by Amanda Afdahl, ICCE, ICBD, RCPC
Did you watch Below The Belt with your fellow ICEA members a few weekends ago? We are planning a few other movie nights together in the future, so keep a watch out for announcements about that and other ways we hope to bring our community together. Of course the biggest event of the year will be our conference October 18-20th. I can’t wait to see you all there. This most recent film, Below The Belt, followed the journeys of several young women and their experiences with endometriosis. I watched the replay and was bummed to miss out on the group discussion that was shared afterward. Many aspects of the movie reminded me of what we, as birth workers, see women encounter on their journey to motherhood. Thankfully, over the last decade of my involvement in birth work, we’ve seen somewhat of an “awakening” not only in women seeking better care but also in the providers offering it. Yet women’s health care still has significant growth opportunities, and this documentary about endometriosis is one example of how women need to be listened to more comprehensively and holistically and where the “cure” seems as dangerous and life-altering as the disease. So what’s missing?
As a doula, my role is absolutely to help parents feel heard and to be an advocate when necessary. In my other field of training as a health coach, I focus on preconception nutrition, pregnancy health and the importance of foundational minerals and the role they have in the body. Minerals are aptly described as “the spark plugs of life.” They are essential for virtually every metabolic process in the body. But many of us are depleted of basic nutrients despite many foods being “fortified”. As doulas and childbirth educators it is important for us to be aware of how basic nutrition impacts a mother and developing baby. One great resource that I have found helpful regarding nutrient dense food choices is Lily Nichols. I love that she focuses on real food, not synthetic supplements, so it’s an easy resource for me to share with my doula clients and not feel like I am “prescribing anything” and am staying within my scope.
Also, another important aspect of supplementation that is often misunderstood is how vitamins and minerals can be both synergistic and antagonistic. People often want to know what their levels of XYZ vitamin or nutrient are, and if, after their prenatal blood tests, find that some levels are low, they will go to their local big box store and buy the shiny bottle that will supposedly raise the levels of XYZ vitamin. This is often done with iron, for example. Women especially are told that their iron is low and they need to supplement, particularly in pregnancy. But the relief this supplementation provides is often temporary and sometimes harmful. Iron has a dynamic relationship with another mineral, copper, which we rarely hear much about. Consequently, we are supporting mothers who are still having issues, and we need to know how to best serve them as advocates and educators.
As birth workers, we see regularly the amazing feats of the human body. But the relationship between copper and iron is one we don’t see quite as clearly as the process of birth, and is unfortunately overlooked by many care providers. Our bodies have something called the iron recycling system. When this is working properly and we’re eating nutrient dense diets, the need for iron supplementation would be rare because copper regulates iron within the body. Instead what is happening is that nearly every packaged food in the grocery store has been fortified with iron. Without going too deep in the weeds the iron you might find in your kids’ cereal is not a bioavailable form of iron. You can crush a bag of your favorite O shaped cereal, add water, seal the bag and drag a magnet over the top of it. If your cereal is fortified you will find little flecks of iron floating towards your magnet. All the excess iron our bodies receive has to go somewhere, because the innate intelligence of our body tightly controls what is in the bloodstream. Then where does all the excess iron go? Into tissues , like the liver, uterus, and bones. Consequently, what I’ve found helpful, when my clients ask about the best prenatal supplements or that they’ve been told they have to supplement with iron, is sharing these two resources from Lily Nichols and Amanda Montalvo, both registered dieticians.
Studies and commercials frequently tell consumers to eat plenty of antioxidant-rich foods. Why? Oxidants are “accidents with oxygen” in our bodies otherwise known as reactive oxygen species. What happens to iron when it is exposed to an accident with oxygen? It “rusts” or creates inflammation and cell damage in the body via the fenton reaction. What does any of this have to do with the movie about endometriosis? Personally, for me and for my doula practice, I wanted to know if there was any connection with this inflammatory disease to iron being stored in the tissue of the uterus. I found this pubmed article with the full-length article available here.
The conclusion found in the pubmed article states: Nuclear factor-kappaB activation dysregulation in the endometrium of endometriosis patients may explain some endometrial biological alterations associated with endometriosis. The scientific evidence strongly suggests that NF-κB activity in endometriotic cells stimulates inflammation and cell proliferation and inhibits apoptosis, favoring the development and maintenance of endometriosis. Iron overload in the pelvic cavity of endometriosis patients could be a main factor enhancing oxidative stress and activating NF-κB in a chronic manner, contributing to endometriosis establishment and growth.
Wow. As someone who loves to learn and “know all the things,” I am continuously blown away at how much we still have to learn about how the body works–especially the female body. I wonder what other aspects of this inflammatory disease we are missing, and if we will see this research impact the way providers approach supporting women struggling with such a debilitating disease. As a doula and childbirth educator I love the opportunity to share with my clients and students about how wonderfully amazing our bodies are and the importance of prioritizing our nutrition for them to be as amazing as possible! Growing a baby takes a lot of energy! If we don’t have the basic building blocks at a cellular level, it leads to further depletion of the mother which increases her risk for pregnancy related complications as well as postpartum depression and impacts the development and health of her growing baby. I would love to be able to ask the ladies in this film and do regularly ask the women I support about their nutrition and lifestyle concerning minerals. When we understand that minerals are the building blocks to health and wellness we are able to recognize issues our clients are dealing with as nutritional needs not necessarily a pathophysiological diagnosis.
If you want to learn more about how minerals impact every aspect of your bodily functions and share evidenced based resources with your clients, start with episode one of Amanda Montalvo’s podcast Are You Menstrual and let me know how amazed you are at what our bodies do with minerals.
