What better way to show you are dedicated to giving this new life every advantage in the world than to arrange for a pregnancy massage from a specially certified therapist. Each session is designed to…
Say good-bye to the myth of the “delicate” condition and hello to pregnancy in the 21st Century!
Current research continues to show that women can safely exercise and maintain their fitness level during the perinatal period. The mom who laces up her sneakers instead of heading to the couch will be rewarded with a healthier pregnancy and a healthier baby.
Pregnancy is a time of excitement, uncertainties, fears, and many profound physical and emotional changes. This “season in life” affords mom a wonderful opportunity to adopt a healthier lifestyle. Starting an exercise program during pregnancy is a great way to begin and continue this healthier lifestyle for herself and subsequently for her child. With obesity on the rise in the US, it is important for everyone to increase their current level of physical activity. This is especially important for pregnant women as the results of obesity and excessive weight gain have been shown to be detrimental to both mom and baby long term.
A Historical Perspective on Prenatal Exercise Guidelines
Moms today are inundated with information regarding pregnancy and exercise. Unfortunately, a great deal of this information is outdated. It is important for women to have a working knowledge of the most current guidelines so that they can make intelligent choices regarding their exercise programs. For many years, pregnant women were advised to “take it easy” during pregnancy. Mom was advised to rest and gain weight in order to ensure a healthy pregnancy. In the 1950’s women were “allowed” to walk a mile a day for exercise and this mile was preferably “broken up” into smaller segments. The American Congress of Obstetrics and Gynecology (ACOG) issued the first formal guidelines for perinatal exercise in 1985 (1). These guidelines were highly restrictive as they were not based on extensive research and were designed for the majority of pregnant women without regard to pre-pregnancy fitness levels. Four of the original guidelines are highlighted below:
- Mom should exercise at a heart rate <140 bpm.
- Strenuous exercise should not exceed 15 minutes
- Maternal core temperature should not exceed 38 degrees C
- No supine exercise after the first trimester
A great deal of research involving both sedentary and trained subjects was published
after the release of the 1985 guidelines. This prompted ACOG to publish a revision of the original guidelines in 1994 which lifted specific limitations for prenatal exercise (2). ACOG said, “There are no data in humans to indicate that pregnant women should limit exercise intensity and lower target heart rate because of adverse effects.” In this revision, there was no mention of the 140 bpm maximal heart rate or an exercise limit of fifteen minutes. Women were advised to use the “talk test” and “perceived exertion” as ways to measure exercise intensity. We were making progress! Although the 1994 guidelines were a refreshing change in the right direction for ACOG, they still did not address the pregnant athlete. In 2002, ACOG published “Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion 267” (3). In this publication, which was reaffirmed in 2009, ACOG recognized that “in the absence of contraindications, pregnant women should be encouraged to engage in regular, moderate intensity physical activity to continue to derive health benefits during their pregnancy as they did prior to pregnancy.” This revision focused more on the athlete as well and was the first formal recommendation by an American physician group to include prenatal exercise. The major points of the 2002 update include:
- Previously sedentary women and those with any medical or obstetrical problems should obtain medical clearance before embarking on an exercise program; NO PRENATAL CLEARANCE, NO EXERCISE, NO EXCEPTION.
- Thirty minutes or more of moderate exercise daily, or on most days of the week is recommended. This brought the exercise guideline for pregnancy more in line with the ACSM guidelines for the general population.
- Competitive and recreational athletes with routine pregnancies can remain active, “listen to their bodies” and modify their exercise routines if medical necessity arises.
- Physically active women with a history of or risk for preterm labor or fetal growth restriction should reduce their activity in the second and third trimesters.
In 2006, the “ACSM Roundtable Consensus Statement: Impact of Physical Activity During Pregnancy and Postpartum on Chronic Disease Risk” was published (4). This report, based on an analysis of the most current research by a panel of scientific and clinical experts, supported the safety and long term benefits of prenatal and postpartum exercise for both mom and baby. Some of the benefits highlighted in this report and other studies show that exercise:
- Reduces the risk of preeclampsia (a condition marked by high blood pressure, protein in the urine and marked fluid retention in the mom which can lead to serious maternal and fetal complications).
