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Guide for a Healthy Pregnancy

EXERCISE

Get in shape before you try to get pregnant. Regular exercise will make you healthier and tone and stretch muscles you’ll need during pregnancy and birth. Being very overweight can make it harder to get pregnant as well as increase complications of pregnancy.

Regular exercise is part of many women’s lives. If your pregnancy is normal, this does not need to change. Exercise can give you a lift, make you less likely to have certain discomforts, and speed your recovery from labor and birth.

As your body changes, you may need to adjust your exercise routine. During pregnancy, your joints become less stable and the extra blood in your body makes your heart work harder. Activity may make you more short of breath than usual. Be sure to talk to your clinician about your exercise program so that he or she can suggest changes if necessary. Generally, a wide range of recreational activities appears to be safe during pregnancy. However, activities with a high risk of falling or those with high risk of injuring your belly area should be avoided during pregnancy.

If you have not been exercising regularly, pregnancy is not the time to start a tough workout program. Start with low-intensity exercises and increase your workouts very slowly.

Tips for Exercising Safely

• Keep your routine mild to moderate. If you do not have any medical complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.
• If you didn’t exercise much before you were pregnant, start your workout with slow, low-impact activities like walking or swimming. After you are more fit, you can move to higher-level workouts slowly.
• Less oxygen is available for aerobics during pregnancy. Slow down if you get short of breath. Never hold your breath and try not to overtire yourself. If you can talk normally while you are exercising you are usually not overdoing it.
• Swimming and cycling are two generally safe, non-weight-bearing exercises you may find easy to keep doing throughout pregnancy. Walking is also unlikely to cause injuries.
• Avoid activities during which you might strike or fall on your belly or lose your balance (which is
  more likely as you get larger). This includes exercise that requires jumping, jarring motions, or quick direction changes. You could hurt yourself or your baby. Examples of these activities include ice hockey, soccer, basketball, gymnastics, horseback riding, downhill skiing, and vigorous racquet sports. Scuba diving should also be avoided throughout pregnancy.
• All pregnant women need 300 extra calories a ay. You’ll need more than that if you are exercising. This is not the time to lose weight. Try to get some of those extra calories from carbohydrates (pasta, bread, rice, vegetables, fruit), which are a good energy source.
• Try not to get overheated, especially in the first trimester. It helps to drink water before, during, and after you exercise. Wear loose, cool clothing and make sure your surroundings are reasonably cool. Avoid heavy exercise in hot or humid weather or while you have a fever.
• Do a 10-15 minute warm-up and cool-down at the beginning and end of your exercise session.
• Reduce your workout levels later in pregnancy. Exercise that was easier earlier in pregnancy becomes more difficult as your belly expands.

Warning Signs during Exercise

Stop exercising and call your clinician if you have any of these symptoms during exercise:

• Moderate or severe pain of any kind, including headache or pain in your back or pelvic area
• Contractions every 10 minutes or less, if you are not yet 37 weeks pregnant
• Vaginal bleeding or leaking amniotic fluid
• Shortness of breath
• Dizziness or faintness
• Rapid or uneven heartbeat
• Difficulty walking
• Calf pain or swelling

If you have doubts about any problem while exercising, it is always best to call for advice.

Who Should Not Exercise

Talk to your clinician before doing any exercise if:

• You have pregnancy-induced high blood pressure
• Your amniotic sac has ruptured early
• You have had premature labor during this or an earlier pregnancy
• Your cervix is effaced (has shortened and thinned out) or dilated (has started to open) before 37 weeks
• You have had persistent bleeding during your second or third trimester
• Your baby is not growing as well as he or she should (called intrauterine growth restriction)

Simple Exercises during Pregnancy

The muscles and ligaments in your lower abdomen, lower back, and around your vagina are greatly strained during pregnancy. Doing some simple exercises will help tone your muscles and make you more comfortable.

