Prepare for the biggest event of your life…

I have been a sports nutritionist for over 15 years now and have worked with a variety of athletes over the years. I have also consulted on programmes that involve getting people doing more physical activity in their day-to-day life and have seen some fabulous transformations.

People who led sedentary lives being inspired to train for big physical challenges have come to me to plan their journey. Sometimes they have been unrealistic in that planning, and sometimes more modest than they needed to be. Whatever the scenario, even in the most ambitious of people I haven’t come across a single person wanting to run a marathon the following day without any prior training. Why is that? Clearly, because even a suggestion of the sort is ludicrous – how can you? The effort required by the body to run 26.2 miles is not something you can take lightly. The adaptations that the body needs to go through in order to sustain this level of activity takes months of training. Your muscles adapt to the sheer repetitive pounding; your blood vessels and other tissues respond by increasing their capacity to do more work; your lungs need to get more efficient, and most, importantly your mind needs to be prepared for the event by being able to assimilate all the physical experience of training and projecting a positive outcome for race day, so that you don’t feel incompetent and experience failure, dejection or even depression when the training gets hard.

People don’t enter marathons without understanding that this will require preparation and months of sacrifice in terms of eating right and training hard.

Yet we expect pregnant mums to ‘run the marathon of their lives’ without any systematic and goal-oriented training. They turn up at labour wards needing to exert the same level of physical exertions (if not more), with much higher levels of mental anxieties and the added emotional rollercoaster that they are perpetually on whilst being pregnant. Is it any surprise then, that we ask for pain relief and other interventions when our bodies are going through the most physically challenging moment of our entire lives? I am not for once suggesting that pain relief doesn’t have its place during childbirth; what I am arguing instead is that perhaps the need for them would drastically reduce if we put into place the preparation that is required to physically birth a human baby.

Epidural anaesthetic use is now at almost at 36% in our country, with almost double that in the US, and even higher in some other countries such as Mexico. This does not merely speak of medical advances in helping women manage their labour, but a generation of mothers now scared of childbirth.

I see these anxious mums on a weekly basis. They have all the right intentions for their birthing journey but very little guidance on how to convert the anxiety of childbirth and fear of unknown into something powerful. We start off with mums wanting to come and relax and reduce anxiety of their high emotional journey of pregnancy. But, somewhere along the way, they get physically strong; the deep squats, the planks, the downward dogs and the balancing postures – they all add up. I start off conversations in the early weeks with terrified women who fear childbirth, but end up with birth stories of wonderful resilience, of grace, of valour and of that true and deep emerging wisdom that comes from knowing yourself, your body and your capabilities.

Being an integral part of this transformation of women has made me a passionate advocate of talking about ‘training for childbirth’; just like we do for marathons, just like we do for climbing the Everest. It bothers me that we can’t see the parallels, and it bothers me even more when people celebrate their race achievements, but we as a society completely ignore and overlook the issues, the obstacles and the need to appreciate what women go through during childbirth.

In fact, it’s only recently we are even talking about physical activity during pregnancy. We do so now, even in 2017, with trepidation. If we are to bring down the rates for C-sections, epidural anesthetic and other pain relief medication use during childbirth, then addition of sensible and appropriate physical and mental preparation should be part of routine antenatal care. Simply saying it’s okay to exercise during pregnancy is like saying it’s okay to train for a marathon. The message needs to be louder, clearer, directed and more goal-oriented. It is not just okay to exercise; it is important to do so to prepare for the ultimate physical event of a woman’s life. Just like any other race, we need to get to the finishing line knowing we did the best we could for ourselves and our babies and, in turn, setting that positive example for our daughters.

This is the only way we can come out at the other side beaming with self-confidence and that strength of character that defines our demographic group.

There is a wealth of information and preparation materials here on MummyYoga. Start your journey of motherhood with the right information, slowly assimilating the positive knowhow of past generations and weave it into your birth story. Your birth belongs to you… your baby…your body and above all how you respond to your unique journey.

