Thursday, August 13, 2009

Is it safe to exercise during pregnancy?

For years it was believed that pregnant women should spend nine months prone on the couch, resting comfortably. Doctors feared that the jarring motion of aerobics or running could damage the fetus, and prescribed rest for even the most intense of professional athletes. Fortunately, the tide has turned. Pioneers such as James Clapp., M.D. and Elizabeth Noble have proven through their work that exercising actually makes for an easier pregnancy and delivery. In fact, Dr. Clapp found through a study of 500 pregnant women that those who exercised delivered a healthier baby with a stronger fetal heart rate. Even more compelling is the fact that of the women who exercised, time spent in labor was shortened by about a third, with 65% of the women delivering in four hours or less. And when you're in labor, every extra hour seems like an eternity.

The reality is that women have been active throughout pregnancy for centuries; there is no such thing as maternity leave (unfortunately) in most of the world. Exercising also seems to ease some common ailments, such as lower back pain and fatigue. However, there are some basic guidelines that should be followed:

* Start slowly. Even if you never exercised regularly before, a program can be undertaken safely. If you have been following a regular exercise regime, there's no reason you shouldn't be able to continue on the same level for the first trimester. The important thing is to listen to your body- if it feels like too much, take it down a notch. This is not the time to break your previous land speed record. Particularly if you suffer from morning sickness, be aware of your limits.
* Monitor your heart rate and breathing. As a general rule, your heart rate should not exceed 140 beats/minute. The fetal heart rate is tied to your own; if your heart is racing, your baby's is too. A heart rate monitor, at around a hundred dollars, is a worthwhile investment. Most feature an alarm that sounds if you exceed the safe target range. If you feel breathless, which is common during the first trimester, slow down or take a break. The first three months are an adjustment period, when your blood volume is initially too low to accommodate both you and a growing fetus- this can result in breathlessness and faintness. Adjust your exercise levels accordingly.
* Avoid exercising at extreme altitude or in hot, humid environments. Now that summer is here, this is an especially important rule of thumb. Your body temperature affects the baby, and it is critical that neither of you becomes overheated.
* Drink plenty of water.
* As the pregnancy progresses, reduce the intensity level. This tends to happen naturally. Remember that even if you are exercising less intensely, the actual level of what you are doing is more difficult, due to the added weight of the baby.
* Be careful not to over-stretch. Early in pregnancy, a hormone called relaxin fills your system. This hormone induces hyper-flexibility in the joints and musculature, which allows for the expansion of the uterus and the repositioning of the pelvic floor. It is common for women to strain muscles and ligaments during pregnancy as a result of this new flexibility. It is still important to stretch after exercising- just know your limits and try not to exceed them.
* In the last trimester, avoid ballistic movements, such as jumping or running. The exercise community is divided on this one. My personal experience with clients has led me to believe that these motions can strain the pelvic floor, which is already supporting more weight than ever before. There are plenty of exercises that can be done without bouncing motions. I always believe that it's better to be on the safe side.
* Do Kegel exercises religiously. The pelvic floor supports the bladder, uterus, and intestines. The added weight of the uterus during pregnancy can stretch out that floor, causing either the intestines or bladder to drop down. This is one of the reasons that so many elderly women suffer from incontinence. Prevention is the best medicine. Kegels involve contracting and releasing the PF muscles, similarly to stopping the flow of urination. Tighten and relax the muscle quickly several times a day.

Deciding which activities are best for you is highly individual. In the first trimester, almost any form of exercise (outside of contact sports and skiing) can be undertaken safely. During the later trimesters, running and cycling tend to become uncomfortable. Most of the women that I trained switched from these sports to swimming, hiking, water aerobics, and cross-country skiing. Every woman that I worked with lifted weights right up to the end. In my experience, the postpartum recovery period was dramatically easier for the women who exercised. I have one thirty-seven year old client who only gained twenty-two pounds during her pregnancy. Just five weeks after delivering a beautiful, healthy baby boy, she had already lost fifteen pounds and felt great!

Pregnancy causes so many physical and lifestyle adaptations, it can be overwhelming. The important thing is to be in tune with your body, and to focus on bringing new life into the world.


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