216. Dr. Labib Ghulmiyyah: On How To Prepare Your Body for Pregnancy, Fertility Decline, and Preconception Health

Interactive Transcript

spk_0 One thing I tell patients before they get pregnant to prepare for the pregnancy as much as they prepare for their wedding.

spk_0 And I think also one area that we forget to talk about is the preparation of the men for the pregnancy.

spk_0 I love what you say about preparing the husband along with a wife because I think that spousal support is so critical.

spk_0 It's a two-player game, it can be one person and I think we throw a pregnancy on women and men should play a role and being supportive.

spk_0 And when you have this support, you will make a difference.

spk_0 Pregnancy is also a time when women are supposed to be elated and joyful.

spk_0 The pregnancy glow, it's really supposed to be a time that they enjoy.

spk_0 So that's how I imagine a perfect pregnancy,

spk_0 preparing the men, preparing the women on all those important pillars from their nutrition, their movement, their sleep, their stress, their family support, which is extremely important.

spk_0 There's so much advice for women that are pregnant, but there's so little medical advice for them.

spk_0 That's why I got into more the function of medicine and started asking why and why.

spk_0 So pregnancy is a medical, it says.

spk_0 Another human comes out of a human and then instinctively they can raise them.

spk_0 Once a woman is pregnancy, what does an ideal, healthy pregnancy look like?

spk_0 To answer you as far as the pregnancy is concerned, I think...

spk_0 Hey guys, welcome back to the Ultimate Human Podcast.

spk_0 I'm your host, Tune Biologist Gary Brecco, where we go down the road of everything anti-aging, biohacking, longevity, and everything in between.

spk_0 And today's guest is going to have a special appeal to my staff because I've got a lot of pregnant women on my staff.

spk_0 And he is a board certified, an obstetrics and gynecology.

spk_0 He's also additional certifications and functional medicine and nutritional medicine.

spk_0 I cannot wait to unpack this podcast because it's so germane to the conversation we've been having here in Saudi Arabia so far.

spk_0 There's a lot around diet, lifestyle, spiritual well-being in the aspects of health that are non-pharmaceutical, non-chemical, and non-synthetic.

spk_0 And so this is going to be an amazing, amazing discussion.

spk_0 I'm really excited about this. Welcome to the podcast.

spk_0 Thank you, Gary. Thank you for having me.

spk_0 Babe Gumaya.

spk_0 Correct.

spk_0 Excellent. I got it right.

spk_0 From the first trial.

spk_0 All right, for the first trial.

spk_0 You can do it.

spk_0 Dr. LeBebe, I'm so excited to get into this topic because just jumping right into pregnancy with women, there's so much advice for women that are pregnant.

spk_0 But there's so little medical advice for them.

spk_0 I mean, we don't do randomized clinical trials on pregnant women because nobody wants to mess with a woman while she has a fetus in the womb.

spk_0 I constantly am asked the question, can I take this during pregnancy?

spk_0 Can I take that during pregnancy?

spk_0 And there's very little evidence for us to fall back on.

spk_0 We have clinical trials on just about everything.

spk_0 But we rarely do them on women while they're in the process of bearing children.

spk_0 So what does a healthy pregnancy lifestyle look like?

spk_0 Most women are so stressed about getting pregnant.

spk_0 And then when they conceive, now the stress shifts to, and we're doing everything right to care for this fetus while it's in the womb.

spk_0 Well, you know, one thing I tell pregnant patients or ideally before they get pregnant to prepare for the pregnancy as much as they prepare for their wedding.

spk_0 Wow.

spk_0 You know, sometimes weddings take six months to prepare.

spk_0 You have to do the same thing for pregnancy, but a lot of times unfortunate they come in already pregnant.

spk_0 Well, what does that look like?

spk_0 Let's back that up a little bit.

spk_0 Yeah.

spk_0 What does it look like ideally moving into all these things?

spk_0 Yeah, ideally, of course, you know, we touch on all the pillars of health, you know, from, you know, their nutrition, their movement, their sleep, their stress, their family support, which is extremely important their connection.

spk_0 So we try to get into all of those pillars and to be honest, you know, even me being an OB-GYN and I did the fellowship and maternal fetal medicine, which, you know, involves only high risk pregnant patients.

