Working out while pregnant

 As vital as exercise is under regular circumstances, it can be even more important during pregnancy.
   The advantages to exercising while pregnant is numerous, but at the same time there are a variety of factors that need to be kept in mind.
   All the usual benefits of exercise apply, though some are greatly magnified during pregnancy.
   “Studies have shown that women who exercise during pregnancy have more self-confidence and higher self-esteem, and generally just look and feel better,” says Ava Gruszka of Anytime Fitness.
   Exercise boosts your energy levels, which can be very important at a time when you will probably feel tired.
   Doing the right exercises can also strengthen important muscle groups like the back, thereby improving your posture and helping relieve backache.
   Exercise can also aid your sleep, which can again help limit the tiredness you feel.
   One of the biggest advantages is that building strength and endurance through exercise can be a great help during labour and delivery.
   Of course, those who stay in shape during pregnancy will also have less weight to lose after pregnancy, which is certainly a bonus.
   Exercise may even help to prevent or manage gestational diabetes, in addition to dietary measures
   
Picking the right exercise
   Certain exercises are less desirable during pregnancy than others. Obviously any contact sport is out, as are sports or exercises that include leaping, jumping, or a chance of abdominal injury. The health of the baby is as important as the health of the mother.
   “As a general rule of thumb, aqua fitness classes or water fitness in general is the number one recommended form of exercise for expectant mothers, for several reasons but most importantly for the regulation of body temperature,” says Gruszka.
   “The most significant risk of exercise that women need to watch out for is overheating. They should exercise in the water, or in a cool environment, and stay well hydrated.”
   Low or no impact exercise routines like swimming, yoga and Pilates are popular, as is walking or riding a stationary bicycle.
   According to Gruszka, heart rate can fall in the 120 to 140 beats per minute range during training, depending on the participant’s fitness level before pregnancy, with around 30 minutes being ideal. A strength programme using low weights and with a greater focus on endurance can also be added two to three times a week.
   “Lying flat on the back is not recommended after the fourth month of pregnancy, so no crunches on the floor,” says Gruszka.
   
Challenges
   Exercising while pregnant has challenges, with many women suffering dizzy spells, especially early in their pregnancies. Later in the pregnancy, because of a shift in your centre of gravity as the baby grows, it becomes easier to lose your balance, which makes falls more likely. This makes it very important to avoid situations where you might be likely to lose your balance.
   It is best to discuss any exercise programme with your doctor, especially during pregnancy.
   It is very important to listen to your body. According to Gruszka, should any of the following symptoms occur during exercise, the workout should be terminated immediately: Vaginal bleeding, dyspnoea before exertion, dizziness, headache, chest pain, muscle weakness, calf pain or swelling (need to rule out thrombophlebitis), preterm labour, decreased foetal movement or amniotic fluid leakage.
   Any unusual changes or events should also be reported to your doctor in case it could indicate some serious side effect of the exercise.
   
Dangers
   In spite of the benefits of exercising during pregnancy, it is not always advisable.
   “There are absolute and relative contraindications to exercising during this time period and all expectant moms must discuss these with their attending healthcare worker prior to beginning an exercise programme in order to rule out any possible issues,” says Gruszka.
   It is impossible to tell who may exhibit such symptoms.
   “These criteria may be present in even the fit of athletes and so everyone should always seek evaluation and clearance from their medical professional,” says Gruszka.
   
Relative contra-indications
   Some of the relative contra-indications where some exercise may be restricted and medical clearance required include severe anaemia, unevaluated maternal cardiac arrhythmia, chronic bronchitis, poorly controlled type I diabetes, extreme morbid obesity or extremely low body mass index, an extremely sedentary lifestyle, intrauterine growth restriction in current pregnancy, poorly controlled hypertension/pre-eclampsia, orthopaedic limitations, poorly controlled seizure disorder, poorly controlled thyroid disease or heavy smoking.
   
Absolute contra-indications
   Absolute contra-indications which would disallow any exercise include: significant heart disease, restrictive lung disease, incompetent cervix/cerclage, multiple gestation at risk for premature labour, persistent second or third trimester bleeding, placenta previa after 26 weeks gestation, premature labour during the current pregnancy, ruptured membranes or pregnancy induced hypertension.

Important muscle groups to work on during pregnancy

To train:
   Pelvic floor muscles
   Upper, mid, and lower back musculature
   Arms (bicep and triceps)
   Inner thigh (adductors)
   Quadriceps and hamstrings
   Gluteals
   
To stretch:
   External rotators of the hips
   Hip flexors
   Hamstrings
   Lower back
   Chest and shoulders

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