August 31, 2024 • 36 mins
Dr. Jonathan Crowther discusses the bodily changes that occur during pregnancy, focusing on the cardiovascular, genitourinary, respiratory, thyroid, musculoskeletal, gastrointestinal, and sleep systems. He explains the physiological changes that happen in each system and provides tips for managing common symptoms. Dr. Crowther emphasizes the importance of seeking medical attention if symptoms become severe or if there are any concerning signs. The conversation concludes with a mom squad secret about using pillows for support during pregnancy.
CHAPTERS 00:00 Introduction and Overview 01:28 Cardiovascular and Genitourinary Changes 12:06 Musculoskeletal and Gastrointestinal Symptoms 23:21 Sleeping Comfortably with Pillows for Support
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
It's the Best Birth Podcast, wherewe interview experts that elevate
you as you prepare your heartand mind to have the best birth.
Each episode will interviewprofessionals so you are prepared
for pregnancy, birth, and postpartum.
Our experts will build your confidenceand empower you to trust your
intuition throughout your pregnancy.
This audio is takenfrom videos on YouTube.
(00:27):
Watch the entire episodes onYouTube at Birth Made Mindful.
The Best Birth [00:04]
You're listening toThe Best Birth podcast.
Today we have guest Dr.
Jonathan Crowther.
He is our resident physician who will beguiding us through what to expect in our
bodily changes and how to best work withthe provider for the best health of the
(00:47):
mother and the baby during pregnancy.
Jonathan Crowther [00:23]
Yeah, I'm glad to be on.
The Best Birth [00:25]
Dr.
Crowther is a husband fatherof two beautiful girls.
And in his spare time, he is inhis final year as an internal
medicine resident physician.
All that spare time.
He lives in Castle Rock, Colorado andpractices medicine out of three hospitals
(01:07):
and a primary care clinic in Denver.
While he has resorted to specializingin internal medicine, he has a passion
for supporting and encouraging womenwho are currently navigating through
pregnancy, birth and postpartum.
He has had the great pleasure ofdelivering multiple babies during medical
school, but of course his favoriteexperiences were helping to deliver his
own two baby girls, Kinsley, age three,and Rae Lynn, age one, whose birth stories
(01:32):
were both unique and life -changing.
And he's going to be ourresident doctor for the podcast.
Thank you and welcome.
Jonathan Crowther [01:13]
Yeah, I'm looking forward todiscussing this exciting topic
with you guys and sharing a littlebit of the knowledge that I have.
Of course, I'm not the expert, butdefinitely have some experience.
(01:54):
The Best Birth [01:28]
One of the many experts that willhelp us just feel comfortable and
confident getting ready for, for birth.
It's like a huge deal.
And a lot of times we don'teven know where to start.
So that's where we wantto bring you on Dr.
Crowther, what are going tobe some of the first changes
that we notice with pregnancy?
(02:14):
Jonathan Crowther [01:48]
Well, there's lots of changesthat can happen with the body.
I mean, I could talk to you about, youknow, in specific systems base, which
actually might be helpful, becausesometimes when we're dealing with
changes going on with our body, wethink of symptoms that are happening.
(02:35):
So one of the things to kind of takein account is when you get pregnant,
the, our cardiovascular system, we getan increase of plasma, like 10 to 15
% increase, within the first 12 weeks ofgestation by your second trimester, you're
(02:56):
getting up to about 40 to 50 % increase.
So what happens is you getactually what's called a
physiological anemia of pregnancy.
and so you get a little bit, you know, ifyou were to get labs from your provider,
you might see that your hemoglobinlevel might be just a little bit low.
(03:17):
So overall what happens as well,your systemic vascular resistance
starts to drop because essentiallyyour blood has been thinned out.
And when that happens, your bloodpressure might be a little bit lower.
So you might be noticing that a littlebit on when you're having a doctor
(03:39):
appointment.
another thing that, happens becauseof that expansion of that plasma, it
actually gives your body a reservepreparing itself for childbirth
for an ex expected blood loss.
We get around, you know,300 to 500 milliliters.
That's almost half a liter of blood andjust a regular, regular vaginal birth.
(04:04):
And if you were to have a cesareanbirth, usually it's around
600 to a thousand milliliters.
that's a good amount ofblood that can be lost.
And so that change that happensjust naturally is an anticipation
for, for having that blood loss.
there, there is one, you know,kind of thing that happens with
(04:26):
your cardiovascular system as well.
as the belly gets bigger from the uterusgetting bigger and baby getting bigger.
this happens more after20 weeks of gestation.
You can have something called,supine hypotensive syndrome.
And if you've been pregnant, youmaybe have noticed this when you're
laying flat on your back supine, youcan have dizziness, lightheadedness,
(04:53):
essentially, feeling verysweaty, getting very pale.
because what happens is when you'relaying down flat, the uterus is actually
compressing on your inferior vena cava.
That's your blood supplyback to your heart.
And because it's a very lackadaisicaltype of blood system on that right side
of the body, it makes it so that the blooddoes not get back to the heart as well.
(05:19):
So essentially you have reduced cardiacoutput, your stroke volumes are...
each time that your heart beatsis actually getting less blood
if you're laying down flat.
So that's why in pregnancy after 20weeks once baby's gotten a little
bit bigger, uterus has gotten alittle bit bigger, it's important
to be sleeping on your left side.
(05:41):
And even when you're getting proceduresor being checked at the doctors or
by your midwife, you should be kindof on the left lateral position, kind
of on your left side so that way.
it takes off some of that pressureso you don't have what's called
that supine hypotensive syndrome.
The Best Birth [05:32]
It's so important to know becauseoftentimes we wouldn't even
(06:01):
think I can't lay on my back.
But once we have a little bit of thisknowledge, then instead of laying
directly on my back, I'm just goingto lay on my side just a little bit.
And, and voila, we have fixed the problem.
Jonathan Crowther [05:37]
Right.
there are, known to be, actuallyheart failure that can come
in pregnancy, for patients.
It's usually a prettyrare thing that happens.
(06:22):
but because of having that extrablood, that extra plasma in the
blood and you have essentially more.
more blood that you're workingwith on a day -to -day basis.
Those who might be prone toheart failure, it can happen.
And it's like a peripartum typeof cardiomyopathy that happens.
(06:43):
So if you're having a whole lot ofshortness of breath, shortness of
breath when you're walking around,shortness of breath when you're laying
down, especially when you're flator you're sleeping at night and you
wake up gasping for air, those areactually signs or even, you know,
Swelling pitting swellingthat happens in your legs.
Those are signs that you could behaving You know some of these signs of
(07:05):
heart failure and it could be good tobe checked by a physician at that time
I'll go on to kind of what happenswith the kidneys and the general you
Genitourido system basicallykidneys just get more of that fluid
because of that plasma increase
They tend to actually get alittle bit bigger in size.
(07:31):
So it makes that their filtrationis working a little bit higher.
Differences that happens with your
lab work could be a little bitof low sodium that could happen.
And that's just a dilutionalaspect of the plasma volume.
