Exercising while pregnant

Exercising during pregnancy not only helps maintain your current physical condition, but it can improve sleep, improve your endurance and strengthen those muscles you need to keep your growing body on its feet! Exercise also prepares your body for the rigors of childbirth, and allows you to bounce back into shape quicker after the birth.

It is important to always consult your doctor when considering an exercise routine, especially if you weren't particularly active before pregnancy. Some women simply should not exercise during pregnancy for health reasons.

FIRST TRIMESTER

What exercises are appropriate during the first trimester of pregnancy?
Aerobics, yoga and relaxation techniques, Kegal exercises, and weight training can be done safely during the first trimester of pregnancy.
Aerobic exercise is any exercise that increases breathing and heart rate, such as brisk walking or swimming.

Aerobic exercise can:
improve the body's use of oxygen;
improve circulation to the foetus;
prevent problems of venous stasis, such as haemorrhoids, fluid retention and varicose veins;
increase muscle strength and tone, which can prevent back pain and ease labour;
improve blood sugar control and reduce your risk of gestational diabetes;
burn calories so you don't gain excess weight;
improve sleep, well-being and confidence.

To get the maximum benefit from aerobic exercise, sessions should last 20 to 30 minutes, several times per week.

Walking is good exercise that poses few risks. Make sure you get properly fitted shoes that provide good support. Be conscious of the weather, and avoid your risk of overheating by not walking long distances outside in hot or humid weather.
Swimming is also a good exercise for pregnant women. It provides a cardiovascular workout while stretching and toning muscles and it provides this in a nearly gravity-free environment, which minimizes joint strain. During your first trimester, swimming at least 20 minutes, three times a week will keep you in good shape.

Relaxation techniques help your breathing and focus, relieve daily stress, make you feel better and help train your mind to let go of emotional tension. This can be especially helpful during labour and delivery. Yoga also helps you control your breathing and provides an excellent means of stretching and toning muscles.
Yoga works both your body and mind, strengthening and toning muscles and leaving you with a renewed sense of peace and calm.

There are many styles from which to choose. Some popular ones include kundalini yoga, which focuses on breathing techniques and meditation; iyengar yoga, which emphasizes posture, alignment, and balance; and power yoga, which features aerobic workouts to build strength and endurance. In your second or third trimester, your doctor may advise you to avoid some yoga postures, such as those that require you to lie flat on your back.

One of the other major benefits of yoga is the focus on breathing techniques. Learning to be conscious of your breathing can be very helpful during labour and can help you stay calm and focused - even through distractions, such as labour pains.

Treat yourself to a massage. Having your body stroked and kneaded can help loosen tight muscles, calm your nervous system, increase blood flow throughout your body, and ease the discomforts that can accompany pregnancy.
Kegal exercises are recommended for all women and have particular benefit during pregnancy. By strengthening and toning the muscles of the pelvic floor, Kegal exercises help prepare these muscles for the stress of delivery and help them return to their former shape after delivery.

Finding the pelvic floor muscles and exercising them correctly is not always easy. The pelvic floor muscles are those that you contract if you are trying to hold back urine and can be identified by halting the urine stream while you are urinating. It is a good idea to consult a nurse or doctor to be sure you are contracting the correct muscles.

The Daily Exercise Regimen

Begin exercising by contracting the pelvic floor muscles as tightly as you can for a count of ten, then relax.
Repeat the contraction again for a total of five contractions.
In sets of five contractions, aim for a total of 25 to 50 contractions performed as tightly as possible. These sets can be spread out over the entire day. You can try getting through a set of five contractions while stopped at a red light, while watching a television commercial, or at any other time.

Weight Training. Using weights to increase muscle tone and strength can have many benefits during pregnancy, delivery, and after. You can either use free weights, resistance training machines, or a combination of both. If you already have a routine, consider working out with lighter weights and increasing your repetitions to prevent injuries from lifting weights that are too heavy.

Be sure to check with your doctor or health care practitioner before beginning a new exercise program. If you use weights during pregnancy, you should avoid straining with your airway closed (as if you were straining to have a bowel movement). This straining is called the Valsalva manoeuvre and is often done unconsciously when lifting weights. Straining in this way increases pressure in your abdomen and pelvis and can be risky during pregnancy. Focus on keeping your breathing smooth and consistent when lifting, inhaling and exhaling without holding your breath. Use controlled movements when lifting and avoid jerky movements that can cause joint injury. Do not lift heavier weights than those for which you have prepared. This is not the time to be pushing your limits. Be sure to rest for 60 seconds between sets of repetitions.

