Exercise guidelines during pregnancy

The Myths of Fitness during Pregnancy- The Straight Facts on the ACOG Guidelines

Pregnancy is a wonderful time to make positive changes as it relates to one's health. Women quit smoking, quit drinking, and if not affected by morning sickness, strive to eat as healthy as possible. They sense that their healthy habits are not just about them anymore, and they want to do the best they can to give their babies the healthiest start. These positive behavior changes can and should include consistent exercise.

Unfortunately, there is a plethora of outdated and erroneous information when it comes to exercise during pregnancy. The American College of Obstetrics and Gynecology (ACOG) guidelines are often misquoted or quoted with outdated information. In fact, two of the myths listed in this article were just printed in a current (Spring 2005), large national publication catering to expectant mothers. Due partly to this misinformation, some women even report feeling guilty when they exercise during pregnancy as if they were doing something selfish and possibly harmful to their babies. Hopefully, this article will help to remedy some of this misinformation. As long as your individual ob/gyn approves it and you have a normal, healthy pregnancy with no contraindications, exercising during pregnancy can benefit the baby in a number of ways. These benefits are included in the responses to the myths below.

MYTH #1:

You cannot workout during pregnancy if you were not previously engaged in an exercise program prior to becoming pregnant.

ACTUAL: The 1994 ACOG Guidelines for exercise during pregnancy stated: During pregnancy, women are permitted to continue to exercise. The current 2002 guideline is stated as, “Healthy pregnant women are encouraged to engage in at least 30 minutes of moderate exercise on most, if not all, days of the week.” This is a significant difference in language. Pregnant women are not only allowed to exercise, but encouraged to do so. It is important to note that the new recommendation is the same one made to women that are not pregnant.

MYTH #2:

You must keep your HR under 140 bpm (beats per minute).

ACTUAL: Unless your personal physician advices against this, assuming he or she is aware of the latest 2002 ACOG Guidelines for Exercise During Pregnancy, this is not a current recommendation. This is actually an old recommendation developed in 1985, and was a conservatively estimated number then. Since 1994, the recommendation has been updated to say that people are individuals with varying heart rates. Patients are advised to follow the “talk test” to determine exercise intensity. If one can comfortably speak during exercise, this intensity level is moderate.

MYTH #3:

You can NEVER lie on your back after the first trimester of pregnancy.

ACTUAL: After the first trimester, pregnant women should avoid the supine position (lying face up on your back) as much as possible. However, it does not state NEVER. Some women experience discomfort in this position. If the mother is comfortable, the baby is comfortable. If you do not experience dizziness or discomfort in this position, you may exercise on your back but in a very limited capacity. The individual exercise should take no more than 1-2 minutes, then roll to your side and perform a series of exercises there.

A great way to begin a fitness program during pregnancy is to make a solid commitment to a walking plan. Depending upon your initial fitness level, walking even 10-15 minutes everyday will give benefits to both Mom and Baby. It’s also a special, planned time to connect with Dad if he wishes to join. Exercise can enhance feelings of well-being and improve overall mood (a welcome change to which anyone that has been pregnant before can attest). Walking on a beautiful day can do wonders for your spirit. Good luck with your program as you embark on being a fitness role model for your children.

If you have further questions, please feel free to contact Patrea Aeschliman: info@gomomfitness.com.

gentle exercises furing pregnancy

Exercise programs should take into consideration your individual medical and exercise history. Consult with your physcian before beginning or continuing an exercise program to see if you have any conditions which might restrict your physical activity during pregnancy.

STOP exercising and consult your physician if you experience any of the following symptoms during exercise:

*bleeding

*cramping

*faintness

*elevated blood pressure

*dizziness

*severe joint pain

Pregnant women should NOT exercise to exhaustion--stop when you are fatigued.

Listen to your body. Exercise should not be painful. Be alert to medical conditions which may indicate the need to change activities or stop exercising. Some examples are:

*early effacement or dilation

*premature labor

*multiple fetuses.

Expect some discomfort, particularly in the third trimester. Learn all you can about exercise during pregnancy so you know how much discomfort is ordinary and what might be cause for concern..

Do not exercise vigorously in hot, humid weather. Do not exercise at all during an illness with fever. A core body temperature that remains elevated for prolonged periods can impair development of the fetus, particularly during the first six weeks of pregnancy.