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Tracing back the roots of evidence.

This is an excerpt from Tricia Anderson’s fabulous article from 2002.

“Everyone knows that cats need to give birth undisturbed in a dark, secluded place – perhaps preparing a softly lined box in the darkest corner of the furthest room underneath the bed. And everyone who knows about cats understands that you must never disturb a cat in labour or a newly delivered cat and her litter of kittens. Otherwise the cat’s labour will stop or she may reject her kittens. Everyone knows this.

But just imagine that one day, quite a long time ago, a group of well-meaning scientists decided that they wanted to study how cats give birth. So they asked anyone who had a cat, that when she went into labour to bring them to their laboratory – a brightly-lit, noisy, modern scientific laboratory where scientists could study them, by attaching lots of monitors and probes, surrounding them by strange technicians constantly coming in and out with clipboards. In the laboratory, the labouring cats could hear the sound of other cats in distress, and there were no private dark corners for them to retreat to, but only rows of brightly-lit cages under constant scrutiny of the scientists.

And the scientists studied the labouring cats in their brightly-lit cages for many years, and saw that their labours were erratic, how they slowed down and even stopped, and how heartbreakingly distressed the cats were. Their mews and their cries were terrible. They saw how many of the kittens were deprived of oxygen and were born shocked and needing resuscitation. And, after many years the scientists concluded ‘well, it seems that cats do not labour very well’.

Then, because the scientists were caring people and wanted to help the poor cats, they invented lots of clever machines to improve the cats’ labours, to monitor the oxygen levels in the kittens; they invented pain-killing drugs and tranquillisers to ease the poor cats’ distress, and drugs to make labour become regular and stop it slowing down. They even developed clever emergency operations to save the distressed kittens’ lives.

The scientists wrote scientific papers which told everyone about the difficulties they had observed and how cats do not give birth very well, and all about the clever feline birth technology they had invented. The newspapers and television spread the word, and soon everyone started bringing their cats to the laboratory in labour, because of all their clever feline technology and of how many kittens’ lives they had saved. Looking round at all the complicated technology, people were heard to say: ‘This must be the safest place in the world for cats to give birth in’.

Years passed, and the workload at the scientists’ laboratories grew busier and busier. They had to take on new staff and train them in their feline labour techniques, and slowly the original scientists grew old and retired. But sadly the new up-and-coming technicians didn’t know about the original experiment; they didn’t even know it was an experiment. They had never seen cats giving birth in softly-lined boxes in the furthest, darkest corner of the furthest room – why, what a dangerous idea! They were absolutely convinced that cats do not give birth very well without a lot of technical assistance – why, think of all the years of scientific evidence they had collected – and would go home at night feeling very pleased with themselves for all their clever and good work in saving cats’ and kittens’ lives.”

Moral of the story is… our beliefs are sometimes blinded by what we see around us.

Read the whole article here.

Being versus Doing

By Samantha Wiltshire

Becoming a new mum, while incredible, at times magical, and completely life transforming, also involves quite a lot of ‘doing’! Suddenly on much reduced sleep we are keeping a whole other person alive, when not so long ago we were mainly concerned with just ourselves on the whole. There’s washing, the feedings, trying to establish nap routines, changing requirements and catching up with what can seem like daily new needs from your baby as they zoom their way through the first year of development. There is the squeezing of jobs into nap times while one ear is also on a potentially ending nap.  There’s the time spent in the house, gearing yourself up (quite literally with nappies, wipes, carrier, toy, snacks….) to go out of the house. I now look back and wonder how much time I actually spent not doing but just taking a moment to breathe, to sense, to just be. And by that I don’t mean the stolen Facebook sessions, browsing lazily through any article that was posted. Nor do I mean that period of clock-watching time waiting for your partner to come in from work and be your adult company. I don’t even mean the occasional impromptu naps – though they were so very good too! I mean just stopping for a moment to take it in. 

