Pregnancy Blues

I’m officially three weeks postpartum and am adjusting to being a mama of two. I love the newborn stage- the constant snuggles, their smell, their tiny fingers and toes, those little reflexes, their sweet innocence. And of course the best part…they can’t talk back! If kids stayed babies forever I don’t think I would be able to stop having them! Although some days certainly have been tough (as expected), I am loving it. And even though miss those tiny little kicks and hiccups in my belly, it’s nice to be able to snuggle little Sadie on the outside now.

My pregnancy with Sadie was much different than Carli’s, and somewhat difficult. I had the picture-perfect textbook pregnancy with my first. I exercised regularly, ate almost perfectly, gained the appropriate amount of weight, was extremely happy and excited, became emotional only over the expected stuff (Publix commercials and Mother’s Day ads), and nested the entire nine months. I couldn’t wait to be a mom.

I expected things to go about the same with this pregnancy- I loved being pregnant the first time and didn’t expect to feel any differently with my second. My first trimester was about the same, only leaving me slightly more nauseous. Early in my second trimester we found out we were having another girl- exactly what I wanted. I was ecstatic, and my motivation built to get the girls’ rooms ready, wash and sort out Carli’s baby clothes that had been put away, and start organizing the house to make room for another baby. I couldn’t believe that I was getting exactly what I  had always dreamed about since I was a little girl- raising sisters! It all seemed so surreal.

When I was about 20 weeks pregnant things changed. I can’t really pinpoint what happened, or if there was a certain event that caused it, but my mood instantly shifted. I no longer felt like I was in control of my emotions. I was constantly crying for no reason and lost my motivation to do anything. I became increasingly negative, my appetite became poor, and most days it was hard to function. Even something as simple as making a grocery list seemed daunting. I lashed out and distanced myself from my husband, became a lot quieter around friends, and just went through the motions when I was taking care of Carli. A lot of the time I would sit her in front of a movie so she wouldn’t notice when I went upstairs to cry. In some ways I felt helpless- and also very angry. It terrifies me to not be in control. I didn’t understand why I couldn’t just snap out of it. I didn’t know what was wrong with me- my usual personality had done a complete 180, and I  had no idea how to feel like myself again.

People started to notice, and I brushed it off,  blaming it on lack of sleep. It’s easy for me to be vulnerable about things that have happened in the past, but it’s extremely hard for me to be transparent about things I’m currently going through. I don’t like being a burden to people, and most of the time I’ll brush things off thinking it’s no big deal. There are people out there dealing with much worse! I felt selfish and angry with myself. Here I was, carrying a perfectly healthy baby girl with another beautiful and healthy toddler at home, and yet I felt completely torn apart inside. What was wrong with me??

At my 28 week prenatal visit my doctor’s office gave me a depression screen to fill out- normal protocol at that stage in the pregnancy. I remember answering the questions honestly and it giving me a pretty big wake up call. My doctor is amazing, and we had a pretty in-depth discussion about how I had been feeling. I remember telling her that I thought I may have postpartum depression- but I wasn’t postpartum! I had no idea that it can be common to have depression symptoms during pregnancy as well- these mothers being more at risk for postpartum depression. Pregnancy hormones can do some crazy things!

I had never understood how a mother could even go through something like postpartum depression. To me, pregnancy and childbirth were so romanticized, something absolutely wonderful. What in the world could cause a mother to be depressed after going through something so incredibly amazing- giving birth to a sweet baby? It never made sense to me, until now. It’s not something they could necessarily control. They weren’t bad moms for feeling that way either.

It’s hard for me to ask for help. But I was fully aware that if I didn’t I wasn’t only hurting myself, I was hurting my kids. And my poor husband! My doctor and I both decided that I wasn’t high enough risk to need any sort of medication, but I did agree to see a therapist who specializes in working with pregnant women. And honestly, it felt so great to be able to talk to a complete stranger about every little thing. I could fully unload everything I had on my mind to someone who didn’t know or judge me. She helped me to change my line of thinking to thoughts that were more realistic and grace-filled. She taught me how to deal with some of the emotions I  didn’t know what to do with.

Beach therapy

Along with getting professional help, I can’t be thankful enough for the support of my friends. They reached out to me, offered to help in any way they could, and most importantly they prayed for me. The minute I  finally opened up about how I was feeling to some of my friends, I felt as if a burden had been lifted. I no longer felt lonely, I felt support.

By the middle of my third trimester, I was already starting to feel more like myself again. And now, three weeks postpartum, I feel better than I have in months. I’m sure my husband would tell you I’m still slightly nuts- but I think it’s much closer to a level of normal for just having a baby a few weeks ago! I’m not sure where my emotional state would be right now if I hadn’t reached out for help. I don’t feel any signs of postpartum depression right now, and I’m keeping myself very aware of how I’m feeling mentally. I think it’s normal to feel a bit overwhelmed and stressed in this stage of life, but it’s not to the point where it is debilitating. If it gets to that point, I may need to reach out for help again. And I’ve accepted that it’s okay- I need to take care of myself first so I can be the best possible mom for my kids.

