EXERCISE FOR TWO PLEASE!
In the two posts that proceeded this one, we built up our knowledge towards being able to discuss how to actually exercise during pregnancy. We surveyed the changes to a woman's body as the pregnancy advances normally, and we have learned about the benefits for both mother and child. Now is the right time for us to take all that knowledge that empowers us, at apply it to learning what to do, and what to avoid while exercising during pregnancy.
The rule of thumb, with limitations that might apply, and a few changes, is that if the woman was actively exercising prior to the pregnancy, she may continue anything she did before the pregnancy, with a few exceptions:
Avoid direct pressure on abdomen; floor exercises should be done while on the side, especially as the pregnancy progresses. The fourth month is usually a cutting point to consider evermore, yet could be prior to that.
Avoid laying on the belly, especially as the pregnancy progresses. The fourth month is usually a cutting point to consider evermore, yet could be prior to that.
Avoid laying on the back, especially as the pregnancy progresses. The fourth month is usually a cutting point to consider evermore, yet could be prior to that.
Avoid hot and humid environments (natural or artificial)
Avoid isometric work and motionless standing, especially as the pregnancy progresses. The fourth month is usually a cutting point to consider evermore, yet could be prior to that.
Avoid the risk of falling, especially forward and on rough surfaces. I am aware that this is obvious, yet if you do not think safety, you do not get safety.
Avoid abdominal trauma at all times
Avoid physical contact in general, especially in the abdomen area. For example, we want to avoid contact sports, or any situation that will result in the direct application of brute force to the abdomen.
Avoid excessive joint loading; Joint pain is a natural result of the natural increase in overall body weight, no need to make it worse.
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If the woman enters the pregnancy inactive and/or over-weight and/or obese, we apply the principles of exercising for untrained and suspected healthy in regards to cardiorespiratory fitness (CRF), and incorporate low impact, non-weight bearing activities as the pregnancy progresses. Muscular fitness (resistance training, weight lifting) should focus mainly on muscular endurance; Especially as pregnancy advances or with clearance from your physician, obstetrician-gynecologist (OB-GYN).
As the pregnancy progresses, we increase our workout's focus on the lower back muscles, shoulder muscles, and four specific pelvic floor muscles: 1) The Pubococcygeus muscle; 2) The Ileococcygeuys muscle; 3) The Coccygeus muscle; and 4) The Puborectalis muscle.
We want pregnant women to exercise aerobically at least 150 minutes of moderate-intensity per week. We want the woman to be able to talk during the workout, yet not sing, as an indication to the advised workout intensity or 40-59% of their maximal heart rate. Examples include brisk walking and moderate work in the garden. While we hope for each workout to be 30 minutes long divided over 5 workouts per week, it is possible to begin with more workouts of shorter duration, that add up to at least 150 minutes per week. Every workout can be elongated by a minute or more, until workouts reach 30 minutes each. The exact progression of workout duration best be approved by your OB-GYN.
These following exercises are agreed upon as being the safest to use during your pregnancy:
Brisk walking - involves a high muscle mass, and does not load the joints to much.
Swimming and water cardio (aerobics) - incorporates a high muscle mass in a supportive and reduced load environment.
Stationary cycling - reduces the chances of falling down or other balance challenges; a recliner cycle allows accommodation for a growing pregnancy belly.
Tailored yoga and tailored pilates - improves flexibility via stretching (range of motion; ROM), reduces stress, ,and improves breathing technique. There are specific and modified yoga and pilates classes for pregnant women. These classes often teach modified poses that accommodate a pregnant woman’s shifting balance.
Specific exercises and activities to avoid or only undergo with specific OB-GYN approval, not exceeding the OB-GYN approval by any means, include:
Ice hockey, boxing, soccer, and basketball.
Skydiving.
Downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and horseback riding.
Hot yoga or hot Pilates which may cause you to become overheated and dehydrated.
Scuba diving.
Activities performed above 6,000 feet (1830 meters; if you do not already live at a high altitude)
Women with the following conditions or pregnancy complications should not exercise during pregnancy:
Certain types of heart and lung diseases
Cerclage
Being pregnant with twins or triplets (or more) with risk factors for preterm labor
Placenta previa after 26 weeks of pregnancy
Preterm labor during this pregnancy or ruptured membranes (your water has broken)
Preeclampsia or pregnancy-induced high blood pressure
Severe anemia
Regardless of fitness level before or during the pregnancy, the following warning signs should cause you to stop and call your OB-GYN immediately:
Bleeding from the vagina.
Feeling dizzy or faint.
Shortness of breath before starting exercise (dyspnea).
Chest pain (as opposed to discomfort).
Headaches.
Unusual muscle weakness (compared to yourself).
Calf pain or swelling.
Regular, painful contractions of the uterus.
Fluid and/or secretion gushing or leaking from the vagina.
The most important principle to remember is that "if you have a doubt, have no doubt". This means that if you are not completely (100%) sure what to do, consult you OB-GYN. If you are sure, yet it is not based on knowledge or being professionally credentialed to exercise pregnant women, consult you OB-GYN. It is always better to do less than put yourself and the pregnancy at risk.
Never do more than approved by your consult you OB-GYN. If you believe that you should be allowed to do more, consult you OB-GYN. Lastly, do not exercise if diagnosed and/or under medical assessment for a high risk pregnancy, immediately stop all and every exercises no matter how long you have been exercising, no matter if you have been pregnant before. Furthermore, it is extremely important to remember that every pregnant stands alone, do not assume that what you were able and/or allowed to do in previous pregnancies applies to this pregnancy.
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It is ill-advised for professionals to train women that are pregnant if you are not experienced and appropriately credentialed as required by law or professional guidelines (if the law is not clear on the matter). Do not ever, exercise a pregnant women without her having medical clearance, and you having a copy of the upmost updated version of her medical clearance.
It is ill-advised to exercise a woman if she is or suspected of being hypoglycemic. Thus, obtain glucose values prior to exercising a pregnant woman to avoid and reduce the chances of her fainting, losing balance, losing accuracy, etc. If needed, make sure to be able to use a POC (point of care, sub-cutaneous blood test) to determine that she meets the minimum glucose levels to exercise (see separate post on required glucose level in order to exercise).
And most importantly, congratulations and may the birth be safe without complications to mother and child. Mother run the world, you have my respect in advance!
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