There can be a couple of reasons why we don’t do this often. There is the obvious one – when am I supposed to fit ‘being’ into my day? Our day doesn’t often seem to have a window for this. Then, when we do, there can be the sense of guilt, that there must be something we should be doing! I found it quite hard to access ‘being’ over ‘doing’ when I was in the house, surrounded by lots of reminders of what I could be doing. So, no matter what, I found it was important to take a walk in my day, with my baby of course, but maybe at nap time. When nap time was taken at home I often filled it with stuff. Or, at the very least, filled it with sitting on the sofa, catching my breath and making mental lists. But when it was out in the park (I lived near the glorious Greenwich Park at the time – the perfect place to ‘be’) I could simply and peacefully absorb what was around me, notice my footsteps, the fresh air, the sounds. Here my mind could detach a little from the busy thoughts, list making etc. and, as a result I was pressing the pause button and replenishing body and soul. 

To draw it back to yoga, these classes were another space for me to ‘be’. Maybe it was because yoga has always held that place for me – moving my body, gently and with love, through the postures that it was so familiar with – maybe it was the indulgence of something for me, but whatever it was, even the simple act of rolling out the mat and stepping onto it had the effect of easing my body and soothing my mind. The, almost ritualistic movement, guided by my breath, held me in the space, in the present. That’s not to say that some amount of mental list making wasn’t happening in Trikonasana. Nor did my mind completely free itself from worried thoughts, inner rants, anxieties around my baby’s welfare. But as the teacher guided me, I could follow, and sometimes it may have taken the whole class time to get there, but I did come back to me, in the present moment, sensing more than thinking, feeling more than analysing.

Some of my friends who have a yoga practice, discovered yoga either when pregnant or when they were a new mum, either through mum and baby classes or as a much needed time for themselves when someone could help give them that time. Pregnancy is a time when our body takes over. It can speak to us more clearly than at any other time of our lives – telling us what to eat and drink, making us slow down and respect the needs of the body. Maybe that is why yoga can be a natural draw for us at this time. Spending time on the mat, respecting the body more than the list of mental jobs we have made, is precious for our well-being – as well as strengthening and preparing the body for birth and what follows. We can swing the other way once baby is born and rather neglect ourselves, and so continuing our practice may be the only time we are kind to ourselves and treat ourselves with the same love we treat our new-born.

Wherever it came from, be it yoga, walks through the park, sitting down to slowly and thoroughly enjoy a sweet treat, treasuring these moments, making time for them, creating space; these were crucial for me. These moments gave me the strength to carry on and enjoy this precious time with the baby I shared it with.

Keep me close – Why our jumbo brains are born prematurely.

In this podcast of Keep Me Close series, I discuss the influence of the book, Sapiens by Dr. Yuval Noah Harai (www.ynharari.com/book/sapiens/).

I talk about how bipedalism and brain growth favoured earlier births. I also touch upon a theory of why we hold an innate existential fear and anxiety that limits us on every turn.

Human babies are born with the most underdeveloped brain in the animal kingdom. As we became bipedal in order to better scan the savannah we were living in, our upright gait made our pelvis narrower. This happened in times when our brains were already going through a massive expansion in neural connections and size. The narrower pelvis and the increasing human skull became a perfect combination that created a major hazard to birthing human babies. The mothers who gave birth to smaller babies with underdeveloped brains, were more likely to survive childbirth and thus we have evolved to birth babies with a significantly underdeveloped brain.

 

Why sitting correctly during pregnancy matters.

 

Everyone, myself included keeps talking about our standing and upright postures and it’s relevance to baby’s position at birth all the time. But today I want to tackle the posture which we assume more than standing… sitting down.

Why does it matter how we sit?

There are two positional issues with seated postures. Your spine and your baby’s position (more important closer to birth after about 36-37 weeks).

If you haven’t taught yourself over the years to carry your upper body weight distributed proportionately across and down your spine then the default position your body will adopt is the “sink all the weight closest to gravity” sort of posture. This means slouching into your lower back and rounding your middle back. Why? Because the closer anything is to the ground the less heavy it gets. That’s why it’s harder to carry anything holding your hands up then letting it dangle by the side of your arms.

