in the world.

What is the Newborn Nursery for?

Our Newborn Nursery is reserved for only those babies who need intensive observation or are having problems that prevent them from staying in their mother’s room.

Moms are encouraged to always keep their baby with them, and at the hospital their partner or a support person is welcome to stay overnight to help them with the baby, as they bond and get to know one another.

Why rooming-in is important

• Rooming-in promotes successful breastfeeding
• Keeping your baby with you at all times helps both of you sleep better
• The safest place for the baby is with the parent
• Being together strengthens your bond – the more time you spend together, the better you will know each other
• You will learn your baby’s cues, and the baby will be calmer hearing your familiar voice and your heartbeat
• You will feel more confident in your ability to care for the baby when you go home from the hospital

Resources
Keefe, MR.  Comparison of neonatal nighttime sleep-wake patterns in nursery versus rooming-in environments. Nurs Res. 1987 May-Jun;36(3):140-4. [Accessed 6-6-2014]

Pregnancy and Back Pain – Tips from an Expert

pregnant woman having back pain sitting on her bedThe waddling gait, the hands pressed into the small of her back, mama-to-be is uncomfortable.

An aching back is such a common part of pregnancy that the waddling, back clutching is a stereotype of late term pregnancy. But backache can start much earlier in pregnancy, and the vast majority of pregnant women will experience back ache during pregnancy and for many it persists post partum.

Tim Evens PT of Agility Spine & Sports Physical Therapy gave us the low down on why back pain is an issue during pregnancy and what to do to prevent and to treat back pain

Why do so many pregnant women experience back ache?

As the baby grows and mama’s belly grows, the increased weight, shift in center of balance, and the hypermobility of the sacroiliac joint all contribute to extra strain on the lower back. This added strain and resulting distorted movements and joints locked at the end range of motion can make daily life painful.

What can you do to prevent back ache during pregnancy?

A strong core and upright posture before and during pregnancy can help prevent backache.

  • Squats help strengthen leg, abs and pelvic floor, and require balance and can be performed during pregnancy.
  • Balancing exercise ex. yoga,  can provide core strengthening
  • Avoid over-stretching.
  • Limit how much sitting you do each day
  • Exercise 30 minutes every day

When to contact a physical therapist?

Evens suggests that if back or pelvic pain is limiting daily function do not linger to see help. Often it is an issue that can be easily addressed. The first port of call is your primary care physician who can rule out other pathologies. If this is a second or third pregnancy and this is a familiar pain you may wish to check in with your physical therapist’s office.

How can a Physical Therapist help you if you experience back ache?

A physical therapist can help you return to fully functional movement, address tissue healing and trauma of back and pelvis pain. As many of these issues can be addressed simply, Evens encourages women to seek help if the pain is limiting their daily function. Don’t let it linger for months when it is easy to fix and can help reduce stress during a time that can be fraught with stress anyway. At your appointment the physical therapist will evaluate your flexibility, strength, balance, and posture. They may manipulate or move your body to address immediate tissue issues and almost always provide you with some at-home daily exercises to increase strength, mobility and flexibility. 

Tips on how to perform a squat from Tim Evens Physical Therapist. Particularly important for pregnant women to maintain/develop core/pelvic strengthHow to do a good squat

Tim provided these tips for performing an effective squat.

  1. Hold your lower lumbar spine in a neutral position, as you squat low the spine should not flex (tail tuck under)
  2. Make sure your knees do not move in front of toes, this ensures that majority of motion is coming from hips
Remember good squats require good hip strength and flexibility.

Tim Evens PT., is taking part in the Tucson Medical Center ‘Oh My Aching Back’ series. In cooperation with TMC, the Center for Neurosciences, Tucson Orthopaedic Institute, Arizona Connected Care and Agility Spine hosts “Oh, My Aching Back,” a monthly series on back and neck pain.

Topics include:

  • March 20    Back Pain in Mid to Later Life
  • April 24       Weekend Warriors — Getting back in the game after a back injury
  • May 22       Workplace Back Issues

Talks are 5:30 – 7 p.m., in Marshall Conference Center on the TMC campus, 5301 E. Grant Road.

