Pregnancy is a time of growth and change. Lifestyle strategies like nutrition and exercise can have the greatest impact on pregnancy outcomes during the first 20 weeks. These strategies set the stage for what happens later in pregnancy, during labor and delivery, and the time after birth (for both mom and baby). Sifting through information online can be challenging, so this article offers some general considerations for a healthy pregnancy.
Food & Nutrition
Nutrition guidelines in pregnancy aren’t extremely different from general guidelines for good overall health. In pregnancy research, nutrition guidelines look at populations with a high risk of pregnancy complications and compare them to low-risk populations. Based on a study in 2018, these are some of the recommendations associated with lower rates of gestational diabetes, small babies, urinary tract infections, high blood pressure, and other high-risk pregnancy complications:
Vegetables and fruits: 12 servings each per week
Nuts and oily fish: 3 servings each per week
Extra virgin olive oil: approximately 30 mL (2 Tbsp) per day
Ample whole grain cereals; limit white rice, pasta, or
white bread to less than 2 servings per week
Plentiful legumes (beans, chickpeas, etc.)
Skimmed dairy products: 1 serving per day
Homemade sauces in place of conventionally processed ones
Limit red meat consumption as well as refined flour,
sweetened drinks, pastries, and biscuits
Even if your eating patterns are very different from this list, decreasing refined flour and white bread while increasing plant-based foods is a good place to start. Most of this data does not account for your cultural or familial eating practices, so please keep this in mind as well.
These vitamins are essentially multivitamins that offer the minimum nutrients needed for a healthy pregnancy. Ideally, a prenatal, or folic acid (400 mcg)—at the very least— should be started before you try to conceive. The WHO and most national guidelines recommend taking folic acid if you’re of childbearing age. Folic acid is needed for rapid cell division (among other things), and a deficiency can cause neural tube defects. If you haven’t been on folic acid or a prenatal, then adding one in as soon as you discover you’re pregnant is recommended by healthcare professionals. Folic acid, choline, and DHA are three nutrients that play important roles in a baby’s nervous system development and should be part of your regimen (through a prenatal, food, or separate supplementation). Choline, especially, should be supplemented (if not prenatal) for patients who do not consume eggs.
This is another supplement to consider. It helps with the development of the placenta and the immune system and supports communication between the fetus and the placenta. Testing through blood and ensuring adequate levels is recommended.
This nutrient is important to supplement, especially if your iron is deficient. Iron deficiency in pregnancy is associated with preterm delivery, low birth weight, mental health issues, and poorer school performance in offspring. It’s also extremely prevalent in menstruating populations globally, so please take your iron!
The last supplement to consider would be calcium, especially if your dietary intake is low. It’s of special consideration for those with recurrent pregnancy loss, high-risk pregnancies, malnutrition, gestational hypertension, pre-eclampsia, heartburn, heparin use, and muscle cramping (which may be experienced at around weeks 18–22). A minimum of 1000 mg of calcium is recommended during pregnancy (there should be a little bit of it in your prenatal too). Food tracking apps or working with a nutritionist/ dietitian can help you figure out if you’re getting adequate calcium.
Exercise & Movement
There’s a lot of information about exercise during pregnancy on the internet. Strength training, walking, and other forms of cardiovascular exercise all show similar levels of benefit, although there may be additional benefits to a mixture of aerobic and resistance training.
“Sometimes Healthcare Professionals Don’t Discuss The Importance Of Exercise During Pregnancy, Which Can Leave Patients Feeling Like It’s Not A Priority.”
The guidelines in Canada are to reach a minimum of 150 minutes of moderate-intensity activity per week, spread over at least three days; ideally, some form of daily exercise is best. You can also layer in some non-exercise activities, like walking or stretching. If you haven’t been active before pregnancy, then perhaps 30 minutes of walking (at once or broken up) a few times per week is a good place to start. If you’re already active, then keeping up with your routine (with minor modifications with the help of a professional) should be fine. Listen to your body to gauge if you need to change the intensity or duration, as pregnancy does alter how your body a ...
While pregnancy can be an exciting and joyful time for many, this life stage comes with many physical and emotional changes. It can present significant challenges to mental health for many others. Depression during pregnancy affects approximately one in five women, which may be an underestimation due to the lack of consistent screening and identification of those struggling. This can be an especially difficult topic to navigate when culturally, pregnant mothers are expected to present as happy and glowing parents-to-be.
