“Can I still exercise now that I’m pregnant?”
“I haven’t been exercising, but now that I’m pregnant I want to start an exercise program. Is that okay?”
These are typical questions women tend to ask about exercise, once pregnant. For women without medical complications, pre-natal exercise can be not only safe, but beneficial, even for those who have been sedentary.
Who Should Exercise?
Exercising during pregnancy used to be taboo. Women were told to stay off their feet as much as possible; a sedentary lifestyle was encouraged. Now, however, medical experts generally agree that moderate exercise is safe for women who have no medical complications or pre-existing conditions, such as vaginal bleeding or a history of miscarriages. The physiologic and morphologic changes of pregnancy may interfere with the ability to engage safely in some forms of physical activity. A woman’s overall health, including obstetric and medical risks, should be evaluated before prescribing an exercise program. Generally, participation in a wide range of recreational activities appears to be safe during pregnancy; however, each sport should be reviewed individually for its potential risk, and activities with a high risk of falling or those with a high risk of abdominal trauma should be avoided during pregnancy. In the absence of either medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.
Epidemiological data suggest that exercise may be beneficial in the primary prevention of gestational diabetes, particularly in morbidly obese women (BMI >33). The American Diabetes Association has endorsed exercise as “a helpful adjunctive therapy” for gestational diabetes mellitus, when euglycemia is not achieved by diet alone. The cardiovascular changes associated with pregnancy are an important consideration for pregnant women, both at rest and during exercise. After the first trimester, the supine position results in relative obstruction of venous return and, therefore, decreased cardiac output and orthostatic hypotension. For this reason, pregnant women should avoid supine positions during exercise as much as possible. Motionless standing also is associated with a significant decrease in cardiac output, so this position should be avoided as much as possible.
Epidemiologic studies have long suggested that a link exists between strenuous physical activities, deficient diets, and the development of intrauterine growth restriction. This is particularly true for pregnant women engaged in physical work. It has been observed that pregnant women whose occupations require standing or repetitive, strenuous, physical activity (like lifting) have a tendency to deliver earlier and have small-for-gestational-age infants. However, other reports have failed to confirm these associations, suggesting that several factors or conditions have to be present for strenuous activities to affect fetal growth or outcome. Scuba diving should be avoided throughout pregnancy, because during this activity, the fetus is at increased risk of decompression sickness, secondary to the inability of the fetal pulmonary circulation to filter bubble formation.
A high-risk pregnancy is one of greater risk to the mother or her fetus than an uncomplicated pregnancy. Pregnancy places additional physical and emotional stress on a woman’s body. Health problems that occur before a woman becomes pregnant or during pregnancy may also increase the likelihood for a high-risk pregnancy.
Warning Signs to Terminate Exercise While Pregnant
- Vaginal bleeding
- Dyspnoea prior to exertion
- Chest pain
- Muscle weakness
- Calf pain or swelling (need to rule out thrombophlebitis)
- Preterm labour
- Decreased fetal movement
- Amniotic fluid leakage
Increased stamina can help during labour and strengthens the muscles most affected by pregnancy: the pelvic floor muscles, abdominals, and lower back muscles.
Benefits of Exercise
Exercising won’t necessarily make your labour easier, but it will help in many ways.
- Improve circulation
- Enhance muscular balance
- Reduce swelling
- Ease gastrointestinal discomforts
- Reduce leg cramps
- Strengthen abdominal muscles
- Ease postpartum recovery
A good prenatal exercise program can also improve posture, which is adversely affected by the growing uterus and expanding abdomen, which cause the pelvis to tilt forward. Exercises to strengthen the buttocks, back, shoulder, and stomach muscles help keep the body in alignment and decrease the discomfort associated with unhealthy posture.
Research tells us that women who work out for 30 min, 5 days a week, have bigger, healthier babies. Women who burn 1,000 calories a week delivered babies that weighed about 5% more than those delivered by sedentary mothers. Pregnant women who burned 2,000 calories a week gave birth to babies who weighed 10% more than babies born to inactive women.
Exercise Program Components
A typical exercise program we advise (and have devised) to help you achieve healthy exercise goals includes the following. components.
The warm-up is essential to preparing muscles to work and stretch without being injured. Walking or leisurely riding a stationary bike are good ways to warm up, as is swimming slowly. The warm-up increases your heart rate, breathing, and blood flow and raises your body temperature. Even if you have a limited time to workout, don’t shortcut your warm-up. Spend at least 5 min preparing your body for the workout.
Aerobic activity increases your heart rate and your maximum oxygen uptake, tones your muscles, and helps you maintain or even improve your fitness during pregnancy. Because of your increased oxygen requirements and increased breathing work, you’ll have less oxygen available for aerobic exercise, so you will have to modify your intensity. Don’t workout to exhaustion; stop when you get fatigued. Walking, swimming, and jogging are common and safe aerobic activities.
Exercises that strengthen your muscles help build tone and endurance, in body parts such as the abdominals, the shoulders and arms, the back, the legs, and the pelvic floor muscles.
Cooling down helps your breathing and heart rate return to normal and inhibits blood, which has been pumping to your working muscles, from pooling in your extremities. You should cool down for 5 min at the end of your aerobic activity by simply decreasing the intensity of your activity or by walking. After your strengthening exercises, we recommend that you cool down with a few leisurely stretching exercises, holding the stretch for longer than normal and concentrating on deep breathing.
Stretching your muscles will lengthen them and increase their flexibility. During pregnancy, it is especially important to stretch slowly and gently, because your joints are loosened by the increase in the hormones progesterone and relaxin. Don’t stretch to your point of maximum resistance or use jerky, bouncy movements. Also, avoid stretches where your joints are unsupported, this can lead to injury.
Relaxation techniques can help you during both your pregnancy and your delivery. Through a variety of techniques, relaxation techniques can release muscular tension and help you feel more comfortable, calm, and in control.
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