- Treats or prevents gestational diabetes, the diabetes of pregnancy. For some women exercise alone may stabilize blood sugar. Moms with gestational diabetes are more prone to Type II diabetes later in life.
- Helps manage or alleviate pregnancy related musculoskeletal issues. Exercise may help with low back pain, urinary incontinence, abdominal muscle and joint and muscle issues.
- Links breastfeeding and postpartum weight loss. Weight loss can occur with moderate exercise and caloric restriction without affecting the quantity and quality of breast milk or infant growth.
- Positively impacts mood and mental health. Exercise is a “mood elevator.” It reduces stress, fatigue, anxiety and improves self-image.
- Baby’s health and development: The panel advised that beginning or continuing a prenatal exercise program had both short and long term positive effects.
The most recent guidelines for prenatal exercise were included in the 2008 US Dept. of Health and Human Services Physical Activity Guidelines (5). Women who are not currently active should strive for at least 150 minutes of moderate intensity cardiovascular activity per week. This translates to 30 minutes of exercise 5 days a week, very similar to the ACOG guideline. They recommend that those women who are currently active may continue their normal routine providing there is an open line of communication with their healthcare providers
The latest research continues to showcase the benefits of prenatal exercise. A 2013 review of the international evidence reinforced the fact that women who engage in prenatal exercise have a decreased risk of developing gestational diabetes and other hypertensive disorders during their pregnancies. They are also less likely to deliver big babies (> 9 pounds). Other studies suggest that babies born to active moms are lighter and leaner at 1 and 5 years of age (6). Additional research has supported these findings and has extended the benefits to older children (8-10 year olds) (7). This is quite significant considering the fact that childhood obesity is on the rise. We now have exciting evidence that the in utero environment of exercising mothers may provide long term effects for their offspring with regards to bodyweight and body fat. Prenatal exercise may also boost babies’ brain activity. Canadian research has shown that babies of exercising moms had greater brain activity 8 – 12 days after they were born, as evidenced by an increased ability to process repeated sounds (8). This was the first study to link prenatal exercise with babies’ brain development.
In 2015, ACOG released two new publications, “Obesity in Pregnancy,” Bulletin Number 156 (9) and “Physical Activity and Exercise During Pregnancy and the Postpartum Period,” Committee Opinion Number 650 (10). Both publications emphasize the need for regular exercise to prevent or combat excess weight gain and /or obesity in the perinatal population. Greater than half of the women of childbearing age in the US are overweight or obese. Obesity in pregnancy is associated with significant risks for both mother and baby. Bulletin 156 authors wrote, “Optimal control of obesity begins before conception. Weight loss before pregnancy, achieved by surgical or nonsurgical methods, has been shown to the most effective intervention to improve other health problems.” The updated Bulletin 156 recommendations include:
- Behavioral interventions that utilize both diet and exercise can improve postpartum weight loss better than exercise alone
- BMI should be calculated at the first prenatal visit and used to counsel women on diet and exercise utilizing the Institute of Medicine Guidelines for prenatal weight gain
- Small preconception weight losses in obese patients can improve pregnancy outcome
- Losing weight between pregnancies in obese patients may decrease the risk for a large-for-gestational-age baby in a subsequent pregnancy
Pregnancy is an ideal time for maintaining or adopting a healthy lifestyle. Recommendations from ACOG Committee Opinion Number 650, “Physical Activity and Exercise During Pregnancy and the Postpartum Period” include:
- Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements.
- A thorough clinical evaluation should be conducted before recommending an exercise program to ensure that a patient does not have a medical reason to avoid exercise.
- Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.
- OB-GYN’s and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered.
- Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychological well-being.
