Mamas on Bedrest: Dr. Linda Burke-Galloway Reviews Updated Recommendations for Exercise During PregnancyJune 28th, 2011
The post below was written by one of my idols and mentors, Dr. Linda Burke-Galloway. Dr. Burke-Galloway is an OB/GYN who practiced for years providing care to high risk pregnant women. She is now a nationally recognized patient advocate, a legal expert in cases involving high risk obstetrics and Medical Malpractice and is the author of The Smart Mother’s Guide to a Better Pregnancy. In this post from her blog, she reviews ACOG’s Guidelines for exercise during pregnancy.
Exercise while pregnant has always been a controversial issue. The days of of “eating for two” to justify inappropriate eating habits is passé. Nine years ago, The American Congress of Obstetrician-Gynecologists published guidelines regarding exercise and pregnancy. Essentially they recommended 30 minutes or more of moderate exercise each day for pregnant women in the absence of medical or obstetrical complications. The Center for Disease Control’s (CDC) recommendations for an “active lifestyle” does not exclude pregnancy.
In the June 2011 issue of Obstetrics and Gynecology, Gerald Zavorsky, Ph.D and Lawrence D. Longo, MD, wrote an excellent article on exercise and pregnancy. They recommend exercise intensity that increases the heart rate to at least 60% of its maximum capacity during pregnancy to reduce the risk of gestational diabetes. Other recommendations for pregnant women are as follows:
• Pregnant women aged 18 to 45 may do 8 to 10 muscular strength exercises for one to two sessions per week on nonconsecutive days. One aerobic training session can be replaced by a muscle strengthening session in the weight room or at home
• Use lighter weights and more repetitions. If you usually perform leg presses with 35 lb for 8 to 12 repetitions, try 20lb for 15 to 20 reps.
• Avoid walking lunges because they may rise the risk of injury to connective tissue in the pelvic area
• Be careful with free weights because they may involve the risk of hitting the abdomen. Use resistance bands instead that offer different amounts of resistance and varied ways o do weight training and should pose minimal risk to the abdomen
• Try not to lift while flat on your back. In the second and third trimesters, lying on your back may cause the uterus to compress a major vein that could limit oxygen received by the fetus
• Zavorsky and Longo recommend that you listen to your body. If you feel muscle strain or excessive fatigue, modify the moves and reduce the frequency of the workouts. “Pregnancy is not the time to perform heavy weight lifting.” Instead, they should do muscle strengthening exercises according to the prescribed guidelines because it will burn calories and increase the resting metabolic rate.”
As always, please consult your physician or healthcare provider prior to starting an exercise program and remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
While Dr. Burke-Galloway’s post is directed towards women having uncomplicated pregnancies, once again I want to reiterate that Mamas on Bedrest need to ”exercise” as well.
OB’s and Midwives emphasize the benefits of weight management, maintenance of cardiovascular endurance, maintenance of muscle strength and tone as well as a decrease in the overall aches and pains of pregnancy as the main reasons women should engage in regular prenatal exercise. Secondarily, they emphasize exercise as a way to ward off Gestational Diabetes and possibly Gestational Hypertension which may lead to pre-eclampsia. All of these benefits of prenatal exercise are even more important to mamas on bed rest, women who are at increased risk of these complications (if the don’t already have them!).
Very few OB’s recommend specific exercises for women on bed rest. For that specific reason I developed Bedrest Fitness. It is a simple yet effective set of exercises that women can do while in bed. I also want to add that women on bed rest should regularly stretch, I recommend hourly, to maintain circulation and to decrease the risk of developing bed sores as well as blood clots in the legs.
As Dr. Burke-Galloway stresses, always check with your health care provider before starting any sort of prenatal exercise program. If ysou have questions about exercise while on bed rest, send an e-mail to firstname.lastname@example.org. And for those interested in more structured and supervised exercise for women on bed rest, join us this fall for online Bedrest Fitness Classes! Details and registration will be available soon!
LIsten to the Mamas on Bedrest Podcast Interview with Dr. Linda Burke-Galloway Here.
On November 30, 2003, my husband’s father died.
It was a heartbreaking loss. We had all gathered at my inlaws to celebrate their 40th wedding anniversary. My husband, daughter and I had flown in to surprise my inlaws and together with my sister and brother inlaw, we were going to throw a big family party to commemorate the event.
On the morning of the anniversary, my husband and I were jolted from sleep by my mother inlaw’s cries, “Daddy isn’t waking up!” While I tried to perform CPR my husband called EMS. The emergency rescuers worked on my father in law for some 45 minutes before transporting him to the hospital. My father in law never regained consciousness. The doctors estimated that he had actually died a couple of hours prior to my mother in law waking up. My mother in law lost the love of her life on their 40th anniversary.
Losing a parent is never easy. Losing a parent in such a dramatic fashion is even more difficult. My husband speaks very little about his father’s death, yet I know that it had a profound impact on him. For months following his father’s death, my husband functioned on autopilot; he went to work, came home, played with our daughter abit and then retreated to his home office. While I knew that he was in great pain, I was unable to get him to talk about his father or to get help in the form of counseling. Those were very dark days.
