Healthy Pregnancy with Dr. Katie Rose

Dr. Cates: Hi there. I’m Dr Trevor Cates. Welcome to The Spa Dr. Podcast. Today we’re talking about how to have a healthy pregnancy. My guest is Dr Katie rose. She is a naturopathic physician specializing in women’s health and fertility. She’s in Tucson, Arizona. She’s been on the podcast before, we’re having your back on and so her own health journey started in her twenties that led her to a naturopathic doctor who helped her to overcome several chronic health issues and inspire Dr. Rose to pursue a career in naturopathic medicine herself. She is passionate about educating and empowering women about their bodies, their fertility and their pregnancies. Currently pregnant with her second son. She has some great firsthand experience to pass along. In today’s interview, we discuss skin issues common in pregnancy and how to address them naturally and Dr. Rose shares top foods to eat supplements to be sure you’re getting and other important tips for a healthy pregnancy. If you’re thinking about getting pregnant are currently pregnant, you definitely want to watch this podcast or if you know anyone who is, please pass along this important interview and please enjoy this interview.

Dr. Cates: Katie, it’s great to have you back on The Spa Dr. Podcast, welcome.

Dr. Rose: Thanks so much for having me again.

Dr. Cates: Yeah. So last time we talked about fertility, this time we’re talking about pregnancy and this is near and dear to you because you’re pregnant right now with your what, your second child right now.

Dr. Rose: Yes, I’m so I’m six and a half months pregnant and I thought it would be nice just to give some continuity. Um, because most of my patients come in for fertility, eventually end up getting pregnant. So the next questions for them are, well, is there anything I need to keep doing with you to have a healthier pregnancy and healthier recovery?

Dr. Cates: Yeah, of course. Awesome. So we’re gonna dive into that today and I’m so, I mean so what is it about naturopathic medicine and pregnancy that that might be a little bit different for people. What are some things that they need to be aware of?

Dr. Rose: Yeah, so nutrition is a crucial piece to pregnancy and it’s something that is really left undiscussed in the western world beyond like, are you eating and are you getting enough to eat? Are you getting enough calories? Uh, you know, beyond that, my experience in my first pregnancy was really lacking. So I’m so glad I had the education that I did going into it. And it’s just the experience I’ve had with a lot of my infertility patients who once they’re pregnant, we refer them out for obstetrics. Since I don’t deliver babies and you know, the lack of conversation about nutrition and any other supplements beyond a prenatal that might be helpful for them and exercise and the mind body connection during pregnancy, all of those things ideally should be addressed and there’s not always time and you know, in an obstetrics appointment for that.

Dr. Cates: Yeah. Okay. Absolutely. So we’ll talk about some of those things today because it really truly is an important time to support your body. And um, so what are some of the, as far as diet goes, what are some things that you think are, are crucial for pregnancy?

Dr. Rose: So getting real whole food is my number one goal for people. And within that more specifically getting enough protein, you know, we always talk about you have to up your calories during pregnancy and oh you’re eating for two, but I really don’t need that many more calories. It’s about 300 calories extra during pregnancy, which you know, that’s a large snack, that’s not a full meal. And I think some people tend to go a little bit overboard with that because they’re not discussing it in their prenatal visits and you know, they’re just eating whatever they want cause they figure, well I got pregnant and my body can take care of the rest. But what’s really important to understand is that what we eat and the nutrients in our food have the power to turn genes on and off. And this translates not only to your own health, but to the health of your child and the health of your grandchildren because of how those genes will get passed on. So you potentially have the capability to prevent diabetes and heart disease and obesity in your children and your grandchildren by eating well during pregnancy.

Dr. Cates: I think that’s such an important thing to realize because people don’t talk about this. And it’s been a while since I’ve had, you know, my kids are now 12, 17 and 20, so it’s been a while since I was pregnant. But people would say to me, and I’m sure they’re still saying this, oh, you’re pregnant. So go enjoy the donuts and go eat as much as you want because you can eat as much while you’re pregnant and enjoy that. And, and it’s not saying that with medical advice, but you know, this like friends would say that that was kind of the encouraging people would bring me food and I’m like, I don’t want to eat this. But, so I think it’s really important to realize that we do want to be really mindful. And like you said, it’s an opportunity for multiple generations. And I, I don’t think that many people are aware of that. And that’s newer information that we know about genetic expression and the study of epigenetics. Right? Nutritional genetics. Right?