The Best Birth [07:22]
Is that why we always have tolike pee more when we're pregnant?
(07:52):
Jonathan Crowther [07:26]
Yes, you are peeing more when you'repregnant because you are filtering out so
much more volume because of that increase.
But not only that, there'sanother thing that happens.
You pee because you're pregnantbecause a little uterus sits
right next to the bladder, right?
And so as that uterus expands, itactually presses on the bladder.
(08:14):
And that's why that urgency to haveto go pee more happens a lot more.
In fact, you can even get what's calledhydrourator and hydro -nephrosis,
which basically means backup of somefluid within the kidneys and the ureters.
(08:35):
Now, this is normal to happen, butbecause of there being a little
less, more backup and less flow ofthat urine within the ureter system,
It makes you more prone to actuallydeveloping a kidney infection.
you may not have any symptoms of,burning with urination, but you might
(08:59):
have symptoms of, you know, frequency
If there's any sort of bacteriawhile we're pregnant, we treat an
infection because we don't wantthat pooling of urine that happens
within the ureter, which happenswithin the bladder and the kidneys
to actually cause a kidney infection.
The Best Birth [08:51]
And when you do have a urinary tractinfection, are you able to take
(09:21):
that medication while pregnant?
Jonathan Crowther [08:57]
Yes, the medications that they willchoose will be ones that are safe for
mom, safe for baby during pregnancy.
The Best Birth [09:06]
I remember not understanding thisconcept my first time around and just
like completely suffering, just tryingto drink as much cranberry juice as I
could manage because I thought, I'm notallowed to take medication for this.
(09:44):
And so I think having some of thisknowledge, just reminding us that
even though it might be a differentmedication than if you're not pregnant,
like our provider has somethingthat will help with this infection.
Yeah, I got.
more UTIs than my whole life whenI was trying to get pregnant.
So there was that complication as well.
(10:04):
So just being aware of how to treatit or how to notice it is good too.
Jonathan Crowther [09:42]
Yeah, exactly.
So it's, it's normal to have symptomsof frequency with urination, getting
up in the middle of night to have togo pee a few times, feeling like you
have to pee right away, peeing veryoften, and also, you know, cough,
(10:27):
sneeze, you lose a little bit of urine.
That's all very, very commonto happen, within pregnancy.
you can have something calledpostpartum urinary retention where,
you're just not getting the urine out.
And that has to do just with the sheertrauma of the vaginal birth, causing, that
(10:50):
trauma will cause that mucosal congestion.
some sub mucosal like hemorrhaginglittle bleeds that will make
it difficult to urinate.
and painful too.
But usually this resolves withinfour to six weeks after being
(11:12):
following delivery on its own.
The Best Birth [10:48]
It's good to hear aboutthe urinating part.
I feel like the most thing I hear isthat first poop after delivering baby.
That is not something peoplelike to look forward to.
Jonathan Crowther [10:57]
Right, exactly, because all of itis kind of intertwined and it's
from that expansion of the vaginato get baby out of that birth canal.
(11:34):
Yeah, so those are kind of the bigthings for the genitourinary system.
Yeah, do you have any kindof questions there or do you
want me to go on to our lungs?
The Best Birth [11:20]
Let's go on to the lungs.
Jonathan Crowther [11:22]
Okay.
Yeah.
So for the respiratory system, kind of aninteresting physiological thing happens.
(11:56):
and I could get very nerdy withthis, but essentially, patients who
become pregnant will, start takingdeeper breaths instead of necessarily
more frequent blood breaths.
But what happens is that theyactually cause a compensatory
respiratory alkalosis.
Basically what that saysin big words is that.
(12:18):
you are breathing off more CO2.
And so your baseline CO2 in your bloodstream should be around 40 or so.
It rests around 27 or 32.
And there's actually a very specificreason for this is that causing that
respiratory alkalosis, it actuallycauses you to excrete bicarbonate
(12:44):
from the kidneys and allowing for
any of the metabolic waste productsfor from babies, just metabolism
to be excreted through the urine.
So, and to think that alljust happens with the lungs.
Physiologically, there's also things thathappen and this actually happens because
of the hormone relaxin, which we'll getto quite a few times here, but relaxin
(13:10):
causes more of an outward flaring of theribs, causes the chest wall to kind of,
increase in diameter.
Your diaphragm with the enlarging uteruswill kind of get pushed up, but it will
still have good excursion, meaning thatit will still be able to press down, but
you might feel a little bit more laboredwhen you're trying to take a deep breath
(13:32):
because of the uterus getting in the way.
The Best Birth [13:10]
Is there anything that wecan do to create more space?
Like should we lean back to havethat breath or is it just something
that you kind of get used to?
Jonathan Crowther [13:20]
Yeah, you kind of get used to it.
Most of the most time our consciousness,you know, we, we don't think about
(13:53):
taking a breath and our body justdoes this all very naturally.
But when you are kind of morecognizant about it, and we'll get
to kind of that feeling of shortnessof breath, which is a very, a
common symptom to have in pregnancy.
essentially you, you canjust take deeper breaths.
(14:14):
There's actually a osteopathicmanipulative technique where you
can raise the diaphragm and thatcould be something that could be
helpful in the future as well.
Another kind of interesting tidbitis that kind of like the urinary
tract, your upper respiratorymucosa starts to become hyperemic.
(14:37):
You have more glandularlactate hyperactivity.
And so essentially,
you can become more congestive,more nasal stuffiness.
You can even have nosebleedsbecause of these changes.
Just, just things thatcan happen with pregnancy.
The, so dyspnea, which is justshortness of breath, very common
(15:01):
to happen in your first and secondtrimesters when the uterus is
actually relatively, you know, small.
Basically,
that dyspnea happens because ofthe increased progesterone, which
causes that baseline decrease inyour CO2 and having that respiratory
(15:22):
alkalosis, you actually start to feela little more short of breath from it.
There's kind of a funny studythat they did with males.
They actually injected themwith Madroxyprogesterone,
which is essentially your...
birth pill and through a shot form, right?
So they inject that into the males andthey looked at their ventilation, but
(15:47):
subjectively, most all the males hadshortness of breath soon afterwards,
which is kind of interesting.
so there's this thing called,progesterone induced hypoventilation.
now that's that feeling ofshortness of breath that you get
in your first and second trimester.
I'm just pregnant,
even that long and I'm stillhaving the shortness of breath.
(16:10):
Very normal, nothing to be worried about.
The issues when you want to be moreworried about it and actually be
seen by a physician are things whenyou're having symptoms such as cough
or wheezing, fever, having pain whenyou're taking a deep breath or having
chest pain or even coughing up blood.
(16:32):
Those things could be...
indications of something else going on.
There's a lot of thingsthat can cause these
symptoms that may need evaluation, suchas that cardiomyopathy that we talked
about, that heart failure, preeclampsia
(16:56):
can have this, even pulmonaryand amniotic embolisms.
because your body actually turns intomore of a prothrombotic state, which
means that the body likes to clot more.