“Education and awareness can help identify those struggling earlier so that treatment options can be implemented sooner"
Perinatal depression does not have a single cause. Research suggests that it’s caused by a combination of genetic and environmental factors. Life stress, the physical and emotional demands of childbearing, and changes in hormones that occur during pregnancy may contribute to the development of perinatal depression. Some of the most prominent risk factors for depression in pregnancy include a history of depression, lack of social support, lack of a partner, unplanned pregnancy, unemployment, experience of violence, and smoking before or during pregnancy. It’s important to recognize individual factors that may predispose someone to a higher risk of mood disorders in pregnancy.
Symptoms of depression in pregnancy can be insidious and often mimic common symptoms of pregnancy, such as low energy and reduced sleep quality. Mood changes can occur in any trimester but are most common in the second and third. A sad mood, difficulty enjoying activities that you usually like to do, feelings of worthlessness or guilt, unexpected fatigue or lack of energy, or unexpected changes in your sleep patterns are important to discuss with your healthcare provider. Education and awareness can help identify those struggling earlier so that treatment options can be implemented sooner.
The following strategies are helpful for reducing the risk of perinatal depression and supporting mild to moderate depression. These tools are also helpful as adjunct treatments for moderate to severe depression in pregnancy; however, Cognitive Behavioural Therapy (CBT) and pharmaceutical antidepressant medications are considered the standard of care in more serious cases of depression, especially when thoughts of self-harm are present. It’s important to work together with a healthcare practitioner for guidance, regardless of the severity of mental health concerns.
Maternal nutrition during pregnancy significantly affects the health of both mom and baby. Several studies have shown that a nutrient-dense diet may help to reduce the risk of depression during pregnancy. Diets with more green vegetables, fruits, legumes, and fish and less processed fats and sugars have been linked to lower levels of prenatal depression.
Iron deficiency anemia is significantly associated with an in- creased risk of maternal depression both during pregnancy and the postpartum period.6 Advocating for testing and following up with the indicated treatment is a key preventative strategy in supporting mental health through the perinatal period. Not only does iron status in pregnancy affect maternal mental health, but we also see it has many links to the baby’s mental and cognitive function for at least the first decade of its life.
Low levels of vitamin D have been linked to depression in pregnancy. Research shows that testing for vitamin D levels in early pregnancy, and treating appropriately to correct the deficiency, is the best strategy to ensure appropriate dosing and the best outcomes.
Fish oil supplementation has shown positive benefits for depression in the general population, and there are many safety studies for its use in pregnancy. Taking fish oil supplements with a combined EPA and DHA omega-3 content during pregnancy has been shown to improve symptoms of depression, and prevent the risk of postpartum depression. Omega-3s are also critical for fetal brain development and cognitive function.
Prenatal exercise has been shown to reduce the onset and severity of depression in pregnancy. Aiming for 150 minutes of moderate-intensity activity weekly (such as brisk walking, water aerobics, stationary cycling, or resistance training) has significantly improved mood symptoms. Prenatal yoga has also shown benefits for improving depression and anxiety in pregnant mothers.
Poor sleep quality and less than six hours of sleep nightly are associated with an increased risk of depression during pregnancy.14 Recognizing the importance of sleep and prioritizing rest, as well as putting sleep supports in place, may help to modify this risk. Evidence-based tools to improve sleep for pregnant women include massages, yoga and mindfulness, regular exercise, progressive muscle relaxation, and CBT.
Cognitive Behavioural Therapy
CBT is conside ...
Perhaps one of the most widely held, popular beliefs is that cranberry juice can help prevent recurrent UTIs or get rid of them.
A UTI itself can severely impact multiple parts of the urinary system – the bladder, kidney, and urethra. While UTIs are possible in men, women are more than 30 times more likely to experience them, with 55-60% of women having experienced one in their lifetime. They also account for close to 25% of all bacterial infections seen in women clinically.
Women’s urethras are more susceptible to bacteria entering the urinary tract, compared to men's.
– if you experience pelvic pain, groin pain, urgent or frequent urination, or burning when you urinate, you should consult a healthcare professional for diagnosis of a possible UTI.
Given the prominence of antibiotic resistance to Escherichia coli, implementing alternate strategies to reduce this exposure to antibiotics is essential to protecting yourself from antibiotic overuse.
The majority of UTIs are caused by this bacterium, and this bacterium is becoming increasingly resistant to commonly prescribed UTI antibiotics like Bactrim and Cipro.
Aside from conventional wisdom towards prevention (increasing hydration with water throughout the day and gentle cleaning), cranberries often have the potential to alleviate symptoms or help prevent recurrence – but they must be in the form of an extract, not just the juice. Most store-shelf cranberry juices are also loaded with added sugars and won’t offer any sort of health benefit.