Please RSVP at (520) 324-3745

 

Preventing Congenital Birth Defects – At the heart of the matter

1 in every 33 babies is born with a birth defect. We want to help you reduce that risk. Learn more about prevention, detection, treatement and living with birth defects at www.cdc.gov/birthdefects.
One of the most harrowing documents I’ve ever had to read and then explain to someone was the autopsy report of my brother. He was just 24 years old when he died of a heart attack. A grown man, but still very much my little brother and my parent’s child. My science background put me in the unenviable position of reading the autopsy to explain to my parents in gentler terms why he died. As I said, harrowing.

Terms like “probable congenital heart defect” and “myocardial bridging” littered the autopsy report.

What does that mean? Probable congenital heart defect?

The coroner didn’t definitively know what caused the irregular rhythm or why the major artery that feeds the heart with blood was positioned within the heart muscle rather than on top (myocardial bridging).  The issues revealed in the autopsy had probably existed at birth (congenital). The defects could have a genetic origin, or perhaps a series of developmental missteps during his time in my mother’s womb or the first month after birth that resulted in my brother’s beautiful, but defective heart.  Maybe my mother was exposed to environmental toxins during pregnancy resulting in this horrifying cacophony of heart defects. Even the diets of parents prior to conception can have a role in the development of congenital disorders in their offspring. The reasons behind congenital defects are varied, complex and not as uncommon as we’d like. Congenital heart defects are the most common birth defects. One in 110 babies are born with a heart defect. Yes, one in 110.
It sounds hopeless, so many factors, so high the numbers of children and families impacted, but it isn’t hopeless. Medical research forges on, and gives us hints on how to reduce the factors that contribute to congenital heart defects. Not all birth defects can be prevented, but we can lower the odds.The following information is from the National Birth Defects Prevention Network.

1. Take a multivitamin with folic acid every day
Folic acid, a type of B vitamin, can help prevent birth defects such as spina bifida and congenital heart defects. It is important to have enough folic acid in your body evenbefore you get pregnant. Every woman who is pregnant or may become pregnant should take at least 400 micrograms of folic acid every day. To receive text message reminders about taking folic acid and other health tips for preventing birth defects from the Centers for Disease Control and Prevention (CDC), text REMINDERS to 87000.

2. Don’t drink alcohol or smoke tobacco during pregnancy
Drinking alcohol and smoking tobacco in pregnancy may increase the risk of having a baby with a heart defect. In addition, alcohol use in pregnancy can cause a child to have serious learning and behavior problems. There is no known safe amount of alcohol during pregnancy, so it is best not to smoke or drink at all if you are pregnant or planning to become pregnant.
Need help quitting smoking? Visit www.smokefree.gov or call toll-free 1-800-QUIT-NOW.

3. Talk to your doctor about medicines that you take
Some medications can increase the risk of having a baby with a heart defect. On the other hand, avoiding needed medications can be harmful. It is best to talk to your doctor about all of your medications before becoming pregnant, so that you and your doctor can agree on a treatment plan that is healthiest for you and your unborn baby. Also, be sure to tell your doctor about any herbal remedies or over-the-counter vitamin or mineral supplements you are taking.

For free information about the safety of medications and other exposures during pregnancy and breastfeeding, call OTIS at 1-866-626-6847.

4. If you have diabetes, keep your blood sugar in good control
Women with poorly controlled diabetes before and during pregnancy are at increased risk to have a baby with birth defects, including heart defects. Very high blood sugar levels can also increase the chance of pregnancy complications, of having an extra large baby, and of having a baby that is at increased risk for childhood obesity and diabetes. You can keep your blood sugar in a healthy range  by eating a healthy diet, exercising regularly, and taking medications (pills or insulin) as ordered by your doctor.

5. Maintain a healthy weight, both before and during pregnancy
Being very overweight (obese) may increase the chance of having a baby with a congenital heart defect. Obesity can also lead to the development of diabetes, which can have health risks for you and a baby.

