Almost out of the first trimester! I think about every mom out there breaths some sort of sigh of relief when they finally reach the second trimester. Miscarriage risks drastically drop after the first 13 weeks, so although nothing is ever certain, much of the initial risk has passed. I am defiantly reassured that my babies both have strong heartbeats and that they will hopefully continue to grow and develop normally.
At 13 weeks, 4 days, on a Saturday after teaching a morning yoga class, I had a scare. I was washing my hands in the restroom at the studio after class and I felt a gush of fluid. At first, I thought maybe I peed myself (how horrifying but I’ve learned never to be above just about anything during pregnancy!), I hurried into a stall to check what was going on. It was some sort of clear fluid, maybe half an ounce in amount mixed with brown blood. Defiantly not urine. My stomach sank and I medially felt nauseous with worry for my babies.
I later called the afterhours line for my OB’s office and was asked to go to Labor and Delivery to be evaluated just to be safe since I was scheduled to move across county the very next day and they wanted to make sure everything was ok before I left. The first thing they did was check for heartbeats which thankfully they found on both babies. Then the midwife checked my cervix which was locked shut; another good sign. She did say that she could see evidence of this mystery fluid and blood. She looked at it under a microscope and determined that is was not amniotic fluid; another good sign. I was discharged feeling reassured but still a bit unsettled about the whole ordeal.
I’ve experienced almost daily light spotting with this pregnancy which is so scary even though some bleeding is considered normal. When I have asked for a possible explanation, they just said that everything is probably more vascular this time around and sensitive. As for the cramping that I experience, its about the same as in my first pregnancy but more worrisome just because its accompanied by the bleeding.
The one thing that helps to relieve the cramping is a somewhat advanced yoga pose; a variation of handstand prep. I place my hands on the ground a few feet from the wall behind me and then walk my feet up the wall until my legs and body form a right angle. Something about being upside down like this releases pressure in my pelvis and I feel all the cramping fade for the few breaths that I spend here. Don’t attempt this if it is not already part of your regular practice, pregnancy is not the time to learn this pose. However, if you are experiencing some cramping, you may be able to find relief from a similar pose that Spinning Babies recommends. Place the forearms on the ground in front of a couch while kneeling on the couch. It can be helpful to have your spouse or partner assist you for extra support and safety. Spinning Babies recommends spending 3 breaths here, letting the head hang freely between the biceps. Here’s a link to their page where they have very detailed instructions on doing this forward leaning inversion. http://spinningbabies.com/learn-more/techniques/the-fantastic-four/forward-leaning-inversion/
I worked with natural supplements for 3 years after college. I did countless trainings with companies, did my own research into them and talked with nutrition mentors who have watched the industry evolve for decades. I have some very strong opinions about supplement brands and their company reputation. I consider where they source their raw ingredients, their third-party testing and manufacture practices.
Herbal medicine and medial nutrition therapy have been passions of mine since I was still in college working towards my nutrition degree. Over the years, I have experimented with different supplements and listened closely to my body to see how they affected me. That’s one of my least favorite parts of pregnancy and lactation; it limits what I can experiment with. I like to look at research but I also like to try things first hand. Something that really peeves me, but I understand why the precautions are there, is that every supplement, even prenatal vitamins contain a warning label telling pregnant women not to consume without consulting their healthcare practitioner. I sympathize with the warning label because there are many people who are uneducated and simply don’t know they cannot take certain substances while pregnant. However, there are some things that in my (non-licensed) opinion, do not need these unnecessarily scary labels.
I’m going to talk about the main supplements I take during pregnancy and why I feel they are vital to my prenatal care. It is important to understand that while I have a lot of education in this field and I am completely confident in my supplement choices, they may not be suitable for all pregnant women and you should consult with your doctor before consuming any of them. I’m going to list them in order of priority, what I deem most important in my routine to least.
