Exercise and your pregnancy
Regular, gentle exercise is one of the simplest things you can do to take care of yourself and your baby during pregnancy. Numerous studies show the many benefits of exercise in pregnancy such as weight control, shorter labour, improved circulation (and a decrease in the possibility of varicose veins), strengthening the back, increased energy and improved sleep.
Most women can continue their usual fitness activity at the same level of exertion for the first trimester, although some are slowed down by nausea and tiredness. It is, however, recommended that you avoid all contact sports, deep sea diving and skiing throughout your entire pregnancy. If you do feel weaker while exercising, take it easy. Spend longer warming up and take breaks when you need to, whatever you do don’t force yourself. Many women find they feel at their best in their second trimester and have more energy and enthusiasm for exercise. The third trimester is often the time women need to slow right down because of a variety of reasons such as nausea, tiredness and heart burn, however many women can perform some type of gentle exercise up to the day their baby is born.
As your pregnancy progresses the body changes; the body carries more weight, the muscles and ligaments begin to relax in preparation for childbirth and there is an increase in the curvature of the lower back as the body adapts to take the weight of the foetus. Overall blood volume increases, but the production of red blood cells doesn’t quite keep up, sometimes resulting in a type of anaemia. As the red blood cells carry oxygen, this slows down delivery of oxygen to exercising muscles so you tire more easily.
There is also a rise in basal metabolic rate and the cardiovascular system has to work harder to supply more nutrients to active tissues. Thus it is important not to overheat your body throughout pregnancy because this can put too much demand on the circulatory system. Also, unborn babies cannot sweat so have no way of cooling themselves down. They rely on their mother’s body to regulate their temperature. If your body temperature rises above 38.5 degrees Celsius for several hours, the risk of miscarriage or abnormal development of the baby is increased. This is also the reason why pregnant women are advised to avoid hot spas, saunas and baths.
Guidelines
As every woman’s medical history, fitness level and pregnancy differs, it is a good idea to talk to your healthcare practitioner before doing any type of exercise during pregnancy. General guidelines for exercising during pregnancy include:
- Use your common sense. Be gentle with yourself. Don’t exercise to the point where you become exhausted or overheated
- Aim to exercise three times a week for about 45 minutes each time
- Drink at least 1.5 litres of water a day, and always drink water before and after exercising.
- Women with multiple pregnancies need to be more cautious. Discuss your needs with your caregiver.
- Always stretch and warm up before and after exercise. Increased progesterone will soften your muscles and ligaments, making you more prone to sprains and injury.
- If your pregnancy makes you feel slightly light-headed, have something light to eat an hour before exercise.
- Keep your heart beat below 140 beats per minute.
Pelvic Floor Exercises
Perhaps the most important exercise of all during pregnancy is the exercise that strengthens the pelvic floor. The pelvic floor or pubococcygeus muscle group is the hammock of muscles that stretches from your pubic bone to your tailbone. During pregnancy they support the weight of your growing baby and uterus as well as your bladder and bowel. During pregnancy and delivery these muscles are stretched. If these muscles sag over a long period of time various problems can occur such as incontinence, dysmenorrhea, haemorrhoids, decrease in sexual sensation during intercourse, constipation and prolapse.
Exercising these muscle is vital for pregnant women, not only to give better support to the uterus, but if you are aware of these muscle you can isolate and relax them during labour when it is time to push the baby out. After labour, if the pelvic floor muscles are toned, they recover more rapidly and strong muscles can also assist the healing of vaginal tears and stitches.
To gain awareness of these muscles, next time you urinate, interrupt the flow of urine before completely emptying your bladder. The muscles you use to do this are your pelvic floor muscles. Don’t try this more than once a week as it can interfere with the functioning of your bladder.
Correct pelvic floor exercises can be preformed any time, anywhere. All you need to do is tense the muscles around your vagina, imagine squeezing and lifting the muscles up inside you, hold for as long as possible, and then slowly release the muscles. Do at least 50 repetitions a day. At first you may tire easily, or find it difficult to hold the muscles for more than a couple of seconds, but they will strengthen overtime. It is important that you don’t tighten your stomach, legs or buttocks when you do these exercises, and make sure that you continue breathing throughout.
Assisted exercise
Assisted exercise involves the use of passive exercise machines to tone the body. These exercise machines were invented back in the 1930s by a physiotherapist named Bernard H Stauffer to rehabilitate his polio stricken wife. Stauffer developed these ‘toning tables’ to allow clients who were weak to exercise muscles in a semi-passive state called Continuous Passive Motion (CPM).