Posture

Good posture makes you look and feel better. It can lessen backache, groin discomfort, and fatigue. When you are not pregnant, your weight is centered in the middle of your pelvis. During pregnancy, the growing uterus shifts your weight out and forward. Without realizing it, you may respond to this change by slumping forward or leaning backward. Check your posture every now and then, and make any changes necessary.

Correct Posture

• Head
  Straighten neck and tuck in chin, so body lines up.
• Shoulders and Chest
  Drop shoulders gently back. Lift up through rib cage. Roll arms gently out.
• Abdomen and Buttocks
  Contract abdominal muscles to flatten back. Tuck buttocks under and tilt pelvis slightly backward, as in pelvic tilt.
• Knees
  Bend a bit to ease body weight over feet.
• Feet
  Distribute body weight through the center of each foot.
• Lining up your body
  Try to keep ears, shoulders, and hips in line.

Pelvic Tilt

This exercise encourages good posture and helps relieve backache.

Position: Lie on your back. Bend your legs and put your feet on the floor a hip-width apart. After the first trimester, do the pelvic tilt while standing with your upper back against a wall for support and your knees slightly bent. You also can do it on your hands and knees.

Exercise: Tighten your abdominal muscles and contract your buttocks. This will roll your pelvis backward and press your lower back against the floor (or wall if you are standing). You can use your hands to guide you. Place one hand on your abdomen and the other at the outer edge of your back. You should feel your abdominal muscles tighten and your back push against your hand.

How Many Times: As you exhale, hold your position for 10 seconds. Repeat 10-15 times.

Kegels

This exercise helps tone the pelvic floor muscles, a sling of muscle that extends from your pubic bone to your tailbone. These muscles support your pelvic organs (uterus, bladder, intestines). Pregnancy and childbirth can weaken them, letting pelvic organs slide out of position. That can make it harder to control your bladder and cause rectal and vaginal problems.

By strengthening the muscle, Kegel exercises can help prevent loss of urine when you sneeze, cough, or laugh. This is especially important after birth. Kegels tone the vaginal muscles, too, which can make sex more pleasurable.

Position: You can do Kegels anywhere – standing in line, driving, lying in bed, watching TV, or sitting at your desk. No one will notice because the muscles you’re working on are small and hidden. A Kegel is what you do when you are trying not to let gas escape in public.

Exercise: First, locate the right muscles and see how it feels to tighten and release them. You can put a clean finger in your vagina while in the shower or bath and try to grip it. You can also try to grip and release your partner’s penis during intercourse.

• Keep your stomach and legs relaxed and breathe normally during Kegels. Practice with your legs apart.
• You may find it easiest to do Kegels lying down at first so you aren’t working against gravity.
• Don’t be discouraged if you can only hold the exercises briefly at first or can only do a few in a row. Keep at it. In a few weeks, you will probably be doing them very well.

Slow Kegels: Tighten the muscles. Hold while you count to three. Relax.

Quick Kegels: Tighten and relax the muscles as quickly as you can.

Elevator Kegels: Imagine an elevator. Slowly pull the muscles up, tightening them more floor by floor. Stomp when you reach the fifth floor. Reverse the process, relaxing the muscles slowly floor by floor.

How many times: Start with five of each exercise (one set). As Kegels get easier for you, add sets until you are doing at least 50 Kegels throughout the day.

Angry Cat

This exercise is good for stretching and relieving backache.

Position: Kneel on your hands and knees with your weight evenly distributed. Your back should be level, from your shoulders to your hips. Imagine your back is a table with a coffee cup resting on your spine.

Exercise: Drop your head and pull up your lower back. It should arch as if you were an angry cat. When you return to the starting position, be careful not to let your back sag.

How many times: Hold five to 10 seconds. Repeat eight to 10 times.

Tailor Stretch

This exercise stretches the inner thighs.

Position: Sit on the floor, tailor-fashion, with the soles of your feet together.

Exercise: Using only your thigh muscles, press your knees to the floor. As you press down with your knees, add resistance by using your hands to try to push your knees up. With practice, your knees will get closer to the floor.