In order to not slouch in and give all your weight to your hips, buttocks and thighs, it is important to learn to sit “taller”… creating the lift in the full length of your spine which will allow your weight to distribute across your whole spine.

Why is this way of sitting beneficial?

Spinning babies explain the benefit of sitting upright clearly.

“Sitting upright helps the abdomen be a hammock for the baby and encourages the baby to settle in an anterior position when the mother’s ligaments and fascia are balanced and she hasn’t waited too long. Start before getting pregnant, if you can, but start when you can.”

Sitting upright also means, stopping the weight of your body and your bump sinking into your lower back area making the pain in your back worse as that’s not to most efficient way and place to keep your weight.

Sitting upright allows for better blood flow across your lower abdominal region making sure your uterus is not being deprived of valuable resources. This is especially important if you are sitting for long periods in excess of 60 min or so.

How to learn to sight upright?

Learning to sit without supported back can be very beneficial as on a birthing ball. But if you have bad habits of slouching then that actually makes the birthing ball or bar stool more of a problem rather than a solution.

I recommend starting at the beginning. If you can sit on the floor. Here are some of the most important cues to remember –

1. Think about your tailbone in relation to your body weight. You shouldn’t be sitting on your tailbone giving your whole weight into that area.

2. Think about the relationship of your tailbone to your lower back. If your tailbone is under you, you lower back will slouch away from you creating a “C” shape. But if your tailbone is in the active position, i.e. sort of touching the ground rather than under you then your lower back will tend to curve forwards. This curve will be rather different for different people and also at different time points in your pregnancy. So just follow what feels natural as long as you sit with that forward motion.

3. Then as you inhale, rise up towards the ceiling slowly letting your body weight spread across your whole back, not merely lifting your chest up and dropping your shoulders down.

This spread of your weight across your back will reduce the high pressure area you can create in your lower back by slouching and also reducing the blood supply in the lower abdominal area impacting the blood supply in your uterus.

Here in this video I explain this whole principle and give you simple positional guides that you can feel and access with your own personal experience rather than a textbook way.

The Due Date saga.

“When are you due?”

How do you answer this question?

a single date? A week window or even more vague?

The politics, the science and the cultural weight of the “due date” escapes no pregnant mum.

The other issue is the due date is also a holy grail for your care providers. This statistical little figment that is plastered all over your notes is so ubiquitous that it’s not possible to think anything else other than this one date in the calendar.

Here is the real low down on when will your labour actually start.

It’s your baby that will determine the start of your labour. The foetus’ lungs are filled with fluid when in the uterus and in order for the lungs to be able to successfully breathe in air, it will need to open and close without collapsing when air is drawn out. The fact that our mature lungs do not collapse in on themselves when we exhale is due to a funny soapy protein that the cells within the lungs create. The new born can only start to create this special surfactant protein from around approximately 36 weeks onwards. This is also the reason why it’s so challenging for premature babies to breathe.

Once this protein in created in the foetus lungs, it signals the maternal system to initiate labour. The early signs of labour is a reduction in the anti-inflammatory hormone progesterone. Progesterone is what keeps your pregnancy and a drop in that hormone is a signal towards birth. Since birth is a stress response created by your body, less progesterone helps in establishing this process.

So when the cocktail of baby hormones, mother’s hormones start to align, then birth initiates. For some women it starts around 36 weeks for some it could be a little later than 42 weeks. It’s a range and if you bear this range in your mind whilst letting people know when your time is due, then you will not feel the pressure of this ridiculous one single day that is in your notes.

Keep calm, keep relaxed, listen to your birth preparation audio guides and baby will let you know when she/he is ready to breathe freely without your help in the big world.