spk_0 We were never trained in, you know, addressing all these pillars.

spk_0 Right.

spk_0 Of course, you know, with time, you know, I learned that these are so important, so basic and there's no doubt that they make a difference in the outcome of the pregnancy.

spk_0 Prevention, preparation.

spk_0 Because, you know, I, you know, maybe I'm biased, but because most of my pregnant patients are high risks.

spk_0 So we see a lot of pre-eclampsia, pre-term labor, gestation diabetes.

spk_0 And I can tell you from the patients who prepare for the pregnancy, they have less of those.

spk_0 Of course, this is not a randomized trial because, you know, it's difficult to do it.

spk_0 And my trial is in pregnancy, but know that preparing, like you're preparing for a marathon, like you're preparing for an exam, you have to be ready.

spk_0 And I think also one area that we forget to talk about is the preparation of the men for the pregnancy.

spk_0 Wow.

spk_0 Because, you know, we are talking about us.

spk_0 Yeah, I mean, we have to go to this too.

spk_0 We assume that, you know, she's carrying the pregnancy.

spk_0 Yes, of course, but again, he's giving half of the genetic material.

spk_0 And this genetic material can epigenetically change in the womb.

spk_0 I know you talk a lot about epigenetics.

spk_0 And during my fellowship, I did a lot of animal studies on epigenetics, on mouse models that were hypertension.

spk_0 And I was a little bit more intensive and not hypertensive.

spk_0 And you would see the offspring's and their outcomes.

spk_0 And we see this going from one generation to another of mice.

spk_0 Of course, we assume that same thing happens in pregnancy, but in humans.

spk_0 But men are important because they're giving the genetic material.

spk_0 They're supporting their partners throughout the pregnancy.

spk_0 And then after delivery, you know, it's stressful too.

spk_0 I mean, that's good.

spk_0 You know, be there.

spk_0 You know, help during rest feeding, supporting their partner.

spk_0 So it's a two game, you know, it's a two player game.

spk_0 It can be one person.

spk_0 And I think we throw a pregnancy on women.

spk_0 And I think men should play a role.

spk_0 And then being supportive.

spk_0 And when you have the support, you will make a difference.

spk_0 And I'm sure physiologically that physiology will improve when they see support.

spk_0 And they see someone caring for them.

spk_0 So that's how I imagine a perfect pregnancy.

spk_0 Preparing the men, preparing the women on all those important pillars.

spk_0 And then, you know, throughout the pregnancy, you will do your prenatal care.

spk_0 And of course, try to fix or optimize any of their, you know, nutritional deficiencies and get to those.

spk_0 One area.

spk_0 And I know you like this.

spk_0 And I love.

spk_0 And that's why I follow you as you know, the biology of, you know, our genes and who she needs to be tested for genetic mutations and all of that.

spk_0 And these are important, but unfortunately, it's not easy to do on, on everyone.

spk_0 And other times they come in already pregnant and.

spk_0 And because of traditional medicine, you know, we're taught not to do those tests.

spk_0 Right.

spk_0 And why I don't know.

spk_0 And I feel like sometimes we just follow the what we were told.

spk_0 Right.

spk_0 And you have no time.

spk_0 Yeah, we call it.

spk_0 And the standard of care exactly evidence based medicine or, you know, legal medicine.

spk_0 We're worried that, you know, this is going to go into a medical legal thing.

spk_0 So we follow what ACOG or what SMFM tells us.

spk_0 And that's it.

spk_0 Yeah.

spk_0 And I think sometimes, I mean, it's good to have guard reals.

spk_0 Yeah, of course.

spk_0 But also the practice of medicine, especially under the, you know, the FDA.

spk_0 Is really meant to be in the hands of the practitioner.

spk_0 You know, you don't have to follow FDA guidelines.

spk_0 Um, you have to follow the regulations, but you don't have to follow the guidelines.

spk_0 Uh, there there is guidelines.

spk_0 And then there's, that's why we have awful label medications and awful label use.

spk_0 People wouldn't use propitia for male pattern baldness if you weren't allowed to practice outside the guidelines.

spk_0 And.

spk_0 But I think there's a prevailing wisdom that there's in medicine anyway.

