Getting enough exercise can be a challenge for any of us. Exercising during pregnancy, because of changes in the body and the level of fatigue, can be even more challenging. But the benefits — during pregnancy, birth and the postpartum period — make it well worth the effort.
A study by the University of North Carolina at Chapel Hill published in the March issue of the journal Preventive Medicine found that fewer than one in four pregnant women meet the activity guidelines set by doctors. In 2002, the American Congress of Obstetricians and Gynecologists recommended that pregnant women get 30 minutes or more of moderate exercise daily if they have no medical or pregnancy complications. The U.S. Department of Health and Human Services guidelines suggest 150 minutes of moderate intensity aerobic activity per week for pregnant women.
Noticing a difference
Women who exercise during pregnancy tout its benefits. For obstetrics nurse Sylva Menard of Troy, who is pregnant with her second child, exercise has made all the difference. She took a weekly yoga class during her first pregnancy, but this time she has been exercising more, using an elliptical trainer half an hour three times a week, and doing lengthy stretching sessions twice a day.
“I notice a difference if I take a one- to two-day break,” Menard said. With exercise, she feels stronger. “It means the difference between having energy and being able to get up and run around after my toddler. It affects you both emotionally and physically,” she said.
Exercise during pregnancy has a host of benefits, including helping to prevent gestational diabetes, supporting healthy weight gain and improving mental health.
Pregnant women need to check with their doctors before beginning any exercise program. Deborah Basso, a obstetrician and the assistant chairwoman of OB/GYN at Seton Health/St. Mary’s, says pregnant women who were not exercising before pregnancy should not take up something entirely new and strenuous during pregnancy.
For example, if a woman does not usually run, pregnancy is not the time to take it up. Walking, stretching and swimming are good ways to exercise during pregnancy.
There are things to watch, though. “You don’t want your pulse to get over 120, and [you want to] stay well-hydrated,” Basso said, recommending that women drink at least 1 liter of fluid before exercising. “If something starts to hurt, slow down.”
Physical therapist Debra Goodman is an advocate of exercise during pregnancy, and she has done extensive work in this field, creating exercise programs especially designed for pregnant women. Goodman, who practices in Albany, said women should to begin thinking about their bodies as different bodies during pregnancy. “There are so many things that are changing — a whole host of physiological changes,” she said.
For example, abdominal muscles will stretch more than 50 percent more than normal. Core muscles weaken. The curves of the spine become more exaggerated. The laxity of muscles, joints and ligaments increases. The outermost abdominal muscle can separate, causing lower back pain.
But how many women really understand these physiological changes and what can help them to cope?
“Even as an educated individual, it’s amazing what you don’t know,” Menard said. This time around, she has the education, and she has found that it has made a huge difference in how she feels and functions during pregnancy.
Goodman focuses on five main components in her specialized prenatal exercise programs. They are abdominal strengthening, core strengthening, stretching, upper body strengthening and posture.
Abdominal strengthening during pregnancy is different. Basso warns against doing “belly crunches.”
“Abdominal strengthening is an important component of prenatal exercise, but it needs to be done in a very appropriate way,” Goodman said. One consideration is doing abdominal strengthening to limit separation of the abdominal muscles.
Core strengthening helps to strengthen muscles that support the changing body during pregnancy. For example, the transverse abdominus muscle is one of the core muscles. Goodman explains that when the transverse abdominus is strong, it holds the uterus up and back, which decreases the strain on the lumbar spine, and also helps to prevent the outer abdominal muscle from separating too much.
Specific stretching is important because certain muscle groups become very tight during pregnancy, Goodman said. “That is primarily what causes a lot of lower back pain and pelvic pain that women suffer,” she said.
The upper body strengthening component is to help prepare a woman for after the baby comes, when she will be doing a lot of lifting. “Wrist and hand problems are one of the most common postpartum problems,” Goodman said.
Focus on posture
The focus on posture is to offset the postural imbalances that come with a growing belly. “Posture really takes a beating,” Goodman said.
Education is key to getting the right type of exercise during pregnancy. “There’s not a lot of information readily available,” Goodman said. “Women, if they want to understand how to exercise safely and appropriately during pregnancy, they really have to seek out the information,.”
Menard is a believer in exercise during pregnancy. “This makes all the difference between being able to function at a high level and not being able to function,” she said.