Most dietary guidelines are very generic, but the Higgins Intervention Method has specific plans for meeting the special requirements of mothers with different nutritional needs. I like the ability this method gives to really personalize the recommendations and the ability it gives me to quantify the nutritional needs rather than just saying “eat more”. If you are working with a pregnant teen, she needs more than the standard prenatal calories and protein.  This is because her body is still growing, and she needs to eat enough to support both her growth and the growth of her baby. So you would need to add the 300 additional calories a dayRead More →

Vitamins and minerals are referred to as micronutrients.  They do not contribute calories to the diet, but do play an important role in cellular function.  Remember cells?  They make up your entire body and are responsible for your body being able to stay healthy. I personally have never been a fan of vitamin and mineral supplementation.  I am a purist in that I believe the diet should be adjusted before a pill is taken. But I do understand there are limits to what a woman is able to eat from time to time. Allow me to use myself as an example. Over the last two months sinceRead More →

If you have done any work with pregnant women, you have probably seen that how a person eats is a VERY personal matter.  Families who seek advice and information on nearly every other topic can seem to drift off into space if you start talking nutrition. So, how do you help a woman get optimum nutrition? That will depend on the woman.  But here are some questions to think about as you formulate a plan. 1. Is the woman ready to learn? Is she interested in what you have to say and trust the information you give her?  Is she open to making dietary changes and learningRead More →

Have you seen the latest weight gain recommendations from the IOM?  They are the same except an increase for the highest BMI levels. Low BMI gain 28-40 pounds; Normal BMI gain 25-35 pounds; High BMI gain 15-25 pounds and Obese BMI gain 11-20 pounds. I personally am a fan of increasing the weight gain for obese individuals.  I’ve always been frustrated that to ensure the recommended weight gain it meant an obese woman actually losing weight during pregnancy (when you adjust for the growth of the baby and the placenta). I prefer to focus on what a woman eats, and if her nutrition is appropriate thanRead More →

When it comes to pregnancy nutrition, there seem to be two types of people. Those who feel it is of the utmost importance, and those who feel it doesn’t matter. Want to know which side of that fence I am on?  Here is some information straight out of Varney’s Midwifery  to help you figure that out. Low birth weight babies, whether they are small for gestational age or premature, have increased rates of perinatal mortality, mental retardation, cerebral palsy, learning disabilities, visual and hearing defects, neurological defects and poor infant growth and development. Factors that influence birth weight are: maternal disease, smoking, gestational age andRead More →

If you’ve ever been in school you probably have seen a grading rubric.  It is the list of things that must be included in your paper and how many points are possible to receive for each item. I’ve become quite fond of them, because they let me know exactly what the professor expects from me. Today I was thinking about women’s reactions to their birth experiences.  More specifically, I was pondering over women’s disappointment and frustration with their birth experiences.  I thought about the words they use to describe their goals before labor and the words they use to explain their birth after. I’ve come to the conclusionRead More →

Moving from the idea of centering pregnancy, we explore another concept in prenatal care – home nurse visits. In one study, home visits were associated with decreased risk of preterm delivery for African-American women. These results were similar to the results of another study. In other studies, prenatal nurse visits demonstrate health effects beyond childbirth. These benefits include decreasing the risk of infant death. It is possible that the best prenatal care needs to fit the specific needs of the family.  Some families may like the structure of traditional private prenatal visits.  Other families may thrive with the social support of centering pregnancy. Those withRead More →

There is another way to think about prenatal care, centering pregnancy. In this model of care, women meet in groups to discuss their concerns and celebrate together.  The women take charge of their prenatal care, performing much of the prenatal assessment themselves. The best part, this model seems to work. What This Means to You If this is a new concept for you, take some time to explore the website and become familiar with the basic idea. Can you think of other ways prenatal care might be improved?Read More →

I thought you might like to see some recommendations for prenatal care.  Grab a cup of tea, these are long documents. The American Academy of Family Physicians offers these  recommendations for Prenatal Care Counseling. The Institute for Clinical Systems Improvement offers these guidelines for Routine Prenatal Care. Rocky Mountain Health Plans offers this printable brochure for Prenatal Care Guidelines. The State of New York as specific guidelines for what type of prenatal care a practitioner must give to receive Medicaid reimbursement. The World Health Organization offers these recommendations for prenatal care. What This Means to You The recommendations for prenatal care can be extensive. Here in the US increasing the amountRead More →

This week I want to spend some time looking at the various benefits (assumed and proven) of prenatal care.  One thing we know, women who have some form of prenatal care have better outcomes in labor than women who have no prenatal care. Why might this be? One reason may be the opportunity prenatal care gives for identifying and treating other health problems.  What kind of problems?  Any kinds of problems.  For example, did you know half of babies  living in poverty are being raised by mothers suffering from depression? It is terrible that 70% of the mothers go without treatment because depression puts both the mother and theRead More →