- 20-30 minutes of moderate intensity exercise per day, on most or all days, is recommended.
- Exercise intensity should be monitored by RPE and the “talk test.” Suggested RPE is 13-14 on a 6-20 scale.
- Women are encouraged to stay well hydrated, avoid long periods of lying supine and cease exercise if they have any warning signs (see below).
- Women who were sedentary before pregnancy should gradually progress their exercise programming
- Women who were regular exercisers prior to pregnancy and who have uncomplicated, healthy pregnancies should be able to engage in high-intensity exercise programs, such as jogging and aerobics, with no adverse effects. High-intensity or prolonged exercise in excess of 45 minutes can lead to hypoglycemia; therefore, adequate caloric intake before exercise, or limiting the exercise session, is essential to minimize any risk.\Contact sports, activities with a high risk of falling, scuba diving, sky diving and “hot yoga” are not recommended
Warning Signs and Symptoms to Discontinue Exercise (11)
If a woman experiences any of the following, she should cease exercise and contact her health care provider as soon as possible:
- Vaginal bleeding or fluid leakage
- Shortness of breath prior to exertion
- Pelvic pressure or cramps
- Headache or any vision problem
- Pain of any kind
- Uterine contractions
- Muscle weakness
- Calf pain or swelling
- Preterm labor
- Decreased fetal movement
- Chest pain
- Temperature extremes (hot or cold; clammy)
- Nausea / Vomiting
As a result of almost 30 years of research showing the benefits of prenatal exercise, we have seen a substantial increase in the number of motivated personal trainers who are certified to work with this very special population. No two pregnancies are the same and no two prenatal fitness programs should be the same. Trainers certified in perinatal fitness and wellness possess the knowledge and skills to design and implement individualized programs to help mom prepare for the “marathon of labor” and the “tasks of mothering” after the baby is born.
Join Sheila for her upcoming webinar:
Sheila Watkins is a perinatal fitness specialist with over 25 years of experience training 2500+ pregnant and new moms, and educating hundreds of fitness instructors, health professionals, and childbirth educators on the rapidly changing field of perinatal fitness. She is the creator of Healthy Moms® Fitness Programs to provide safe and effective group exercise classes and personal training for new and expectant moms, as well as education and training in the field of perinatal exercise for fitness professionals, childbirth educators and other health professionals.
- ACOG. The ACOG Guidelines for Exercise During Pregnancy and Postpartum; Home Exercise Programs, 1985.
- ACOG. Exercise During Pregnancy and the Postpartum Period. ACOG Technical Bulletin, No.189, February 1994.
- ACOG. Exercise During Pregnancy and the Postpartum Period, ACOG Committee Opinion, No. 267, Washington, DC: ACOG, January 2002 (reaffirmed in 2009).
- Pivarnik, J. et al. American College of Sports Medicine Roundtable Consensus Statement, June 2006.
- Mudd LM, Owe KM, Mottola MF, Pivarnik JM. Health benefits of physical activity during pregnancy: an International Perspective Med Sci Sports Exerc. 2013 Feb;45(2):268-77.
- Pivarnik. J. and Kuffel, E. ACSM Sports Medicine Bulletin; Active Voice: More Maternal Physical Activity May Lead to Leaner Pre-Adolescent Children; June 20, 2010.
- ACOG. Obesity in Pregnancy. ACOG Practice Bulletin, No.156, December, 2015.
- ACOG. Exercise During Pregnancy and the Postpartum Period, ACOG Committee Opinion, No. 650, December 2015
- Watkins, Sheila S. “Healthy Moms@ Perinatal Fitness Instructor Training Manual.” 2013.
Pelvic floor dysfunction, or PFD, is a broad term used to describe several physical conditions that occur mainly as a result from pregnancy and childbirth. As a pre and postnatal fitness specialist for over 20 years, almost every one of my clients has had some form of PFD. What does this mean and why is it relevant to women’s fitness? I will further define PFD in detail and explain how it changes the way we as exercise professionals program design for this clientele.