6. Get vaccinated
Some infections during pregnancy, such as rubella, can increase the risk of congenital heart defects and other birth defects. Before you become pregnant, talk to your doctor about whether your vaccinations are up to date. Influenza (the flu) is more likely to cause severe illness in pregnant women than in women who are not pregnant. It is recommended that all women who are pregnant or may become pregnant during the flu season get the flu shot.

7. Know your family history
Certain genetic factors can increase the chance of having a baby with a heart defect. If someone in your family was born with a heart defect, or if you have questions about genetic testing for heart defects, ask your doctor for a referral to a genetic counselor.
To find a genetic counselor near you, go to the National Society of Genetic Counselors’ website (www.nsgc.org) and click on Find a Genetic Counselor.

We don’t know what caused that probable congenital heart defect in my brother -genetics, environment, some combination of the two. If you’re planning to get pregnant take control of the factors you can to lower the chance of birth defects. January is Birth Defect Prevention Month. Check out the National Birth Defect Prevention Organization and the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities.

Reblogged from TMC for Children

Kate Middleton has a baby AND a baby bump! More about the Postpartum Body

So it seems to be big news that Kate Middleton was photographed with a visible bump when she and Prince William left the hospital with wee baby George. Some posted comments on both news and gossip blogs pondering how it was possible that she was ALREADY pregnant and showing. Really? That would be quite a miracle. This response unfortunately reflects the unrealistic expectations for new mothers to return to their pre-pregnancy bodies immediately following giving birth.

The truth is, of course, that it takes a while for the uterus, that a day or two before held a dozen pounds of baby, placenta, and fluid to shrink to its usual size (that of a fist). It takes up to eight weeks for this process to be complete. So that bump is perfectly normal.

Breastfeeding aides in the return of the uterus to its original size.  Breastfeeding releases oxytocin, which causes uterine contractions, slowing bleeding and helping the organ to shrink. For women who’ve already given birth, these contractions are sometimes painful, like early labor–typically not the case for first births. But there is no way that any woman, breastfeeding or not, will have a flat postpartum belly.

Tucson’s own Jade Beall, whose photographs of mothers’ bodies in all their un-Photoshopped glory have received staggering attention around the globe recently, commented on the Kate’s post-baby photo on The Daily Beast:

This is a historic moment for women around the world. Kate has chosen to confidently show what our bodies can look like after undergoing one of the most life-changing feats a human can experience.”

I, for one, was thrilled to see Kate not only hiding under a tent-like dress, as was done in previous generations, but actually rocking an empire waist, accentuating the perfectly normal body of a brand-new mom. (Of course she also had perfectly coiffed hair, but that’s how it works when you have your own full-time stylist. Hey, I wouldn’t have minded a nice shampoo and blow-out after delivery…)

It’s so wonderful that what must be the most widely seen photo of a new mom this year is both beautiful and educational.Thank you, Kate, for not hiding the normal belly of a new mother. And thank you Jade, for your work in sharing the beauty of bodies in all their glorious forms.

Preeclampsia and Eclampsia at Downton Abbey

Oh Downton Abbey, how could you?

Alright, who was watching the fourth episode of Season Three? Spoiler Alert if you haven’t yet seen it and plan on soon

don’t

read

on.

lady-sybil-dies-baby-bransonLike many across the US watching PBS Masterpiece’s Downton Abbey last night, our household reeled as we watched the latest episode of Downton. The loss of the much loved Lady Sybil to eclampsia was shocking and senseless to us in this day and age, but less than a hundred years ago,  the maternal mortality rate was dramatically higher than it is today. In 1920, whether from infection, hemorrhaging, or toxemia (eclampsia), the possibility of death during or following a pregnancy was a concern for most pregnant women no matter how poor or how wealthy.

What is preeclampsia and eclampsia?

Preeclampsia is a pregnancy-related problem. The symptoms of preeclampsia include new high blood pressure after 20 weeks of pregnancy along with other problems, such as protein in your urine. Preeclampsia usually goes away after you give birth. In rare cases, blood pressure can stay high for up to 6 weeks after the birth.

