​Exercise is wonderful during pregnancy.  If you already have a workout routine, I applaud you.  If you are looking for ideas, here are some excellent options to consider incorporating into your pregnancy fitness routine:

• Walking: This is often recommended as a fantastic starting point and can be continued throughout your pregnancy. It's low-impact, accessible, and great for cardiovascular health.
• Swimming and Water Aerobics: The buoyancy of water provides excellent support, reducing stress on your joints and back. Swimming works multiple muscle groups and feels refreshing, especially in later trimesters.
• Prenatal Yoga and Pilates: These classes are specifically designed for pregnant women, focusing on gentle stretching, strengthening, flexibility, balance, and breathing techniques. They can help alleviate common pregnancy discomforts like back pain and improve posture.
• Stationary Cycling: This provides a cardiovascular workout with minimal impact on your joints. You have more control over the intensity and can easily stop if needed.
• Low-Impact Aerobics: Activities like modified Zumba or dance fitness classes designed for pregnancy can be a fun way to get your heart rate up.
• Strength Training (with modifications): Maintaining muscle strength is important for supporting your changing body and preparing for the demands of motherhood. Use lighter weights or resistance bands and focus on higher repetitions. Avoid exercises that put direct pressure on your abdomen or involve holding your breath. Focus on functional movements like squats, lunges, and rows.

How to Progress in Exercise:
Progression should be gradual and based on how your body feels. Here are some general guidelines:

• Start Slowly: If you are new to exercise, begin with shorter durations and lower intensity. Gradually increase the time and effort as you feel comfortable.
• Focus on Duration Before Intensity: Initially, aim to increase the length of your workouts before significantly increasing the intensity.
• Listen to Your Breathing: You should be able to hold a conversation comfortably while exercising. If you are too breathless to talk, you are likely pushing yourself too hard.
• Pay Attention to Posture: Maintain good form throughout your exercises to prevent injury and maximize effectiveness.
• Incorporate Rest: Allow for adequate rest between workouts to allow your body to recover.

Don't compare yourself to others. Every pregnancy is different, and what feels comfortable for one person may not feel right for another. Focus on what feels good for your body.  Incorporating some form of exercise into your day is so beneficial for you and for baby.

Symphysis pubis dysfunction (SPD), also called lightning crotch, refers to pain and discomfort in the pelvic region, specifically at the symphysis pubis joint. This joint, located at the front of your pelvis, connects the left and right pubic bones. 

What causes SPD?
The symphysis pubis joint is normally quite stable, held together by ligaments. However, during pregnancy, hormonal changes (specifically relaxin) loosen these ligaments to allow for the expansion necessary for childbirth. This can let the two sides of your pelvis shift or move unevenly which can be very uncomfortable. 

Recognizing the Symptoms:
SPD symptoms can vary in intensity, but common signs include:
Pain in the pubic bone area, which may radiate to the groin, inner thighs, or lower back.
Clicking or grinding sensation in the pelvic area.
Pain that worsens with movement, such as walking, climbing stairs, or turning over in bed.
Difficulty separating your legs.
Pain when standing on one leg.

Managing SPD: 
While SPD can be painful, there are several strategies you can employ to manage the discomfort and improve your quality of life:
Rest and Activity Modification:
Take frequent breaks during prolonged standing or sitting.
Try to minimize activities that require you to stand on one leg.
Avoid heavy lifting.

Supportive Measures:
Wearing a pelvic support belt can help stabilize the joint and reduce pain.
Using ice packs or heat therapy can provide temporary pain relief.
Pain Management:
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage mild to moderate pain.

Exercise and Stretching:
Gentle exercises, such as swimming or yoga, can help improve flexibility and strength.
Stretching the muscles surrounding the pelvis, such as the hip flexors and hamstrings, can also be beneficial.
Chiropractic care:
Seek out a chiropractor who is certified in the Webster Technique which is specifically for pregnancy.
Maintain Good Posture:
Good posture helps to distribute weight evenly across the pelvis, reducing stress on the symphysis pubis joint. As an added bonus, good posture encourages baby to get into a good position for birth.

Will SPD go away?
SPD tends to become more intense as pregnancy progresses.  It goes away after birth as the body stops producing the hormone relaxin.  Some women notice relief within a few days after birth and for other women it can take a few months before it is completely resolved. SPD tends to be more intense with subsequent pregnancies.