Dr. Rose: Yeah. Yeah. It’s really fascinating. And you know, they’ve studied it in human populations and then they’ve been able to study this and mouse and rat models too. And actually, you know, changing the carbohydrate and the fatty acid content that the animals are getting and then, you know, testing their future generations for certain diseases like diabetes and obesity and heart disease and cancers. So we know that this is true. It’s just, it takes a while to actually make it into medical practice. Right? So we try to stay up on that as much as we can. And with people who have any sort of modified diets, whether they’re, you know, on a vegetarian or plant based diet, you know, they have specific food aversions, then we can troubleshoot that together and decide what might be lacking in the diet that then may need to be supplemented because there’s so many nutrients that we have much higher need for during pregnancy.

Dr. Cates: Right. And you mentioned protein being one of the really important things that you need to get during pregnancy. So how much protein is that? And if someone is doing more of a vegetarian diet or more plant-based, what are they kind of shooting for and how can they make sure that if they are doing a vegetarian diet that they’re still getting the right amount of protein?

Dr. Rose: Great questions. So in earlier pregnancy, so I usually just divide it up and be like the first half of the pregnancy. See in second half of pregnancy and the first half we’re aiming for about 80 grams of protein and in the second half 100 grams of protein. And so if you’ve been eating a typical Mediterranean or Paleo style diet, that’s not very difficult to accomplish. But if you’ve been eating based on, you know, old school food pyramid, which has nine to 11 servings of grains, you’re not going to be getting that goal very easily. So for people who are on a plant based diet, we need to really hone in on how they can get their protein from beans and nuts and lentils and even, you know, coming down to, well what whole grains are a little bit higher in protein and you know, are you willing to make some adjustments in terms of, you know, would you be willing to add eggs or would you be willing to add, you know, a whole fat grass-fed dairy option. So whether it’s, you know, based on ethical reasons or health reasons that they were previously eating a plant based diet before I, I do really encourage adding some animal products back in if possible because there’s some nutrients that are really only found in animal products.

Dr. Cates: Right. And so those nutrients are things like certain B vitamins and zinc and what other, yeah, some of that. What are some of the nutrients?

Dr. Rose: Yeah, so B12 is a primary one that we think of. And so if I’ve been working with a couple for infertility prior to them getting pregnant and they’re both doing a plant based diet, we’re usually supplementing B12 beforehand. And testing their levels to make sure that they have appropriate serum levels of that going into pregnancy and then maintaining it throughout. Choline is another one. You know, it is found in some legumes and cruciferous vegetables, but it’s actually highest found in eggs and it’s a crucial nutrient for neuro-development. And there are studies that are being done on the offspring of women who ate higher choline levels during their pregnancies and showing that their children actually have twice the processing speed of women who ate either the recommended daily allowance or below that. So if there’s so many trace nutrients that we don’t think about beyond like what’s inside a single prenatal but are really important for that development.

Dr. Cates: Yeah, absolutely. So, and then you mentioned high protein grains, so that would be what? Sprouted sprouted grains and then like quinoa.

Dr. Rose: Yeah, absolutely. So sprouted grains. So you know, if you are eating a sprouted organic bread, one slice, usually gets between four and six grams of protein, even in oatmeal, we’ll have six grams of protein in one serving. Um, so then thinking about, well, how do I bulk up my oatmeal? You can add chia and hemp hearts and nuts and peanut butter and really get closer to about 20 grams per bowl of oatmeal when you’re doing it that way. So that’s often a go to, that I’ll have for my plant-based patients during breakfast for pregnancy.

Dr. Cates: Right. Okay. And, um, you know, another thing that I, you know, we, we talk about when we look at epigenetics and what’s passed on through generations are also the toxicity, toxic exposures and that that can be passed along in genes. Do you talk to your patients about that too?