Ina May Gaskin and her “Sphincter law”

Declaration: I Love Ina May, her spirit, her passion, her tenacity in the face of critics, her sheer will power to fight the existing status quo and above all her ability to believe in womankind at a time when it wasn’t so cool to do so. Still isn’t, is it?

Ina May’s book Guide to Childbirth was one among many resources that helped me become confident about my first birth. I was a terrified 30 something year old, too busy with my life and career when I got pregnant in 2013. At this time, since my adolescence I had struggled with period pains so bad I couldn’t attend school and college for the first day or two every month. Then in the big bad world of career progression, I started taking stronger and stronger painkillers to get me to work when I couldn’t manage. So the thought of giving birth was a most terrifying one. I too like most women assumed this will be the mother of all period pains to endure in order to receive the gift of a child. Maybe that’s what people called the “passage”.

So I set upon preparing for this mammoth task like the way I approach practically everything, reading as much on the topic I can lay my hands on. Slowly, very slowly I realised my fear could be tamed as there was another way. In that journey was a gem I discovered, “your body is not a lemon, It is important to keep in mind that our bodies must work pretty well, or there wouldn’t be so many humans on the planet.” Now this sort of thinking; simple, logical and linear appeals to the scientist in me a lot.

I started reading more Gaskin. Then, I came across something termed, “the sphincter law” what this law proclaims is that all spinchters in our body behave the same way, are voluntary in their opening. Particularly these statements below describe Ina May Gaskin’s sphincter law –

  • Sphincter muscles of both anus and vagina do not respond on command.
  • Sphincter muscles open more easily in a comfortable intimate atmosphere where a woman feels safe.
  • The muscles are more likely to open if the woman feels positive about herself; where she feels inspired and enjoys the birth process.
  • Sphincter muscles may suddenly close even if they have already dilated, if the woman feels threatened in any way.

The issue with this “law” is that there are hundreds of sphincters in the body. Some voluntary, as the anus (actually even here the internal anal sphincter is a smooth muscle and not under voluntary control, only the external anal sphincter is under voluntary control) and a lot of them involuntary like in the blood capillaries. Not all open at the same time (well you would certainly not want that!) and not all care for privacy.

Another issue is that, neither your vagina or cervix is a sphincter. I will simply repeat this for clarity and confirmation, not effect… your cervix is not a sphincter. The cervix dilates as an effect of the cervix contracting and effacing from its top end.

The cervix cannot open and close like the anus. However, the idea that dilation may reverse is a possibility that has been documented. This is true even in animal kingdom where a potential threat may slow/stop and in some cases even reverse labour.

This threat and its effect on labour is not associated with any sphincter. It’s a physiological response to threat that is also rather involuntary in action. The outcome of course is detrimental in that the beautiful high oxytocin drenched physiological response to childbirth will now be taken over by the flight or fight hormonal cocktail of adrenaline and cortisol.

It’s not that Ina May is wrong on the outcome of fear and threat based childbirth journey, it’s just that her limiting and erroneous use of medical terms means this wonderful message of birthing from a place of love and security gets discarded by medical professionals who get more stuck up with her inappropriately used terminology.

So let’s stop calling this the “sphincter law” and perhaps just spread the message on birthing from a physical, emotional, mental and physiological safe, secure, warm and above all loving place.

How do we get fat? You ask. 

Today I revert to my beginnings. I want talk on health, nutrition and wellbeing more broadly than yoga. After a few chats this week surrounding losing weight/fat, getting fitter postnatally after the new born phase is over, I thought it was a good time to bring up some basic physiological underpinnings of getting fat.

Almost everyone you know can tell you a million ways to lose body fat. From the 1950s’ advocacy for smoking cigarettes to yesterday’s newspaper there is a weight loss article to read. But if you understood how we get fat (no, not the simplistic idea of calories in and out), and how the body works to store excess energy, then hopefully despite all the faddy diets and exercise regimes you can reverse-engineer your body composition to a more healthy level. That has been my premise for twenty years now in maintaining healthy body fat levels, despite having a strong familial predisposition to be obese. So, in this post I am going back to basics. But before I start let me just say, once you know something that is only the beginning; the big prize goes to those who act on the knowledge. Remember the post on habit forming?