During pregnancy, all the connective tissue in the body becomes more lax than normal. To help prevent injury, avoid deep flexion and extension of the joints and avoid activities that require jumping or jarring motions or rapid changes in direction. If an activity becomes uncomfortable due to joint instability, modify or discontinue the activity.

Drink plenty of fluids, especially water, before and after exercise to avoid becoming dehydrated. If your exercise session is longer than 15 minutes, interrupt your workout to drink additional liquids. Drink even if you are not thirsty, as thirst lags behind the body's need for fluids.

Rise gradually from the floor to avoid a sudden, rapid decrease in blood pressure which may result in a momentary blackout. Continue walking after rising to assist return blood flow to the heart.

Exercise at a comfortable intensity, and be prepared to modify exercise intensity as your pregnancy progresses. You can gauge exercise intensity by using the talk test--you should be able to talk while exercising. Consult your physician or a qualified exercise instructor to determine your specific target heart rate.

Measure your heart rate 2-3 times during peak activity to make sure your are exercising at the proper intensity. Avoid an anaerobic or breathless pace during exercise and avoid competitive events.

Your core temperature should not exceed 100.4 degrees--do not become overheated. If you feel you are becoming too hot, decrease your exercise intensity. Avoid exercising outdoors during the hottest part of the day.

Limit strenuous activities to a duration that does not cause exhaustion If you wish to exercise for longer time periods, alternate light and vigorous exercise.

Avoid exercises that use the Valsalva maneuver (forced exhalation against closed mouth and nostrils; for example, lifting weights while holding your breath). This can lead to an increase in blood pressure and can interfere with return blood flow to the heart.

After your fourth month is completed, discontinue prolonged exercise done lying on your back since the enlarging uterus can interfere with return of blood to the heart. If dizziness, shortness of breath, nausea, or tingling of the lower limbs occurs while exercising on your back, role onto your left side and remain in that position until the discomfort passes. Subsequent exercise should be modified to avoid the back-lying position or to remain on the back for brief periods of time interspersed with exercise done in other positions. Experiment with exercise done for 1 minute in the back-lying position interspersed with 2-3 minutes of exercise done in other positions (i.e. side-lying or sitting).

Exercises to strengthen the muscles most stressed by pregnancy--abdominal, low back and pelvic floor--can be performed daily.

Check abdominal muscles weekly after 20 weeks gestation to determine if the rectus abdominus muscle has separated. This condition, known as diastasis recti, can occur during pregnancy, though it often occurs during delivery.

To check for diastasis recti, lie on your back with knees bent and feet flat on the floor. Place your fingertips in the center of the abdomen just above the navel. Exhale and lift your head off the floor as you press your low back into the floor. Gently press the fingertips into the gap between the two sides of the muscle. A 1-2 finger-width gap is considered normal. A gap of more than 2 finger widths requires corrective exercise to prevent further muscle trauma

Increased Braxton-Hicks contractions are normal late in pregnancy. However, if these contractions increase markedly during or after exercise you should:

* decrease exercise intensity

* change posture

* try a different activity

If Braxton-Hicks contractions continue regularly for more than 24 hours after exercise, notify your physician.

Follow your exercise session with a 5-15 minute cool-down consisting of slow biking or walking. Cool down until your heart rate is less than 100 beats per minute (16 beats in 10 seconds).

Your ability to exercise may decrease during the first three months of pregnancy as well as the last few weeks before delivery. You can continue to exercise until delivery barring medical problems

A general guideline for exercise during pregnancy--consider your pre-pregnancy fitness and activity level. Most physically fit women can continue most activities at or slightly below levels prior to pregnancy. Do not try to exceed pre-pregnancy levels.

Activities that can be started during pregnancy, even by those not currently participating in an exercise program are:

* low impact aerobics

* cycling/stationary biking

* golf

* rowing machine

* stairmaster/stair climbing

* swimming

* walking

* water aerobics

* tennis/racquetball (only if you are in good physical condition)

* weight training

Activities that can be continued during pregnancy by those currently participating are:

* backpacking (only if in good physical condition)

* ballet (not professionally)

* basketball (non-competitive)

* body building (non-competitive; only for experienced)

* cross country skiing (only if in good physical condition)

* running (only if in good physical condition; non-competitive)

* softball (non-competitive)

* volleyball (non-competitive)

The following activities should be avoided during pregnancy due to increased risk to the mother and/or baby.

*competitive sports

*hang gliding

*horseback riding

*inversion

*scuba diving

*sky diving

*snow skiing

*springboard diving

*water skiing

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