Dr. Rose: Absolutely. And especially if they’ve been working with me for infertility or hormone balance issues beforehand, we’re always having that discussion about the pesticides, the plastics, the parabens and phthalates and anything that, you know, we weren’t really designed to be processing on our own. One of the best studied now is phthalates in male fertility. So when we’ve looked at the population of rats that they exposed to high level of phthalates, the rats themselves didn’t necessarily have horrible issues with fertility, but their offspring and then their grandchildren both did. So again, when we’re talking about epigenetics, those satellites have the ability to downregulate how well the male rats were able to produce from. And so this is where we’re seeing, you know, in the last 50 years, we have a huge reduction in male sperm count. Oh by about 47%. And that’s significant. So if we can switch over to nontoxic household cleaning products and beauty products, skin care, hair care, even before getting pregnant, that would be ideal. But even the exposures that we’re getting while pregnant will have a significant effect on our children and our grandchildren.

Dr. Cates: Right. And the majority of phthalate exposures comes from, uh, plastics. And then also like you mentioned in cleaning and beauty, proud of beauty products. Like, I know in fragrance there’s diethyl phthalate that’s in there. What are some of the main ones that you talked to people?

Dr. Rose: The main ones we talk about. So when we were talking about, you know, looking at ingredients in skincare, I mean there’s so many ingredients that could be listed, but then there could just be listed fragrance and that could be one of 183 different compounds that may or may not have toxic effects on the body. And so if we don’t know, it’s better to be safe than sorry and know where your products are coming from. And when you’re reading the ingredients now hopefully it says organic or you know, essential oil-based fragrances, those are gonna absolutely have less effects on the body.

Dr. Cates: Right? Absolutely. I know that, um, there, you know, a lot of times that people start switching over to natural beauty products is when they’re pregnant. Like, I know, actress Zoe Deschanel found my products because she was looking for when she was pregnant, she was looking around for natural skin care options and her makeup artists had found my products and kind of pass them along to her. So, and I know that that’s like, we hear that and like celebrities, but it’s true. People start being more mindful. Sometimes that’s when they start to, they start to switch over to more natural options. And that’s, and that’s great and better, better to do it then, than never right. Just start it. You know, there, there’s something to be sad about that like switch that gets flipped

Dr. Rose: when you’re entering into parenthood. It’s like, oh my gosh, I have to take care of someone other than myself and this is going to matter for their health and potentially, you know, downstream from there. So it is a great time to make those changes, right. Um, and we also see a lot of skincare issues that can crop up during pregnancy. And so that can be motivation for some women too, to make changes to the or less harsh ingredients. So I see that a lot as well. People with acne or melasma that are cropping up during pregnancy. And then we have to go back to, well, it was your, what was your original toxic burden like, and if the liver is having to flush through some of that now, where can we reduce your toxic burden?

Dr. Cates: Right? And so the really the biggest thing with when it comes to toxins is not to try and detox during pregnancy, but to reduce your overall exposure. Because people do ask me sometimes, can I do you know, your detox program during? And I always tell people that, you know, during pregnancy really it’s just about what reducing exposures. And I mean, if they wanted to do something, maybe they could do colonics or something like that. But really it’s really not the best time, right.

Dr. Rose: Absolutely not. Yeah. You know, you do that three to six months beforehand, give your body time to actually get all of those toxins out of circulation and we want to pull them out of the fat tissue for the most part and get it out of the body well before conception, during pregnancy, if things are relatively stable in the body, we want to keep it that way. So we don’t want to bring it into circulation and then risk it, you know, moving through the fetal blood stream.

Dr. Cates: Yeah. Yeah, absolutely. So you mentioned skin issues during pregnancy. And so I want to touch on that a little bit more. So acne and melasma. So those are two of the big ones that you see. So with acne, what are, what are people struggling with and what are the things that seem to help?