First, let’s look at the pelvic floor muscles. The pelvic floor looks like a sling or hammock that forms the floor of the bony pelvis and it serves several important functions in our bodies. The internal layer or “pelvic diaphragm” work with the external muscles of the pelvic floor to support our internal organs, stabilize our bodies, allow for sexual function, urinary and bowel movements and assist in contracting and pushing in the birthing process. These muscles are prone to trauma from the various functions they perform. The stress of the growing uterus in the body during pregnancy coupled with the changing gravity, posture and production of the hormone Relaxin all contribute to weakening the pelvic floor muscles.
Second, consider the whole Neuromuscular Core system. Pelvic floor muscles connect to the Transverse Abdominus (TVA) and they work together in harmony essentially hold the body upright. It is almost impossible to engage one without the other. Tightness in the hips combined with weak pelvic floor muscles creates PFD.
Diastasis Recti, Symphosis Pubis Dysfunction (SPD), Urinary and or fecal incontinence, pelvic pain, chronic lower back pain, Piraformis syndrome, sciatic pain, pelvic organ prolapse are all conditions under the pelvic floor dysfunction umbrella. Below these conditions are listed and defined in more detail.
Diastasis Recti: This is a separation of the right and left side of the Rectus Adbdominus in the Linea Alba connective tissue more than 2 cm in width
Pubic Symposis Disorder: A separation of the pubic bones, which often occurs during birth but sometimes during the third trimester.
Urinary incontinence: Uncontrollable leakage from bladder.
Fecal incontinence: Uncontrollable leakage of fecal matter from colon. Usually as a result from severe tearing during birth.
Pelvic pain: This type of pain can be during sex or when performing a movement that is irritating or uncomfortable, many possible underlying issues.
Chronic lower back pain: Unexplainable chronic lower back pain
Sciatica: Pain that radiates from lower back down one leg along the sciatic nerve as a result of compression of the sciatic nerve
Piraformis syndrome: Also a result of an inflamed sciatic nerve but more localized
Pelvic organ prolaps: When organs of the pelvis fall as a result of weak pelvic floor muscles.
These conditions can be limiting for many women and go untreated because they are embarrassed or told that they are normal “experiences” after giving birth. Until recently, very few fitness programs existed to help women strengthen pelvic floor muscles. It is my opinion that every pregnant woman and new mother should be automatically screened for PFD and treated right away. If women do not learn proper strengthening exercises of pelvic floor muscles they can potentially live in discomfort for years. The sooner preventative care is offered the better the quality of life for these women.
As mentioned earlier, many of these conditions are preventable and remedied through a combination of functional strength with corrective, posture-based range of motion exercises. When a woman becomes pregnant there is an immediate increase in pressure to the pelvic floor muscles. The body begins to produce relaxin which affects the joints throughout the body, especially the pelvis as it prepares to accommodate the growing uterus and eventually for birth. If treatment begins to help women continue strengthening the muscles surrounding the hips immediately, the pressure on the pelvic floor muscles will be reduced.
It was common practice until recently that women were advised to learn and perform Kegel Contractions. We understand more now as movement therapists that Kegel contractions are very hard to teach, very isolated, and in most cases, when examined internally by a women’s healthcare PT, women are not performing them correctly. A more effective approach to strengthening the pelvic floor muscles is to treat the entire hip complex as “one”– or a “global approach” — as described in applied functional science.
