There are lots of blog posts and articles written about how a second (or third or fourth) pregnancy may differ from a first, but this is more how I plan to incorporate some of the things I’ve learned since my first that may help set me up for a better experience.
I stopped running and all high impact exercise to protect my pelvic floor. I know a lot of women who run right up to the day the delivery, and they seem to be just fine. Other women suffer pelvic floor issues like prolapse or incontinence after delivery. Unfortunately, there isn’t a way to predict who is going to have trouble afterwards and who isn’t. This is one of those times that I’d say weigh the risk vs reward. What is the reward for running? Is it ego or praise? It’s difficult to step away from something that is such a part of who you are, but it’s temporary vs potentially forever. If reasons to run were purely to stay in shape, there are plenty of other ways to stay in shape during pregnancy. I know a lot of runner friends are rolling their eyes at me, but if you want to be a runner forever you need to protect your body now. Your pelvic floor is already working overtime to hold up a growing fetus, can it also handle impact on top of that load? Who knows.
I stopped single leg exercises in my workouts, and monitor them in my daily actions as a preventative to the Pubic Symphysis Dysfunction I experienced starting at 18 weeks last time. This one, I don’t think every pregnant woman needs to be this careful, but having a history of PSD, I’m not risking it again – it was miserable. Single leg activities, or motion that separates the legs can aggravate it. Ex: lunges, step ups, single leg dead lifts or single leg squats. Once aggravated, it’s tough to calm and easily flares up again. If you do notice ANY pain in your pubic bone, monitor how single leg activities feel and cut them out if needed.
Focus on breath and breathing strategies during exercise and lifting reps to protect my pelvic floor. Exhale on exertion. I also try to breath into my sides and back to more equally disperse the pressure, rather than belly breathing which could put extra pressure on a weakened abdominal wall (think Diastasis recti, unavoidable but we can minimize some strain). Along with that, I’ve been monitoring my belly for any coning during exercise OR daily movements. It seems to be when I’m not thinking ‘ab exercise’ that it cones – but when I focus I can better manage the pressure. I often notice it sitting up from laying in the tub! This also made me aware that it may be happening when I get out of bed or move off the ground too….
I plan to hire a doula. I have a consult set up with one to see if she’s a good fit, but will fill you in once I know more.
Plan to visit my Pelvic Floor Physical Therapist several times before delivery. One of the suspected issues with Maura’s delivery was tense pelvic floor muscles. Rather than relaxing and letting her descend, I tensed up with the pain making it difficult for her to come through. My PT and I have worked on relaxation exercises in the past, but I want to verify that they’re working as they should. (FYI It’s common to have a tight, hypertonic, pelvic floor…. this doesn’t mean strong! Tight muscles are weak muscles, and tightness can contribute to incontinence later as well. In these cases the kegels your OB may tell you to do aren’t going to do anything but potentially make it worse!)
I’m also monitoring my nutrition a bit more and switched to a food based prenatal with folate instead of folic acid. I’m supplementing Vitamin D (I’m insufficient – and not even sure it was checked last time), and monitoring my iron levels while eating lots of meat to try and keep them up. I ended up anemic by the end of my last pregnancy, and critically anemic after delivery on the verge of needing a blood transfusion (According to my medical records, I was offered a transfusion but turned it down….. but I don’t remember it ever being offered to me). I think the severe anemia significantly slowed my recovery. I also intend on doing some more research on postpartum nutrition.
I’m sure more things will come up as I progress, but these are the things I’m already doing/planning.
As for a pregnancy update – the first trimester was rough. I feel a bit better now but still am lagging on the energy. I feel far larger than I did last pregnancy at this point… I don’t think I was actually showing at all yet. I like to think my larger belly is making lots of extra room for healthy hip development, I can dream right? More on that, but it looks like if babe is a girl we’re looking at 50/50 odds, with a bit less for a boy.
Week 9, 12, 16…. I think these make my bump look smaller than it in- I pulled out the maternity jeans at 12 weeks and starting with the maternity tops now! You can see my first trimester with Maura here.