To keep myself grounded, I’m trying harder than ever to lower my expectations for myself and my family. More grace, more laughter, more messes, and a greater appreciation of the place I am in my life right now. Understanding that it’s not always going to be easy, and to accept that. To laugh at myself more and be kinder to myself. To ask for help when I need it, and accept that I can’t control everything.

So to anyone who was in my line of fire the past few months- I’m sorry. Thank you to everyone (especially my husband and Carli) who gave me unending grace. If you prayed for me, I felt it. If you fed me, if you offered to help in any way, if you just texted asking me how I was doing- you have no idea the impact that had on me.  From the bottom of my heart, thank you.

 

Running with my bump

I’ve been a runner for several years, mostly training for and competing in distance events (my favorites being 15ks and half marathons). When I became pregnant with my first daughter, I knew I wanted to continue running, but wasn’t sure of any risks or benefits that would be associated with it. I had friends who ran up to their 40th week of pregnancy, and I was hoping that could be a goal of mine as well.

There are quite a few myths out there about exercising while pregnant. I’ve heard many (older) fitness instructors say pregnant women should not get their heart rate above 140 (not true). I’ve also heard that abdominal exercise should be avoided and that running can be too jarring for the baby (both also not true). The American College of Sports Medicine recommends exercising while pregnant because there are so many proven benefits. Of course, it’s important to be safe. The safe level of exercise depends on the fitness level of the mama.

Running with both my girls- 33 weeks pregnant

Right before I became pregnant with Carli I ran my fastest marathon to that date. I had been training hard all fall, and already had a 15k and half-marathon under my belt (both were PRs for me at the time). I’m a prime example that strenuous training does NOT make you infertile, and I found out I was pregnant with her 3 weeks after the marathon. My body was already in great shape from all the training I had done that fall, so I was able to continue running at about the same speed and distances. Instead of keeping a watchful eye on my heart rate monitor, I exercised at the intensity I felt comfortable at. Some days that was a 7:30 min/mile pace. Other days it was closer to a 9 min/mile pace. Some days I had to stop and take walking breaks, other days I could run 8 miles continuously. The bigger my belly grew, the slower my pace and distances became. Once I hit about 25 weeks I started using a belly support band during runs. This not only kept my belly more comfortable but it also lifted some of the strain off my back.

By the time I was 35 weeks pregnant with Carli I was still running 4-5 days per week, with 5-6 miles being the longest distance I could cover. My last week of pregnancy I was able to run 3-4 miles maximum, and ended up running 3 miles the day I went into labor with her.

A 5k I ran when I was 26 weeks pregnant with Carli

 

A 5k I ran recently- 31 weeks pregnant with my second baby girl

As a runner, one of the best benefits to maintain my running while pregnant was the effects it had on my fitness level post-partum. Even though I was training at much shorter distances and speeds, my body had to learn to be more efficient at transporting oxygen to my working muscles and the baby. Studies have shown that a person’s VO2 max can actually increase when exercising while pregnant, and this definitely proved to be true once I was able to start running again post-partum. I ran my fastest 5k when she was only 3 months old (I didn’t start running again until she was about 7 weeks old). I ran a personal best half-marathon when she was nine months old and beat my marathon time by 5 minutes when she was 19 months old. The crazy thing was, I wasn’t training as hard as I was before I got pregnant- I didn’t have the time to! I really think that my fitness level just improved over the course of my pregnancy, and I was able to maintain that once I started running again.

My first half marathon post partum

With this pregnancy, I’ve been incorporating more strength training. I’m horrible about resistance exercises, in fact, I HATE them. I can run all day long but I hate picking up a dumbbell. Because I wasn’t weight lifting much before I got pregnant, I don’t push myself in this area. There are a few total body conditioning type classes at my gym, which focuses mainly on light weights and a lot of repetition. One class I absolutely love and plan on sticking with it until the baby comes. I’m not overly straining myself, but I’m also building muscle in areas other than just my legs which feels nice.

Something else I’m doing that I didn’t with my first pregnancy is more abdominal exercises. I’m not trying to have a six-pack form immediately after she’s born, but mainly to build strength in my core which can be beneficial for labor and recovery. If there is core work in a fitness class I’m attending, I do have to modify it at times. Doing a full sit up (from laying to sitting position) can put too much strain on the ab muscles and cause them to tear.