The Best Birth [16:47]
So when we're coming in for ourappointments, every month or every two
weeks, are these some of the things thatour doctor is checking when they're doing
(17:21):
like the blood pressure and, you know,like seeing how much oxygen we're getting?
Jonathan Crowther [16:59]
Yeah, exactly.
Making sure that you're nothaving any sort of hypoxia or
your oxygen levels are doing well.
Making sure that you're not having othersymptoms such as wheezing, because you may
actually have asthma that is undiagnosed.
(17:43):
And this is a time where you're seenso much by the doctor that it's a
good time to catch some of thesethings that may have gone overlooked.
So really, you know, the big things with,because of the shortness of breath is a
very common thing, but say if you're justlike having a really hard time breathing,
(18:04):
you notice that you're like using all ofyour muscles to kind of get a breath in.
If you're having any sort ofstridor, meaning, you know, a
sound from your throat becauseyou're having difficulty breathing,
chest pain, if your fingers are turningblue, if you're coughing up blood,
(18:24):
If you're feeling very depressed oragitated or having swelling around
your neck, those are all thingsto kind of take in consideration
and say, Hey, this is different.
I need to be checked out for this.
The Best Birth [18:11]
Wonderful.
What about our next system?
Jonathan Crowther [18:15]
I was going to talk about thyroid,which is actually kind of interesting.
(18:47):
Essentially our thyroid hormonedoes everything and we usually don't
think about it unless you have eitherhyperactive thyroid or hypoactive thyroid.
But in general, HCG, which is humanchorionic gonadotropin, you might know
this because that's what we test forwhen you're positive for pregnancy.
(19:11):
So HCG actually activatesour thyroid gland.
And so that makes us createmore thiroxine, which is our
thyroid hormone in our body.
And simply because it is supplied bythe Corion or essentially the placenta
(19:33):
and that rather from the pregnancy.
So.
you get a transientsubclinical hyperthyroidism.
Basically what that means is your bodybecomes in a hyperthyroid state, but
it's not enough to actually cause hugechanges with your thyroid function tests.
(19:55):
Now there are some of those people whowill actually get overt hyperthyroidism,
meaning very much too much hyperthyroid.
And then there's overt hypothyroidismthat can actually happen.
Hypothyroidism happens due to two reasons.
Iodine deficiency, which we don't reallyhave to worry about here in the United
(20:18):
States because we put iodine in our salt.
Two is going to be Hashimoto'sthyroiditis, which is a genetic condition.
So if you've already had that,then you might be low thyroid.
If you're feeling overly fatigued,if you're noticing even weight
gain before your pregnancy,
(20:39):
Changes with your hair, yournails become more brittle.
Those could be indications of you maybebeing more hypothyroid and a simple check
of your thyroid stimulating hormone oryour TSH can be a very telling thing.
And usually in pregnancy, it's astandard thing to be checking for.
(21:03):
Hyperthyroidism is usuallyfrom something called Graves'
disease or even toxic nodular.
thyroid goiter and you treat itwith medications called thionamides
but essentially you would have moreprobably painful neck at your thyroid
(21:23):
gland and you might be feeling a littlebit more stressed your heart rate might
be in the 100s those are all thingsthat could be reason for hyperthyroid.
The only other kind of talking pointto talk about the thyroid is if you
do have hypothyroidism, low thyroidfunction, maybe you were diagnosed
(21:50):
with it early in your pregnancy oryou already knew about it and you're
already taking a medication calledlevothyroxine for that or Synthroid.
If you already have that medication,we increase that by 30 to 50%.
during your pregnancy.
it's better for baby to be more inthat physiological hyperthyroid state.
(22:11):
The Best Birth [21:46]
And so since many of us will move froma primary care physician to, a maternal
fetal medicine or an OB -GYN, it'sour responsibility, right, to let them
know if we're taking those medications?
Jonathan Crowther [21:58]
Yes, you need to let them know whichmedications you're on because there
(22:31):
may need to be a change of medications.
You might be on a medication for yourhigh blood pressure like lysinepril,
which is actually a taretogenic,which means that it's bad for your
baby when you are taking that.
So being off of that during yourpregnancy is going to be helpful.
we'll talk about the skin very briefly.
(22:53):
you guys kind of already knowyou just get this nice glow.
Everybody's like, wow,you guys look so great.
but essentially it's all from therelaxin and you're getting more, that
hormone relax and is going to, increaseyour joint lax, laxicity as well as
your skin laxicity, hair and, and skin.
(23:17):
a good symptom of having a nicelittle glow to it for once, right?
It's the one thing.
The Best Birth [22:55]
For once.
But then we get the postpartumhair and nails and it seems
like it wasn't worth it.
Jonathan Crowther [23:03]
Yes, exactly.
Cause that the hormone balances arejust so much off and then you get
hair loss and it's, it's just not fun.
(23:39):
But, the, with the musculoskeletal system,you have to think relaxin is a driving
factor in a lot of things, a lot of,you know, just it, kind of normal aches
and pains that you get in pregnancy.
so you think that you get a20 to 25 to 35 pound weight.
gain on average for pregnancy.
(24:02):
So what happens is you could get more.
but in general, the average is 25 to 35.
the,
yeah, center center ofgravity is going to change.
so it's going to put a little bitmore strain on your axial skeleton
or on your spine and your pelvis.
So you'll get exaggeratedcurvature of your lower back.
(24:24):
You'll get forward forflexion of your neck.
The Best Birth [23:36]
Is that all?
Jonathan Crowther [24:01]
and downward movement of yourshoulders to compensate all for
your, your enlarging uterus.
that joint laxity on, the lumbarspine makes you a little bit more
instable and a little bit morepredisposed to getting muscle strain.
Cause you have to think in thespine, you've got the large,
(24:47):
large muscles that you can feel
which are your erector spinae muscles,but then you also have these interspinal
muscle muscles that are very small.
And when there is less, you know,there's more laxity and less
support happening with the spine.
It makes it very easy for,muscle strain to happen.
You also see muscle laxity or, or ligamentlaxity in your knees and your feet.
(25:14):
And so pains in your knees and feet back.
are very, pelvis are very common to occur.
So
the question is when dothese become an issue, right?
Well, it's not very fun to deal with thepain as it is, but the times where you
(25:38):
would want to get seen by somebody isif you're having very severe pain that
interferes with your function, meaningthat not even positional, you know,
You get up, you lay down, you're sitting,you're standing, whatever it might be.
You're having severe pain.
and, and especially pain at nightwhen you've kind of relaxed your back.
(26:00):
if that's getting worse, that'ssomething to be seen for.
if you have pain with when you'recoughing or you're sneezing,
those are also, indications ofmaybe something else is going on.
if you have something like asudden bladder incontinence.
Not just when you cough or sneeze,but you just lose all of your
(26:21):
urine or even bowel incontinence.
You lose your stool.
That could be some from something calledCata Aquinas syndrome, where the laxity
has gotten so bad that you've actuallyhave compression onto your spinal cord.
And that's something that needs to beaddressed on an emergent kind of basis.
