Staying cool in the summer is a challenge especially for pregnant women. Staying hydrated and avoiding prolonged heat exposure are among the ways to maintain a healthy pregnancy in the summer heat.
In your chiropractic clinic, you help a lot of pregnant women stay as comfortable as possible throughout all stages of pregnancy. In your experience, could you explain some of the ways the summer heat makes pregnant women especially uncomfortable?
Dr. Gregg Rubinstein: Wow, that’s a great question. And the weather we can’t control, but it does certainly have an effect on us. One of the things that’s very common, if you’re pregnant, you’re much more likely to get heat exhaustion or heat stroke sooner than someone who’s not pregnant. And there’s a couple of reasons for that. Primarily, your body’s got to work harder to cool down both your body and the unborn baby. And if you’re pregnant, you’re also more likely to become dehydrated. So, some clinicians recommend not spending really more than 10 minutes in a hot tub, due to risk of hyperthermia. A body temperature higher of 102.2 Fahrenheit can lead to exhaustion, heat stroke, and dehydration. Overheating can also lead to some adverse pregnancy outcomes like premature birth, low birth weight, stillbirth, and congenital disabilities. But just being outside, generally is not going to push your temperature up to 102, that’s if you spend excessive time in hot tubs and things like that.
It’s important to understand that pregnant women are a little bit more susceptible. So, things like staying inside, limiting your time outside, especially if the heat index is over 100, those things are all really important to understand. You’re going to be a little more susceptible. So, one of the most important things is just stay inside, limit your exposure. If you’re going to be exercising, do that inside when possible, especially when it’s going to be hotter out. Just being mindful is going to be the most important thing to staying more comfortable. That affects people who are pregnant and not pregnant, but definitely when you’re expecting, you’re going to be a little more susceptible to those two things.
What are some tips to ensure pregnant women do not get dehydrated?
Dr. Gregg Rubinstein: Oh, that’s an easy one, drink water. Besides the obvious, drinking water during pregnancy is vital because of the increased demands on your body. It’s even more important to do that in the summertime when hot temperatures will speed dehydration. Not drinking enough liquid can lead to heat exhaustion. Again, it can also cause some Braxton Hicks contractions.
Signs of dehydration are really important to notice, especially with a lot of different things going on. If you’re dehydrated, you might be dizzy or lightheaded. You might experience nausea, headaches, muscle cramps, dry mouth, flush skin, chills, constipation, dark colored urine, or a high heart rate with low blood pressure. Generally speaking, you want to be drinking your 8 to 12 cups of water a day, and you want to be drinking before you get thirsty. Because, by the time you’re thirsty, it might already be too late.
So, it is real important just to stay hydrated and that’s mostly common sense but you are at higher risk when you’re pregnant. So again, limiting your sun exposure, limiting your time outside when it’s hot. If you are exercising, maybe do that inside or dial it back. Those are all things that are really important. And some of those signs and symptoms of dehydration do have some crossover into other conditions during pregnancy, especially like the muscle cramping and things like that. But it is really important to recognize the signs of heat exhaustion.
Do you have any tips on how pregnant women can continue to exercise during the hot summer months?
Dr. Gregg Rubinstein: I’ve got another smart-ass answer, probably staying indoors in the air conditioning. But it is very important to continue to exercise. There are a lot of benefits from exercise when you’re doing it when you’re pregnant, but stay indoors when it’s really hot.
Walking, taking a brisk walk outside is great and that doesn’t strain your muscles or your joints. Swimming, and water workouts are great. Riding a stationary bike. Yoga and Pilates classes, they can be done indoors. Low impact aerobics classes can be done indoors. Strength training can be done indoors. So, there are a lot of things that can be done indoors or if you really want to get out and experience the outside, do it just in the early morning or in the late evening when the sun isn’t so strong. Those are great things. But we want people certainly to continue to exercise because there are so many benefits from exercise.
While we’re talking a little bit about exercise during pregnancy my absolute favorite is the prenatal yoga, because it’s gentle and it’s run by women who have probably had kids and work with lots of expecting moms. We absolutely adore the prenatal yoga center here in New York City on 72nd Street. They’re just a wonderful tribe of people who really support chiropractic and they’re just open for natural health and healing. So, they’re great and that’s absolutely my favorite. If anyone asks me what they should be doing during pregnancy, I almost always tell them to do that prenatal yoga.