Preeclampsia can be deadly for the mother and baby. It can keep the baby from getting enough blood and oxygen. It also can harm the mother’s liver, kidneys and brain. Women with very bad preeclampsia can have dangerous seizures. This is called eclampsia.

Less than 1 percent of women who have preeclampsia experience seizures.1 Eclampsia is life-threatening for both a mother and her fetus. During a seizure, the oxygen supply to the fetus is drastically reduced.

Sudden seizures can occur before, during, or (rarely) up to 6 weeks after delivery (postpartum). Postpartum seizures are most common during the first 48 hours after delivery.

Symptoms of preeclampsia and eclampsia

Preeclampsia is often a silent condition, the signs subtle or dismissed as just a ‘normal’ part of pregnancy – making prescribed bed rest particularly frustrating to a woman who feels fine. Sometimes there are symptoms:

  • Swelling (Yes a little in your feet might be fine, but around your face? hands? Get it checked.)
  • Sudden weight gain (Those repeated weighing measurements are not just some torture device; they have an important purpose. Watch for more than two pounds a week
  • Nausea or vomiting
  • Pain in the stomach area just beneath the ribs and/or shoulder
  • Migraine-like headache (If it doesn’t go away with your obstetrician-approved over-the-counter medication, call your provider that day.)
  • Vision changes (From flashing lights and light sensitivity to blurry vision, if your vision changes contact your provider immediately.)
  • Confused, muddled thinking, racing pulse, sense of anxiety (More than usual, see a doctor)

How is preeclampsia diagnosed and treated?

Today, the number of women who die as a result of eclampsia, or suffer complications from preeclampsia is much lower than in Lady Sybil’s time thanks to prenatal blood pressure monitoring, urine tests, and the use of magnesium sulfate and other anticonvulsants to treat seizures in women with eclampsia and prevent seizures in women who have preeclampsia. But the precise cause of preeclampsia and eclampsia is not known and there is no cure, only management and treatment. Which is why it is critical that all pregnant women get regular monitoring from their obstetrician or midwife.

During these visits, your blood pressure is measured with a blood pressure cuff. A sudden increase in blood pressure often is the first sign of a problem. You also will have a urine test to look for protein, another symptom of preeclampsia. If you have high blood pressure, tell your doctor right away if you also have a headache or belly pain. These symptoms of preeclampsia can occur before protein shows up in your urine.

Treatment of preeclampsia

The only cure? The end of pregnancy and even then as in Lady Sybil Crawley’s case the impacts of preeclampsia and eclampsia can be seen upto six weeks post partum.

If diagnosed your doctor may suggest:

  • magnesium sulfate or another anticonvulsant, if you have severe preeclampsia to prevent seizures
  • blood pressure medication to lower your blood pressure until post partum
  • corticosteroids if you have severe preeclampsia or HELLP
  • Bed rest or reduced activity (Dependent on the severity of the preeclampsia this might be just keep off your feet for a certain amount of time each day, bed rest at home, or bed rest in the hospital)
  • Toward the end of pregnancy or if the preeclampsia is particularly severe, it maybe suggested to induce labor, or to perform a Cesarean section.

For Lady Sibyl Crawley and women of that time, change in the treatment and management of preeclampsia and eclampsia was just around the corner, just not in time. Today, we still have no cure, and preeclampsia and eclampsia are still very serious medical conditions, but we do have treatment and management plans. For the healthiest pregnancy, we encourage keep up with your prenatal appointments with a obstetrician or midwife throughout your pregnancy.

(TMC for Women offers a free Healthy Pregnancy class one Sunday afternoon each month, with info on nutrition, exercise, fetal development and more. Especially useful for women and couples early in pregnancy, the next class is 4 p.m., Feb. 17, Sagebrush Room, Marshall Conference Center – and registration is not required.)

Resources
Tucson Medical Center Health Encyclopedia
Mayo Clinic

Folic Acid Soup – Getting folate into your diet.