I am currently taking the Mega Food Baby and Me 2 but I also really like the prenatals by New Chapter and Garden of Life. All three of these choices are whole food based, meaning the vitamins are not synthesized in a lab. The theory being that our bodies can better utilize these natural forms of the vitamins and they are as close to food as you can get in tablet/capsule form. I find these companies to be reputable and use clean, responsible sourcing as well as manufacture practices.
I have been taking the Mega Food prenatal for about six months now. I took the New Chapter Perfect Prenatal for most of my last pregnancy but I switched shortly after birth when my son with diagnosed with a soy allergy. I originally switched to Garden of Life’s One a Day Prenatal (it is the only one of the GOL prenatal line that is soy free) but then I found the Mega Food Baby and Me 2 which is also soy free. I preferred it over the GOL because it is a twice a day versus a one a day. I prefer multivitamins that are split into two or three doses instead of one big pill. By taking the vitamin in smaller does, multiple times a day, the body is better able to absorb the vitamins. Some women who really struggle with stomaching their prenatal or remembering to take it, might do better with a one a day just because then its only once they have to take it. I also always consume food with my prenatal vitamin. Not only does this help with absorption, but it’s much easier on the stomach.
I only recommend two brands of fish oil. The first getting a gold star, Nordic Naturals. They are by far my favorite; very clean and the oil is in the most absorbable form. The other brand that I like is Carlson’s.
Let’s talk Nordic Naturals. If you look at shelf prices, they are significantly more expensive than Carlson’s, however if you do a breakdown of how much DHA/EPA and overall omega 3 fatty acids you get, the winner is Nordic Naturals. Their product that packs the most powerful punch is the Ultimate Omega but if you get a little nervous about taking general supplements while pregnant, they offer a prenatal omega supplement. When looking at the labels, Carlson’s is slightly deceiving, they list the number of grams of fish oil in each serving, then later they say how many of those are omega 3 fatty acids. Nordic only lists the number of grams of omega 3’s so it is very clear what you’re getting. The omega 3’s are what is most important so that is the number I am looking at. Both labels then go on to break down the amount of DHA and EPA in the serving.
DHA is traditionally thought of as being great for brain health and development which is why it is stressed as being important for prenatal health. EPA is generally more for cardiovascular health; however new research has uncovered that both are equally important for all cell development. There are a whole bunch of other juicy details and discoveries in this new research, but that’s getting off topic for this post.
The other big reason why I personally select Nordic Naturals as my fish oil fav is that all their products are in the triglyceride form. They are the only company to my knowledge that after filtering out heavy metals such as mercury, which takes the fat structure apart, they put it back together again. The human body will take fish oil in the ethyl ester form and convert them to triglycerides to use them. Our conversation rates are not necessarily very reliable and there’s no way to know how efficiently your body’s conversion process is. If the oil is already in the triglyceride form, the body will be able to utilize the oil to the fullest regardless of its ability to convert the oil. I prefer not to leave this conversion process to chance, but to feed it to my body in the most bioavailable form.
I take a couple different probiotics during pregnancy. My regular is the Garden of Life Vaginal Care. It has a lot of women specific strains that help ward off yeast and bacteria that could wreak havoc on the urinary tract and vagina. These systems are especially vulnerable during pregnancy due to fluctuating hormones, sugar/carb cravings and a baby sitting on the bladder causing frequent trips to the bathroom. These two products also contain two strains specific to prevention of group B strep. The GOL probiotic is my daily choice because it also has a wide variety of strains that support gut health and immune system function.
The Fem Dophilus is mostly in my emergency stash in case of a UTI or yeast infection. It only contains a few strains specific to these problems but in case of these, it is highly effective. You can look up the clinical trials that support the use of this product as well as the several different methods for administering it that were used for the studies. http://www.femdophilus.com/
There are many forms of magnesium and they are all good for different functions but there is only one form I would recommend avoiding. Magnesium Oxide is very poorly absorbed by the body, its primary function is as a cheap laxative so stay away from that one. The reason I prefer Magnesium Citrate in pregnancy is that pregnancy is notorious for causing constipation. Mg Citrate is a great form for the body to absorb and utilize with the added pregnancy benefit that it also is a mild laxative effect. I appreciate this gentle nudge to make sure everything keeps moving daily. Start with a small dose and see how your body responds. Gradually increase the dose to either the RDA or until your bowls cannot handle it (stools become too loose).
