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Exercise and Pregnancy

pregnancy and exercise I'm approached regularly by clients who are pregnant or trying to become pregnant, but are concerned that they'll have to curtail their gym or exercise program as they get larger. They ask me "Will exercises harm the baby?", "Can exercise possibly induce premature labour?", "Could I injury myself?", "Which exercises should I do?"  Every woman and every pregnancy is completely different. It is therefore critical that you consult your obstetrician before embarking on an exercise program. Exercise and pregnancy can coexist.

Studies have shown that exercising, besides giving the benefits of maintaining fitness, can also attenuate the symptoms of nausea, fatigue, and back pain. The American College of Obstetrics and Gynecology is now emphasizing the importance of exercise before, during and after pregnancy. Years ago doctors restricted the type of exercise that was safe; today the emphasis is on promoting exercise and pregnancy so long as certain precautions are followed.

The exercise you do on the exercise ball can gently work the muscles that help support your back during pregnancy. Also advertised as the "birthing ball", the exercise ball is helpful for easing labour and delivery. Once the baby is born, you can get back into exercising easily using the ball again.

Benefits of Exercise


The rationale of exercise and pregnancy includes relief of  low back pain, preparation for labour and delivery by increasing strength, endurance, and tolerance for the physical and mental stress.  Posture may be improved and postpartum recovery may be easier and faster.  
exercise ball pregnancy warning CAUTION:  Prenatal and postnatal women must get clearance from their physicians before participating in an exercise program.  They must be screened for conditions that would limit their medical, cardiovascular, musculoskeletal, or pregnancy related complications.



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The American College of Obstetricians and Gynecologists has the following recommendations regarding exercise and pregnancy - discontinuing exercise under the following circumstances:

    • Risk factors for preterm labour
    • Vaginal bleeding
    • Premature rupture of membranes
    • incompetent cervix
    • intrauterine growth retardation
    • multiple gestation

Pregnant women are best to consult their physician for advice regarding exercise and pregnancy if they have conditions such as

  • hypertension
  • gestational diabetes
  • heart or respiratory condition
  • history of premature labor
  • placenta previa
  • preclampsia
_________________________________________________________________________________________

Most experts suggest that you adhere to the guidelines suggested by the acronym FITT:

Frequency:    3 to 5 times per week
Intensity:       Moderate intensity
Time:             Maximum of 40 minutes per session
Type:             Low impact aerobic type exercise (swimming, walking, bicycling)



Months 1 to 3

If you are were active several months prior to the pregnancy you should remain active but adhere to the FITT guidelines. If you were inactive prior to your pregnancy, hold off exercising for the first three months. Your usual routine is safe. Listen to your body.  Nausea and fatigue may limit your endurance so shorten your routine, reduce its frequency, or change the time of day you exercise. During this period it is still safe to lie on your back. Take this opportunity to strengthen your abdominal musculature as this will weaken very quickly once your abdomen starts to expand. Women with strong abdominal muscles will return to their pre-pregnant figures faster after giving birth, and will suffer less back pain.

Months 4 to 9

Previously active women are able to increase their exercise intensity during the second trimester by 10-15% but within the target zone established by your health care professional. Previously inactive women may begin low impact aerobic activity such as walking, swimming, or cycling.

Changes occur in your body during pregnancy that can affect your ability to exercise while pregnant:


Ligaments: The hormones produced during pregnancy, especially the last trimester, cause the ligaments that support your joints to become more elastic. This causes your joints to lose stability and are therefore at risk for injury. You should avoid sudden bouncing, jerking, or high impact activities. Be careful when exercising if you notice loose or unstable joints.

Balance: As you gain weight, your centre of gravity changes and therefore your posture changes, putting strain on new muscles and ligaments. This can result in altered balance and increased risk of falls. Most exercise ball exercises require some degree of balance so be aware of this and adapt your movements accordingly.

Cardiac Output: Your heart needs to work harder at rest due to the increase in weight, and therefore works even harder when your muscles are demanding increased oxygen. Increases of up to 50% in cardiac output, 15 beats per minute in resting heart rate, and 45% increase in blood volume can occur by the third trimester. The body may divert blood flow from some parts of your body in order to meet the needs of the muscles. It is therefore important not to overdo it. Standing for long periods can reduce placental blood flow so keep changing positions.

Metabolic Rate
Both pregnancy and exercise increase your metabolic rate and therefore core body temperature. It is also know that core temperatures in excess of 102.60F are potentially teratogenic in the first three months. While adaptive changes that occur to the woman's body during pregnancy help dissipate this extra heat, it is still prudent to maintain adequate hydration and avoid exercising in hot or humid environments. To avoid compromising fetal growth, caloric intake should be adequate to offset the combined needs of pregnancy and exercise (typically an extra 300 calories a day).

Pregnancy and exercise both increase the bodies need for oxygen. Oxygen requirements during pregnancy are greater therefore limiting your ability to perform high intensity activities. You need to heed signs of fatigue and stop workouts short of exhaustion to reduce the potential risk of hypoglycemia. Sessions for recreational athletes are best limited to 45 minutes.

Increasing abdominal size: The weight of the growing fetus will compress the inferior vena cava and hence affect blood return to the heart possibly causing your blood pressure to drop when lying in the supine position. This can disrupt the oxygen supply to the fetus.It is obvious then to avoid the exercise ball exercises that require you to be in the supine position. Prone abdominal hollowing, and  pelvic tilts in standing can be used to activate the abdominal muscles.

 The increase in abdominal size puts extra strain on
 the supporting back muscles so avoid those more
 advanced exercises such as
      • push ups
      • double leg raises
      • full sit ups
      • jumping, hopping or skipping
      • quick dance moves
Supportive bras and back braces are now available to assist you with these changes as you exercise. Exercise and pregnancy can go hand in hand.

The Exercise Ball is Otherwise Known as the Birthing Ball

  For information on the birthing ball click here!




exercise ball exercises pregnancy warning signs



For the American College of Obstetricians and Gynecologists' Educational Brochure click on the following link:
http://www.acog.org/publications/patient_education/bp119.cfm


For Guidelines of the American College of Obstetricians and Gynecologists for exercise and pregnancy and the postpartum period click on the following link:
 http://bjsm.bmj.com/cgi/content/full/37/1/6





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