The machines work through repetitive isokinetic exercises to isolated muscle groups. The slow, continuous, controlled movements of the tables not only improve muscle mobility and flexibility, they also stimulate lymphatic circulation. While the machines do not improve fitness, they are useful for activating muscles and can also improve posture and re-align the pelvis and spine which is important during pregnancy.
Because you are required to lie on your back for approximately seven minutes when using most of the machines, this type of exercise is best for the first trimester of pregnancy, particularly if you don’t have a lot of energy. For further information on assisted exercise go to www.boda.com.au
Pilates
Pilates is a type of exercise which was designed to strengthen ligaments and joints, increase flexibility and tone muscles. Pilates exercises focus on correct alignment and good posture which is very important during pregnancy when body changes can lead to aches and pains It consists of a series of slow, controlled movements that are low-impact and can be practiced throughout pregnancy, although if you are new to Pilates it is advised you wait until after 16 weeks before you start your practice.
Swimming
Many pregnant women find swimming to be a great relief as they are supported by water and move with considerably more ease. Swimming promotes cardiovascular fitness, flexibility, endurance and breath control. While it is important that you choose a stroke you enjoy breaststroke is best avoided in pregnancy because the pelvic ligaments are softer than usual in pregnancy and the joints can easily be overstretched by the breaststroke kick, especially the pubic joint in front, which may begin to separate in pregnancy in readiness for the birth. Always swim at a relaxed pace, breathing at a comfortable rhythm, using floating aids if you need to and stop before you get too tired or rest between laps.
Tai Chi
Tai Chi is another lovely, gentle exercise you can do during pregnancy. The postures performed in Tai Chi can help to correct posture, regulate breathing, improve flexibility, strength and circulation. The slow, meditative pace of Tai Chi can also help to reduce stress and promote good health. Some Tai Chi postures can also help to induce an overdue baby and other postures are said to relieve pain during labour.
Walking
Walking is one of the easiest, cheapest and most convenient forms of exercise. It not only strengthens the muscles in your legs and bottom, it is also a good cardiovascular workout. If you are used to regular walking you may notice that you tire more easily when pregnant, so use your common sense and don’t push yourself too hard. If you are not use to walking, start gently, begin walking about 30 minutes a day three times a week, and slowly increase your distance covered.
Yoga
Yoga is a wonderful exercise to do when you are pregnant because it helps you to connect with your body. Pregnancy can be a fearful time for women, particularly if it is their first child or the woman has had trouble with her fertility or experienced a miscarriage, and she may not trust that she knows how to look after her growing baby. Yoga in pregnancy can help a woman feel stronger and more relaxed both physically and mentally and there are many postures that can assist her during childbirth and also provide relief from common pregnancy complaints such as leg spasm, insomnia and back ache. The physical benefits of regular yoga also include improved muscle tone, posture, flexibility, circulation, balance and breath control.
The aspects of yoga which are of most value for the expectant mothers are pranayama (breathing), asanas (postures) and dhyana (meditation). Pranayama exercises focus on getting you to breathe more efficiently, increasing oxygen intake and ‘prana’ or life force. The asanas help to release any tension or stiffness while strengthening and toning the whole body. Dhyana is an invaluable tool during pregnancy as it helps the woman achieve deep relaxation and relieve stress.
It is advised that you attend a prenatal yoga class if you are pregnant, particularly if you haven’t practiced yoga before. If you are new to yoga it is advised that you begin practicing after your first trimester. You may also want to supplement your classes with a few sessions at home and be guided by a dvd, video or book. There are many excellent resources available such as Yoga Babes DVD (available from www.yogababes.com.au), a 70 minute DVD that features special postures and breathing exercises for pregnancy and labour.
Other types of exercise that are recommended during pregnancy include belly dancing, cycling on a stationary bike and water aerobics. The key to exercising during pregnancy is finding something that you enjoy. Remember pregnancy is not an illness that requires you to hide under the covers. It is a time where you get to experience how amazing the human body really is.
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Contra-indications
It is best to avoid exercising in pregnancy if you have:
- A history of miscarriage or premature labour
- Cervical incompetence
- Vaginal bleeding
- High blood pressure
- Fever
- Placenta praevia
- Pre-eclampsia
- Maternal heart disease
- Maternal diabetes
If at any time during your pregnancy you experience any of the following, stop exercising immediately and see medical advice:
- Your waters break
- You are in pain
- You are very short of breath
- You feel disorientated
- You develop an irregular heart beat
- You develop swelling, pain or tenderness in your legs
- Your pulse stays elevated after exercise
- Your baby stops moving
- You develop severe headaches, blurred vision or pain at the side of your ribcage
- You have difficulty walking
