Transcription:
Tips on Having A Healthy Pregnancy

Prakash Chandran (Host): Taking care of yourself throughout your pregnancy is so important and something that’s actually very topical for me, given that my wife is due in just a few weeks with our first. Very excited here. So, today, we’re going to be learning tips on how to keep your baby healthy during the pregnancy and the role a midwife might play during and after the process. Let’s talk with Karen Bergstein, a Certified Nurse Midwife at Montefiore Nyack Hospital.

This is Health Track, the podcast from Montefiore Nyack Hospital. I’m Prakash Chandran and Karen, I’m just remembering back to when we found out that we were pregnant. There’s obviously so much excitement, but I also recall my wife being so anxious thinking how can we make sure this pregnancy goes well. So, I’d love to start with what steps a woman should take once she confirms that she’s pregnant.

Karen Bergstein CNM (Certified Nurse Midwife) (Guest): Sure. And I want to congratulate you on your upcoming life changing event.

Host: Thank you so much. We’re so excited.

Karen: Very exciting. And I think the first thing that women and parents-to-be need to remember that our bodies are intelligent, and pregnancy is a natural process. It’s not a disease. So, the things that make and keep us healthy as human beings, will help support a normal healthy pregnancy. The woman wants to trust in her body’s ability to accomplish this incredible, miraculous feat.

So, my top tip for a healthy pregnancy is diet. And to eat real food. One of my favorite quotes is from Michael Pollan, he’s a New York Times author and he did a lot of writing and books on food and the food system in the United States and his quote that I’m constantly relaying to women of all ages is “to eat food, not too much and mostly plants.” That being said, it can be difficult for women in this crazy time, everybody is busy, they are running around, they are working crazy hours and they try to – they eat on the run, but at the time when a woman is pregnant can be a time when she takes a step back and she starts to care for herself and her growing baby.

So, eating organic when possible. Eating real food, avoiding the processed foods. If you can’t pronounce the ingredients on the ingredient list; it’s not a good thing to put in your body. Another tip is to shop the perimeter of the supermarket. That’s where you have the fresh food and the meats and the eggs and the dairy. And cooking for yourself. Usually we use less fat, sugar and salt when we cook ourselves.

Host: I love that. I love that whole metaphor around shopping the perimeter of the market. You don’t think about that, but that’s where all the good stuff is and your advice around eating real food and eating mostly plants is great. I think that’s something that I’ve really tried to work with, with my wife even when she has those cravings, so, speaking of which, when we get these cravings or when women get these cravings; what should we do about them if they want to eat a lot of meat or a lot of ice cream? What do you recommend for situations like that?

Karen: Sometimes it’s the body’s way of telling us we need more of a certain nutrient. If a woman is anemic, sometimes she craves some more meat, although ice is another thing that she craves, and I couldn’t tell you why that happens. But I don’t think anybody can. If you go by the 80:20 concept where 80% of the time you are eating a healthy whole food-based diet and then the other 20% of the time, you are indulging a little bit in ice cream or cookies or some salty foods. Sometimes the salt, if you are not getting enough water in your diet and you should drink 10 glasses of water a day; the body wants to hold onto that water, so you start to have a salt craving.

So, listening to what your body’s telling you is really important.

Host: Absolutely. So, that’s really good advice around diet and I’m assuming for lifestyle as well, just to exercise and let the body do its thing, right? Wouldn’t you say that exercise is important as well?

Karen: That’s my second tip.

Host: Heh, I got it. I’m a good student.

Karen: Yes. You want to move your body, okay, every day. Not only does it keep your body strong and flexible; but it helps relieve stress and as we know, pregnancy can be a stressful time. You worry about how you’re going to manage and how everything from is the baby going to be healthy, how is my labor going to go, how am I going to be responsible for this human being for the rest of my life. So, finding an exercise that you love, even simply walking 20 to 30 minutes a day can help us process the sugars and the carbohydrates that we eat so we are less likely to develop gestational diabetes or if we have gestational diabetes; it can help us manage our blood sugars, to not gain too much weight and just to blow off stream. You get out there and you walk.