So, how do fitness professionals help create beneficial, safe and effective exercise programming for pregnant clients and new mothers that hone in on the core and pelvic floor? We must start by helping our clients improve their posture first and foremost, then work on proper breathing techniques and lastly incorporate larger exercises that do not isolate, but recruit many muscles from the hip complex and surrounding muscles groups. By incorporating all three planes of motion instead of working primarily in the sagittal plane (forward and backward) when performing even the most basic of exercises (i.e., the squat), you must change the movement by foot placement, arm placement, direction, tempo, range of motion etc. The variety in actions creates good stress to the pelvic floor and core muscles. Additionally, increasing the adduction and abduction action simultaneously while performing various exercises will help activate and recruit pelvic floor muscles subconsciously. Anatomically speaking, everything is connected in the body. Understanding that big global movements of the upper body and lower body together affect the position and strengthen of pelvic floor and core muscles is essential. The body is most efficient at strengthening the small muscles when big muscle groups are stimulated in combination. Throughout my years, I have seen much success with clients that incorporated these types of movements into their workout regimen and were safe and conscientious not to perform exercises that added bad stress to the external abdominal muscle group or impact exercises.
Each woman is different on how quickly it takes her to recover from PFD. The most important rule of thumb is to be reassuring and provide support and remember the time line is different for everyone depending on severity of PFD, the fitness level of the client, if the client is breast feeding and prior injuries that could prolong healing time.
Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com
The understandable fear (due to things like decreased oxygen supply to the baby) that existed with pregnancy & exercise years ago is no longer warranted. Because of substantial research, it is now safe for women to continue or start exercising while pregnant. As long as she gets approval from her doctor & seeks out a qualified and certified fitness professional, she should be confident in knowing that the recommendations below will help her.
Considerations & Exercise Suggestions
1. Posture Change from the Growth of the Baby: As a result of the baby growing in the wound, the mother to be’s posture will change. This causes certain muscles to become weak, particularly her core. In the 1st and 2nd trimester, a mother to be should focus on strengthening her core through exercises such as planks, bridges, and birddogs. Once the 3rd trimester hits, it would be wise for the mother to be to avoid supine or prone core exercises. She can still work her core by doing standing exercises such as medicine ball chops, reverse chops & rotations. All of these exercises can be performed 2-3 days/week, 1-2 sets of 12-15 reps with appropriate rest time (45-90 seconds) between sets.
2. Cardiovascular Exercise: With the growth of the fetus, also comes more stress to the mother to be’s heart and lungs. As a result, her ability to work harder and longer is decreased. However, a mother to be can still perform low impact or step aerobics that do not involve jarring motions. Walking on the treadmill, stationary cycling and water aerobics done 3-5 days/week for 15-30 minutes is suggested.
3. Flexibility Exercise: Because the mother to be’s body posture has changed, this may cause certain muscles to overwork or become tight. As a result, she may feel the need to stretch certain muscles. This is ok to do so. Static and active stretches are advised along with foam rolling that can be tolerated. However, foam rolling on varicose veins or swollen muscles should not be done. I would advise stretching muscles that appear to be overworking such as her calves and lower back. This can be done everyday for 1-2 sets, holding each stretch for 30-60 seconds.
4. Weight Training Exercise: Circuiting training has shown to be very effective for mother’s to be throughout their entire pregnancy. These include exercises that work the entire body and can be performed back to back with little rest in between. I recommend exercises that work the following muscles: legs, chest, back, shoulders and arms. They can be done 2-3 days/week, 1-2 sets of 12-15 reps. The rest period can be in between 45-75 seconds.
5. Cautions: Mothers to be should stop or avoid exercises that cause nausea, dizziness, stomach pain, prolonged shortness of breath, bleeding and fainting.
By taking the appropriate precautions, mothers to be can safely exercise during pregnancy. As a result, the pregnancy can be smoother and the recovery can be quicker.
Helpful links for exercises
Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.
Clark, Sutton, Lucett. NASM Essentials of Personal Fitness Training, 4th Ed. Revised. 2014
Choosing the type of exercise that is best tolerated during pregnancy depends on the following considerations:
- Which activities the client enjoys or is skilled at performing
- Whether the activity poses any risk to the mother or fetus
- Is she is able to do the activity without being compromised by balance and center of gravity changes
- Can the activity be easily modified as pregnancy progresses
Weight-bearing exercise such as walking, dancing, and running help maintain bone mass and some studies suggest they are more effective for keeping pregnancy weight gain within normal limits. As pregnancy progresses some women may not be able to continue weight-bearing exercise because of back or round ligament pain. If modifications such as wearing a belly support don’t relieve discomfort, switching to non-weight-bearing activities such as swimming, stationary biking, or other types of stationary exercise equipment is recommended.