If you are among the few individuals who cannot tolerate Mg Citrate in any amount, Mg Glycinate or Malate are two very well absorbed forms that will not have any laxative affect. Magnesium is very important for muscle and bone health. Most people do not get near enough magnesium through their diets and are deficient. It’s great during pregnancy because it supports healthy muscle function so that hopefully those middle of the night calf or foot cramps can be kept at bay.
Bio Sil and Vitamin C:
I take these two supplements for skin and connective tissue elasticity. I also appreciate the immune support from the vitamin C. Bio Sil is a clinically tested form of silica, a mineral important for skin, hair and bone health. We get it naturally through our diet but not in a very high amount. There are no studied adverse effects in the amount that I am taking and although it is not traditionally recommended as a prenatal supplement, I deem it very important.
I first started taking it in my last pregnancy when I realized my abs were separating. I desperately wanted to prevent diastase recti and I was already avoiding all the main triggers such as ab exercises. With my heavy background in nutrition, I thought there must be a specific nutrient that will help support my body’s ability to stretch. After much thought and research, I decided silica was what my body needed and I went with the Bio Sil because of the studies that back up its results and I trust the company’s reputation. I also figured that my skin would benefit from some extra elasticity so hopefully I didn’t get any stretch marks (which I didn’t) and that because of its positive affect on bone health, with me growing an entire human skeleton inside of me, it couldn’t hurt!
Endure by Trace Minerals Research:
I don’t take this supplement diligently; I just add a few drops to my water or a smoothie whenever I think about it. This product is a cocktail of 72 trace minerals that support overall health and wellbeing. We get most of our minerals through the diet from fruits and vegetables. We also get some minerals in our water. With the breakdown of the ozone layer and the over-population of the earth, the soils are depleted which makes our foods unfortunately less nutrient dense than they were 100 years ago. I just like to give my water a little mineral boost when I can.
Gaia Ginger Supreme:
First off, can I just say that I love, love, love Gaia as an herbal company. Hands down they are my favorite source for every herb. I take this in my first trimester for nausea reasons; it helps take the edge off my morning sickness. Later in pregnancy as baby grows and cramps the digestive system, it gently nourishes and encourages healthy gut function. This supplement also contains a little bit of turmeric which is also amazing for gut health. Ginger and Turmeric work together synergistically and complement each other well. Not only are they great for gut health but they also contain properties that support a healthy inflammation response.
I have often heard the question of whether turmeric is safe in pregnancy; here’s what I must say about that. Again, I am not a licensed health care practitioner, this is just my educated opinion. I believe that it is safe in the dose in this supplement. Think about how much turmeric has been traditionally consumed by pregnant women in India for centuries and no harmful side effects have been observed. Indians are some of the healthies, longest living people on the planet and that has been contributed to their consumption of turmeric. Pregnant women in India do not stop consuming curry. If it makes you uneasy, don’t take it. I strongly believe in listening to your own instincts. You probably know more about what is good for your body than you consciously realize.
This zinc supplement is a combination of three different forms of zinc. I will admit that I am not a zinc expert and don’t know the benefit of the different forms. This one was recommended to me by my nutrition mentor as being a very well balanced zinc supplement and I completely trust him. Zinc is another mineral like magnesium where often people don’t get quite enough through their diets. Excessive zinc can be very harmful to the developing fetus so take in moderation. I feel that taking one dose of this zinc product daily is very reasonable and should not put anyone at the upper limit where it might be harmful to the baby.