So if there's any sort of associatedweakness, sensory deficit, meaning
(26:46):
numbness, tingling, sharp shootingpains, or even when they check you
out, you've got abnormal reflexes.
Those are all indications that youshould be checked out by a physician.
The Best Birth [26:35]
Wonderful.
This is such important information toknow that there's certain thresholds
(27:08):
that if it's beyond, then it's timeto bring it up to your provider.
I think our bodies are reallygood at giving us those signals.
And it's been comforting as I'vebeen listening to you that if it's
far beyond the norm or somethingout of the ordinary, that's when
it's more likely to need to be seen.
Pregnancy is such a change in our bodiesand there's so many unknowns, but.
(27:30):
Jonathan Crowther [26:46]
Yeah, exactly.
The Best Birth [27:03]
There's also a lot of comfortthat other people have studied
things that happen as well.
Jonathan Crowther [27:08]
Yeah.
And it's always okay to talk toyour provider when you're in doubt.
you're never going to be faultedby somebody when you're just unsure
about what's going on, because youknow, your body and your body's
going through a lot of changes.
You might be more comfortable atwith baby number two or three, you
(27:53):
know, but, if something's different,that's when you want to speak out.
so.
The Best Birth [27:31]
Were there any other systemsthat you wanted to cover for
this first trimester period?
Jonathan Crowther [27:37]
I think the most other important, wouldjust be with the gastrointestinal tract.
that's probably the most important,on, on others, but I'll give you a
(28:16):
couple of tidbits and I'll get tothat, with back pain, and, pelvic pain,
knee pain, ankle pain, those kinds ofpains, you know, just simple things,
you know, lift with your back straight.
You can use a small pillow forlumber support when you're sitting.
You can sleep on the side and usea pillow in between your legs.
(28:40):
Exercise, exercise before you getpregnant will help to minimize that
amount of laxity that happens justnormally from the relaxing and you
may have less pain during pregnancy.
You can use chiropractor, you canuse osteopathy for pain reduction.
(29:02):
trials that they've done were kind oflimited, but there's other things like
acupuncture could be very helpful.
Physiotherapy, working with a physicaltherapist can very much so benefit as
well as even doing water exercises.
So those are all very good things.
And then go to pain medicationswould be something like Tylenol.
(29:26):
In general, you want to avoid insets.
during pregnancy, that's thingslike ibuprofen and Alleve.
And then they found that even with reallysevere back pain that using narcotics
or opioid medications, usually there'sno benefit from it and there's just
more risks that are associated with it.
(29:46):
Yeah,
but going on to our GI tract.
You know, one of the things that peoplewill start maybe complaining about
is GERD, gastroesophageal reflex.
And this doesn't just happen mechanically.
It is one of the reasons when you'relater on, when you have the uterus kind
(30:09):
of pushing up on, on your diaphragm.
But it's also again, from ourgood hormone, relaxin, you have
decreased tone of your loweresophageal sphincter, which is.
what basically separates betweenyour stomach and your esophagus.
And so because there's less tone there,there's more chance for reflux to happen.
(30:33):
So treatment for that is, you know,taking more frequent meals during the
day, trying to take your last meal atnight, two to three hours before bedtime.
And then if the symptoms really are bad,famotidine or Pepsid is a good way to,
treat that.
(30:56):
The, let's see, other GIissues, you got hemorrhoids,
common in the third trimester.
There are preparation H, there'smedications that your provider can give
you so that you don't have to suffer fromsymptoms of, you know, the anal itching,
(31:18):
discomfort, bleeding, things like that.
And then constipation happens a lot too.
And that's because there is actuallydecreased motility that happens
just normally with pregnancy.
So to help with that constipation,eating nice fibrous foods is going to
(31:42):
be your best friend during pregnancyand at all stages of pregnancy.
And then if needed, you can alsotake a laxative that can help.
The Best Birth [31:29]
I feel like we can't escape thefirst trimester without talking
about morning sickness, which shouldactually be called all day and night
sickness, because I felt way morenauseous and uncomfortable at night.
(32:07):
can you tell us if there's anythingthat we should be aware of?
or like different provider recommendedmedication for morning sickness.
Jonathan Crowther [31:41]
Yep.
Yeah, nausea and vomiting from morningsickness is a very common GI side effect.
So what I would say is, Zofran isgoing to be one of your best friends.
(32:30):
It's usually, it's a prescriptionmedication, but it can really help
with, with, that morning sickness.
some people get it so bad thatthey're, you know, just having.
intractable, they cannot stop this nauseaand vomiting and that's where they they
you could even use other medicationsthat are both oral but then there's other
(32:55):
suppository medications that you cantake like fenugrin if needed and that
those can really help with that nauseaand vomiting in that early pregnancy.
The other things to take in mind with
with early pregnancy is it'svery common to have insomnia.
(33:16):
So my go -to medications forpatients that are safe is vitamin
B6, as well as taking Unisom.
Unisom, it's the doxylamine succinateis the actual active ingredient of it.
(33:37):
But those can both help very, very well.
The Best Birth [33:15]
Well, thank you for giving us an overview.
It's really helpful to begin with theend in mind and just kind of being
aware of all these changes that arehappening within all of the systems.
I felt a little bit like we were onthe magic school bus going through
all the parts of the body andfiguring out what is happening where.
(33:58):
So thank you for your expertise on that.
Is there anything else we should lookforward to for the first trimester?
Jonathan Crowther [33:29]
Yes.
Of course, yeah.
You know, I think the things to lookforward to with our first trimester is
just knowing that it's cute because babiesare, when they're being formed as the
(34:22):
fetus, they are sized usually by fruit.
And so, you know, referringoften to your little strawberry
or your little cantaloupe or...
whatever it might be, your plumin your belly is very endearing.
So it's a good thing to kindof look forward to in that way.
(34:44):
The Best Birth [34:18]
When I announced my first pregnancy, Igave a few navel oranges to some friends
to say, this is the size of my baby.
So exciting.
Well, thank you so much, Dr.
Crowther for joining uson the best birth podcast.
We're going to end withour mom squad secret.
We have a tip fromsomeone in our community.
(35:04):
This is from Christina and shesays sleep with as many pillows
between your knees and against yourback early in pregnancy as needed.
Your body will thank you whenyou're seven months pregnant.
Jonathan Crowther [34:26]
Yeah, that's great.
The Best Birth [34:48]
So just as you mentioned, withoutsupport and all of those things to
make you comfortable throughout.
If you'd like to share a mom squadsecret, we'll have a link in our
show notes to the Facebook group.
(35:25):
Thank you so much forbeing on the podcast.
Jonathan Crowther [35:01]
Thank you so much.
Looking forward to coming on again.
Thanks for joining us on today's episode.
We hope you've been elevated andinspired by this week's expert.
Subscribe today so you never missan episode and please share our
podcast or post on your socialmedia so that other moms and dads
to be can also have the best birth.
(35:49):
Please note that the informationprovided is based on the expert's
insights and personal experience.
It is not intended as medical guidance.
Please seek the advice of yourmedical provider as it applies
to your specific condition.