Lentil and Brown Rice Soup from Debbie Koenig

Lentil and Brown Rice Soup from Debbie Koenig

The temperature just took a dip again, it’s gray and raining outside, and the idea of a warm bowl of soup or stew is very appealing. No wonder January is National Soup Month! January is also National Birth Defects Prevention Month – perfect timing for the healthy, warming, folate-rich soup suggested below. But, I’m not pregnant yet or planning on getting pregnant, so why bother with a prenatal vitamin like folic acid (Vitamin B9)? The rather blunt truth is that more than 50 percent of pregnancies aren’t planned. Yes, that’s right over 50 percent. And folic acid? It’s most important in those first few weeks of pregnancy. Those initial weeks where you probably don’t even know you’re pregnant. This is the time, as the cells that will become the brain and spinal column begin to differentiate, that folic acid is particularly important. Folic acid helps to prevent neural tube defects like spina bifida. It’s estimated that if all women of childbearing age were to take 400mcg of folic acid (also known as folate) per day, the occurrence of spina bifida and other neural tube birth defects would decrease by 70 percent. A stat not to be ignored. Folate is also important in red blood cell production, so for all adults getting sufficient folate acid can help combat anemia.

Don’t wait until  you get a positive pregnancy test. Folic acid is really something that needs to be part of any woman’s diet who is of child-bearing age.  There  are a couple of things that you can do

1. Take a Folic Acid supplement – 400 mcg a day.

2. Eat a diet rich in folate (the naturally occurring folic acid) or in foods fortified with folate like some cereals and grain based foods. Dark green leafy vegetables tend to be rich in folate, as are carrots, celery, asparagus, beets, avocado and parsley. Lentils and beans are a great source too, with a cup of lentils packing a mighty 358mcg of folate!

Back to the soup – the soup on the stove right now is super easy (chop veggies and add everything, but the parsley and cider in one pot and cook), and nutritious, packing around one third of the recommended daily 400 mcg of folic acid. The kids, including the toddler, love it, and it can be frozen. We found this recipe on Debbie Koenig’s Parents Need to Eat Too blog where it’s named Lentil and Brown Rice soup rather then Folic Acid Soup, which admittedly sounds more appetizing.

Get the ingredients ready and then head over to Debbie’s blog for the instructions.

5 cups low sodium vegetable or chicken broth (we used 3 cups of low sodium vegetable broth and 2 cups of water)
1 1/2 cups lentils, picked over and rinsed
1 cup brown rice
a 28-ounce can diced tomatoes (we threw in a few tomatoes as well that weren’t going to get used for the salad they were originally intended for)
3 carrots, halved lengthwise and cut crosswise into 1/4-inch pieces
1 onion, chopped
1 stalk of celery, chopped
3 garlic cloves, minced
1/2 teaspoon crumbled dried basil
1/2 teaspoon crumbled dried orégano
1/4 teaspoon crumbled dried thyme
1 bay leaf
1/2 cup minced fresh parsley leaves
2 tablespoons cider vinegar, or to taste (don’t forget this one- it makes a difference)
Optional – a pound of smoked sausage (not vegan if you add this)

Dependent on the broth used this soup can be vegan, gluten free and is dairy free.

If you’re pregnant or planning a pregnancy join us for our free Healthy Pregnancy Class held every month.

A healthy pregnancy starts here – 10 Tips for a healthy pregnancy

10 Tips for a healthy pregnancy.

Those two little blue/pink/red lines are just the beginning. Whether this is a long awaited pregnancy, or a little bit of surprise (more than 50% of pregnancies in the US are unplanned), we have tips from those in the know on a healthy pregnancy.

Pat Brown, Manager of Tucson Medical Center’s Newborn Intensive Care Unit, and Margie Letson, TMC for Women Childbirth Educator, had these tips for the newly pregnant expectant mom:

1. If you smoke, please talk to your doctor about a smoking cessation program.

Pregnancy can provide a powerful motivator for stop smoking, but ending a smoking addiction is difficult, get help to stop. 