And one of my favorite exercises to encourage women to do is yoga. It incorporates strength and flexibility and there’s a little bit of mindfulness in there. You get used to spending a few minutes being mindful in meditation and another tip I have is for stress to try and find something that helps you lower your stress levels. Mindfulness, journaling, writing down your thoughts at the end of the day if you are worrying about something. Going for a walk in nature if possible. Chamomile tea is something that’s very nice to incorporate in the evening. It’s safe in pregnancy, it helps you to relax and it can help you sleep better at night which is something else that pregnant women should try to get their rest, in addition to their movement.

Host: All really great advice. You know my wife is actually doing some prenatal yoga right now and when she doesn’t do that or in addition to that, she also tries to get in that 5000 steps a day just to keep the body moving and I think the biggest thing I’m hearing from you is just to take care of yourself and let the body do its thing, right?

Karen: Absolutely.

Host: So, I’ve heard a lot about the services that midwives offer, and I think for a lot of people, they don’t know what a midwife is. They’ve heard of maybe the “Call the Midwife” television show, but they don’t know all the benefits that come with having a midwife before, during and after the pregnancy. So, maybe you can give us a little bit of a summary of a midwife and what they do.

Karen: Absolutely. And “Call the Midwife” is one of my favorite shows. So, midwives in the United States are licensed in all 50 states and in the District of Columbia. The majority of midwives are Certified Nurse Midwives. There are also a few states that have Certified Midwives without the nursing degree. But the education is all the same. It’s a master’s level education. There is a national exam that we take and then are licensed in the states where we would practice.

In 2014, the last statistic that I know, midwives delivered 12% of all vaginal births in the United States. And about 95% of those births occurred in hospitals. I frequently get the – when I tell people that I’m a midwife, they’ll say to me oh, so you do that where in somebody’s house. And home birth is safe, and midwives are the most common practitioners that do home births. But the majority of us work in hospitals where we have the immediate back up of physicians, anesthesiologists, nursing staff, pediatricians should something unexpected happen.

Host: Yeah, what a big relief that you have such a great relationship with the hospital and the doctors because if there’s any sort of last minute intervention that needs to happen; you are right there for it.

Karen: Absolutely.

Host: Yeah, you mentioned that a midwife has all sorts of different certifications and I’m curious to know what role they exactly play during the process of the pregnancy and how might they differ from an OB/GYN for example?

Karen: Midwives are expert in natural, normal pregnancy. We care for predominantly healthy women. We can comanage a pregnancy in a woman that becomes a little complicated if she develops diabetes or hypertension, but then we do that in collaboration with the physician. But we can care for women also throughout the lifespan. We do well-women care. We can see a woman for her annual GYN visits. We can prescribe birth control, treat infections, pretty much everything but surgery. That’s the one thing that we don’t do.

Host: And would this be in conjunction with your primary care physician or would you get a midwife instead? That’s something I’ve always been a little confused about.

Karen: So, midwives are independent healthcare providers, so a woman can see a midwife just a midwife for her care. We can do well-women care, pregnancy care, deliver their babies, post-partum care. If there’s a complication, we consult with physicians, but we don’t need to be supervised by a physician, nor employed by a physician. We can have our own practices or in my case, I work in a practice with a physician. So, the woman can see just me, just the physician or a combination of the two of us.

Host: So, just in wrapping up here. Is there anything that we didn’t cover today that you want our listeners to know about just tips for maintaining a healthy pregnancy or engaging with a midwife?

Karen: I think that listening to that voice and tuning into that voice. So many times, we women will get so focused on external factors and not listening to herself and realizing that she’s wise beyond her years and she has the – her body has the knowledge to take care of her and her growing baby. And not being afraid to – if you are with a provider and they are not answering your questions and they don’t make you feel safe or feel listened to; then it’s okay to maybe look for somebody else that does listen to you.

Host: That’s Karen Bergstein, a Certified Nurse Midwife at Montefiore Nyack Hospital. Thanks for checking out this episode of Health Track and for further information or to schedule an appointment with a midwife please call 845-353-5900 or 845-348-2550.

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