spk_0 Um, there's only one way to do everything.

spk_0 Right.

spk_0 Um, I mean, in California, license could be a risk even if you go against the sort of state outlined dogma.

spk_0 And at what point the state was able to decide the practice of medicine when the practitioner is interfacing with the patient to me seems pretty.

spk_0 And this is assuming everybody is the same.

spk_0 And we are not the same.

spk_0 Everybody is genetically different.

spk_0 Everybody, uh, you know, detox their, you know, the endocrine disruptors in a different way.

spk_0 You know, I have a friend actually now they just moved to a house in Miami and his wife within few weeks is having allergic reactions.

spk_0 Uh, you know, she's worried about, you know, mold toxicity and they found mold.

spk_0 Yeah, they found mold.

spk_0 But he's not feeling anything and she's having, you know, headaches and, you know, sinus.

spk_0 And so people even living in the same household will feel different.

spk_0 And there's no question.

spk_0 That's why, like you said, a lot of things we do off label.

spk_0 And by the way, do you know that when we induce women, we use a product called mesoprostol, which is a prostaglandan to induce, you know, to dilate the cervix.

spk_0 And this is not FDA approved for induction of labor.

spk_0 It's off label use.

spk_0 And I will say maybe, you know, most of the inductions in the US are done through mesoprostol or another prostaglandan.

spk_0 And if you look at the label, it's used off label and many, many drugs are used off label.

spk_0 But yeah, sometimes we have to follow some of the guidelines.

spk_0 And then again, if you drift a little bit from the guidelines, you have to be really, you know, make sure you are doing something not to harm the patient.

spk_0 But a lot of times we don't have the answer to a question because it's difficult to do strides and pregnancy.

spk_0 But as long as you are, you know, being reasonable, you are taking, you're looking at the whole patient as a whole, not just, you know, one value from her lab work, then I think it's a good way of practicing.

spk_0 And that's how we're going to learn and change, you know, our practice and maybe improve pregnancy outcomes because preterm labor, for example, has not the prevalence or the incidence of preterm has not changed over the last 20 years.

spk_0 Actually, it has increased a little bit.

spk_0 Yeah.

spk_0 And, you know, so many places are trying to do, you know, research and trials to detect who's at risk for preterm labor, but we have no solution to it.

spk_0 Right.

spk_0 We're seeing more and more babies being born preterm.

spk_0 Yeah.

spk_0 You know, it's fascinating to me that we're so advanced medically in the United States.

spk_0 We definitely don't have a spending problem is spending $5 trillion a year on health care general.

spk_0 But in the civilized world, we rank among the highest in maternal mortality and infant mortality.

spk_0 Absolutely.

spk_0 Both.

spk_0 What do you attribute that to?

spk_0 Yeah, I think a major major risk factor that we see is, you know, the demographics and the metabolic diseases that we have and the pandemic of, you know, obesity, which is probably a final sign of inflammatory disease and insulin resistance plays a major role.

spk_0 And that will increase your risk of preterm labor, preterm delivery of because of pretty clumsy and other complications, C section rates are higher because of obesity.

spk_0 So I think, you know, there are multiple factors, but I think it all leads to the unhealthy lifestyle that, you know, the US has been, you know, getting that diet plays a major role in this.

spk_0 It's a huge role.

spk_0 I mean, and use a practitioner.

spk_0 I mean, you have to play with the hand that your dealt.

spk_0 I mean, when the patient shows up, you don't have a choice over what lifestyle choices they've made to that point.

spk_0 So you're inheriting whatever risk pattern they've developed for themselves.

spk_0 And I love the idea of preparing six months out for pregnancy.

spk_0 You know, like you were prepared for, I'm preparing for 10K and I've been on a program.

spk_0 Yeah, of course.

spk_0 Otherwise, you'll stop in the middle and you can't finish it.

spk_0 Yeah.

spk_0 So I think that preparation is so important.

spk_0 And that's, that's all knowledge.

spk_0 I mean, you don't have to get pregnant in six months.

spk_0 You can maybe prepare even a year or two years before, but at least have the knowledge of what's important to be done.

spk_0 You know, those, you know, lectures and workshops should be given to high school students, to college students and like sexual health.