In this story of fatal attraction, there are two suitors and one princess. The handsome hunk is called muscle tissue and the ugly ogre is called fat tissue. The princess is sweet and delicious (even a slice of wholemeal toast eventually breaks down to sugar!). The princess secretly likes muscle, but muscle is such a Casanova, he is always hanging out with many girls. So the princess has no choice but to cosy up with fat. The End.

You see, our muscle tissue is the storage pot for all energy we eat. The size of the pot depends on the amount of muscle you have. The more muscle you carry, the more energy you can store as valuable ‘glycogen’ (the only way a body can store carbohydrates). Any excess energy is then converted to fat and stored as fat tissue. Every time you use your muscles the glycogen in them reduces, and every time you eat it gets replenished. However, if you eat when the muscle glycogen levels are not low, then it has no choice but to get stored as fat.

So, if you use this simple principle of making sure you have depleted your glycogen before meals (physical activity) you are less likely to store the energy as fat. Another time the glycogen is low is after your overnight sleep, when the glycogen is used up to repair the body as you sleep. So the simple principle here is to exercise first and eat after.

How does this food energy get into the muscles? There is a master controller in this game of storing energy, and his name is ‘Insulin’. Every time you eat carbohydrates, insulin is sent in to mop it out from the blood (the carbohydrates break down as sugar and come into your blood through the intestines) and store it in the muscles as glycogen. The amount of insulin sent in is generally well matched with the amount of sugar from the food in your blood. Especially if you have eaten complex carbohydrates (e.g. wholemeal bread) and their breakdown has taken some time for the sugar to drip feed into your blood, giving your brains plenty of time to calculate the amount of insulin to be produced (by your pancreas). However, if you eat (or drink) simple sugars (e.g. white bread/sweets) then its panic time! Since there is nothing to digest, all the sugars rush into your blood almost at the same time, leaving your brain very little scope to calculate the right amount of insulin needed.

It is very dangerous for you to have excess sugars floating in your blood, so the brain deploys as much insulin as it can in this rush to clear the excess sugars from the blood. Invariably you are left with more insulin than what was needed, and the blood sugars drop below the optimum levels. This is the cue for the other master controller to come in – ‘Glucagon’; he is the restorer of sugar in the blood. Mostly, this is done by giving you food cravings (particularly carbohydrate) and so the see-saw starts. Eat simple sugars, and after a while you will want to eat some more. See how that bag of sweets disappears despite all the will to eat only one?! This is how you end up eating more than you need to store the energy in your muscles. The overflow then gets stored as fat instead, as we are not programmed to let go of any spare energy (in case of a famine).

The other problem with this see-saw effect is that it also plays havoc with your energy storage system, as I explained earlier, and in the long run this perfectly calculated ‘insulin-glucagon’ synergy breaks down, leading to type 2 diabetes. Once you have reached this stage, your attempts for general weight loss will also be an uphill struggle.

So, here are my top five tips on working with your body rather than against it to maintain a lifelong healthy levels of body fat:

  1. Exercise – it fine-tunes the insulin-glucagon system, especially resistance exercise.
  2. Do aerobic/endurance exercise on an empty stomach (to accentuate the effect, exercise early in the morning when your glycogen stores are low anyway, forcing you to use stored fat as energy).
  3. Eat a mixed meal after exercise, not a high-sugar drink. Meals containing protein and fat reduce the rate at which the sugars come into your blood. If you want to drink something instead of eat, try milk.
  4. Control portions, and don’t eat too often – spiking insulin levels all the time will continually keep you in the energy-storage mode, and if you don’t have space in your muscles (which you won’t if you eat all the time) then that energy will get stored as body fat.
  5. If you must eat sugar, eat it first thing in the morning or after an intense exercise session, so the insulin can drive it into the muscles.