Absolute and relative contraindicated activities for pregnant women are listed below. Pregnant women should always consult with their healthcare provider before taking part in any exercise program and assess the risk/benefit ratio whenever there is a question about the safety of any activity during pregnancy. Keep in mind that activities such as downhill skiing must be assessed for risks that are not controllable, such as the effect of high altitude on oxygen delivery to the fetus.
Contraindicated Activities for Pregnant Women
- High-altitude sports
- Horseback riding
- Downhill skiing
- Scuba diving
For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com
Article reprinted from Catherine’s Maternal Fitness blog with permission.
Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.
Exercise duration during pregnancy should reflect a woman’s current level of fitness and the type of activity she is doing. If you’re working with someone who’s just starting a prenatal exercise program the duration will be shorter (15-20 minutes) and progress slowly over time to 30-60 minutes. A pregnant woman who is already taking part in a fitness routine can continue with her current duration level, but exercise duration should be modified as needed to enable her to achieve a moderate to somewhat hard level of intensity without discomfort or undue fatigue.
Some exercise activities, such as swimming, may require a longer duration in order to achieve a moderate to somewhat hard intensity, so close monitoring of exercise intensity will help determine whether a longer bout is needed. As pregnancy progresses, pregnant women may find that they are able to tolerate a longer duration, lower intensity exercise bout better than a higher intensity, shorter bout, but avoid taking the intensity below the targeted zone of 12 to 14 on the 20-point scale or 3 to 4 on the 10-point scale.
In the case where a pregnant woman is having difficulty maintaining her normal exercise duration, try dividing the workout into two shorter sessions during the day. This is a helpful tool for enabling women to continue to exercise when she’s experiencing more fatigue in later pregnancy.
Want to learn more about how to develop a safe and effective maternal fitness program? The CE correspondence course “Prenatal and Postpartum Exercise Design” is available ppfconsulting.com
Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.
Article reprinted from her blog with permission.
Exercise is recommended to keep the body strong and in proper working order. Exercise also builds and maintains healthy joints, bones and muscles. Postnatal exercises help a woman get back into shape after giving birth, and they also help combat postpartum depression. There are several basic exercises you can do within a few weeks after giving birth. However, if you’ve had a Caesarean section, you may want to wait at least six weeks before doing any abdominal exercises. If you experience pain while exercising, stop immediately and call your doctor for advice.
Walking is the most basic of exercises, and it’s a good way to begin a new workout regime. Begin by walking at a leisurely pace, and increase your pace and distance over time. Once you’re comfortable in your movements, take advantage of all those great baby registry gifts you’ve received. Put the baby in the baby carrier and push the child in front of you as you walk.
Some women enjoy walking with a friend, as it gives them time to socialize, an activity you may be neglecting while caring for your new baby. If you are a runner, avoid an intense running workout until you have spoken with your physician. Some women are discouraged from exercising strenuously in the first few weeks after giving birth, especially if they are waiting for the wound from a C-section to heal. A doctor can answer questions about your limitations.
Pelvic Tilt Exercise
The tummy is a major problem area for many women after giving birth. Thus, pelvic exercises are often helpful. The pelvic tilt exercise is easy to do and can tighten up your stomach and strengthen your back. Begin on your back on the floor with your knees bent and your feet flat against the floor. Then, flatten your back against the floor as you tighten your abs and lift your pelvis slightly off the floor. Hold this position for 10 seconds. Repeat the exercise by doing three sets of ten seconds each. Pelvic tilt exercises can be done anywhere. After you’ve finished breastfeeding and put the baby down for a nap, take a few minutes to do your exercises.