Dr. Rose: Well, the dietary suggestions seem to help a lot because sometimes acne can be related to nutrient deficiencies like zinc or vitamin C. And so if we change the diet in such a way in which they can get more in sync, which you know, just found in a good quality, pasture-raised beef and you know, freshwater or freshly caught seafood, then you’re going to have a better think contents in the body. But that is something that is also safe to supplement if they’re unable to eat those foods. Vitamin C if you’re, you know, getting lots of fresh fruits and vegetables, you’re going to be able to get your recommended vitamin C as well. But again, also safe to supplement in low doses in pregnancy. So those are two of the nutrient issues that I see. And then of course, you know, we have a lot of hormone circulating during pregnancy. So if the liver is not, you know, in a good place to be processing those hormones, that’s when we might see some hormonal patterns of acne. So around the jaw line or chin around the mouth. And in those cases, I, that’s when I recommend just switching to really gentle skincare routines. And so I, I personally love your cleanser and, the Step 2 Antioxidant, I mean it’s, that’s a beautiful combination that I’ve seen good results with and myself and with my patients. And you can use some spot treatments pretty safely, but I typically will start with diet and hydration too. Cause it’s so easy to get dehydrated during pregnancy and then you’re just going to concentrate any toxins that are circulated.

Dr. Cates: Yeah, absolutely. And then with Melasma can explain to people what that is and what to look for.

Dr. Rose: So melasma is a darkening pattern of this skin and it usually will start, you know, it’s just one little spot and then can spread really all over the face for some women. But oftentimes is over the bridge of the nose and the cheeks. So it can happen oftentimes with women who are in a higher estrogen state. So pregnancy being one of those times, sometimes perimenopause is a time when it’ll crop up as well. And it can be really frustrating because it can kind of come out of nowhere for someone then. So the first step for me is skin protection because the sun seems to exacerbate it in most people. So using a really safe zinc based sunscreen would be my number one. And you know, wearing wide-brim hats. Followed by using less harsh skincare products, cleaning out any toxic cleaning things that you might have in the house, cause that’s going to put the extra burden on the liver and then the liver is going to have trouble processing those extra estrogens and that’s going to translate into weird skin changes. So rather than having that gorgeous pregnant glow that women expect they’re dealing with, you know, these spots that can be really frustrating and embarrassing.

Dr. Cates: Yeah. And then other skin conditions, people might have Eczema or psoriasis or other preexisting skin conditions they might have. Do you tend to see a, a worsening or no change in that?

Dr. Rose: It really depends on the person. So with autoimmune conditions like psoriasis, some autoimmune conditions actually will go into remission during pregnancy because our immune system has to change in such a way where, you know, it’s not rejecting this foreign DNA that’s developing inside of us. So someone will go into remission, whereas some women will get flare ups and I tend to see more flareups of Eczema and psoriasis during pregnancy. I don’t know exactly what the mechanism behind that would be. But again, I come back to diet and we talk about, well, you know, prior to this, were you eating a diet that was, you know, richer and you know, your omega three fatty acids and lower in sugars and food allergens and did you get pregnant and just kind of throw caution to the wind and say, well, I’m just gonna eat whatever I want because I have all these food aversions. And the only thing that sounds good is you know, M&Ms, which is something that came up with one of my patients, who was previously eating Paleo style diet. So I tend to again come back to what’s happening in your diet. Are you getting the nutrients that you need? Getting the B vitamins that you need and the magnesium, because that will kind of change how your body processes Histamines, which then are reflected and itchy skin conditions.

Dr. Cates: Yeah. And then another skin skin issue that people tend to have is the concerns of stretch marks. So you don’t necessarily see those until after the fact, after having the baby. And then you start to go back to your normal size and then they appear. But some women tend to get stretch marks easier than others. So what are some, what have you, anything that you can recommend for preventing stretchmarks?

Dr. Rose: So coming back to the diet, making sure that they’re getting foods that are rich in the vitamins a and e and c and glycine and proline and vitamin C, especially with proline and glycine are going to help with Collagen formation. So they’re gonna give skin, you know, that little extra stretch that it needs to support the growth of the fetus. And what’s really interesting about the uterus is that it will actually increase its collagen component by 800% during pregnancy. But our skin kinda takes the brunt of, you know, what, what our body can’t produce in college and it’s going to give straight to the uterus and not really care about the skin cause that’s not vital at that point. So I do typically recommend using a collagen protein during pregnancy. If women are eating animal content. I add a couple tablespoons to my smoothies every day or if I’m doing a good tea or decaf coffee, I always add it to that as well. And so that would be one and making sure that you’re keeping your skin moisturized. So I usually will use, you know, a natural oil, adding some vitamin e oil to rub onto the valley a couple times a day or you know, the thighs or the breast if those areas are getting stretch marks as well.