It's the Best Birth Podcast, wherewe interview experts that elevate
you as you prepare your heartand mind to have the best birth.
Each episode will interviewprofessionals so you are prepared
for pregnancy, birth, and postpartum.
Our experts will build your confidenceand empower you to trust your
intuition throughout your pregnancy.
This audio is takenfrom videos on YouTube.
(00:27):
Watch the entire episodes onYouTube at Birth Made Mindful.
The Best Birth [00:04]
You're listening toThe Best Birth podcast.
Today we have guest Dr.
Jonathan Crowther.
He is our resident physician who will beguiding us through what to expect in our
bodily changes and how to best work withthe provider for the best health of the
(00:47):
mother and the baby during pregnancy.
Jonathan Crowther [00:23]
Yeah, I'm glad to be on.
The Best Birth [00:25]
Dr.
Crowther is a husband fatherof two beautiful girls.
And in his spare time, he is inhis final year as an internal
medicine resident physician.
All that spare time.
He lives in Castle Rock, Colorado andpractices medicine out of three hospitals
(01:07):
and a primary care clinic in Denver.
While he has resorted to specializingin internal medicine, he has a passion
for supporting and encouraging womenwho are currently navigating through
pregnancy, birth and postpartum.
He has had the great pleasure ofdelivering multiple babies during medical
school, but of course his favoriteexperiences were helping to deliver his
own two baby girls, Kinsley, age three,and Rae Lynn, age one, whose birth stories
(01:32):
were both unique and life -changing.
And he's going to be ourresident doctor for the podcast.
Thank you and welcome.
Jonathan Crowther [01:13]
Yeah, I'm looking forward todiscussing this exciting topic
with you guys and sharing a littlebit of the knowledge that I have.
Of course, I'm not the expert, butdefinitely have some experience.
(01:54):
The Best Birth [01:28]
One of the many experts that willhelp us just feel comfortable and
confident getting ready for, for birth.
It's like a huge deal.
And a lot of times we don'teven know where to start.
So that's where we wantto bring you on Dr.
Crowther, what are going tobe some of the first changes
that we notice with pregnancy?
(02:14):
Jonathan Crowther [01:48]
Well, there's lots of changesthat can happen with the body.
I mean, I could talk to you about, youknow, in specific systems base, which
actually might be helpful, becausesometimes when we're dealing with
changes going on with our body, wethink of symptoms that are happening.
(02:35):
So one of the things to kind of takein account is when you get pregnant,
the, our cardiovascular system, we getan increase of plasma, like 10 to 15
% increase, within the first 12 weeks ofgestation by your second trimester, you're
(02:56):
getting up to about 40 to 50 % increase.
So what happens is you getactually what's called a
physiological anemia of pregnancy.
and so you get a little bit, you know, ifyou were to get labs from your provider,
you might see that your hemoglobinlevel might be just a little bit low.
(03:17):
So overall what happens as well,your systemic vascular resistance
starts to drop because essentiallyyour blood has been thinned out.
And when that happens, your bloodpressure might be a little bit lower.
So you might be noticing that a littlebit on when you're having a doctor
(03:39):
appointment.
another thing that, happens becauseof that expansion of that plasma, it
actually gives your body a reservepreparing itself for childbirth
for an ex expected blood loss.
We get around, you know,300 to 500 milliliters.
That's almost half a liter of blood andjust a regular, regular vaginal birth.
(04:04):
And if you were to have a cesareanbirth, usually it's around
600 to a thousand milliliters.
that's a good amount ofblood that can be lost.
And so that change that happensjust naturally is an anticipation
for, for having that blood loss.
there, there is one, you know,kind of thing that happens with
(04:26):
your cardiovascular system as well.
as the belly gets bigger from the uterusgetting bigger and baby getting bigger.
this happens more after20 weeks of gestation.
You can have something called,supine hypotensive syndrome.
And if you've been pregnant, youmaybe have noticed this when you're
laying flat on your back supine, youcan have dizziness, lightheadedness,
(04:53):
essentially, feeling verysweaty, getting very pale.
because what happens is when you'relaying down flat, the uterus is actually
compressing on your inferior vena cava.
That's your blood supplyback to your heart.
And because it's a very lackadaisicaltype of blood system on that right side
of the body, it makes it so that the blooddoes not get back to the heart as well.
(05:19):
So essentially you have reduced cardiacoutput, your stroke volumes are...
each time that your heart beatsis actually getting less blood
if you're laying down flat.
So that's why in pregnancy after 20weeks once baby's gotten a little
bit bigger, uterus has gotten alittle bit bigger, it's important
to be sleeping on your left side.
(05:41):
And even when you're getting proceduresor being checked at the doctors or
by your midwife, you should be kindof on the left lateral position, kind
of on your left side so that way.
it takes off some of that pressureso you don't have what's called
that supine hypotensive syndrome.
The Best Birth [05:32]
It's so important to know becauseoftentimes we wouldn't even
(06:01):
think I can't lay on my back.
But once we have a little bit of thisknowledge, then instead of laying
directly on my back, I'm just goingto lay on my side just a little bit.
And, and voila, we have fixed the problem.
Jonathan Crowther [05:37]
Right.
there are, known to be, actuallyheart failure that can come
in pregnancy, for patients.
It's usually a prettyrare thing that happens.
(06:22):
but because of having that extrablood, that extra plasma in the
blood and you have essentially more.
more blood that you're workingwith on a day -to -day basis.
Those who might be prone toheart failure, it can happen.
And it's like a peripartum typeof cardiomyopathy that happens.
(06:43):
So if you're having a whole lot ofshortness of breath, shortness of
breath when you're walking around,shortness of breath when you're laying
down, especially when you're flator you're sleeping at night and you
wake up gasping for air, those areactually signs or even, you know,
Swelling pitting swellingthat happens in your legs.
Those are signs that you could behaving You know some of these signs of
(07:05):
heart failure and it could be good tobe checked by a physician at that time
I'll go on to kind of what happenswith the kidneys and the general you
Genitourido system basicallykidneys just get more of that fluid
because of that plasma increase
They tend to actually get alittle bit bigger in size.
(07:31):
So it makes that their filtrationis working a little bit higher.
Differences that happens with your
lab work could be a little bitof low sodium that could happen.
And that's just a dilutionalaspect of the plasma volume.
The Best Birth [07:22]
Is that why we always have tolike pee more when we're pregnant?
(07:52):
Jonathan Crowther [07:26]
Yes, you are peeing more when you'repregnant because you are filtering out so
much more volume because of that increase.
But not only that, there'sanother thing that happens.
You pee because you're pregnantbecause a little uterus sits
right next to the bladder, right?
And so as that uterus expands, itactually presses on the bladder.
(08:14):
And that's why that urgency to haveto go pee more happens a lot more.
In fact, you can even get what's calledhydrourator and hydro -nephrosis,
which basically means backup of somefluid within the kidneys and the ureters.
