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I’m Pregnant. Now What?

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Month after month of unhappy faces, single lines, and not-pregnant responses… When you finally see a smiley face, a double line, and/or (likely and, because most of us take about 20 tests to make sure it’s right) a pregnant message, you almost pass out. After the excitement, shock, and joy subside, anxiety, confusion, and uncertainty set in. What do I do now? And while we may not be on your speed dial, we can share with you a few of the pointers we point out to those that are!

First things first, take a deep breath. There is a lot that will happen over the next nine months, and you want to try and remain as calm as possible. (Good energy is transferred through the placenta!) After a few good, deep breaths, a bunch of OMGs this might actually be happening, and a call to your plus one (or best friend), the next step is to purchase a prenatal vitamin (if you aren’t already on one). Generic or brand, it really doesn’t matter. You just want to make sure that your body is chock full of nutrients and essentials to start nurturing that little one. If you haven’t already been taking one, there is no need to stress. You have not caused any damage or done any harm.

Additionally, if you have had a few cocktails, colored your hair, or partook in any activities that are off limits during pregnancy, don’t sweat it. The first weeks between ovulation and early pregnancy are what we OB/GYNS call the “all-or-none” interval. Your actions will either have absolutely no impact on the pregnancy, or they will result in a non-pregnancy/miscarriage type of situation. Simply stated, there will be no long-term effects on the fetus!

While the “all or none” gives you a get-out-of-jail-free card, you do want to start to alter your habits. Hang up your love of unpasteurized cheeses, your obsession with tuna (that one was hard for us, too!), and your passion for cold cuts. While you can still eat cheese, tuna, and cold cuts, the quantity needs to be reduced and the way they are cooked slightly altered. For example, cold cuts should be warmed before eating.

But don’t obsess about what you are eating in those first few weeks. Nausea is at its peak during this time, and whatever you can keep down is all you and your baby needs. Don’t stress if only grilled cheese, bagels with butter, and saltines are all that you are craving. Your lack of greens, veggies, and fruits won’t harm your little one. Your tastes will change shortly, and you can stock up on good things at that time.

It’s also a good idea to buy yourself a water bottle and make sure you are constantly sipping. The changes in blood volume that occur during pregnancy can make you dehydrated pretty quickly. To avoid that “Oh no, I am going to pass out” feeling, drink lots of fluid. And while we are on the drinking subject, it’s totally cool to continue with caffeine. A cup or two a day is definitely not a no-no. Furthermore, the occasional glass of wine, flute of champagne, or bottle of beer is not a big deal. While there is no safe amount of alcohol that can be consumed during pregnancy, a few drinks (over the nine months, not one day!) is certainly not going to do any damage.

From food, we transition to fitness. For all of you die-hards out there, pregnancy does not mean you have to hit pause on your fitness habits. Exercise in pregnancy is totally okay. You may need to tailor your exercises and taper the intensity, but staying active is A-ok. With that being said, the only things we are not fans of are the activities performed in 100 degree-plus heat (e.g., hot yoga). That temperature is not only going to seriously dehydrate you but also may not be so good for your baby’s developing organs. It is always a good idea to let your exercise instructor know that you are expecting. Most studios/fitness clubs have done a good job at training their teachers on how to modify and be mindful of moms to be.

After food and fitness, most women usually want to know about sex and personal grooming. Here’s the deal: sex is okay. Unless you start bleeding, there is really no reason to go on pelvic rest (aka- no sex). If bleeding should occur, we usually recommend resting (no sex, no exercise, and nothing in the vagina) until you are blood free for about 48 hours. After that, it is okay to give it another go. Most bleeding after sex is from the cervix or from the development of a tiny blood clot around the placenta, neither of which routinely cause a miscarriage.

In terms of personal grooming, continue pushing forward: bikini waxes, manicures, pedicures, facials, and massages are all good. Hair coloring is the only questionable practice on the list. We usually suggest sharing your news with your colorist and asking him or her to switch to a more suitable dye for pregnancy.

And finally, we arrive at family (a.k.a. whom should you tell and when). The telling part is totally up to you. While we always recommend that our patients share their news whenever and with whomever, remember that a positive test does not equal a baby. You may not want your 300+ Facebook friends to know that you just peed on a stick and saw a smiley face. However, you probably do want to tell your parents your sister and your BFF should anything go wrong and you need support. In general, most women wait until the one-third mark (about 12–13 weeks) before telling their employer and their Instagram. But bottom line is that this is a personal decision. Do what is right for you.

Make friends with a good Internet source (like Truly, MD!), buy a good book, and make sure you like your OB. He or she will serve as a guide during the next several months. You want to be comfortable and confident with your baby team. If someone or something is not working for you, kick them off, quickly! Your OB/GYN is like the coach of this team, so if you are not jiving with the coach, start looking for another team captain. This game is a big deal. These nine months, even for those of us who are not pregnancy lovers, are sort of sacred. There are only so many times in women’s life that they will be pregnant. So relish the good stuff—the first time you hear your baby’s heartbeat, the first time you feel movement, the first time you see your baby on the ultrasound, and the first time you hold your baby. You are in for a lot of firsts. Let us be the first to say congratulations on your pregnancy!