2. Eat a healthy diet for you and your child.

Annette Miller MD encourages a healthy varied diet, but reminds us not to ‘eat for two,’ however great the temptation. “Between 2,000 and 2,500 calories is plenty for most women.” It depends on how physically active you are and if you’re carrying twins that adds another, well, little person to the mix. Talk to your physician if you’re unsure.

3. Keep your prenatal appointments throughout your pregnancy

Those appointments are scheduled for critical times in pregnancy. This isn’t just a case of listening to baby, but also other tests and measures that help ensure a healthy pregnancy and healthy baby. For example, your visits will probably include a urine test. This simple, quick and non-invasive test gives feedback on proteins, ketones, sugars and bacteria and detect, diabetes, bladder or kidney infections, dehydration and preeclampsia.Any of these issues could arise at any point in the pregnancy and the sooner they are dealt with the less impact on you and your child. Margie also suggests marking your calendar or planner with fetal milestones.

4. Take your folic acid

That multi-vitamin won’t work unless it includes Folic Acid. Whether you’re trying to get pregnant, not actively trying to prevent pregnancy or in your first trimester of pregnancy, get on the Folic Acid bandwagon. The estimation is that if every pregnant woman took Folic Acid prior to pregnancy and throughout pregnancy neural tube disorders like Spina Bifida and anencephaly would decrease by 70 percent. The Centers for Disease Prevention and Control recommend 400 micrograms per day, and those women who have already had a child with Spina Bifida or other related birth defect are encouraged to up that dose to 4,000 micrograms.

5. Take Childbirth Education Classes

Whether this is your first or your third baby there is always something new to be learned and new fellow parents to meet (and their children could be potential playmates for your little one). Your first class could be Healthy Pregnancy , a free class for first-time parents in their first trimester. We also have classes for those wanting to try for a vaginal birth after a C-Section, and a whole series of basic childbirth classes including a crash weekend course  for those who want to squish it all into one weekend.

6. Ignore odd advice or freaky birth stories from strangers at the grocery store or random blogs

(TMC blogs are OK!) Pregnancy seems to be an invitation to all sorts of folks known or unknown to share advice and tales of horror. At one level, it demonstrates just how amazing pregnancy is that people want to share some aspect of it, but it can be a little disturbing, along with the uninvited rubbing of your pregnant belly by anyone other than a small child, who can be excused.

7. Know signs of premature labor

  • Regular contractions for an hour
    This means about 4 or more in 20 minutes, or about 8 or more within 1 hour, even after you have had a glass of water and are resting.
  • Leaking or gushing of fluid from your vagina. You may notice that it is pink or reddish. This is called a rupture of membranes, also known as your water breaking. When this happens before contractions start, it’s called premature rupture of membranes, or PROM. When it happens before 37 weeks of pregnancy, it is called preterm premature rupture of membranes, or pPROM.
  • Pain that feels like menstrual cramps, with or without diarrhea.
  • A feeling of pressure in your pelvis or lower belly.
  • A dull ache in your lower back, pelvic area, lower belly, or thighs that doesn’t go away.
  • Not feeling well, including having a fever you can’t explain and being overly tired. Your belly may hurt when you press on it.

7. Be prepared.

Read the sections of the pregnancy books on interventions, even if you plan to have birth without interventions. Most C-sections are unplanned; best to know just in case, as Julie explains in this post.

8. Know comfort techniques

They make a difference. Our healthy pregnancy class teaches these techniques.  I still use the techniques I learned as meditation in stressful situations.

9. Avoid excessive stress (physical & emotional)

I know, easier said than done. Talk with your partner, trusted family and friends about how you might do this if you’re likely to get into stressful situations.

10. ENJOY the pregnancy – believe it or not, it will fly past.

Tucson Medical Center offers a FREE Healthy Pregnancy class each quarter, providing consumer-friendly information on nutrition, exercise, fetal development and more. The class should be especially relevant for those in their first trimester of pregnancy, and each session includes a tour of the Labor & Delivery and Mom/Baby units.

Registration is not required.

For information on any of TMC’s Childbirth Education classes, call 324-1817.