Pregnancy and exercise are not mutually exclusive.  Yes, pregnancy does require some lifestyle changes as the pregnancy gets farther along like not sleeping on your back, but being pregnant does not relegate you to invalid status.

Exercise and pregnancy go hand in hand. The benefits of exercise during pregnancy are significant.

• Reduced constipation
• Better sleep
• Helps to keep weight gain at appropriate levels
• Increased strength and endurance
• Reduced risk of gestational diabetes
• Reduced risk of high blood pressure
• Helping baby settle into a good position for birth
• More energy
• Stress reduction
• Improved mood

Pregnancy is a perfect time to start exercising regularly if you haven't been working out.  Walking is a great place to start, although you can start with just about anything like having a dance party with your kids, or raking leaves.  Build up gradually until you are working out for at least 30 minutes 5-6 days a week.  If you are already working out, you may want to modify what you do.  For example, if you are doing heavy weight lifting, consider using lighter weights and more reps.  Be mindful of avoiding exercise that puts you at risk of falling such as mountain climbing, or contact sports such as hockey.  Also modify abdominal exercises to reduce the chances of diastasis recti.  

I encourage all the clients I serve to exercise because the benefits are too great to miss out on. Labor and birth require strength and endurance. Regular exercise will go a long way to help with being prepared for the demands of labor and birth. 
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Sleep. We all need it and most of us would benefit from better sleep or more sleep. During pregnancy, getting good sleep or enough sleep can be challenging.  

Pregnancy can create new issues with sleeping. Trying to get comfortable, having to get up to go to the bathroom, having vivid dreams, and not being able to fall asleep again if waking up are common issues that can interfere with sleep during pregnancy.

Getting comfortable can be a challenge, especially if you are used to sleeping on your back. Pillows can be your best friend in this situation. Putting a pillow under a hip just enough to tilt you off your back can help in early pregnancy.  As your baby grows, having a pillow tucked behind your back, one between your knees, and one to support your belly may help you with being comfortable. I am a huge fan of the pregnancy pillows that surround you, almost like a nest. As pregnancy progresses, you might need more pillows for more support, or you might want your partner to tuck you into bed, helping get the pillows just right to let you sleep in comfort and bliss.

Vivid dreams can be something else that interferes with sleep. These dreams can be weird, intense or scary.  It seems like the mind goes into overdrive as you sleep, and you just don't feel as rested as you would with more normal dreams. Catnip tea, or Valerian tea are options to help you quiet your mind and let you have more restful dreams. Have a cup shortly before you go to bed.

If you are waking up often, or having a hard time getting to sleep in the first place, it might be time to add a snack to your bedtime routine. Sometimes your blood sugar can drop low enough that your body just isn't happy and it will wake you up or keep you awake. I recommend a protein rich snack such as nuts, cheese, or jerky before bed. If you fall asleep easily enough but can't get to sleep after waking up to go to the bathroom in the middle of the night, try adding in a small protein rich snack while you are up.

In the last trimester, many mothers can sleep but it is often interrupted by having to go to the bathroom multiple times in the night. Baby might be low enough to use your bladder as a pillow which means there's just less capacity in there. My suggestion for this situation is to set a cut off time for hydrating and focus on getting all your hydration in before that cut off time. Usually 2 hours before bed is plenty of time. Just make sure to start hydrating again as soon as you wake up for the day.

Hopefully, these ideas will having you sleeping through your pregnancy like a baby!  

How much weight will I gain in pregnancy?  How much weight should I gain in pregnancy?  What can I do to keep weight gain down during pregnancy?  What if I gain too much weight while I'm pregnant?  Should I lose weight while I'm pregnant because I started pregnancy overweight? These are all questions I have been asked in my midwifery practice.

We know some of the weight gain that comes with pregnancy will go away with birth. Expanding blood volume is 3-4 pounds, amniotic fluid is about 2 pounds, the placenta is about 1 1/2 pounds, 2 lbs as breast tissues preps for breastfeeding, and your baby may weigh 7-8 pounds.  So, with birth you will drop around 12 pounds or more as soon as birth happens, and lose a few more pounds as your blood volume returns to normal levels. 

ACOG has guidelines on weight gain that are tied to what BMI was before pregnancy. The guideline for someone carrying one baby who starts pregnancy at a healthy weight is 25-35 pounds. If pregnancy starts out underweight, then the guidelines allow for higher weight gain, and the guidelines are lower for a pregnancy that starts out overweight.