This is not a supplement I take every day. I purchased it to have in my emergency stash in case of a UTI. It is incredibly effective at making the lining of the bladder slick so that bacteria cannot grow on it. This supplement also contains cranberry which has a reputation for being great for UTI’s. The cranberry is only effective with certain strains of bacteria (only e-coli if I remember correctly) and it works by binding to the bacteria so that it is eliminated with the urine and does not stay inside the bladder.
Is it safe during pregnancy? There are no sources that say yes or no. A naturopathic doctor I know says that it is safe and D- Mannose is just a simple sugar found in fruits. It is 100% natural (which does not always mean a product is safe), but since no negative side effects have been observed and it is found naturally in most people’s diet, I say it’s a good option for occasional use if I feel a UTI coming on. I’m much rather take this for a few days than a round of antibiotics.
This last week I am feeling more normal and more pregnant at the same time. I finally feel mostly free from morning sickness with only occasional nausea, but my belly is feeling very pregnant. I’ve noticed that sometimes, especially when I get out of bed, I start out walking with my left hand under my baby bump. I don’t consciously do it, it’s some unconscious gesture to hold or support my tummy. I’m not sure when it started in my last pregnancy, but I definably remember doing it towards the end. I’m also noticing that sometimes when I’m feeling particularly uncomfortable, I walk with a little bit of a waddle.
I also think I may be starting to feel some tiny flutters from the babies. I’m definably questioning it since it’s so early still, according to my Google search, second time mamas can sometimes feel fetal “quickening” as early as 12 weeks. It is clearly different than gas bubbles, which I often feel along the ascending, transverse or descending colon but never have I felt any gut related movement in the middle of my abdomen. I feel these new movements low between my hips, right in the middle and just a few inches below my belly button which is where I think my fundus (the top of the uterus) is at this point. I’m still not 100% sold that these flutters are actually my twins moving, but I am excited at the prospect that they might be!
I have a confession and apology for my dear readers. I do not have baby bump pictures for 12 weeks. I’m not sure what happened, it just somehow slipped my mind and I don’t have them.
The most exciting thing about this weeks is that over the course of the week, my morning sickness drastically faded. It started out that I was not waking up doubled over with nausea first thing in the morning but was still experiencing some nausea throughout the day. Its been super nice to not be hit by the nausea like a ton of bricks just as I’m waking up.
I wrote in a previous post that I didn’t want to know my weight throughout this pregnancy. I did decide to weigh myself this week to see where I was at. These twins are really changing all my plans! My reasoning behind wanting to know how much I weighed was that with twin pregnancies, weight gain is more critical. Not only do I want to prevent excessive weight gain, but I also want to make sure that I’m gaining enough to support a full term, healthy twin pregnancy. As of this week, I weighed 174 pounds. If I had to guess my weight at conception, I would say somewhere between 170-172 pounds. With my first pregnancy, I started at 168 which was after our honeymoon where I was a little lax about my diet and exercise; I use to hover around 165 prior to any pregnancies.
I had a urinary tract infection scare this week. I wasn’t having any burning, but I was having to push to urinate. Not fun when you’re pregnant with twins and desperately need to pee. It takes 48 hours for a full urinalysis to come back and UTI’s are a big risk to a pregnancy in the first trimester. The preliminary results came back suspicious for bacterial growth so much to my disappointment, I was started on antibiotics. Normally, I would have attempted to treat it naturally with cranberry, D-mannose, probiotics and lots of fluids and frequent urination. However, in pregnancy I was hesitant to take that risk and I knew it had already been going on for several days before I was seen in the clinic.
Two days later, the results came back negative for a UTI but containing “mixed flora,” so I was able to stop the antibiotics. Honestly, I’m pretty sure I did have a slight UTI but I had hit it hard the day before with all of those natural things and I was already feeling a little better by the time I was seen. I’ll never know for sure but that is my suspicions and either way, I’m super thankful to be off the antibiotics. I now have a bottle of D-mannose with cranactin in it and I’m more aware of the symptoms I need to watch out for.
Twin Mom, Yogi, and Health Nut!