(08:35):
Now, this is normal to happen, butbecause of there being a little
less, more backup and less flow ofthat urine within the ureter system,
It makes you more prone to actuallydeveloping a kidney infection.
you may not have any symptoms of,burning with urination, but you might
(08:59):
have symptoms of, you know, frequency
If there's any sort of bacteriawhile we're pregnant, we treat an
infection because we don't wantthat pooling of urine that happens
within the ureter, which happenswithin the bladder and the kidneys
to actually cause a kidney infection.
The Best Birth [08:51]
And when you do have a urinary tractinfection, are you able to take
(09:21):
that medication while pregnant?
Jonathan Crowther [08:57]
Yes, the medications that they willchoose will be ones that are safe for
mom, safe for baby during pregnancy.
The Best Birth [09:06]
I remember not understanding thisconcept my first time around and just
like completely suffering, just tryingto drink as much cranberry juice as I
could manage because I thought, I'm notallowed to take medication for this.
(09:44):
And so I think having some of thisknowledge, just reminding us that
even though it might be a differentmedication than if you're not pregnant,
like our provider has somethingthat will help with this infection.
Yeah, I got.
more UTIs than my whole life whenI was trying to get pregnant.
So there was that complication as well.
(10:04):
So just being aware of how to treatit or how to notice it is good too.
Jonathan Crowther [09:42]
Yeah, exactly.
So it's, it's normal to have symptomsof frequency with urination, getting
up in the middle of night to have togo pee a few times, feeling like you
have to pee right away, peeing veryoften, and also, you know, cough,
(10:27):
sneeze, you lose a little bit of urine.
That's all very, very commonto happen, within pregnancy.
you can have something calledpostpartum urinary retention where,
you're just not getting the urine out.
And that has to do just with the sheertrauma of the vaginal birth, causing, that
(10:50):
trauma will cause that mucosal congestion.
some sub mucosal like hemorrhaginglittle bleeds that will make
it difficult to urinate.
and painful too.
But usually this resolves withinfour to six weeks after being
(11:12):
following delivery on its own.
The Best Birth [10:48]
It's good to hear aboutthe urinating part.
I feel like the most thing I hear isthat first poop after delivering baby.
That is not something peoplelike to look forward to.
Jonathan Crowther [10:57]
Right, exactly, because all of itis kind of intertwined and it's
from that expansion of the vaginato get baby out of that birth canal.
(11:34):
Yeah, so those are kind of the bigthings for the genitourinary system.
Yeah, do you have any kindof questions there or do you
want me to go on to our lungs?
The Best Birth [11:20]
Let's go on to the lungs.
Jonathan Crowther [11:22]
Okay.
Yeah.
So for the respiratory system, kind of aninteresting physiological thing happens.
(11:56):
and I could get very nerdy withthis, but essentially, patients who
become pregnant will, start takingdeeper breaths instead of necessarily
more frequent blood breaths.
But what happens is that theyactually cause a compensatory
respiratory alkalosis.
Basically what that saysin big words is that.
(12:18):
you are breathing off more CO2.
And so your baseline CO2 in your bloodstream should be around 40 or so.
It rests around 27 or 32.
And there's actually a very specificreason for this is that causing that
respiratory alkalosis, it actuallycauses you to excrete bicarbonate
(12:44):
from the kidneys and allowing for
any of the metabolic waste productsfor from babies, just metabolism
to be excreted through the urine.
So, and to think that alljust happens with the lungs.
Physiologically, there's also things thathappen and this actually happens because
of the hormone relaxin, which we'll getto quite a few times here, but relaxin
(13:10):
causes more of an outward flaring of theribs, causes the chest wall to kind of,
increase in diameter.
Your diaphragm with the enlarging uteruswill kind of get pushed up, but it will
still have good excursion, meaning thatit will still be able to press down, but
you might feel a little bit more laboredwhen you're trying to take a deep breath
(13:32):
because of the uterus getting in the way.
The Best Birth [13:10]
Is there anything that wecan do to create more space?
Like should we lean back to havethat breath or is it just something
that you kind of get used to?
Jonathan Crowther [13:20]
Yeah, you kind of get used to it.
Most of the most time our consciousness,you know, we, we don't think about
(13:53):
taking a breath and our body justdoes this all very naturally.
But when you are kind of morecognizant about it, and we'll get
to kind of that feeling of shortnessof breath, which is a very, a
common symptom to have in pregnancy.
essentially you, you canjust take deeper breaths.
(14:14):
There's actually a osteopathicmanipulative technique where you
can raise the diaphragm and thatcould be something that could be
helpful in the future as well.
Another kind of interesting tidbitis that kind of like the urinary
tract, your upper respiratorymucosa starts to become hyperemic.
(14:37):
You have more glandularlactate hyperactivity.
And so essentially,
you can become more congestive,more nasal stuffiness.
You can even have nosebleedsbecause of these changes.
Just, just things thatcan happen with pregnancy.
The, so dyspnea, which is justshortness of breath, very common
(15:01):
to happen in your first and secondtrimesters when the uterus is
actually relatively, you know, small.
Basically,
that dyspnea happens because ofthe increased progesterone, which
causes that baseline decrease inyour CO2 and having that respiratory
(15:22):
alkalosis, you actually start to feela little more short of breath from it.
There's kind of a funny studythat they did with males.
They actually injected themwith Madroxyprogesterone,
which is essentially your...
birth pill and through a shot form, right?
So they inject that into the males andthey looked at their ventilation, but
(15:47):
subjectively, most all the males hadshortness of breath soon afterwards,
which is kind of interesting.
so there's this thing called,progesterone induced hypoventilation.
now that's that feeling ofshortness of breath that you get
in your first and second trimester.
I'm just pregnant,
even that long and I'm stillhaving the shortness of breath.
(16:10):
Very normal, nothing to be worried about.
The issues when you want to be moreworried about it and actually be
seen by a physician are things whenyou're having symptoms such as cough
or wheezing, fever, having pain whenyou're taking a deep breath or having
chest pain or even coughing up blood.
(16:32):
Those things could be...
indications of something else going on.
There's a lot of thingsthat can cause these
symptoms that may need evaluation, suchas that cardiomyopathy that we talked
about, that heart failure, preeclampsia
(16:56):
can have this, even pulmonaryand amniotic embolisms.
because your body actually turns intomore of a prothrombotic state, which
means that the body likes to clot more.
The Best Birth [16:47]
So when we're coming in for ourappointments, every month or every two
weeks, are these some of the things thatour doctor is checking when they're doing
(17:21):
like the blood pressure and, you know,like seeing how much oxygen we're getting?
Jonathan Crowther [16:59]
Yeah, exactly.
Making sure that you're nothaving any sort of hypoxia or
your oxygen levels are doing well.
Making sure that you're not having othersymptoms such as wheezing, because you may
actually have asthma that is undiagnosed.
(17:43):
And this is a time where you're seenso much by the doctor that it's a
good time to catch some of thesethings that may have gone overlooked.
So really, you know, the big things with,because of the shortness of breath is a
very common thing, but say if you're justlike having a really hard time breathing,
(18:04):
you notice that you're like using all ofyour muscles to kind of get a breath in.