spk_0 Like, you know, you're not gonna, you're not gonna cause people to be more sexually active if you teach them about it.

spk_0 I think that's what a lot of people fear, especially actually in this part of the world, because I lived in Lebanon also practiced for 12 years.

spk_0 And Lebanon, which is, you know, part of the Arab world and a lot of people fear that if you talk about sex or sexually health people are going to become more sexually active.

spk_0 And actually it's the other way around.

spk_0 So same thing, talk about pregnancy preparation for pregnancy and definitely the outcomes will be better.

spk_0 Yeah, I couldn't agree with you more.

spk_0 You know, I think too that we have a very serious challenge going on in the US.

spk_0 I mean, statistically population wise, you see fertility rates beginning to decline.

spk_0 And you also see sperm rates beginning to climb about 1% per year.

spk_0 1% per year doesn't sound like a big decline.

spk_0 That's 10% every decade.

spk_0 And you combine that with infertility rates and women conceiving.

spk_0 And you have a repopulation disaster potentially on your hands, or at least we're heading for one.

spk_0 What do you account for the declining rates of sperm counten men and declining rates of fertility and women?

spk_0 Yeah, I think they go kind of hand in hand.

spk_0 And when the sperm count is dropping, also the fertility rates will drop.

spk_0 But I think because the sperm and the eggs come from endocrine organs and those endocrine organs are so vital for our health span and even longevity.

spk_0 You know, now the ovaries are so important for that same thing for testes.

spk_0 But we are bombarded with toxins.

spk_0 And when I say toxins, I don't mean just chemical toxins.

spk_0 That's financial toxins, social toxins, social media toxins, always bad news.

spk_0 I mean, wars all over the world, hurricanes.

spk_0 I mean, we're always bombarded.

spk_0 I'm sure our ancestors had also issues.

spk_0 But so many things happening at the same time.

spk_0 I think all this is stressing our body.

spk_0 Cortisol levels are high continuously.

spk_0 And then you have those endocrine disruptors that are constantly invading our bodies.

spk_0 And we can get rid of them easily.

spk_0 I'm so happy to hear you say that.

spk_0 I mean, not happy to hear you talk about these problems.

spk_0 But I mean, I'm happy to hear you say that that that alopathic medicine, traditional medicine is recognizing that, you know, the body has frequency and motion mood.

spk_0 These have a major impact and stress on our ability to conceive our sperm counts, you know, terms of healthy pregnancies.

spk_0 So, you know, once a woman is pregnancy, what does an ideal healthy pregnancy look like for you?

spk_0 What are some of the recommendations, the guidelines that you tell your patients to give them the best possible outcome?

spk_0 Because I feel like that is the time when a woman is the most selfless, you know, I've seen it in my, the mother and my children, I've seen it in my wife now is a phenomenal mother.

spk_0 You know, during that time, their soul concern almost like it's a genetic programming is everything is about that fetus.

spk_0 You know, they give up some of the things they love the most wine coffee, you know,

spk_0 but you know, so it interrupts you they give up those, not because they're obliged to do it.

spk_0 They know it's harmful, but their physiology changes. They're got microbiome changes.

spk_0 And so they stop having those cravings.

spk_0 So I think it's a lot of the hormones that the placenta secretes makes them, you know, not liking certain smells just to protect their baby.

spk_0 So there is something there's something, you know, like too holistic that happens without us interfering, but of course sometimes, you know, we have patients that still smoke or you know,

spk_0 you drugs during pregnancy and that has a lot of, you know, reasons why, but in general, I think the human body knows so well what to fear and what to avoid in preparation for, you know, that pregnancy.

spk_0 But to answer you as far as the pregnancy is concerned, I think, you know, continuing with those pillars, sleeping well, you know, eating, you know, the correct foods and amounts to keep your microbiome healthy, avoid toxins.

spk_0 And of course, you know, lowering your stress, all of these are things that we advise women to do.

spk_0 And I usually it's so difficult to work on all of them. I try to see where is the weakness where this patient is having issues with them. We try to work on that part.

spk_0 The first part of the pregnancy, the first 12 weeks is when the fetus is developing. So it's a very critical time.

spk_0 But even afterwards the baby is growing your brain keeps growing until, you know, later in the pregnancy, even after birth, the brain keeps growing the lungs.