After a 4 mile run- nine months pregnant with Carli

Here’s some encouraging evidence about exercising while pregnant from the IOC, based on a systemic review of studies:

  • There is little risk of abnormal response in the baby’s heart rate when exercising at <90% of maximal heart rates in the second and third trimesters.
  • Baby’s birthweight is less likely to be excessively high, but also not a greater risk for being at a low birth weight
  • Exercise does not increase the risk of preterm birth.
  • Exercise during pregnancy does not increase the risk of induction of labour, epidural anesthesia, episiotomy or perineal tears, forceps or vacuum deliveries.
  • There is some evidence that the first stage of labor (before full dilatation) is shorter in exercising women.
  • Exercise throughout pregnancy may reduce the need for caesarean section.
  • Exercising while pregnant can decrease risk of developing gestational diabetes or preeclampsia
  • Exercise can reduce maternal weight gain
  • Exercise enhances psychological well-being (something that has been crucial for me this pregnancy- those hormones have been extra crazy this time around!)

So yes, exercise (in elite athletes, even strenuous exercise) is safe during pregnancy. I have gotten some disapproving looks or looks of shock from some when I’m out running with my big ol’ belly. I know it probably seems weird to some people. But as long as I’m listening to my body, I know both me and my baby are safe.

 

Eating for Two

I would have to say that one of the biggest differences between this pregnancy and my first is that I’m a lot less strict about what I’m eating. The first time around I cut caffeine cold turkey, obsessed about calories (was I  getting too little? Too much?) and tried to avoid heavily processed foods as much as possible.  I was so worried that the smallest glitch in my diet would produce a baby who wasn’t healthy, and I didn’t want to be responsible for doing anything to potentially harm her.

Now even though I still make sure I’m eating as healthy as possible to give both myself and my growing baby the nutrients we need, I’ve definitely learned that balance is okay. I’m also trying to not focus so hard on what I shouldn’t be eating, and more on what I should be eating. When I know I can’t have something, it makes me want it even more. All I want is a deli sandwich for lunch and a large plate of sushi with wine for dinner. Why is it that the foods I know I can’t have are the ones I crave the most??

Most OB doctors and midwives spend a good deal of time talking with expecting mothers about the foods that are off limits. Rarely is there time spent on reviewing the foods and nutrients that bring benefits to expecting mothers and babies- even though it’s just as important!

Pregnancy is a time of high metabolic and nutrition demands. It’s important to remember that even though you are feeding both yourself and baby, the baby is not the size of another adult. Calorie needs are higher during pregnancy, but you don’t need to literally “eat for two.” Conversely, it’s important to meet the higher calorie needs to support a healthy growing environment for your baby. Eating too little can cause intrauterine growth restriction, low birth-weight, and may even set metabolic markers in place that results in the baby being more likely to become obese as an adult. There’s evidence that if that baby’s not getting adequate nutrition in utero, it causes their tiny bodies to think they will have very little to survive on. This can result in their metabolism being impacted long term. A poor diet during pregnancy can also put the baby at risk for insulin resistance, type 2 diabetes mellitus, and cardiovascular disease later in life. So what can you do to make sure you are giving your growing baby and body everything it needs?

What you need

Folic Acid

This important nutrient is found in all prenatal supplements. In fact, it’s role in neural tube defect prevention is largely why practitioners say taking a prenatal vitamin is so important! I actually recommend that women of childbearing age aim to get an ample amount of folic acid in their diets, either from foods or a supplement, before trying to get pregnant. The reason? Because of the amount of development that happens in those first few weeks post-conception, you’ll want to make sure that you aren’t folic acid deficient from the start. Food sources of folic acid include orange juice, fortified cereals, beans, lentils, leafy greens, and whole grains.

Iron

Iron needs are high during pregnancy due to increased blood volume, fetal development, and the possibility of blood loss during delivery. Iron needs increase as the pregnancy progresses. It’s important for proper brain function, especially in the development of the hippocampus (which is responsible for memory formation and emotional regulation). Because the baby’s brain experiences a growth spurt in the 3rd trimester and then relies on iron stores obtained in utero to sustain growth for the first sixth months of life, consistent and adequate iron intake is essential during pregnancy. Children who aren’t exposed to enough iron prenatally have been shown to have poor cognitive and motor skill development due to improper gray-matter organization. Iron-deficient children tend to suffer learning and behavioral problems and also show abnormal cognitive development into their late teens.

Iron is found in a variety of plant and animal foods as well. The type of iron found in animal foods (red meat, seafood) is referred to as heme iron, and is absorbed best by our bodies. Nonheme iron is found in many plant foods, the best sources being spinach and other leafy greens, dried fruits, beans and peas, tofu, seeds, nuts, soy milk and fortified breakfast cereals. Nonheme iron has a decreased rate of absorption by the body, so if you are getting most of your iron from non-animal sources try consuming a good source of Vitamin C in the same meal. The acidity will help to absorb the iron. Avoid consuming nonheme iron sources with foods high in tannins and phytate (coffee, tea, bran, soy and pinto beans, potatoes) because they compete for absorption and reduce iron availability. Iron isn’t commonly found in prenatal supplements, since the calcium found in these will bind to it and reduce absorption. If you are anemic you may need to take an iron supplement throughout your pregnancy.