If you're having any sort ofstridor, meaning, you know, a
sound from your throat becauseyou're having difficulty breathing,
chest pain, if your fingers are turningblue, if you're coughing up blood,
(18:24):
If you're feeling very depressed oragitated or having swelling around
your neck, those are all thingsto kind of take in consideration
and say, Hey, this is different.
I need to be checked out for this.
The Best Birth [18:11]
Wonderful.
What about our next system?
Jonathan Crowther [18:15]
I was going to talk about thyroid,which is actually kind of interesting.
(18:47):
Essentially our thyroid hormonedoes everything and we usually don't
think about it unless you have eitherhyperactive thyroid or hypoactive thyroid.
But in general, HCG, which is humanchorionic gonadotropin, you might know
this because that's what we test forwhen you're positive for pregnancy.
(19:11):
So HCG actually activatesour thyroid gland.
And so that makes us createmore thiroxine, which is our
thyroid hormone in our body.
And simply because it is supplied bythe Corion or essentially the placenta
(19:33):
and that rather from the pregnancy.
So.
you get a transientsubclinical hyperthyroidism.
Basically what that means is your bodybecomes in a hyperthyroid state, but
it's not enough to actually cause hugechanges with your thyroid function tests.
(19:55):
Now there are some of those people whowill actually get overt hyperthyroidism,
meaning very much too much hyperthyroid.
And then there's overt hypothyroidismthat can actually happen.
Hypothyroidism happens due to two reasons.
Iodine deficiency, which we don't reallyhave to worry about here in the United
(20:18):
States because we put iodine in our salt.
Two is going to be Hashimoto'sthyroiditis, which is a genetic condition.
So if you've already had that,then you might be low thyroid.
If you're feeling overly fatigued,if you're noticing even weight
gain before your pregnancy,
(20:39):
Changes with your hair, yournails become more brittle.
Those could be indications of you maybebeing more hypothyroid and a simple check
of your thyroid stimulating hormone oryour TSH can be a very telling thing.
And usually in pregnancy, it's astandard thing to be checking for.
(21:03):
Hyperthyroidism is usuallyfrom something called Graves'
disease or even toxic nodular.
thyroid goiter and you treat itwith medications called thionamides
but essentially you would have moreprobably painful neck at your thyroid
(21:23):
gland and you might be feeling a littlebit more stressed your heart rate might
be in the 100s those are all thingsthat could be reason for hyperthyroid.
The only other kind of talking pointto talk about the thyroid is if you
do have hypothyroidism, low thyroidfunction, maybe you were diagnosed
(21:50):
with it early in your pregnancy oryou already knew about it and you're
already taking a medication calledlevothyroxine for that or Synthroid.
If you already have that medication,we increase that by 30 to 50%.
during your pregnancy.
it's better for baby to be more inthat physiological hyperthyroid state.
(22:11):
The Best Birth [21:46]
And so since many of us will move froma primary care physician to, a maternal
fetal medicine or an OB -GYN, it'sour responsibility, right, to let them
know if we're taking those medications?
Jonathan Crowther [21:58]
Yes, you need to let them know whichmedications you're on because there
(22:31):
may need to be a change of medications.
You might be on a medication for yourhigh blood pressure like lysinepril,
which is actually a taretogenic,which means that it's bad for your
baby when you are taking that.
So being off of that during yourpregnancy is going to be helpful.
we'll talk about the skin very briefly.
(22:53):
you guys kind of already knowyou just get this nice glow.
Everybody's like, wow,you guys look so great.
but essentially it's all from therelaxin and you're getting more, that
hormone relax and is going to, increaseyour joint lax, laxicity as well as
your skin laxicity, hair and, and skin.
(23:17):
a good symptom of having a nicelittle glow to it for once, right?
It's the one thing.
The Best Birth [22:55]
For once.
But then we get the postpartumhair and nails and it seems
like it wasn't worth it.
Jonathan Crowther [23:03]
Yes, exactly.
Cause that the hormone balances arejust so much off and then you get
hair loss and it's, it's just not fun.
(23:39):
But, the, with the musculoskeletal system,you have to think relaxin is a driving
factor in a lot of things, a lot of,you know, just it, kind of normal aches
and pains that you get in pregnancy.
so you think that you get a20 to 25 to 35 pound weight.
gain on average for pregnancy.
(24:02):
So what happens is you could get more.
but in general, the average is 25 to 35.
the,
yeah, center center ofgravity is going to change.
so it's going to put a little bitmore strain on your axial skeleton
or on your spine and your pelvis.
So you'll get exaggeratedcurvature of your lower back.
(24:24):
You'll get forward forflexion of your neck.
The Best Birth [23:36]
Is that all?
Jonathan Crowther [24:01]
and downward movement of yourshoulders to compensate all for
your, your enlarging uterus.
that joint laxity on, the lumbarspine makes you a little bit more
instable and a little bit morepredisposed to getting muscle strain.
Cause you have to think in thespine, you've got the large,
(24:47):
large muscles that you can feel
which are your erector spinae muscles,but then you also have these interspinal
muscle muscles that are very small.
And when there is less, you know,there's more laxity and less
support happening with the spine.
It makes it very easy for,muscle strain to happen.
You also see muscle laxity or, or ligamentlaxity in your knees and your feet.
(25:14):
And so pains in your knees and feet back.
are very, pelvis are very common to occur.
So
the question is when dothese become an issue, right?
Well, it's not very fun to deal with thepain as it is, but the times where you
(25:38):
would want to get seen by somebody isif you're having very severe pain that
interferes with your function, meaningthat not even positional, you know,
You get up, you lay down, you're sitting,you're standing, whatever it might be.
You're having severe pain.
and, and especially pain at nightwhen you've kind of relaxed your back.
(26:00):
if that's getting worse, that'ssomething to be seen for.
if you have pain with when you'recoughing or you're sneezing,
those are also, indications ofmaybe something else is going on.
if you have something like asudden bladder incontinence.
Not just when you cough or sneeze,but you just lose all of your
(26:21):
urine or even bowel incontinence.
You lose your stool.
That could be some from something calledCata Aquinas syndrome, where the laxity
has gotten so bad that you've actuallyhave compression onto your spinal cord.
And that's something that needs to beaddressed on an emergent kind of basis.
So if there's any sort of associatedweakness, sensory deficit, meaning
(26:46):
numbness, tingling, sharp shootingpains, or even when they check you
out, you've got abnormal reflexes.
Those are all indications that youshould be checked out by a physician.
The Best Birth [26:35]
Wonderful.
This is such important information toknow that there's certain thresholds
(27:08):
that if it's beyond, then it's timeto bring it up to your provider.
I think our bodies are reallygood at giving us those signals.
And it's been comforting as I'vebeen listening to you that if it's
far beyond the norm or somethingout of the ordinary, that's when
it's more likely to need to be seen.
Pregnancy is such a change in our bodiesand there's so many unknowns, but.
(27:30):
Jonathan Crowther [26:46]
Yeah, exactly.
The Best Birth [27:03]
There's also a lot of comfortthat other people have studied
things that happen as well.