spk_0 So I think you just have to give advice on, you know, where they are lacking as far as issues with their sleep or with other issues.

spk_0 And then of course the regular prenatal care coming to their visits, having, you know, the ultrasounds, make sure the pregnancy is normal.

spk_0 We have multiple testing that we can do to predict if this woman is going to develop a clamsia with screen for diabetes.

spk_0 So there are, you know, standard guidelines that so far work well and they do decrease the risk of morbidity and mortality.

spk_0 But I think as physicians, we need to, you know, let the patient, you know, tell you what's bothering her, you know, make every parental visit count.

spk_0 Yeah. So instead of having 10 visits, you can do four visits and a low risk patients I'm talking that are really meaningful.

spk_0 So I think those will make a huge difference. Then also having the woman have access to knowledge, whether through an app, whether through, you know, social media, just for them to be educated.

spk_0 And not just listen to their friends and because everybody's different. I keep telling them that because all my friend took this vitamin. Is this vitamin better?

spk_0 Yeah. You know, you should not compare yourself. Right. Anything. Not in the pregnancy night that on social media, everybody's different.

spk_0 You know what I found fascinating. We first had children, you know, with my, my former spouse, the mother, my children. And, and we were able to successfully separate the husband and wife from the mother and child.

spk_0 We still maintain a very great friendship and an amazing modern family. But one of the things I was fascinated about was I was paralyzed by fear.

spk_0 I was in my 20s.

spk_0 She got pregnant, which we were not trying to conceive, but we weren't not trying to not conceive.

spk_0 And I was very excited about the prospect of having a child.

spk_0 But I also was absolutely paralyzed because I was like, I have no, like no idea what is there like a book chapter one ticket out of the crib, wrap it up like this.

spk_0 What if the baby folds on? Yeah.

spk_0 So, you know, there's no guideline. But what happened and, and, you know, obviously, I knew my wife at the time very, very well.

spk_0 We had stayed a long time and engaged for a period of time and got married. And so I knew her very well.

spk_0 But I noticed right after our first child was born, this entire new human being came out of her. I don't know where she adopted this knowledge from.

spk_0 On what to do, how to know what to do. And I've heard a lot of men talk about this with her wives do.

spk_0 She knew like the different cries that the baby would have. Like, oh no, she's constipated. Nope, she needs to be fed. No, she's, she's lonely. I'm like, hell the hell.

spk_0 Do you know my turn? I think this is called maternal instinct.

spk_0 It all sounded the same to me. Yeah, I think you're not doing breastfeeding, you know, like the baby being on skin to skin with the mom or with the dad.

spk_0 The connection happens immediately. And yes, you're absolutely right. Like, you know, I was an OB-GYN for almost 12 years.

spk_0 And then that's when I met my wife and we had the baby. I had no idea also about, you know, I delivered the baby, give it to the parents.

spk_0 And my job was done. Right. Right. And now this time it's mine. So same thing. I had no idea what to do. And I felt the same thing.

spk_0 She knew how to do the right. Professional all this training. Like all this. That's the big questions. I don't know. I don't know.

spk_0 Yeah. So and then the other part which was shocking is like the postpartum recovery of my wife also was something I discovered.

spk_0 Like, wow, women go through so much stress from the recovery because pregnancy is so tough on the heart and on all your organs.

spk_0 So it takes time for them to recover. And my wife is a very healthy person. And it took her almost a year to go back.

spk_0 So I started imagining what would happen to somebody who had pre-cramsia at 26 weeks. And she had an emergency C section and how her recovery will be. I never thought about it before.

spk_0 Yeah. So that's why, you know, I got into more the functional medicine and start asking why and why. So pregnancy is, I think, a medical it's an amazing.

spk_0 Like you said, another human comes out of a human and then instinctively they can, you know, raise them.

spk_0 It's, you know, not to frame it the wrong way, but it's a parasitic relationship, you know, between the fetus and the mother.

spk_0 And so the fetus is there to take everything that it needs for itself. And so that withdraws a lot from the mother.

spk_0 I mean, it will take minerals from the bone, you know, acid from the muscle. I mean, it was.

spk_0 Today used to spoke about the immune system. And like I said, because the baby is, you know, DNA half of it is foreign to the mom.