Some people worry about finding the time to exercise. However, both pelvic tilts and Kegels can be done in a short time frame. The purpose of Kegel exercises is to strengthen the muscles in your pelvic floor. During pregnancy, the muscles of a woman’s pelvis are often weakened. This is why some women experience incontinence after childbirth. If you notice that coughing, sneezing or laughing causes you to leak small amounts of urine, then you could probably benefit from Kegel exercises.
Kegels are simple. First you must identify your pelvic floor muscles. These muscles are the ones you use when you stop yourself from urinating mid-stream. Practice stopping and starting urination while in the bathroom, but only do this once or twice to identify the proper muscles. Do not make a regular habit of contracting your muscles during urination, as this can cause bladder problems.
Once you’ve identified your pelvic floor muscles, you are prepared to do Kegels. Lie on your back and contract your muscles for five seconds, and then relax for five seconds. Do this until you can contract for ten seconds at a time. Do three sets of ten seconds 2-3 times each day. You can even do Kegels while standing up and walking around. Kegels can help those who leak a small amount of urine but probably won’t be helpful to women with a serious incontinence problem.
Planks are good exercises that target and tone your abs, thighs and butt. Planks are also a great way to strengthen your abs without straining your back and neck. Begin by lying on your stomach on the floor. Put your forearms on the floor beneath your shoulders and keep your back straight with your legs extended so that your toes touch the floor.
Then, lift your tummy from the floor so that it is parallel to the floor. Using your forearms and toes to hold your body weight, tighten your tummy and hold your abs off the floor for 30-60 seconds. Rest for 30 seconds, and then repeat the exercise 4-5 times. You can also do planks with your palms flat against the floor and your arms straight rather than placing your weight on your forearms.
Finding time to exercise after giving birth can be a challenge. Try to schedule a brisk walk several times weekly at a local park, or simply walk around your neighborhood. Any exercise is better than none at all. Kegels, pelvic tilts and planks can be done inside your home. Take a few minutes several times a day while your baby sleeps to do your exercises. It’s also a good idea to have your doctor recommend stretches and workout routines. Remember to start light, then increase your exercise intensity over time.
I’m the woman next door, with all of the problems and joys of everyday life. I know that the more I give, the more I’ll receive–so my blog is intended to help people, and hopefully, it will do good things for me too. As a working mother, I’m often faced with many practical, everyday situations that make life harder, but that shouldn’t be the case. Visit my website at thebabbleout.com
Pregnancy can be a joyous time for women and it is also a period where the body experiences many significant changes. Since exercise can be beneficial to the mother in managing stress and staying healthy, it is important to for every pregnant woman to get clearance from their physician for both starting a new exercise program and/or maintaining her existing one.
Before becoming pregnant, I led a healthy and active lifestyle and continued to teach classes until I was ready to deliver. During the first trimester I had to change all strenuous workouts to low-impact workouts with lots of self-care such as taking frequent breaks to hydrate. This article can help women in all stages of pregnancy assess value of low-impact exercise during pregnancy and postpartum.
What is low impact exercise? Low impact (LI) basically means maintaining movement with one foot always on the floor. We do this when we are walking, doing yoga, dancing and strength training.1 Low impact exercises have several benefits such as maintaining healthier joints, weight and heart.