Jonathan Crowther [27:08]
Yeah.
And it's always okay to talk toyour provider when you're in doubt.
you're never going to be faultedby somebody when you're just unsure
about what's going on, because youknow, your body and your body's
going through a lot of changes.
You might be more comfortable atwith baby number two or three, you
(27:53):
know, but, if something's different,that's when you want to speak out.
so.
The Best Birth [27:31]
Were there any other systemsthat you wanted to cover for
this first trimester period?
Jonathan Crowther [27:37]
I think the most other important, wouldjust be with the gastrointestinal tract.
that's probably the most important,on, on others, but I'll give you a
(28:16):
couple of tidbits and I'll get tothat, with back pain, and, pelvic pain,
knee pain, ankle pain, those kinds ofpains, you know, just simple things,
you know, lift with your back straight.
You can use a small pillow forlumber support when you're sitting.
You can sleep on the side and usea pillow in between your legs.
(28:40):
Exercise, exercise before you getpregnant will help to minimize that
amount of laxity that happens justnormally from the relaxing and you
may have less pain during pregnancy.
You can use chiropractor, you canuse osteopathy for pain reduction.
(29:02):
trials that they've done were kind oflimited, but there's other things like
acupuncture could be very helpful.
Physiotherapy, working with a physicaltherapist can very much so benefit as
well as even doing water exercises.
So those are all very good things.
And then go to pain medicationswould be something like Tylenol.
(29:26):
In general, you want to avoid insets.
during pregnancy, that's thingslike ibuprofen and Alleve.
And then they found that even with reallysevere back pain that using narcotics
or opioid medications, usually there'sno benefit from it and there's just
more risks that are associated with it.
(29:46):
Yeah,
but going on to our GI tract.
You know, one of the things that peoplewill start maybe complaining about
is GERD, gastroesophageal reflex.
And this doesn't just happen mechanically.
It is one of the reasons when you'relater on, when you have the uterus kind
(30:09):
of pushing up on, on your diaphragm.
But it's also again, from ourgood hormone, relaxin, you have
decreased tone of your loweresophageal sphincter, which is.
what basically separates betweenyour stomach and your esophagus.
And so because there's less tone there,there's more chance for reflux to happen.
(30:33):
So treatment for that is, you know,taking more frequent meals during the
day, trying to take your last meal atnight, two to three hours before bedtime.
And then if the symptoms really are bad,famotidine or Pepsid is a good way to,
treat that.
(30:56):
The, let's see, other GIissues, you got hemorrhoids,
common in the third trimester.
There are preparation H, there'smedications that your provider can give
you so that you don't have to suffer fromsymptoms of, you know, the anal itching,
(31:18):
discomfort, bleeding, things like that.
And then constipation happens a lot too.
And that's because there is actuallydecreased motility that happens
just normally with pregnancy.
So to help with that constipation,eating nice fibrous foods is going to
(31:42):
be your best friend during pregnancyand at all stages of pregnancy.
And then if needed, you can alsotake a laxative that can help.
The Best Birth [31:29]
I feel like we can't escape thefirst trimester without talking
about morning sickness, which shouldactually be called all day and night
sickness, because I felt way morenauseous and uncomfortable at night.
(32:07):
can you tell us if there's anythingthat we should be aware of?
or like different provider recommendedmedication for morning sickness.
Jonathan Crowther [31:41]
Yep.
Yeah, nausea and vomiting from morningsickness is a very common GI side effect.
So what I would say is, Zofran isgoing to be one of your best friends.
(32:30):
It's usually, it's a prescriptionmedication, but it can really help
with, with, that morning sickness.
some people get it so bad thatthey're, you know, just having.
intractable, they cannot stop this nauseaand vomiting and that's where they they
you could even use other medicationsthat are both oral but then there's other
(32:55):
suppository medications that you cantake like fenugrin if needed and that
those can really help with that nauseaand vomiting in that early pregnancy.
The other things to take in mind with
with early pregnancy is it'svery common to have insomnia.
(33:16):
So my go -to medications forpatients that are safe is vitamin
B6, as well as taking Unisom.
Unisom, it's the doxylamine succinateis the actual active ingredient of it.
(33:37):
But those can both help very, very well.
The Best Birth [33:15]
Well, thank you for giving us an overview.
It's really helpful to begin with theend in mind and just kind of being
aware of all these changes that arehappening within all of the systems.
I felt a little bit like we were onthe magic school bus going through
all the parts of the body andfiguring out what is happening where.
(33:58):
So thank you for your expertise on that.
Is there anything else we should lookforward to for the first trimester?
Jonathan Crowther [33:29]
Yes.
Of course, yeah.
You know, I think the things to lookforward to with our first trimester is
just knowing that it's cute because babiesare, when they're being formed as the
(34:22):
fetus, they are sized usually by fruit.
And so, you know, referringoften to your little strawberry
or your little cantaloupe or...
whatever it might be, your plumin your belly is very endearing.
So it's a good thing to kindof look forward to in that way.
(34:44):
The Best Birth [34:18]
When I announced my first pregnancy, Igave a few navel oranges to some friends
to say, this is the size of my baby.
So exciting.
Well, thank you so much, Dr.
Crowther for joining uson the best birth podcast.
We're going to end withour mom squad secret.
We have a tip fromsomeone in our community.
(35:04):
This is from Christina and shesays sleep with as many pillows
between your knees and against yourback early in pregnancy as needed.
Your body will thank you whenyou're seven months pregnant.
Jonathan Crowther [34:26]
Yeah, that's great.
The Best Birth [34:48]
So just as you mentioned, withoutsupport and all of those things to
make you comfortable throughout.
If you'd like to share a mom squadsecret, we'll have a link in our
show notes to the Facebook group.
(35:25):
Thank you so much forbeing on the podcast.
Jonathan Crowther [35:01]
Thank you so much.
Looking forward to coming on again.
Thanks for joining us on today's episode.
We hope you've been elevated andinspired by this week's expert.
Subscribe today so you never missan episode and please share our
podcast or post on your socialmedia so that other moms and dads
to be can also have the best birth.
(35:49):
Please note that the informationprovided is based on the expert's
insights and personal experience.
It is not intended as medical guidance.
Please seek the advice of yourmedical provider as it applies
to your specific condition.
Popular Podcasts
True Crime Tonight
If you eat, sleep, and breathe true crime, TRUE CRIME TONIGHT is serving up your nightly fix. Five nights a week, KT STUDIOS & iHEART RADIO invite listeners to pull up a seat for an unfiltered look at the biggest cases making headlines, celebrity scandals, and the trials everyone is watching. With a mix of expert analysis, hot takes, and listener call-ins, TRUE CRIME TONIGHT goes beyond the headlines to uncover the twists, turns, and unanswered questions that keep us all obsessed—because, at TRUE CRIME TONIGHT, there’s a seat for everyone. Whether breaking down crime scene forensics, scrutinizing serial killers, or debating the most binge-worthy true crime docs, True Crime Tonight is the fresh, fast-paced, and slightly addictive home for true crime lovers.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.