Calcium

Calcium absorption is increased in pregnancy, which typically results in positive calcium balance. You will still want to get calcium from food sources, because prenatal supplements only provide about 500mg (the maximum amount that can be absorbed by the body at once). Aim for at least 2 extra servings of calcium per day. Aside from cow’s milk, good sources include yogurt, leafy greens, beans, soy/nut/rice/hemp milk and fortified juices and cereals.

Vitamin D

Vitamin D deficiency during pregnancy is currently the focus of ongoing research. It has been suspected to be linked to preeclampsia, low birth weight, poor postnatal growth and higher incidence of autoimmune disease in babies. The best food sources of Vitamin D is oily fish, fortified foods (some dairy products, soy milk, cereals), egg yolks and cheese.

Omega-3’s

The omega-3 fatty acid DHA is a necessary part of cell membranes and is important for brain development. Babies born with higher umbilical cord plasma levels of DHA have been found to have higher memory function once they are school-age. Sources of DHA  include fatty fish (salmon, herring, anchovy), fish oils, and fortified egg and dairy products. ALA is a fatty acid that is converted to DHA, and is found in flax seed, hemp seeds, walnuts, canola oil and leafy greens. The conversion of ALA to DHA can be reduced by having an excess of omega-6 fatty acids in the diet. Sources of omega-6 fats include animal meats, eggs and vegetables oils (corn, safflower, soybean and sunflower). Aim for obtaining fats from DHA and ALA sources, and less from omega-6 sources.

My favorite lunch- salmon with salad and quinoa. The quinoa isn’t fancy, it’s straight out of a steamable bag found at Target. BUT it tastes amazing!

 

Strive for balance and variety

Eating a well balanced diet when pregnant may result in having a child who’s more inclined to try and accept a larger variety of foods. Around 21 weeks post conception, babies start talking gulps of the amniotic fluid surrounding them- and it actually tastes like the foods and beverages mom has consumed in the past couple of hours! It was hard for me to pass up sweets in my first pregnancy- and my firstborn loves them (but then again, what kid doesn’t love sugar??). But she also loves and is willing to eat about any vegetable I put in front of her. Something else I ate a lot of when I was pregnant with her!

To make sure you are getting the most balance and variety in your diet as possible when pregnant, aim for lots of color in your meal. The more colorful your meal, the more nutritious it is! Try to avoid an all brown or all white plate. I know this can be hard in the first trimester- I lived off buttered pasta and bread for two months straight! Once the nausea wears off and food tastes good again, really try to focus on that good nutrition. It’s when it matters the most.

BLT and homemade sweet potato fries. My favorite summer meal. I crave bacon when I’m pregnant!

You’ll want to ask yourself each meal if you are getting all of the major nutrients (fat, carbohydrate, protein). Aim for carbohydrates that are high in fiber like fruits and whole grains. Reach for lean proteins and healthy fats. I know I feel much more energetic when I eat a healthy balanced meal- especially in that 3rd trimester! With my last baby, it was extremely difficult to eat a full meal once I was past 30 weeks. Especially since I  was so pregnant in the heat of the summer! I have a short torso, and eating the littlest bit made me feel overly full. Instead of focusing on meals, I tried to make the most out of snacking. I would snack about once every 1-2 hours, still incorporating a variety of all the major nutrients. Smoothies were my best friend! Much easier to eat spinach and fruits blended together with flaxseed than making myself eat a big salad or heavy meal.

Balance doesn’t just mean eating that perfect plate. It’s about treating yourself a little bit too! My sweet tooth definitely comes out when I’m pregnant, and it can be hard to control at times. I remember having one of those huge cupcakes from a food truck in Austin, TX when I was about 27 weeks pregnant with Carli. I told myself I would only eat 1/2 and finish the rest later, but I couldn’t stop from eating the whole thing. It was delicious and Carli seemed to enjoy it too- the gymnastics she did in my belly from the sugar rush kept me up until almost 2AM that night!

My love for cupcakes passed through to her in utero

Eating a healthy diet during pregnancy isn’t about being perfect. It’s about doing what you can to provide the best nutrition for yourself and your growing baby. I’ve definitely had to give up the guilt I’ve had for not passing up my morning coffee or being too tired to make anything other than a bowl of cereal for dinner (or..ahem..ice-cream) some nights. I just make sure that 80-90%  of the time I’m filling my body with the best nutrition I can give it- and in just 13 more weeks, I’ll be enjoying that big plate of sushi and tall glass of red.