What Can I Expect During the First Trimester?

2nd Month. By now, you may have noticed some changes in your body. For many women, this is a period of significant fatigue. While exercising may seem too exhausting, it is important and may even decrease your fatigue. Exercising regularly is the key. Even a 20-minute walk around the neighbourhood every day will make you feel better, strengthen your heart and lungs, tone your muscles, and stimulate your body's natural feel-good chemicals (endorphins). Just make sure you get a thumbs-up from your doctor on your chosen workout and don't overdo it - moderation is key!

3rd Month. At this point in your pregnancy, you may find it as easy to exercise as you did before you were pregnant. If you are feeling fatigued, try light exercise or stretching at a lower level than your usual workout. You can gauge the level of your workout by ensuring that you can talk comfortably without stopping to breathe too much. Also, make sure to stretch before and after exercising and drink lots of fluids. At this stage of pregnancy, most exercises are considered safe - jogging, swimming, low-impact aerobics, dancing and weight training are all good choices. You'll need to change or stop some of these activities, such as jogging and heavy weight training, near the end of pregnancy, so now is the time to make the most of it.

SECOND TRIMESTER

Exercise during the second trimester of pregnancy can be very important in keeping up your energy level and for helping you sleep well at night. The key to exercise during pregnancy is to take it slowly and steadily. You should warm up, exercise, stop if you feel short of breath or are in pain, and slow down before you come to a complete stop. It is always wise to get your health care provider's stamp of approval before you begin an exercise program or if you want to change your program while pregnant.

When you exercise, make sure you stay below 60% of your maximum heart rate. For most women, this means you should maintain your heart rate at less than 140 beats per minute. Keeping your heart rate in a good range is important when you exercise because your body moves more blood to your muscles and skin and may move less to your uterus. If exercise is too strenuous, there is a risk that less oxygen will reach the baby. If you stay below 60% of your maximum heart rate, you don't need to worry about harming your baby when you exercise. Remember to avoid overheating and keep yourself hydrated during any exercise.

With all this talk about the benefits of exercise, there is also little harm in not exercising. Women who choose not to exercise also have healthy babies. Don't worry if your doctor has suggested that you should not exercise. It is recommended that you abstain from exercising if you have a variety of pregnancy-related conditions, for example, placenta praevia, pre-eclampsia or intrauterine growth retardation. If you have a history of spontaneous abortions or an insufficient cervix, it may also be recommended that you not exercise. The beneficial effect of protecting your baby by not exercising outweighs any good done by a few laps in the pool.

What types of exercise are appropriate during the second trimester of pregnancy?

Aerobic activities such as running and swimming, relaxation techniques, and strength training are all appropriate during the second trimester of pregnancy, as long as you are aware of your limits and follow simple guidelines for safety. Month-by-month guidelines are given below:

4th Month:
Weight training: As you begin your second trimester this month, your total blood volume has increased and the placenta and baby are growing. When you stand, blood can pool in your legs, causing you to become lightheaded or dizzy. For this reason it may be safer to do weight training exercises while seated.

Jogging and running: If you are a runner, you can safely continue to run in moderation. During your second trimester your uterus gets larger, causing your centre of gravity to shift which makes you more prone to losing your balance. Therefore, pay close attention to where you're running, and be sure to run on flat ground with as few obstacles as possible.

Yoga: As you slowly get bigger and your joints loosen, your balance may be affected, putting you at risk of injury. Pay attention to your body and only do as much exercise as is comfortable. Your breathing should stay smooth, and if you find you cannot breathe easily and smoothly during positions, think about shifting into an easier version of the position, stretching or extending less, or staying closer to the floor.

Swimming: If you are a swimmer, you should be able to continue swimming into your second trimester without any difficulty. If you are new to swimming, start slowly by swimming gently for short periods of time, taking caution not to overexert yourself, and working up to longer workouts.