Dr. Cates: Yeah. And I remember seeing a study a while back about massage in general. It doesn’t necessarily matter as much about what you’re using to massage, although we know, you know, we don’t want to expose to, to toxins, but, um, but the, the act of massage, uh, is, is, um, with an oil like good oil is as helpful at preventing stretch marks. And so, I mean, I think the ones that I’ve found to be really helpful are like the really thick ones. Like shea butter, cocoa butter, those are nice, but even just a nice almond oil thing, it’s simple and making sure that it’s not, it’s not going to be a, you know, like baby oil would be like the worst mineral oil. I want to stay away from this oils that say that they’re, you know, natural and they’re, you know, like it might say almond oil, but then if you look closely at it, it’s got other oils in there. So just making sure that it’s a pure plant-based oil, right?

Dr. Rose: Yeah. And with massage, but your goal is just to get some increased circulation to the area.

Dr. Cates: Yeah. Perfect. All right. So going back to diet, you mentioned a few things and of course we talked about toxin and reducing toxin exposure. So we wanna make sure that we’re eating organic right during pregnancy. Any other dietary tips that you want to suggest? I mean immunity, blood sugar balance, I’m sure is is a big thing you talk to your, your uh, patients about? Absolutely, especially because I have a

Dr. Rose: high percentage of pcls patients which tend to be at higher risk for developing gestational diabetes. So avoiding, you know, your processed grains, refined sugars, those are number one, keeping your protein levels up. So really for them, I’m aiming for that hundred grams of protein for the majority of their pregnancies and getting enough vegetables to fulfill your trace nutrient needs. When there are a lot of food aversions, then we try to find ways around that by doing the smoothies where we can hide our Greens and our veggies or you know, I, I have like a green water that I do for myself when veggies are just really unappealing that day so that I can get all my greens and easily, because it’s not just about are you not getting sugars, but are you getting the micronutrients that you need? And so that’s where we come back to your, your choline and your zinc and your vitamin B’s and your vitamin C and those factors. So there, I tend to individualize diet, but if I could choose just one plan for everyone, it would be, you know, getting that a hundred grams of protein from a combination of nuts and beans and wild caught salmon, pasture-raised meats and eggs along with getting least a minimum of five servings of vegetables a day. But ideally, you know, between seven and 10 and then getting a few servings of fruit everyday with my preference being dark berries. But any fruit that’s in season is going to be higher in nutrient content too.

Dr. Cates: Okay. And food cravings are common in pregnancy. And I mean they can really range. Right. Um, I have, do you find that people that are eating the Diet that you’re talking about have less of the unhealthy food cravings?

Dr. Rose: They do because a lot of times food cravings are related to something that your body is missing. So with sugar cravings, I usually find that you actually, you’re getting some hypoglycemic episodes, which means you probably needed more protein earlier on in the day to begin with. And a lack of protein earlier in the day tends to contribute more to morning sickness, which for a lot of people is really all day sickness. So that can be really helpful for people who aren’t getting enough meat and they are having, you know, all of a sudden a weird steak craving when they haven’t eaten steak in years. We’re usually looking at, well like what’s your iron, your B12 and your calling status because your body might be telling us that you’re really craving that. With chocolate cravings we’re often looking at magnesium, because we know that good dark chocolate is high in magnesium and it might be okay to indulge just a little bit, but I think it’s really important to encourage people to listen to those cravings and talk to their provider about it before, you know, eating the entire pint of ice cream.

