Expecting difficulties

Any woman knows the challenges that come with being pregnant — nausea, multitudes of doctors appoint

Any woman knows the challenges that come with being pregnant — nausea, multitudes of doctors appointments, fatigue and an increasingly heavy load to carry, to name a few. Add working outside the home to that, and you have one tall order.

“The greatest challenges are for them to be able to maintain a healthy lifestyle, which is particularly important when they’re pregnant,” said Dr. Renee Samelson, associate clinical professor of OB/GYN at Albany Medical College and a member of the Division of Maternal-Fetal Medicine. “The most important healthy behaviors to maintain are to have appropriate diet and exercise and have an appropriate time to rest.”

Think about it. How many of us find it easy to fit self-care into our busy lifestyles, which includes work, family, household chores and leisure activities? Planning, shopping for and cooking nutritious meals, fitting in exercise, and practicing some form of relaxation — all elements of maintaining a healthful lifestyle, are difficult enough for those of us who are not pregnant. Factor in the physical and emotional changes that come with being pregnant, and you can see the awesome task facing expectant mothers.

The good news is that women tend to be motivated when they’re pregnant, Samelson said. Even with full-time employment, they look for ways to take the best care of themselves that they can during pregnancy.

Combating fatigue

In early pregnancy, fatigue is almost universal, said Dr. Marjorie Greenfield, author of “The Working Woman’s Pregnancy Book” (Yale University Press Health and Wellness, May 2008). Greenfield interviewed more than 100 women for her book, learning how they dealt with various issues when pregnant. Samelson agrees that the first trimester fatigue can be “just overwhelming.”

Some women found that they just had to put their heads down for 15 minutes to combat the fatigue, Greenfield said. Others went for a brisk 15-minute walk to break up the afternoon, while some nibbled on a snack. “It tended to be the middle of the afternoon that people were having trouble with,” she said.

If a job has flexible hours, going home for an afternoon nap and then returning refreshed in the evening to finish up the day worked for some women.

Nicole Helstowski, a nurse manager at Ellis Hospital who is currently pregnant, said that she has found it hard to get out of bed some mornings, but that it is easier once she was up and moving. “I would say the best thing to do is to take care of yourself and get the rest you need, especially at night,” she said.

One of the biggest challenges for Diane Cross, an accountant at MVP Healthcare, was finding the time to get everything done at home and at work. Asking others to help out with tasks at home so that you can rest is another suggestion. When Cross was pregnant with her first child, it was easier, because she could rest whenever she wanted. With her second pregnancy, she had another child to care for when she got home. Cross enlisted her husband’s help to do things around the house, which allowed her to go to bed earlier.

Kathleen Grey, a behavioral health intake specialist at MVP and mother of three children, learned quickly to crash as soon as she put her kids to bed so that she could get a good night’s sleep.

During her first trimester, exhaustion overwhelmed Karin Giroux, a medical reviewer at MVP. “I just felt like my head was going to drop on the keyboard,” she said. Giroux enlisted her supervisor’s help, asking if she could take a break for five minutes to close her eyes. “She was very understanding,” Giroux said.

To make sleep as restful as possible, Greenfield suggests creating a bedtime ritual. “We run, run, run, run all day long and then jump into bed and say go to sleep,” she said. Just as one creates a bedtime ritual for children, like teeth brushing, a story, etc., creating one for ourselves is important, too. This might include taking a warm bath or listening to relaxing music, any habitual relaxing activity that signals the body that it’s time to rest.

Setting priorities is important, too. “It’s more important to sleep or exercise than to go do an errand for somebody or to wash the floor,” Samelson said.

When nausea strikes

Another first trimester whammy is morning sickness, which 50 percent to 70 percent of pregnant women experience. The main symptoms are nausea and vomiting, and they are not limited to just the morning hours.

Cross said that she was sick every day until her fifth month of pregnancy. She kept her desk stocked with ginger ale, oyster crackers and “Preggie Pops,” a specially formulated lollipop design to ease the symptoms of morning sickness.

To combat nausea and vomiting, Samelson suggests that women be their own investigators, paying close attention to what triggers their nausea, which varies widely from woman to woman. She notes that women try all different kinds of things, including lemonade, mint tea, ginger (plain, tea or tablets), vitamin B6, acupuncture and even hypnosis. Some women will graze all day so that their stomachs are never empty.

If vomiting can’t be avoided, Greenfield found that women had some strategies for dealing with it at work. If they were in a meeting, they would make sure to sit by the door so that if they had to get up to leave, it wasn’t as noticeable. Other women would combine a trip to the restroom with another task that they would normally perform, like making copies or going to the mail room. Greenfield also suggests keeping mouthwash and a clean blouse in an “emergency pack” at work.

Scheduling doctors’ appointments can be a juggling act. Much of what women can do is determined by their employers. Most women tried to do them early in the morning, on their lunch hours, or late in the afternoon, so as to not be away from the office during busy times. Cross found an added difficulty when her physician was on call, because the doctor’s office would call at the last minute and have to reschedule an appointment.

Taking time off

What goes hand in hand with working while pregnant is taking the time off after the baby is born. “There are issues of maternity-leave policies that are not very well managed nationally,” Greenfield said. “They really need to know what the laws are,” she said, pointing out that the Family Medical Leave Act only applies to about 40 percent of working women. Specific information about this law is available at the U.S. Department of Labor Web site .

Disability may apply to part of a woman’s post-pregnancy leave, as a woman is considered medically disabled for a period of time after giving birth, Greenfield said. The Pregnancy Discrimination Act, an amendment to Title VII of the Civil Rights Act of 1964, mandates that women who are pregnant or affected by related conditions must be treated in the same manner as other applicants or employees with similar abilities or limitations. The bottom line is that women should familiarize themselves with the benefits that are available to them with respect to maternity leave.

Returning to work after having a baby is also a challenge. “The separation of baby and mother is just wicked,” Giroux said. “Take advantage of the 12 weeks if you can afford it,” she said.

Going back can be tough

After her three months at home, Cross took advantage of her company’s lactation room so that she could pump breast milk at work. “I had this parenting tape that I would listen to over and over, and I had a picture of my daughter that I carried with me,” she said.

One of Greenfield’s interviewees told her that she bought herself flowers and took herself out to lunch on the day she returned to work to mark the day because she was feeling so bad.

Greenfield came across another woman who started her own volunteer program of visiting women who are just starting back to work after having a baby. She brings them a little basket of goodies and listens to them to help ease the transition back to work. “When she went back to work, she just felt terrible, just isolated,” Greenfield said. While going back to work is such a significant and often emotional event for a new mother, co-workers may not realize that.

Samelson entreats women to take the time they need to care for themselves while they’re pregnant. For second time mothers who may not need all of the start-up baby clothes and equipment, she suggests asking people for frozen portions of healthful food during pregnancy so that they can maintain good nutrition.

“I think if you can have a little bit of time for yourself every day — meditation, stress reduction, a yoga class once a week — I think those thing are a huge investment in your health and the health of your family,” Samelson said. “You’re only pregnant for a small amount of time, and it can have a huge impact on what can happen,” she said.

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