The Myths and Facts of Prenatal Fitness
MYTH: You shouldn't workout during pregnancy if you were not previously engaged in an exercise program prior to becoming pregnant
- ACSM states a healthy woman may continue with her regular exercise regimen or begin a new program during pregnancy.
- If you have not exercised prior, start slow and build up gradually.
- Consistency is most important.
FACT: Exercise may prevent gestational diabetes
- Exercise has an insulin like effect on the muscles causing blood sugar levels to drop.
- 3-5% of pregnant women will get Gestational Diabetes.
- REGULAR exercise is one of the most important factors in prevention!
- Small meals, include protein, reduce sugars.
MYTH: You should cut back exercise in the last trimester
- You might cut down the intensity, but you should remain consistent.
- It's important to continue at a similar RPE throughout the pregnancy.
MYTH: Pregnant women should not exercise more than three times per week
- ACOG recommends 30 minutes or more of moderate exercise daily, with doctor approval.
- ACSM recommends 5 or more days per week.
MYTH: You must keep your Heart Rate under 140 bpm (beats per minute)
- This is not a recommendation on the current guidelines.
- This old recommendation was removed as a guideline in 1994.
- Use Rate of Perceived Exertion / Modified Borg Scale.
- ACOG recommends mild to moderate workout.
FACT: With a few exceptions, you can participate in any sports while pregnant that you did before
- You can continue past sports if you listen to your body.
- Avoid contact sports.
- Avoid exercises with risk of falling.
- Non-weight bearing exercise is likely to be more comfortable.
MYTH: Kegels are not necessary if you are going to have a Cesarean
- Most pelvic floor damage is caused during pregnancy.
- Cesarean patients still complain of urinary incontinence.
FACT: Absolute Reasons to NOT Exercise During Pregnancy
- Significant heart disease
- Restrictive lung disease
- Incompetent cervix
- Multiple gestation at risk of premature labor
- Persistent second or third trimester bleeding
- Placenta previa after 28 weeks of gestation
- Premature labor during current pregnancy
- Ruptured membranes
- Preeclampsia/pregnancy induced hypertension
FACT: Warning Signs to Stop Exercise During Pregnancy
- Dyspnea (labored respiration) prior to exertion
- Premature labor
- Severe abdominal pain
- Feeling unusually tired
- Chest pain
- Muscle weakness
- Calf pain or swelling
- Decreased fetal movement
- Amniotic fluid leakage
First 6 weeks after delivery
Post Partum Depression
Exercise after Cesarean
Fact : One in four babies born in the United States are born cesarean section. (That’s about 1 million deliveries per year)
Cesareans have been part of human culture since ancient times. According to Greek mythology Apollo removed Asclepius, from his mother's abdomen. The term is commonly believed to be derived from birth of Julius Caesar. Roman law under Caesar decreed that all women who might die in childbirth must be cut open; hence, cesarean. No matter the origin, the fact is that cesareans account for nearly 30% of births in the United States.
Cesarean birth is the birth of a baby through surgical incisions (cuts) made in the abdomen and uterus.
There are multiple possible reasons for Cesarean including:
· Multiple Birth
· Failure to progress
· Concern for baby
· Problems with placenta
· Previous cesareans
After delivery, you can expect the hospital stay to be anywhere from two to four days. It takes a few weeks to heal abdomen. It’s not uncommon to feel:
· Mild cramping
· Bleeding or discharge for 4 - 6 weeks
· Bleeding with clots / cramps
· Pain at incision
To get more comfortable, do your best to walk soon after delivery, even if just across the room. The more often you do, the easier it will be. Some moms feel comfort if they splint the incision. Avoid leaning forward. Do your best to stand tall. You will want to learn to log roll so that you can get up with minimal discomfort.
A cesarean is major abdominal surgery. You will need support when you go home. Make sure to get adequate rest. Eat nutritious, high fiber foods. Drink lots of water. Don’t lift anything heavier than baby
This set of exercises can be done immediately so long as there is no pain or discomfort. Take baby steps - go slow!
1 )Huffing - Exercise to clear lungs if general anesthesia was used. Helps clear mucus from throat and lungs. Huffing will help improve transverse abdominal muscles. You take quick, forceful outward breaths while bringing abdominals and pelvic floor muscles up and in. This is different than coughing and less painful.
2) Kegels - These are designed to strengthen pelvic floor muscles. These muscles are weakened by pregnancy and birth process even if cesarean. Start gently.
• Squeeze the pelvic floor muscle for three seconds, relax the muscle for three seconds, then squeeze again.
• Begin with 10 three-second squeezes, three times a day. Increase repetitions gradually.
• Work up to doing 50-100 Kegels each day.
*Note: Do not do all of the kegels in one session, as these muscles fatigue quickly. Each week, reassess your holding time and increase your hold until you are able to perform a 10 second hold.
3) Diaphragmatic Breathing
Diaphragmatic breathing is essentially abdominal tightening on outward breath. Lying on your back, place your hands over your abdomen. Inhale and allow your belly to rise as it fills with air. Exhale through your mouth as you tighten your abs, pulling them in towards your spine. Your stomach should flatten, not bulge, as you exhale.
3) Pelvic Tilt
While it may seem basic, this simple exercise can be quite difficult if you have lost strength in your core. Lie on back, knees bent, feet flat on floor. Exhale, engage abs and tilt pelvic upward, flattening small of back. Return to neutral and repeat.
4) Ankle Circles
While this exercise won’t help you get your pre-pregnancy body back, it is important to prevent thrombosis. Ankle circles increase circulation and prevents swelling. Do 10 circles on each foot, 3-5 times.
5) Leg Slide
Lie on back with knees bent. Engage abdominal wall. Slide one leg out away from body. Slide back and repeat. Do 10 leg slides on each side, 3-5 times.
While you may be eager to get back to traditional exercise, it’s important to take it slow. Most doctors will recommend you wait 6 - 8 weeks for traditional exercise. They are waiting for the uterus to resume to normal size and for your incision to heal. When the time comes, progress slowly.