Gaining too little weight has risks including that baby will have a low birthweight, and it is tied to premature labor. Babies who are smaller seem to have a harder time thriving after birth, requiring more frequent feedings than a baby who is born at a healthy weight. Gaining too much weight also is associated with risks such as gestational diabetes, preeclampsia, postpartum hemorrhage, and baby's blood sugar may drop too much after birth.

I want my clients to gain weight. I don't have "rules" about how much should be gained during pregnancy or when weight should be gained. I don't have a scale in my office to weigh clients. I figure we all have enough stress about our weight without the need to stand on a scale at appointments. 

I want clients to eat enough nutrient dense food to support their body and pregnancy. I rely on non-scale ways to ascertain if a client's diet is supporting pregnancy well. I use assessments like how fundal height is increasing, and how baby feels when I palpate. I also observe how clients look, if they feel well, and if they are having any issues such as swelling as pregnancy progresses. I like to see a food log at the start of prenatal care, and I like to see one again around 30 weeks. Some of my clients find it really helpful to keep a food log as a way to help keep the focus on eating nutrient dense foods.

I understand the desire not to gain more weight than needed for a healthy pregnancy. I work with clients to encourage them to eat nutrient dense foods, and recommend foods they may want to add or focus on if they experience cravings. If a client is eating primarily nutrient rich foods during pregnancy and engages in regular exercise, I believe she will gain the amount of weight her body needs to sustain that pregnancy. 

While encouraging clients to eat nutrient dense foods, we focus on ways to make that sustainable and enjoyable. After all, if you don't like it, you won't keep doing it. We are all individuals and while there are recommendations about weight gain, they may or may not be appropriate for the client. I do not believe in a one size fits all approach to maternity care, and I certainly do not believe a one size fits all approach is appropriate for pregnancy weight gain.

Being a midwife can be challenging, and it requires many skills. One of the skills I have had to hone as a midwife is juggling....

Being a midwife means being an expert in calendar juggling.  Scheduled commitments and activities may get canceled at the very last minute, or rearranged a few times depending on when babies decide to come.  Being a midwife means being dependable for clients, occasionally at the expense of your friends and family.  Sometimes you have to put the needs and desires of your family second. Yay for flexible families and friends who understand this and support the midwife wholeheartedly!

Sometimes being a midwife means juggling vehicles.  In my life, we have an older car which is fun to drive but isn't the car you want to drive for longer distances.  If the hubby needs to travel, we have a discussion about where my clients are located to decide which car he's taking.  Sometimes he may come and switch out cars while I'm at a birth.  

Being a midwife means you may juggle your own needs so you can support a client in labor.  I've been at many births where my needs for sleep, eating or drinking were shifted or delayed so I could be available to support a client in labor.

Being a midwife means trying to juggle the expectations you have of yourself, the expectations your clients have, and expectations others who are invited into the birth may have. Trying to juggle expectations means I am forever second guessing myself. I always wonder if I have missed something, if I am understanding what I can see, feel and observe correctly.  I am not perfect and know I will make mistakes, but I keep chasing after perfection. 

Don't misunderstand me, I am not complaining. I chose to be a midwife. I have impressed myself at times with the juggling that is part of midwifery.  Maybe one day I'll even learn to juggle balls or fruit!

Today, I'm going to rant a little.  One of my personal pet peeves as a midwife is that once it is obvious that someone is pregnant, it is as if they become public property.  Complete strangers suddenly feel as if they have carte blanche to comment about your pregnancy, your choices, your health and so on.  Sometimes they feel that pregnancy entitles them to come over and touch your belly without asking first!  You may get told birth stories whether you want them or not.  

Why does it seem to so many that it's acceptable to comment on a stranger's pregnancy.  Comments like "You look ready to burst", or "I hope your water doesn't break while you are shopping" are often shared when someone sees a pregnant mother.  It's sad that people just can't keep their comments to themselves.  

A large proportion of society seems to have the tact to restrain comments on someone's appearance while with them in person (social media is another matter) unless it's a pregnant mother.  We don't walk up to strangers and tell them how to take care of themselves unless it's a pregnant mother.  We don't tell siblings that their lives are never going to be the same, that they will have to grow up unless they are with a pregnant mother.  We keep our comments to ourselves unless it's about a pregnant mother.

We need to stop making comments, expecting we can pat bellies, and giving unsolicited advice.  What if we kept our mouths shut and didn't share unless asked?  What if we shared a smile with the pregnant mother and went on with our day knowing we made her life easier by smiling instead of assuming we have something to say she wants to hear?