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Pregnancy, the 4th trimester: What is it and how do I prepare for it?

You become pregnant and you’re happy and excited to grow your baby. 30 weeks down the line, the 3rd trimester, and you feel tired, heavy and uncomfortable and yet you may have another 10 weeks to battle through before you hit the 4th trimester! I call it the 4th trimester as, for many, you are still providing for and nourishing your baby. You are its primary provider but you are also healing and recovering from the last 40 weeks and the physicality of labour.

Pregnancy depletes our bodies of 10% of our most vital vitamins and minerals that we need to function optimally. Mineral loss, combined with the physiological stress of not sleeping and the adrenaline that comes with caring for a new life, can leave us feeling drained. Although it is important to care for your baby, it is equally important to care for yourself!

The good thing is that supporting your wellbeing in pregnancy and after is easy if you know how. Ideally you work with a practitioner to create a targeted plan specific to you as the best approach to wellbeing is to test and not guess

Here are my 10 top tips to future mothers to prepare for the fourth trimester:

1. Ideally you test your mineral and vitamin status BEFORE you get pregnant and rectify imbalances and deficiencies. I obsess over hair mineral testing as it is an easy, affordable and hugely insightful test that shows us what we are missing, how our bodies are using the stores we have and what we need to support. Optomisation pre-pregnancy can facilitate an easier pregnancy, with less nausea, sickness and cravings.

2. Supplement but do it smart. Supplements were not born equal. It is an unregulated industry, where quality is not controlled. Often supplements on the high street contain traces of heavy metals, hormone disrupting chemicals, synthetic substitutes for wholefood nutrients OR just not enough of what we really need. So, supplement based on your hair test, supplement what you know you need more of and ensure you are getting practitioner grade, quality ingredients. For example: we want folate not folic acid. We want whole food vitamin c, not ascorbic acid. We want retinol, not beta-carotene. But most of all, we want the real food!

3. You may not have the biggest appetite in the first trimester but when you can try to think of food as the fuel and the building blocks, for you and your baby. Eat the rainbow in colour to increase phytonutrients. Ensure you get 1.6grams of protein/kg of weight in a day. Eat lots of complex carbohydrates, ideally from root vegetables such as beetroot, sweet potato, squash, carrots and others including broccoli, brussels and spinach as these increase butyrate in the gut and we need butyrate to support the gut microbiome and to make all those extra hormones required to support your baby’s growth.

4. Don’t shy away from wholefood Vitamin A. All too often women stop consuming Vitamin A rich food altogether, such as pate or organ meats or omega fish oils as they are told it is toxic for the baby. In fact we need Vitamin A in the form of Retinol, which is found naturally in such foods. Correct, we do not want an excess of synthetic, supplement form, beta-carotene but we do need Vitamin A. Nourishing the foetus requires huge amounts from the mother’s stores and almost everyone we is depleted in their 3rd and 4th trimester. This then leads to increased levels of unbound copper in the blood. It is not that we get too much copper, it is that we need Vitamin A to use copper correctly. Excess copper settles in the brain tissue and is a cause for baby blues, post-partum depression and in more severe cases, psychosis.

5. The Adrenal glands – the home of energy in your body- are put under increased demand through pregnancy and the 4th trimester and we need to support them. A simple hack is to make an ‘adrenal cocktail’ to sip on. It hydrates you, reducing water retention and cramping, and it supports the vital minerals needed by the adrenals. Mix 150ml of coconut water (or more!) with ¼ -1/2tsp of good quality salt (Rock salt/Maldon/Himalayan) and a good squeeze of lime. You can make this first thing in the morning to wake and hydrate and again later in the day or pre-bed. This will support your Potassium, Magnesium and Sodium levels in particular which is needed for energy and is even a fantastic drink to get your through labour as it supports good, strong contractions!

Recipe: -150ml of coconut water (or more!) -¼ -1/2tsp of good quality salt (Rock salt/Maldon/Himalayan) -A good squeeze of lime* *You can also use a 1/4tsp of whole food Vitamin C powder.

6. In the first trimester: Get in some extra Magnesium, our body burns through it in those first few weeks as it needs all the energy it can to develop that embryo and make it into a foetus.

7. In the second and third trimester: Add in some Vitamin E (mixed tocopherols not just d-alpha!) and some choline to support the rapid development and growth of your baby’s brain and neuro-health. Eggs are of course a great source of choline and that much needed cholesterol and protein.

8. Get yourself another hair mineral test at the start of your third trimester to see what your body needs to support the final months of pregnancy and set you up for successful lactation (if that is what you want to do!).

9. From week 32, get tested for Strep B by asking your practitioners to test for it or buying a kit yourself. Knowing the result can allow time to support the microbiome and vaginal microbiome before delivery, reducing the risk of infection for you and the baby and mitigating the need for antibiotics in those early days, making for a calmer, healthier start to newborn life.

10. Finally, once you have delivered do not stop eating and try to lose weight! Of course you want your body back, but reducing food intake has a negative affect on your recovery as well as your thyroid health and adrenal health long term. This will in fact make it more difficult for you to lose that pregnancy weight. Your body is smart, feed it, look after it and it will do the hard work for you! Enjoy your baby, enjoy your food and your body will look after itself.

Bonus tip!

4-6 months after delivery, get a final hair test. At this point, your body’s metabolism and hormones will have settled after birth. We will gain a better insight into your post-pregnancy base line and know how to optomise your health in a targeted and personal manner. Did you know, it takes an estimated 3 years for women to fully recover their baseline health after pregnancy? The more targeted your approach, the quicker we can restore. This is especially key if you are planning baby 2,3 or 4!

The take home: Prepare pre-conception and through pregnancy to optomise life in the 4th trimester!

For help, guidance and to work with Dr Lizzie Almas book in a consultation.

Until next time,

Dr Lizzie @ Mi Health


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