Benefits of Exercise During Pregnancy
A combination of low impact dance classes, strength training and stretching during pregnancy helped me maintain my sense of self and self-esteem as my body changed drastically both anatomically and physiologically. There are several documented benefits of exercise during pregnancy including: improved circulation, sleep, digestion, as well as muscle tone to support joints, increased energy and endurance; improved body image and self-esteem.2
ACOG recommends that pregnant women get at least 150 minutes of moderate-intensity aerobic activity weekly. Moderate intensity means that you are moving enough to raise your heart rate and sweat and you can talk normally, but you cannot sing.3 If you are new to exercise it might seem daunting to get a 20 minute work out every day, but you can start out slowly and gradually increase your activity. For example, you can start with 5 minutes a day and add 5 minutes each week until you can stay active for 20-30 minutes a day. If you were very active before pregnancy, you can continue doing the same workouts until the third trimester, when a logical reduction in activity is recommended.2
Regardless of fitness level, one commonality between pregnant women is the release of Relaxin, the hormone that is responsible for softening the ligaments and joints during pregnancy and childbirth. Having relaxin in the joints can lead to wobbly, unstable joints and a loose pelvis so women should take extra precaution while choosing or continuing a fitness regimen.4
Examples of some exercises that you can do safely while you are pregnant are walking, water workouts, stationary bicycling, yoga and Pilates. Walking is a good option for many pregnant women because it is easy on the joints and muscles and it also gives a total body workout. If however you have low back pain you might consider wearing a pregnancy support belt and/or water workouts to reduce stress on the back. The water supports your weight so you avoid injury and muscle strain. For those who like bicycling and want to continue, stationary bicycling is a great alternative to avoid falls. Modified yoga and Pilates are great for reducing stress, improving flexibility, and focused breathing. Keep in mind that balance poses/exercises can be challenging due to a shift in the center of gravity caused by a growing belly, so it is okay to modify to accommodate this change. Pregnant women should also avoid poses that require them to be still or lie on their back for long periods.3
Benefits of Exercise After Pregnancy
The postpartum experience is different for every woman both emotionally and physically. My postpartum experience brought a mild-depression and weight-gain due to nursing (yes, many women gain weight during early nursing). Like many women, I waited 8 weeks before starting an exercise routine (most women are given a time period of 6-8 weeks for healing). Getting back to exercise helped me gain a sense of control over my body and helped cope with depressive episodes. According to ACOG, exercising after your baby is born may help improve mood and can help you lose the extra pounds that you may have gained during pregnancy.3 Additional benefits of exercise for postpartum women are that it helps strengthen abdominal muscles, can regulate energy level, can promote better sleep and relieve stress.3
Like the exercise guidelines during pregnancy, ACOG suggests that the duration of exercise for postpartum women, after physician approval, is at least 150 minutes of moderate-intensity. Working out after having a baby is different for every woman and it is a good idea to go at your own pace, listen to your body and gradually increase intensity. A key point to remember is that since relaxin can stay in the body for up to six months postpartum,4 it’s a good idea to choose a workout that is not too jerky in movement and stretching is controlled. Doing a good warm up prior to the workout and a good cool down after the workout are essential. ACOG suggests aiming to stay active for 20–30 minutes a day and trying simple postpartum exercises that help strengthen major muscle groups, including abdominal and back muscles. It is also a good idea to prepare for your workout by wearing clothing that will keep you cool and wear a high-support bra. Hydration is key, and it is okay to take water breaks as you need during your workout. For those mothers who are breastfeeding, it will be important for you to either nurse your baby or express your milk prior to working out to avoid the discomfort of engorged breasts.
Although the pregnancy and postpartum experience is different for every woman, and each stage of pregnancy brings unique challenges, maintaining a low-impact exercise program can be very helpful to the mother in managing stress and staying healthy.
Richa Jauhari is a fitness instructor, personal trainer and proud new mother based in Los Angeles. She has a passion for seeing individuals strive for their best and achieve their goals. Her personal weight loss experiences, pregnancy journey and working with senior populations have helped her understand the value of believing in oneself, balance, healthy eating and regular exercise. Visit her website at richajfit.wixsite.com/richaj
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When designing a prenatal fitness program the key components of intensity, duration, frequency, and mode are used, but specific modifications in the level of progression, supervision, and monitoring are needed in order to keep the exercise safe for mother and fetus. The goal of a prenatal exercise routine is to maintain or improve overall fitness, strength, and flexibility. Keep in mind that each woman’s fitness level and ability will vary, and as pregnancy progresses changes in her body will affect her ability to exercise comfortably.