Recurring UTIs, while less common, are still a huge problem for a number of women and are often caused by the same pathogen. Do cranberries really work for UTIs? We’ll take a closer look at what the science says.
Cranberry Extract for Uncomplicated UTIs - What the Science Says
Cranberry extracts contain a compound known as ‘proanthocyanin or “tannin.” This reduces the adherence of E. coli within the urinary tract and the colonization of the bacteria.
Studies show that extracts can help to prevent recurrent UTIs, but that cranberry juice is of little benefit.
This is mainly due to the fact that there are not enough of the A-type proanthocyanins present in grocery store cranberry juice for it to be effective enough to stop bacteria from adhering to the walls of the bladder or urinary tract.
One scientific review from 2013 found that cranberry extracts were found to be protective against recurrent UTIs, in a PAC (proanthocyanin) dose-dependent manner.
You’ll typically want to look for 240 mg - 500 mg of cranberry extract per capsule, which contains ~15% PACs; 36 mg of PAC minimum in each capsule. Most brands won’t explicitly list the PAC content, so keep an eye out for the total mg of cranberry used per capsule.
Taking a supplement like D-Mannose in conjunction with cranberry extract can help ensure faster elimination of bacteria, and shows greater efficacy at preventing bacteria from adhering.
Given that cranberry extracts and unpasteurized cranberry juice products (with no added sugar) have no reported side effects and are of no harm, they offer a solution that is worth trying for any woman experiencing recurring UTIs.
Known as a member of the ‘Buttercup’ family of flowering plants, Black Cohosh is a plant used as an herbal and botanical extract in naturopathic medicine historically for women’s health.
Previously, the Natives often used it to address menstrual pain or irregularity, as well as fever and cough – now, present day: not much has changed. Black Cohosh today is used as an ingredient in many formulations for women’s hormonal health, or individually as a supplement targeted for menopausal symptoms. These types of symptoms include such things women may experience as hot flashes (or flushes), night sweats, sleep issues (apnea), irritability, vaginal dryness, and nervousness.
Menopause typically occurs in women around 50-60 years of age, at the cessation of menstruation and the supposed “end of the reproductive period.” However, menopause can begin earlier and can also be much more severe in terms of symptoms for many women.
Black Cohosh for Menopausal Symptoms: What Does the Research Say
Black Cohosh is typically prepared for use as a medicinal supplement by using the roots and stems of the plant, which is then sold as a dietary supplement via whole herb, liquid extracts (alcohol-based tinctures), and dried extracts in pill form. Typically, as with most supplements – you’ll likely find the liquid-based tincture to be the most effective, as it is the most easily absorbed and utilized in terms of concentration and strength. However, capsules are a great option as well for people that would like to avoid consuming alcohol in tinctures.
The compounds believed to be responsible for the menopausal relief in Black Cohosh are likely the ‘glycosides’ present in the herb, along with natural caffeic, and fukinolic acids.
You’ll notice many Black Cohosh products ‘standardized’ to contain a certain quantity of glycosides per capsule or dose, which is the amount of ‘active’ compound you’re after for benefit/relief from menopausal symptoms.
When picking a product, keep an eye out for whether it states “standardized to triterpene glycoside content” or simply “equivalent to [X] amount of Black Cohosh root.”
This will help you to determine how potent the supplement you’re purchasing actually is.
So, how exactly does Black Cohosh work to relieve menopausal symptoms?
There are believed to be a number of possible pathways in regard to this action – some note that it is through the antioxidant abilities of Black Cohosh, in addition to it be a selective estrogen receptor modulator.
What this essentially means is that Black Cohosh may potentially increase the level of estrogen in the body (which is in much lower levels in those with menopausal symptoms) due to this reduced natural production of estrogen. In those with higher estrogen or estrogen dominance, it may act to lower estrogen through the ‘modulation’ of estrogen receptors.
Black Cohosh can then be said to function as a phytoestrogen.
While studies are never conclusive (and you always need to determine if a product is right for you, individually), Black Cohosh appears to help reduce symptoms of hot flashes/flushes, and sleep disturbances related to menopausal women – what there is not great evidence for, is using Black Cohosh for fertility purposes: a modest improvement in pregnancy was shown in women with infertility when using Black Cohosh along with pharmaceutical medication.
Additionally, Black Cohosh does seem to help with other symptoms associated with women’s health specifically – and the importance of hormonal balance.