Dr. Cates: Right, right. Yeah. I’ve heard people say, well, you know, if your body craves it, that means, you know, you should just go ahead and eat it. And I think there is some truth to paying attention to your cravings like, but doing it in a healthy way that you talk to me if you’re talking about and finding out why are you craving this and is it a healthy craving? Um, because I think that our bodies do, you know, like you’re saying there, you’re craving some aspect of it, but you meet many the magnesium from the chocolate but not all the sugar that comes along with it. So how, what are there other ways that you can get those nutrients? So speaking of that, let’s talk about supplements. What do you recommend for supplementation during pregnancy?

Dr. Rose: So in terms of prenatal there, there’s really only a handful of really good ones out there. And what qualifies a prenatal as being really good in my mind is that it has folic acid, not as synthetic folic acid, but as folate in its natural form. It’s five MTHF or folinic acid because we know how important folic acid is for neural tube development. But we also know that a good half of the population has issues activating folic acid. So it’s perfectly safe to be getting it in that form. And so many people need it in that form that I’d prefe we just start off on that foot. The seeking health brand of prenatal is easily the best one that I’ve come across because it actually has a higher level of choline. Um, most prenatals don’t have Coleen at all. And the ones I’ve looked at that do mostly range between like seven to fifteen milligrams per serving, whereas the seeking health one is upwards of 125 milligrams, which is excellent because it’s kind of hard to get as much as you need from food everyday as we want during pregnancy.

Dr. Rose: So that’s number one. It’s also really important to the getting enough fatty acids, especially DHA, which is also really important for neural development in babies. And DHA is one of the omega three fatty acids. So if we’re getting enough wild caught salmon during pregnancy, like three servings a week, then you probably don’t need to supplement DHA. But I don’t know that many women who are actually getting salmon that often. And I personally, one of my biggest food aversions during pregnancy as fish. So what something is usually a go to for me, like I cannot stand the thought of right now. So I do supplement DHA for myself and I recommend it for most people who aren’t getting that in their diets on a regular basis. And then everything else, I tend to tailor to the person, you know, what has their previous history been with, you know, diabetes or hypertension and we decide together what’s safe. So it’s hard to make broad recommendations if I don’t know what a person has been through before.

Dr. Cates: Okay. Well what about probiotics? I know that there’s, especially for when there is a genetic predisposition to a atopic diseases, you know, allergies and Eczema and things, that there has been some research showing that probiotics can help, um, prevent those. Do you, is that something that you recommend?

Dr. Rose: I do. I off, I will usually recommend some more probiotic if people aren’t able to eat a lot of fermented foods. And probiotics not only are helpful in that relationship with skin health because it’s helping with gut health, but we also see it reduce the incidents of Group B Strep, um, specifically with the lactobacillus rhamnosus strains. So for several reasons, probiotics might be a good idea for some women. And that’s another thing I find is not discussed with most, um, obstetricians in the prenatal visits. You know, once it 35 week visit comes around and they’re testing for group-based job, um, that might be the first time a woman has even heard of it. Where, you know, in my practice we’re talking about it upfront in the first trimester because some of the studies that they’ve started doing with the group B strep and probiotics, they’re starting as soon as they find out a woman is pregnant with using, you know, live active probiotics.

Dr. Cates: Okay. All right, great. All right. And what about he can be talked to, you talked a little bit before about stress management and certainly that we can have changes with the mood and energy and things like that. So what are some safe, natural things that pregnant women can do for those?

Dr. Rose: So like finding good support in the first place is really important. And identifying whether or not this is just, you know, the crazy hormones or if the hormones are actually changing your neurotransmitters in such a way where you are experiencing clinical depression or anxiety. And in those cases, you know, you have to talk to a provider about that because it’s not well screened for during pregnancy, the way they screen for it in a postpartum period. And yet you have up to 25% of women who actually experience true depression or anxiety during pregnancy. So I do bring this up, frequently, you know, at every visit that I see a pregnant woman during, you know, how is your mood, how is your outlook, are you feeling hopeless, are you having bouts of crying and how can I support you with that? And what is your support system in terms of your partner, your friends, your family, your coworkers? So finding out, you know, who they have around them first. And then I do tend to recommend meditation and mindfulness. So there are a few books and apps that can be helpful for people who are going through that and then deciding along with their obstetrician, is this something that they need to be treated for beyond that and would it be safe for us to use some natural things like theonine or five HTP versus using an SSRI, which you know, has some potential risks during pregnancy.