Breaking a Sweat without Breaking the Bank

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Let’s face it. Exercise and popular workout classes are not free. In fact, they are not even cheap! Clipping into the saddle or popping onto a Pilates machine can cost you a cool 40 bucks (depending on where you live and what studio you like to frequent). Times this by 5 or 7, and you are not talking chump change. Furthermore, if you have kids, breaking free to break a sweat requires a babysitter. Add an additional 30 to 40 dollars for that, and you have gotten yourself an expensive afternoon. All of this makes exercising not only unappealing but also nearly impossible. But despite these roadblocks, the benefits of exercise are big, so it’s important to find ways to bypass them, no matter how impassable they may seem.

Here’s some of our five favorite free ways to break a sweat:

  1. Use your feet. We use our feet to get us everywhere. Whether it be walking to and from work or running to and from errands, we try to get there on foot. We never leave home without a pair of sneakers! This practice not only saves money and time (best way to beat the traffic), but it also gives you some fresh air (Vitamin D) and some alone time. It’s a great way to let your head go and get recentered…all while burning some calories!
  2. Start climbing. No, we’re not referring to your nearest hike, although that would be a great form of free exercise! The climbing we are talking about is the one that gets you from the bottom floor of your office building to your desk (plus maybe a few extra levels to really drive your heart rate up). By ditching the elevator, you can get your blood moving, your heart pumping, and break a good sweat. And although we too will miss those good elevator tunes, a few hikes up and down will do a lot for your bottom line and your overall health.
  3. Do some research. It may surprise you to know how many low-cost exercise options are out there. While everything may seem pricey at first glance, with some research you might find some good choices that don’t cost too much. Don’t take what you see at face value. Ask about packages and deals. Often, fitness centers will sell packages if you buy in bulk. Last, consider taking your workout woes to your human resources department. Gyms and studios are often eager to make deals with companies (the more members, the better). This is a great way not only to save money but also to engage your colleagues.
  4. Make a date out of it. Couples who sweat together stay together! Going out for a run or taking a class not only allows you to break a sweat but also spend some quality time together. Think about substituting the movies or dinner for a sweat session. The costs will be fairly comparable, including the babysitting fees, and you will get some good cardio out of it. And honestly, what’s better than a date where you don’t have to wash your hair, worry about what you wear, or put make-up on?
  5. Do it as a family. There is nothing better for your kids than to learn healthy eating and exercise habits at a young age. Like mother, like daughter; like father, like son. Go outdoors and run around. Play tag. Take a hike. Go for a swim. Walk in the park. Whatever you can do to get moving, make it happen. Turn off the TV, the iPad, the iPhone, and anything else that needs to be charged. Family activities centered on fitness will recharge your family’s battery. Togetherness is way more powerful than any electrical device!

Do I Have to Put My Gym Membership on Hold While Doing Fertility Treatments? Exercise during IVF

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From Twitter to Instagram and Facebook to Google, we are constantly surrounded by other people’s thoughts, opinions, and advice (with the latter often being unsolicited). Do this; don’t do that. Eat this; don’t eat that. Wear this; don’t wear that. It’s overwhelming. One of the most hashtagged topics is what a woman should and should not do while she is either pregnant or trying to get pregnant. And while most advisors are well intentioned, their advice is often not well researched. This can not only be frustrating but also confusing; deciding whom to listen to can add to an already stressful process. Exercise and fitness top the list of hotly debated topics when it comes to preconception and pregnancy. But we are here to tell you to lace up, because your daily gym routine is unlikely to be the one to blame for your fertility struggles.

Exercise has taken quite the negative rap when it comes to preconception and conception. It has been blamed as the culprit for infertility, failed IVF cycles, miscarriage, early delivery, and everything in between. Keep your heart rate below 140. Don’t lift greater than X number of pounds. Don’t run more than three miles…the list goes on and on. But the science behind these data is weak, making them more fiction than fact. While there are times during fertility treatment where you may need to modify your regimen, it actually has less to do with the impending pregnancy and more to do with the size of your ovaries.

Fertility treatments, specifically IVF, cause the ovaries to grow in size. Bigger ovaries have a bigger chance of twisting (medical term = ovarian torsion); this is a medical emergency and requires surgery to correct. To reduce the chance of this happening, old-school fertility recommendations included a blanket recommendation: “Don’t exercise.” However, with more modern treatment protocols and a slew of exercise regimens, this is no longer the case. While you may not be able to run the New York City marathon three days before your IVF retrieval, you can certainly participate. The key is modification (and moderation!)—just as you would modify regimens and activities when pregnant, you can do the same while trying to get pregnant. But you don’t have to stop. It is likely what makes you feel good about you and what makes you sane. The medications can mess with you (both mentally and physically), and we want to help you maintain every aspect of what makes you YOU.

No one regimen, routine, or practice has been demonstrated to be the best. You should always share with your doctor what you are doing and let them referee your activity level. Additionally, if exercise is a big part of your life, then pick a doctor who gets it and your needs. Being avid exercisers ourselves, we get the yen for a good sweat. We have ways to alter your IVF treatment plan so that we can keep you moving throughout the entire process.  There will most certainly be a brief pause to any impact exercise at some point in the process, but the resume button can be hit pretty quickly!

You may not be a world-class athlete or make the next Olympic team, but if exercise is important to you, then you should not have to stop. Motivating yourself to move can be hard. We commend you for wanting to keep “moving it,” no matter what the season, the occasion, or the situation. Although you may have to move slower or lift lower, we can find something that you can do to keep that blood moving and the endorphins flowing, even when you might be growing!