spk_0 So there is this kind of barrier where you don't want the mom to reject the baby. So your immune system is active.

spk_0 In a way, so this is also maybe adding to more stress on her organs. And we know there are few studies showed that moms with age, you know, faster after a pregnancy.

spk_0 But then they can, you know, catch up later on, but that immune response also, I think, plays a huge role.

spk_0 If you do a regular blood count, you'll see the white count is higher when you're pregnant. So interpretation of labs should be also different in pregnancy.

spk_0 But this immune system that you spoke about is huge in pregnancy.

spk_0 Yeah.

spk_0 You're constantly fired, you know, immune, immune wise throughout nine months.

spk_0 So imagine what that can cost your body. And the body of woman is so resilient. It's unbelievable.

spk_0 I've seen a lot of data on the difference between C section rates of different neuro developmental conditions and vaginal purse.

spk_0 And, you know, supposedly linked to the inoculation through the vaginal canal, certain bacteria that help inoculate the gut.

spk_0 We know now how important the gut microbiome is.

spk_0 This was, you know, there was a book written by Dr. Pearlmutter years ago called the gut brain connection.

spk_0 And then he wrote another book called grain brain. It was the first time as a human biologist that I read something that really drew my attention to the importance of the gut and the microbiome and the microbiome in general.

spk_0 And it really starting at birth. This is this first inoculation in birth. So for women that have had C sections.

spk_0 And they want to avoid this. Are there infantile probiotics? Are there some natural ways that she can mitigate having had to have a C section versus a vaginal birth?

spk_0 There's few trials that were done. I think small studies where they do smearing of the baby. Like after the baby's, you know, deliver to a C section, they would take, you know, vaginal swab and smeared the baby with the, you know, the floor of the mom.

spk_0 And to see if this makes a difference, but they were very short term studies. So there's no proof that they would change the outcome. But definitely the gut and the brain are connected.

spk_0 The baby one that in the womb, their, their GI tract is basically sterile. So once they pass through, you know, the birth canal, they're going to collect all these good micro. And the microbiome changes during that time to be really beneficial to the baby.

spk_0 Right. It's unbelievable. Even the milk, you know, let's say a mom delivered that 26 weeks her milk composition will be different than if she does a term. So that way that milk will be very beneficial to the baby.

spk_0 It's, I mean, it's unbelievable. What the machine. But yeah, there are some trials are smearing the babies to kind of read on in your collate them with that, you know, microbiome.

spk_0 But it's not a routine thing that's that's done.

spk_0 But the initial colostrum that's created from mother's milk, which is unbelievable. If you look at the composition of it, it's largely ketogenic, lots of fat going into the baby.

spk_0 There are microbes in there as well, which is also fascinating to me that only exists during that time and her entire lifetime. They don't come out in breast milk. They only exist during the first 48 hours of pregnancy.

spk_0 I mean, such a miracle thing. And the more you study it, the more you understand and know about it, the more you don't understand for me, yeah, the more I'm makes people even got me because I don't think that any of this happened by accident.

spk_0 Absolutely. But, but you know, that set aside. So, you know, healthy pregnancy is not much different from just being a healthy young woman, right? I mean, clean food, rest, stress mitigation.

spk_0 I love what you say about preparing the husband along along with the wife, because I think that's a powerful support is so critical.

spk_0 But you know, pregnancy is also a time when women are supposed to be elated and joyfully, the pregnancy glow. It's really supposed to be a time that they enjoy, maybe not the delivery itself, but the.

spk_0 The delivery has to be a nice experience.

spk_0 Yeah.

spk_0 And I think we medicalize that so much that a lot of times it becomes non-enjoyable because, you know, they're hooked up to monitors and to the IV and within a period.

spk_0 So, a lot of times they feel the experience is not nice, but I know so many patients they love being pregnant because of the glow, the hair.

spk_0 So, yeah, we try to make that time as nice as possible.

spk_0 But again, there are physiological changes that happen, you know, the center of gravity changes.

spk_0 Sure does.

spk_0 The pelvic pain, you know, yeah, working out is not very kind of way of saying, yeah, put on weight.

spk_0 Yeah, I mean, working out is not easy. So, but I think that's why the preparation will make that experience nicer.