Dr. Cates: Yeah. And having that support during pregnancy is so crucial, I think because of the risk of postpartum depression. And, and when you already kind of go into that postpartum time with support, then if postpartum depression is there, then you kinda got that built in and it might help prevent it from, from happening too.

Dr. Rose: Absolutely. And again, if we’re, if we’re getting the nutrients that we need, then we tend to get the right precursors and cofactors to build our neuro-transmitters. So I do see diet, again coming around and helping with anxiety and depression as well. But ultimately we have to have a conversation. And I think so many women get caught up in this idea that they’re supposed to be happy when they’re pregnant, especially if they’ve gone through a really rough infertility journey. And so to have that realization of like, oh my gosh, I just, I feel miserable and I’m down and I’m hopeless and I feel guilty about this. They don’t feel comfortable bringing that up with people around them sometimes because it’s like, oh, you should be happy and it’s not always the case. So I think we need to dispel some of the taboo behind that for people.

Dr. Cates: Yeah. And realizing that it’s not just in your mind and head, you don’t always have control of that, that your body is doing things. There’s so many changes in hormones that happen during pregnancy and after pregnancy that it’s not your fault. It’s not, you don’t always have control over this and understand that working with someone, um, that understands that, you know, you can have those changes and recognizing that.

Dr. Rose: Absolutely. And it’s a good time to learn how to ask for help because then again, during that postpartum period, I think and in our culture, women are, you know, we take pride in being able to do it all and you know, be pregnant and working and have our baby and go back to work and just do this all in the seamless, graceful way, but not really reality for most people. You need a good support system. There’s a reason the term it takes a village was coined because in the ideal world we would have that village helping us out.

Dr. Cates: Yeah, yeah, absolutely. Creating that support and then also with movement, like Yoga. I remember those things were so key for me to be healthy during my pregnancy as much as it’s allowed. Of course someone’s on bed rest or something like that, then that makes it limited. But, um, what kinds of recommendations do you have for movement?

Dr. Rose: Generally speaking, if women have been active coming into their pregnancy, they can usually continue doing whatever they’ve been doing for most of their pregnancy. They obviously need to talk to their obstetrician about what they’ve been doing. You know, if it’s obviously something you know, crazy martial arts, then that might not be a good idea. But if they’ve been lifting weights or running, then it’s usually safe to continue doing those things. Now if you’ve never been active before or you’ve had limited activity, then it’s best to start slow and start with walking and maybe seeing a personal trainer who’s well versed in pregnancy, joining a prenatal yoga class, which is, you know, more specifically geared towards modifications that can be made to yoga and specific breathing patterns that can be used throughout pregnancy and then in labor and delivery. And it’s also a great way to meet moms. So if you’re trying to build that connection and that support group, finding other pregnant women to work out with can be a great resource too.

Dr. Cates: Right. I remember my first pregnancy I was playing polo, horse polo and realized I had to give that up. And I remember looking for other options that I found a yoga and swimming to be some of my favorite things to do. And um, I really do think that that helped me, especially the prenatal yoga classes. They’re specifically designed for, you know, pregnant women’s bodies and the development and the changes that occur. I think that can really help with labor and delivery. Do you?

Dr. Rose: I absolutely agree. Yeah. And even just carrying the pregnancy a little more easily because it can be hard for some people. You, their musculoskeletal system was just not perfectly designed for it and even though as women were supposed to be designed for it, but it’s not always a comfortable experience. And so we really only have one prenatal yoga instructor in Tucson, she’s been practicing a really long time. She’s just, she’s just so amazing about empowering women during their pregnancies. So I definitely recommend it if you could find one to go to in person. It’s a great idea. But there are great online programs for Prenatal Yoga and all sorts of prenatal workout programs online that can be useful as well. And the instructors will give some, you know, virtual one-to-one support as well.

