One of the awesome things about writing and promoting our Healthy, Happy Pregnancy Cookbook  (a food as medicine approach to eating and cooking for the healthiest pregnancy) has been connecting with other women’s healthcare professionals, specifically those focusing pre- and postnatal care and childbirth.

We recently had the opportunity to get-to-know and interview Risa Klein, a Certified Nurse Midwife in New York City, about some of the same discomforts that we cover in our cookbook. We found her answers, and the whole idea behind how what you eat during pregnancy can influence your childbirth experience fascinating….and thought you might too! This interview helps paint the picture of some of the other connections between symptoms, discomforts, and what they all can mean from a medical professionals standpoint.

Without further ado…. here it is.

Q & A with Risa Klein, CNM:

Q: We often think of discomforts like constipation, nausea, heart burn, and fluid retention during pregnancy as annoying…but can letting any of these symptoms go untreated have an impact on labor and delivery?

A: Yes. Letting these discomforts go can make labor and delivery more uncomfortable. For instance, it’s more difficult to relax between contractions when you have heartburn symptoms. Or, with constipation, the back-up can create extra gas, discomfort, nausea, dizziness, anxiety and pain.

Untreated discomforts might also increase your chances of needing medical intervention during labor/delivery. If a woman is constipated during labor, it can create a blockage for the descent of the baby (which can, in turn, lead to the use of Pitocin and further interventions) and can precipitate a longer and more painful labor. If untreated nausea has caused inadequate protein intake, the uterus is often lax, and a woman may need medications to induce or help the labor along. This often leads to other medical interventions.

If these discomforts persist, they can lead to minimal weight gain for mom, low birth weight for baby, low amniotic fluid for baby, and preterm labor and birth. Women who do not gain proper weight as a result of extreme long lasting nausea throughout their pregnancy, often grow smaller babies with smaller placentas. For women struggling with nausea, I often recommend starting the day with a protein-rich snack, which not only helps contribute an important nutrient for pregnancy, but protein can also help keep nausea at bay. You can find many protein-rich (non-offensive!) recipes in the nausea chapter of Willow and Stephanie’s Healthy, Happy Pregnancy Cookbook. Women who are undernourished will be more apt to develop anemia, feel constantly tired and weak, feel short of breath, and are at higher risk for preterm labor and/or premature rupture of membranes.

When it comes to fluid retention during pregnancy, some fluid build-up is normal and healthy. In fact, ninety percent of women experience edema or swelling. This is the body’s way to provide protection for mom and baby during labor to maintain sufficient fluid levels to protect baby.  However, when fluid retention is extreme or accompanied by excess weight gain, high blood pressure and or protein found in the urine, it could be indicative of metabolic disease of late pregnancy, which requires further testing and possibly the need for medications, bed rest, hospitalization, and induction of labor when baby’s lungs are mature.

Overall, the more discomforts left untreated, the more for your health care provider to handle at labor and delivery as more complications can arise and interventions may be needed. The postpartum period could be filled with medical interventions for both you and your baby, rather than the close, quiet bonding you deserve.:

Q. Which untreated discomfort(s) do you see the most and how does this typically affect labor/delivery? What do you recommend to your clients?

Both preterm labor and depleted amniotic fluid are two of the complications of late pregnancy that I see often and that, although not directly related to one discomfort in particular, are often caused by improper nutrition overall, which may have been contributed to by the discomforts.

A lack of amniotic fluid during labor means less cushioning for baby and increases the chances of fetal distress. Cord compression, descent of the baby’s head and ease of baby making an internal rotation to fit into the pelvis during pushing stage, are often times predicated on adequate fluid volume to cushion the baby. While there can be true complications of fetal maternal circulation exchange with low amniotic fluid, and other unexplained reasons for blood flow challenges, it can fortunately be determined with an ultrasound and a consult with a perinatologist.

Ultimately, eating a nutritious diet helps optimize both mom and babies health and avoids the complications we can control.

Q. Can changes made to diet, exercise, sleep, and other lifestyle factors late in the third trimester still have a positive impact on labor and delivery outcome?

A. Yes, I have seen and had many positive results when adjustments are made to a woman’s lifestyle, nutrition, and level of activity even later in the third trimester. When changes are made it is more than possible to turn around many a woman who would have been induced by most providers due to low amniotic fluid levels or small for dates babies. Preterm labor contractions can also be stopped with improved nutrition and supplementation of certain nutrients. This is strong motivation for a woman to turn her old routine into a new one that will benefit her baby’s health.

About Risa:
Risa’s midwifery experience spans home birth, birth center and hospital birth settings since 1992. She attended Columbia University’s School of Nursing and received a Masters Degree in Midwifery. She co-managed high risk pregnancies with perinatologist Andrew Garber, MD for 11 years in New York and New Jersey. She is presently in collaboration with midwife friendly Dr. Jason Kanos, Director of Quality Assurance for Labor and Delivery at Mt. Sinai West.

Risa believes birth is a  catalyst for growth and a means to deepen and explore your role into motherhood if in fact you have the right health care provider to guide you.

Check out Risa’s website to learn more.