spk_0 And yeah.

spk_0 So, let's talk about a couple of those things real quick.

spk_0 Are there, where do you fall and in the advice of exercise during pregnancy?

spk_0 I tell patients they need to exercise and keep moving. I mean, you don't want to.

spk_0 It's not just rest, just relax, just lay down.

spk_0 Not even, you know, not even women that are high risk for preterm labor, we tell them to stop exercising.

spk_0 Of course, we might limit the type of exercising if they've had preterm contractions or a very early delivery, the previous pregnancy.

spk_0 We might limit a little bit the movement, but not better.

spk_0 Actually, I went, patients come in and say, oh, my previous doctor told me to be on bed rest.

spk_0 Yeah.

spk_0 I tell them this is bad rest because it's going to make things worse. They're going to get blood clots. They're going to be depressed.

spk_0 They're going to gain weight.

spk_0 So, no, everybody should be moving.

spk_0 Yes.

spk_0 Of course, it depends on your risk factors. We might modify some of those, but they can continue, you know, weightlifting.

spk_0 They can, you know, do some cardio. So, they do whatever they were doing before.

spk_0 And maybe sometimes they were not exercising. And now it's a good opportunity to get them into exercise.

spk_0 Yes. So, yeah, absolutely. They need to work out. And this is what the guidelines say you have to work out at least five days a week, you know, for real.

spk_0 Yeah, that means yes.

spk_0 That's fantastic.

spk_0 So, they should all, and of course, depending on the trimester, the type of exercises changes because of the center of gravity changes, you don't want to injure those, those women.

spk_0 And their joints are a bit more flexible. So, you want to avoid things that could injure their joints.

spk_0 So, you have to be very knowledgeable in the types of exercise. And there are many professionals that can guide you.

spk_0 Not the time sign up for a marathon.

spk_0

spk_0 No, exactly. Or go skiing or horseback riding. No, but, you know, so I think this is a great time to initiate movement if they were not because movement is the huge.

spk_0 So, I'm not sure if movement is such a good longevity.

spk_0 Dr. Goma, you know, I, there's so much to unpack here. I, I hope that you will come back on the ultimate human podcast because I really, there's so much in your background here that is so germane to my audience.

spk_0 We're in Saudi Arabia now. And I, I have a hard stuff for commitment and the conference is running so, so, so late.

spk_0 So unfortunately, we're not going to get to unpack it now. But you're in Miami. I'm going to use the.

spk_0 Okay, so if you will promise me you'll come down to the studio. Okay, great. Yeah, come to the Miami studio.

spk_0 Of course, thank you so much. Because there's, there are, you know, so many women in my life.

spk_0 Now that are key parts of my team that are, you know, going through pregnancy or just delivered. It's such a, it's such a.

spk_0 A near and dear thing, you know, to, to my heart, my audience is craving, you know, quality information.

spk_0 So make sure to come to Miami, they'll be at the studio. So, I will. So, yeah, I'm bringing you on a conversation.

spk_0 Yeah. But Dr. Goma, I really appreciate you sitting down with us for a few minutes on the ultimate human podcast that I'm really excited to continue to run this when we get back to Miami because my, my audience is desperate for this type of information.

spk_0 But until then, where can they find out more about you? Well, they can find me on social media. Okay.

spk_0 My name, Dr. LeBeeb Pumia, have a website, Dr. LeBeeb.com. So I tried to use my first name, so easier.

spk_0 And yeah, I, you know, I do practice, or we join MFM and Miami. And I do some telehealth consultations.

spk_0 Okay, really? Okay. Great. As needed. But, yeah, I mean, my social media linked in.

spk_0 Great. I'm going to put today to find people. Yeah, I'm going to put all of this. Well, if you can put this glass name together. But I'm going to put all of this in the show notes for you guys.

spk_0 I wish we had more time done practice. We will run this one again because there's just so much in his background of this.

spk_0 So, germane and so aligned with our mission. And there's so many of you that have submitted questions. I want to make sure that we get to all of those.

spk_0 But until next time, that's just science.

216. Dr. Labib Ghulmiyyah: On How To Prepare Your Body for Pregnancy, Fertility Decline, and Preconception Health

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