But while we’re talking about exercise, there are some things that expecting moms should be avoiding during pregnancy. Anything that might cause mild abdominal trauma, including activities that have jarring motions or rapid changes in direction. Anything that requires extensive jumping, hopping, skipping, or bouncing, deep knee bends, full sit ups, double leg raise, straight leg toe touches, bouncing while stretching. All those things really need to be avoided during pregnancy which I think we could actually even do another whole topic on in the future.
It is very important to understand, you need to keep the core temperature down. You should be able to have a decent conversation while you’re in the later stages of pregnancy, while you’re working out. Any more than that, if you’re having trouble catching your breath, you’re probably working too hard.
Foot and ankle swelling affects many pregnant women in the summer. What are some tips to avoid swelling or ways to deal with it?
Dr. Gregg Rubinstein: I want to talk a little bit more about some of the other reasons as to why you might see the foot and ankle swelling, and when that happens. Because we need to discern just general swelling from a few other things.
During pregnancy, absolutely your body is going to retain more water, which generally means that you’re going to see some more swelling, especially around the ankles and feet. It’s normal. And when the weather’s really hot, swelling can be even more pronounced. So, while you’re pregnant, your body’s expanding to accommodate the growing baby, and your feet are going to swell along with your waistline. Feet swelling is referred to as edema, and it affects eight out of 10 pregnancies in women usually. It’s caused by that increase of fluid circulating around the body.
Also, a woman’s blood volume increases. It goes up almost 30%, 35%, to 50% in some women. And the blood tends to be a little bit more watery so it seeps into the interstitial tissue and that’s where we see swelling. When it’s related to heat, excessive swelling from heat is called heat edema. That’s because the blood vessels are expanding, and then the bodily fluids move into the tissues resulting in swelling.
While it’s common effect to see swelling during pregnancy, it also can be cause for concern. If the swelling is extreme, you need to call a doctor, especially if it’s in your hands and face, and it comes on suddenly. Because, excessive swelling, particularly in the hands and face, is a sign of preeclampsia, which is a dangerous condition. And so, it’s really important. And remember to stay out of the heat to avoid excessive swelling in the summertime.
If you do find yourself experiencing heat edema, try to rest with your feet up. Taking a cool shower and putting your feet in a cool water or a bath is going to be very important to make sure that you cool yourself down. So, all these things are super important.
During a pregnancy, swelling is common, but you need to be able to know what the signs of preeclampsia are just from routine swelling in the ankles. It’s not as common in the first trimester, but in the second and third trimester, you’re going to see a lot more swelling in the legs and those things are really important.
There are some ways to reduce the swelling in the legs. Maintaining regular exercise and movement is going to help reduce swelling. Reducing your salt intake, wearing those compression socks that always look so cool that women love to wear, staying hydrated, and elevating your feet. Just basically lying flat with your feet going straight up the wall on your back will help drain the feet. Epson salt baths tend to be helpful and also help with muscle cramps, which are a common effect with dehydration or later in the pregnancy. Prenatal massage is wonderful to help with edema. And of course, seeing your chiropractor.
Are there any treatments or therapies you would recommend to help pregnant women get through the summer heat?
Dr. Gregg Rubinstein: Absolutely. Obviously, staying inside, reducing exercise, and staying inside when the temperatures climb really high. But obviously, being a chiropractor, my favorite option for women is chiropractic for back pain and neck pain.
The Webster technique is so important in prepping the body for birth. The Webster technique affects the sacroiliac joints. About a quarter inch of spread at the sacroiliac joints more is the difference between having a vaginal birth versus a C-section. One of the important things that chiropractors provide is relieving tensions in the round ligament and the ureteral sacral ligament, which, when they’re tight, can actually slow down labor and lead to dystocia, which is a slow, difficult, labor.
Other great things to do while you’re pregnant, and you know I’m a big fan of, prenatal yoga for exercise, prenatal massage, the cool baths, elevating the legs, and compression socks. All different things that are going to help a pregnant woman get through the summer heat. But as far as aligning the spine and minimizing back pain, neck pain, and all those different things, chiropractic by hands down seems to be my favorite. I wonder why.
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To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.
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