The thyroid gland, a butterfly-shaped organ located in the neck, is a vital part of the endocrine system. It produces hormones that regulate the body's metabolism, which is the process of converting food into energy.  Here's how it works: 

• The thyroid gland produces two main hormones: thyroxine (T4) and triiodothyronine (T3).
•  T4, or thyroxine, is like a storage form of thyroid hormone. It circulates in your blood, but it's not the active form that your cells can use. To become active, T4 needs to be converted into T3. This happens mainly in your liver and kidneys, but also in other tissues throughout your body.
• The conversion process involves removing one iodine atom from the T4 molecule. This is done by enzymes called deiodinases. There are different types of deiodinases, and they work in different parts of the body to regulate how much T3 is produced.
• Once T4 is converted into T3, it can enter your cells and bind to receptors, triggering all sorts of important metabolic processes.                                                                                                                               

Why is the thyroid so important during pregnancy?
Your thyroid produces hormones that regulate metabolism, which is essential for energy production and overall body function. During pregnancy, your body's demand for thyroid hormones increases significantly. This increased demand is driven by several factors:

• Baby's Development: Your baby relies on your thyroid hormones for healthy brain development, especially in the first trimester when their own thyroid isn't fully formed. These hormones are crucial for neurological development, impacting everything from intelligence to motor skills.
• Maternal Health: Adequate thyroid hormone levels are essential for maintaining your own health during pregnancy. They play a role in energy levels, weight management, mood stability, and preventing complications.
• Placental Function: The thyroid also supports the healthy function of the placenta, which provides essential nutrients and oxygen to your baby.

What happens to the thyroid during pregnancy?
During pregnancy, several changes occur to ensure adequate thyroid hormone levels:

• Increased Hormone Production: Your thyroid gland naturally increases its production of thyroid hormones to meet the demands of pregnancy.
• Increased T4 to T3 Conversion: The body becomes more efficient at converting T4 (the storage form) to T3 (the active form) of thyroid hormone.

What are the most common thyroid problems during pregnancy and what issues are associated with them? 
Hyperthyroidism: This condition occurs when the thyroid gland produces too much thyroid hormone, speeding up many bodily functions. In pregnancy, hyperthyroidism is most often caused by Graves' disease, an autoimmune disorder where the immune system produces antibodies that stimulate the thyroid to make excess thyroid hormone. During pregnancy, untreated hypothyroidism can lead to complications such as preeclampsia, premature birth, low birth weight and neurological issues in baby.
Hypothyroidism: This condition occurs when the thyroid gland does not produce enough thyroid hormone, causing body functions to slow down. The most common cause of hypothyroidism is Hashimoto's disease, an autoimmune disorder where the immune system attacks the thyroid, impairing its ability to produce thyroid hormones. Untreated hypothyroidism is associated with an increased risk of miscarriage, preeclampsia, placental abruption, postpartum hemorrhage,  premature birth, low birth weight, stillbirth and transient or permanent hypothyroidism in baby.
What are the treatments for thyroid problems during pregnancy?
Levothyroxine is used to treat hypothyroidism during pregnancy. If you are already taking Levothyroxine, you may need to increase your dose.  Thyroid levels should be checked every 4 weeks during pregnancy. 
Natural thyroid hormone options like Armour Thyroid, which contain T3, are not recommended during pregnancy because they can cause lower levels of T4 in the maternal blood stream. Baby needs T4 so having lower levels will lead to decreased T4 available for baby and can lead to baby having hypothyroidism.
What can you do to support healthy thyroid function during pregnancy?

• Ensure adequate iodine intake: Follow your doctor's recommendations regarding iodine supplementation. Prenatal vitamins often contain iodine. Include iodine-rich foods like seafood (in moderation), dairy, and iodized salt in your diet. However, it's important not to overdo it with iodine, as too much can also be problematic.
• Maintain a balanced diet: A healthy diet rich in essential nutrients supports overall health, including thyroid function.

Sources:
https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-endocrine-system#:~:text=The%20thyroid%20plays%20an%20important,of%20the%20body's%20calcium%20balance
https://www.ncbi.nlm.nih.gov/books/NBK500006/#:~:text=The%20thyroid%20hormone%20is%20well,and%20many%20other%20bodily%20functions
https://www.ncbi.nlm.nih.gov/books/NBK537039/#:~:text=The%20thyroid%20produces%20approximately%2090,%2C%20or%20triiodothyronine%20(T3)

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