Dr. Cates: And getting body work could be a good thing too. I know that, you know, there are, so like you were mentioning, there are changes that are happening in the body and and so discomforts and tight muscles and you’re not used to your, your posture changes. A lot of things change because of the weight distribution, the muscles, ligaments being kind of more lax and uh, especially as you get closer to, your due date. Right?

Dr. Rose: Definitely. So searching out of, you know, a massage therapist who has a certification in prenatal massage can be helpful. I personally get a little bit more out of myofascial therapy and acupuncture than I do traditional massage. I’ve had issues with pubic synthesis dysfunction in my pregnancies, um, which can then limit activity. And that’s really frustrating for me cause I’m used to being so active and I have a really active three-year-old to keep up with too. So I have found that those two things have helped me tremendously and just being able to maintain my activity level throughout pregnancy.

Dr. Cates: Yeah. All right, well that’s great. You know, this has been so valuable and we could talk about pregnancy, you know, for a long time we could write books about it. So many different aspects of it. I mean, I remember when I, you know, years ago, the really the best resource was the book. What are the series of what to expect when you’re expecting, you think that there are so many more resources now available for us, you know, for pregnant women. And so, are there any resources that you think are particularly helpful for you?

Dr. Rose: Definitely. So there’s a book that was published last year called Real Food for Pregnancy and it was written by a woman named Lily Nichols who just did a tremendous amount of research for this book and looking at traditional diets and the micronutrient needs during pregnancy. And so that is a book that I recommend to most of my patients as soon as we find out they’re pregnant or you know, even in the preconception period if I’ve had that time with them beforehand. So that’s one of the first resources. There’s also a book called Mindful Birthing that is a really great resource just for, you know, getting through pregnancy with more mindfulness and preparing for labor and delivery, it can give some tools to help with, you know, specific thought patterns and fears that you might have leading up to delivery too.

Dr. Cates: Yeah, that’s fantastic. So I was born in 1973 and according to my mom, she says, she thinks I was the first natural childbirth in the town where I was born and in Virginia. So it was really unusual at the time. We’ve come a long way since that time, but she was, they were doing a lamaze method and it was even just a having my dad in the waiting, I mean in the room and the delivery room with her was a new thing. But we’ve come such a long way since then in pregnancy, labor delivery. So it’s, it’s so nice that there’s more resources and more available. Um, and uh, so you know, it’s been so great talking about this and I know you have so much experience with this. Tell everybody how they can find you, and learn more about what you’re doing.

Dr. Rose: Ah, so you can check out my website, DrKatierose.com and I do have a quick guide to an empowered pregnancy that you can download from the website. So we’ll make sure that you guys have access to that link. And I just, I run through pretty briefly a lot of the things that we discussed today and some of my favorite resources. Um, I’m also on Instagram @DrKatieRose and on Facebook. So always happy when people ask me fun pregnancy questions and it’s pretty much my favorite thing.

Dr. Cates: That’s great. And so are you going to take some time off when you have your baby?

Dr. Rose: I will. Yeah. I don’t know how much time cause you know, it just kind of, I’m gonna listen to my body and see how things are going. But probably a few months and I have a few patients who are scheduled for their IVF this fall, so we’ll work out a plan to support them through that still.

Dr. Cates: Yeah. Okay. All right. Well thanks again Katie for coming back on. It’s been so much and I can’t wait to hear how everything goes with them. Your next little one.

Dr. Rose: Thank you so much. We’re so excited.

Dr. Cates: I hope you enjoyed this interview today with Dr Katie rose to learn more about her. You can go to the spa Dr Com, go to the podcast page with her interview and you’ll find all the information, show notes and links to find out more about her there. And while you’re at TheSpaDr.com, I encourage you to join our communities. You don’t miss any of our upcoming shows. And if you haven’t taken the skin quiz, you can find valuable information about what your skin might be trying to tell you about your health, even during your pregnancy. So just go to theskinquiz.com to take the free online quiz and get some valuable tools and information. And I invite you to join us on social media, on Facebook, Twitter, Pinterest, Instagram, and Youtube, and join the conversation and I’ll see you next time on The Spa Dr. Podcast.