5th Month:
As your belly gets bigger, you may find that your centre of gravity has shifted and you're not as agile as you once were. Compensate by being more careful when you step. At this time you will also want to stop exercises that require you to lie on your back. As your uterus increases in size, lying on your back can put pressure on the inferior vena cava, the large vein that runs vertically the length of your abdomen and is responsible for returning blood to the heart.

As you progress in pregnancy, your body produces a hormone which is responsible for loosening joints in preparation for a growing baby, labour and delivery. As your joints become looser, you are at more risk for sprains and strains. Your increased weight and the change in your centre of gravity may cause you to lose your balance, also putting you at greater risk for injury. For this reason, it is better to avoid exercises that involve extreme stretches or those high-impact activities like aerobics and running that put a lot of stress on your joints and put you at risk for falls.

Yoga: As your pregnancy progresses and has a larger impact on your activity, it might be wise to consider joining a yoga class for pregnant women or buying a book of yoga poses that are safe for pregnant women.

Walking: As your gait changes because of the changes in your body shape, be sure to focus on your posture when walking and keep your hips tucked under to prevent arching your back due to the increasing amount of weight you're carrying in front. When you feel out of breath, slow down or stop, and rest. You shouldn't be huffing and puffing.

Swimming: If you are a swimmer, you should be able to continue swimming into your second trimester without any difficulty. If you are new to swimming, start slowly by swimming gently for short periods of time, taking caution not to overexert yourself, and working up to longer workouts.

6th Month:
Your blood volume increases by 40% during pregnancy and your cardiac output (heart rate multiplied by amount of blood pumped per beat) increases by 30 to 40%. During exercise, your heart rate increases even more. Although research shows that women who exercise regularly have no increased risk of problems with their pregnancies, the key is still moderation. Don't push yourself too hard. Keep yourself hydrated and cool.

Weight training: You may want to decrease the duration or frequency of your workout, depending on how you're feeling. If you use free weights, be very careful to avoid blunt injury to the abdomen from dropping weights.

Yoga: Now that you're at the end of your second trimester, you may need extra balance support when doing standing poses. Avoid poses that stretch the abdominal muscles and that require you to lie on your back. Bend from your hips. If you feel discomfort, stop and re-evaluate if there's an easier way to do the position.

THIRD TRIMESTER

Now that you've made it to the third trimester, it may be time to slow down your exercise program. Depending on how you feel, you may want to cut down the frequency, duration, or the type of exercise. Some women continue to exercise through the end of pregnancy, but most women find it more comfortable to slow down. You might consider swimming, stretching, or brisk walking, rather than continuing with weight-bearing activities. If you have access to a gym, you might try a reclining stationary bike. Stay away from exercises that require you to lie on your back because this can put pressure on some of your major blood vessels, possibly impairing blood flow.

Continuing with some form of exercise is beneficial in the long run. The better shape you are in before delivery, the easier it may be to get back into shape after the baby is born.

As your belly gets bigger, you may feel clumsier. Take this into account when you are exercising. Be sure to exercise on non-slip floors and wear shoes with good traction. Wear a bra that is supportive enough to prevent bouncing, which can be painful.

You can probably continue to jog or run if your exercise program before pregnancy included jogging. However, the extra weight of pregnancy, the loosened joints, and your changing centre of gravity all put you at greater risk of injury and falls. Unless you feel you must run or jog, this is a good time to switch to lower impact exercises, such as stretching and brisk walking.

As your size increases, the challenge of doing normal daily activities increases as well. Activities like getting up out of a chair or off the couch, carrying groceries, or doing the dishes may be exhausting, and the couch may be even more inviting when the idea of exercise comes to mind. A great antidote to feeling lethargic when it comes to exercise is doing something fun that is not too strenuous. Call a friend and arrange to go for a walk. This may lift your spirits and help you feel more energetic. Be sure to take water with you to stay hydrated.

Exercise may also help you sleep better, even if you have difficulty finding a comfortable position. If you exercise during the day, you may be more tired, making it easier to fall asleep and get a good night's sleep.

It is safe to resume your exercise program about six weeks after delivery. It is almost always okay to take walks and do gentle stretches. Since every woman's situation is different, ask your doctor about the safest time for you to resume more strenuous activities.

For more information contact

Pfizer South Africa
Solly Mabotha
Pfizer Public Relations Manager
www.pfizer.com