Exercise Caution Before you lace up your athletic shoes, let’s go over a few key points about prenatal exercise. Many experts agree that not only is physical activity safe for women with low-risk pregnancies, it may actually lower the odds of certain complications, control or even prevent conditions like gestational diabetes, ward off muscle aches and pains, and reduce interventions during labour. (Contraindications to exercise include persistent bleeding in the second or third trimester, incompetent cervix, and pregnancy-induced high blood pressure.)
Check with your doctor or midwife before beginning an exercise program, especially if you have never exercised before — some care providers may advise newcomers to aerobic exercise to wait until the second trimester to begin. Other recommended precautions: avoid overheating and dehydration, breathe normally (no holding your breath), and steer clear of exercises that involve lying on your back after the fourth month. (By then, the weight of the uterus can compress the large artery that supplies oxygen to the baby — not to mention mom’s brain!)
With that out of the way, here’s the what, why and how of five essential exercises for expectant moms.
Intensity Guidelines Just how much can expectant moms exert themselves? And how do you judge whether you’re working too hard during aerobic activities like walking? Different groups of caregivers are divided on this issue: Some suggest women adjust exercise intensity according to how they feel, and others advise not allowing your heart rate to climb above certain targets. No matter which approach your doctor or midwife endorses, you can find out more about different methods of gauging intensity by visiting the Canadian Society for Exercise Physiology website at csep.ca.
Alert your caregiver if you experience any of the following symptoms:
• persistent uterine contractions (more than six to eight per hour) • bloody discharge, or a sudden gush of fluid from the vagina • unexplained abdominal pain • sudden swelling in the ankles, hands or face • sudden pain, redness or swelling in the calf • persistent headaches or vision disturbances • unexplained dizziness or faintness • marked fatigue, chest pain or palpitations (racing heartbeat) • weight gain of less than one kilogram per month during the final two trimesters • sudden reduction in baby’s normal movements
Putting one foot in front of the other is an inexpensive, easy form of aerobic exercise — the kind that builds up your endurance and maintains heart and lung health. “A lot of people don’t think they’re being active when they’re walking, but it’s a marvelous aerobic activity,” says Michelle Mottola, associate professor of kinesiology and director of the R. Samuel McLaughlin Exercise and Pregnancy Laboratory at the University of Western Ontario in London. Walking is low impact, and therefore doesn’t over-tax joints that are already coping with extra weight and lax ligaments (pregnancy hormones make these tough fibres laxer than normal, which can make you vulnerable to injury from over-stretching when you bounce or quickly change direction). It can also help guard against excessive weight gain, and control or prevent gestational diabetes.
How-to Another great thing about walking — chances are, you’ve been doing it most of your life, so you don’t need much instruction! Stroll for ten to 15 minutes to warm up, then pick up the pace until you feel you’re working “somewhat hard.” Aim for 15 minutes at this tempo to start, gradually adding about two minutes per week. Slow to a more leisurely amble for ten to 15 minutes while your muscles cool down. So how much and how often can you stride at this speed? As your caregiver for guidance: Some draw the line at 30 minutes five times a week, while others will okay a similar number of 45 to 60-minute sessions.
Safety tips Wear supportive, shock-absorbing, properly fitted shoes to ease the stress on your knees, hips and back. Sip water before, during and after your walk, particularly in warm weather. Avoid extremes in temperature: Mall-walking is a terrific option when the streets are slippery, or the mercury and humidity are hovering at high levels.
It doesn’t take a rocket scientist to realize that during pregnancy, your abdominal muscles are stretched to their limit. What you may not know is that since your abs help stabilize your pelvis and lower back (which is already toiling harder to balance the weight of your growing belly), weakness in this area can lead to painful back strain.
How-to Karen Nordahl, a Vancouver family physician and co-author of the prenatal exercise book Fit to Deliver, recommends a regular regimen of exercises that “fire and sustain” your core (deep abdominal, back and hip muscles that support your spine and torso), so this corset-like structure can pick up the slack. First, identify your transversus abdominus (TA) muscle — the ‘belt’ that narrows your waist. You can do this by lying down with your knees bent, placing two fingers on the point of your front hip-bone, and moving them slightly toward your bellybutton. Then squeeze the same muscles you would use to stop the flow of urine: You should feel a slight tightening. During the following movements, focus on contracting both the TA and the pelvic floor muscles (the muscular sling that supports your uterus, bladder and bowel).
To perform the exercise, sit in a hard chair, then scoot your bottom towards the edge, and lean back. (Before four months, you can do the same moves on the floor, lying on your back). With your knees bent, march your feet up and down several inches, repeating this action ten times for each leg. Other variations (using the same basic position) include bringing your opposite arm and knee to 90°, or sliding each foot forward and back.
Safety tips Women whose rectus abdominus muscles (they run lengthwise from your pubic bone and your breastbone) separate during pregnancy should consult their caregivers before doing any exercises involving the abs, since exercises like conventional crunches can exacerbate the problem. If you have this condition — dubbed diastasis recti — you may be able to see a rippling, or feel a ‘slot’ above your bellybutton while lying on your back with your knees bent.
Chandra Farrer, a spokesperson for the Canadian Physiotherapy Association, suggests including a half-squat in your prenatal exercise routine. This movement maintains strength in your legs (for hefting your baby, plus car-seats, strollers, and other cumbersome gear), and helps reinforce proper lifting technique, which will help prevent back strain.
How-to Farrer, a physiotherapist with the SportCARE program at Sunnybrook & Women’s College Health Sciences Centre, describes the semi-squat. “While standing, place your feet hip-425 apart, and hold onto a table for support. Then squat down, as though you’re going to sit in a chair. Work towards bringing your thighs parallel with the floor.” You can do three sets of ten repetitions.
Safety tips “You want to always be able to see your second toe (the one next to your big toe),” Farrer emphasizes, to guard against over-stretching tendons in your knee. Sticking out your bottom just a bit will also help minimize stress on your back.
“A lot of women complain about upper back pain as their breasts enlarge,” Farrer observes. Rowing against some form of resistance helps shore up the strength of muscles that can lighten the load on your upper back.
How-to Fasten the middle part of a TheraBand (a sort of gigantic elastic available at exercise supply and home health care stores) to a doorknob and grab one end in each hand. “With your arms parallel to the floor, you’re going to squeeze your shoulder blades together as you pull your elbows back,” Farrer explains. Repeat the motion ten times, for three sets.
Safety tips Keep your back stationary to ensure your shoulders and arms are doing the work.
Many women don’t have a lot of upper body strength — something you’ll need to lift and carry your baby, a diaper bag, carseat, and several kilos of assorted baby gear. This exercise works your biceps, triceps and pectoral muscles, to help meet the increased demand on your arms and chest muscles.
How-to “Stand facing a wall—your feet should be about 12 to 18 inches away, and your knees should be straight,” says Farrer. “Place your hands on the wall about shoulder-425 apart, with your arms parallel to the floor. Lower your body towards the wall, then straighten out the elbows to start position.”
Safety tips Be certain your entire back remains straight so you’re not placing extra stress on your lower back.
Finally, have fun. Remember—working out doesn’t have to be work. “When you think about healthy active living, there are a lot of things you can do to increase your activity,” says Mottola. “You can rake your lawn, take the stairs instead of the elevator, or put your child in the stroller and go for a walk. If you have a normal healthy pregnancy, there’s no reason you need to stop being active.” In fact, it’s one of the best things you can do for yourself and your family — not only will you be improving your own health, you’ll be setting a terrific example for your kids!
Originally published in December 2013.
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