Those with irregular menstrual cycles, PCOS (polycystic ovarian syndrome), and uterine fibroids have found relief through supplementation with Black Cohosh (often in addition to prescribed medication).
This includes increasing the chances of getting pregnant, a reduction in the size of fibroids, and helping to ensure a regular menstrual cycle in those with PCOS – outside of those who are menopausal.
Black Cohosh: Precautions, Safety, and How to Supplement with It
Typically, any side effects noticed (or noted) with Black Cohosh are extremely mild – and usually, just involve some sort of digestive upset or nausea if the individual reacts poorly to it.
Black Cohosh, has in rare cases, been linked to liver damage – this is important to note for those with liver disease, as this may be related to how effectively the liver processes the glycosides and compounds in it – generally, most people seem to tolerate daily use without issue.
For those taking it as a supplement, the dosage will depend on whether it is being taken as a capsule or liquid tincture. Dosage will vary between brands – anywhere from 20mg – 120mg as an extract or powered capsule.
Generally, most of the studies indicated benefits for menopausal symptoms at 20mg of Black Cohosh daily. Overdoing it on dosage may in ...
If you have a period, this is a sign to consider transitioning to using a menstrual cup. Today, almost all sanitary pad companies have come out with their own menstrual cup. And for good reason – there are so many more benefits. What are you waiting for?
Why should you make the switch to a menstrual cup?
Most menstrual cups hold up to 15mL of blood, so you can go up to 12 hours before changing it again. You can change the cup before you leave the house for the day and again when you come home. Most people find they do not have to change their cups when they’re out in public. Because the silicon material is anti-bacterial, there is no risk of toxic shock syndrome, even if you leave it in longer than 12 hours.
Unlike conventional tampons and pads, menstrual cups are made from 100% medical-grade silicone and are completely toxin-free. Conventional products contain bleached cotton and plastic materials that can cause skin irritations and allergic reactions. Organic sanitary products may contain less of these substances but will be significantly more expensive.
Save hundreds of dollars
If one cycle’s worth of pads or tampons costs $5 per cycle, and you go through an average of 450 periods in your life, you may end up spending $2250 on your period products. If you use organic sanitary products, the cost will be even higher. Compare this with a $40 menstrual cup that lasts around 10 years each. You will be saving hundreds!
The most comfortable choice
Many people forget they’re wearing a menstrual cup. With a pad or tampon, you may start to feel uncomfortable when they get full. The menstrual cup is inserted into an area where there are no nerves, so you cannot feel it at all. You may even forget you’re on your period!
How to use a menstrual cup
To correctly insert a menstrual cup, it’s easiest to start by visualizing how the cup will go into the vagina. Your cup should come with instructions and a diagram of the angle to insert the cup (it’s not the same as a tampon, which is inserted more vertically). The easiest position will be squatting over a toilet as if you’re just getting up from the seat. In this position, your vagina opening will be wider. Fold the cup so that the tip is smaller, then insert it into the vagina. You should hear a small “pop” sound if it is inserted correctly. If not, you can use a finger to push the sides of the cup until you hear it. Over time, you’ll be able to get it open faster.
Best options: Nixit, Diva Cup (3 sizes available)
How to remove the menstrual cup
To remove the cup, you must be in the same position, squatting over the toilet. Use your pelvic muscles to push the cup down. Use your thumb and index finger to pinch the base of the cup. This breaks the seal on the cup so that you can pull it out easily.
How to clean the menstrual cup
It’s easier than you think. The cup can be cleaned and sanitized at the end of every cycle by boiling it for 20 minutes. You can have a pot that you keep just for this purpose. If you’re on the go or don’t have time to boil the cup, you can use special wipes or soap to clean it. Make sure you use brand-specific soap or wipes because normal ones may be too harsh for the material of the cup.
Becoming comfortable with using a menstrual cup
If you’ve been using pads or tampons for most of your whole period of life, it may take time to make the transition to a menstrual cup. Don’t be discouraged if you don’t get used to it after trying it once. Most people need at least 3 cycles to get the hang of it. After that, it’s a seamless process every month!
Grace Tien is a women’s health holistic nutritionist. She helps her clients optimize their nutrition habits so that they can get rid of afternoon slumps and live each day full of energy. Grace specializes in nutrition for healthy periods, you can find out more at @gracetien.ca on Instagram.
Women’s health holds a different meaning and significance for every individual. However, when we’re trying to put a specific meaning of this term, we’d like to think of it as Women Empowerment. Physical Strength, Emotional Strength, and Intellectual Wellbeing are the three core elements of the aforementioned subject.