Even now, 9 years later, my husband speaks very little about his father or his death. When we spoke recently, he admitted that the void that he feels is almost unspeakable. Without my father inlaw, my husband finds himself with no male role model, no patter for fatherhood. His grandfathers are deceased. His father had 2 sisters and his mother has 3. My husband is the oldest grandchild so others look to him as a role model. There is no living male relative to whom he can turn for advice or guidance.
It really took me aback when I considered my husband’s situation. When I had my daughter, I was constantly on the telephone with my mother and sister, making sure each little “coo” was okay and that I was providing her with everything she needed. When I had my son 3 1/2 years later, my sister became my beacon, as she had 2 boys. I talked to anyone and everyone; moms at parks, moms at preschool, moms at church, women in the grocery store, friends…I sought out and accepted any and all advice. I don’t know how I would have made it without all the sage advice of the multitude of women in my life. I really could not imagine how my husband was making it on his own.
I have repeatedly suggested that my husband obtain counseling to help him cope with his feelings surrounding his father’s death as well as his feelings of being the family “patriarch”. I have also suggested that he seek out other men, other fathers, with whom he can share ideas and gain support. To date he has refused.
Dr. Bruce Linton has clearly outlined the stages men go through as they transition into fatherhood. According to Linton, an important stage is reconciling one’s feelings with one’s own father. My husband has admitted that there is much he had hoped to share with his father and now he’ll never have the chance. It’s tragic indeed.
I will keep trying with my husband. It will be very difficult for him to resolve some issues as my father in law is gone. Ultimately he has to find a way to cope with his feelings so that he can have some peace. But he will have to choose whether he wants to resolve his feelings or bury them.
Recently my husband and I were talking about things and we broached the subject of my pregnancies. I’ve had a dicey pregnancy history to say the least and each pregnancy had its share of drama. What I never realized was that when I was at my most vulnerable and most broken, my husband was doing his best to shoulder my pain and the burden of his own feelings of inadequacy.
My husband is a process engineer. In simple terms, he solves problems for a living. In his world of semiconductors, he figures out ways to make computer chips hold more information and to be able to access and distribute that information easier and faster. Don’t ask me for more details because that is the extent of my understanding of what he does. What I can say is that he becomes very frustrated when he can’t solve a problem or when a process is not cut and dried. I imagine my pregnancy history totally warped his circuits!
My first pregnancy ended very early in miscarriage. I had just learned that I was pregnant and had jetted off to a conference. I miscarried in the hotel room a couple of days into my trip. I didn’t call my husband or even go to the emergency room. I knew what had happened recognized that the miscarriage was complete (I spare you the graphic details) so I waited until I got home to tell him. He felt horrible that he had not been there. I told him that there was nothing that he could have done, it just sort of happened. I realize now that was of no comfort to him. He wanted to be able to ease my pain, to share my burden. He could not so he felt like he had let me down. He felt like he had failed me.
My second miscarriage (third pregnancy) was also early, at about 9 weeks. I knew that I was pregnant and was feeling great. When I went to my OB for what I thought would be the routine first OB visit and to get my vitamins and set up my monthly appointments, I was told instead that the sac looked abnormal and that there was no heartbeat. I had had an ultrasound 3 weeks earlier (due to my history of early miscarriage) and everything had looked fine. What a difference a few weeks makes. But because everything had looked good at 6 weeks, when my husband suggested that he reschedule an international business trip the same week as my first OB, I told him not to worry, to go ahead and take his trip and I’d be fine. I was so wrong. I was utterly devastated when my OB told me that the pregnancy was not viable and cringed at the thought of calling my husband in Japan to give him the news. Distraught, I spoke with one of the pastors at my church and this very sweet young man told me that no matter how it may hurt my husband to hear the news over the phone, it would be far worse to wait until the end of the week when he returned.
It was truly one of the worst phone calls of my life. My husband was already concerned when he picked up the phone and heard my voice because I never called him while he was away internationally (he always called me!). Before I could say anything I began to cry. Then he was really worried. I finally sputtered out what had happened and all I heard at first was silence. Then, “I’m coming home”. I knew that he was presenting some data to the higher ups in his company, so I told him to finish his meeting and then to come home which he did.
But the most maddening and frightening time had to be the birth of my daughter, my second pregnancy. This pregnancy had been fraught with all kinds of complications from spotting at about 16 weeks to “cramping” throughout much of the pregnancy which I now realize were possibly preterm labor (Ignorance is bliss??) contractions. I went into real labor (which I was not supposed to do because of previous fibroid surgery) at 36 weeks and 6 days. My OB’s patner evaluated me and decided to proceed with the c-section.
The anesthesia made me immediately sick, so I vomitted though the entire delivery. When they first brought my daughter out, my husband says that she was blue and floppy. I could not see her but she did cry so I had assumed she was okay. The cleaned her up and whisked her off because of breathing issues. At the same time, my OB’s partner was trying to stitch me up and each time she threw a stitch, my uterus spouted blood like Old Faithful. And there, standing in the middle of the operating/delivery room was my process engineer husband; not understanding what was going on with his little girl, unable to help his vomitting and bleeding wife and no one explaining a damned thing to him. When we spoke about that night, he got very quiet and a little pale and said, “I wasn’t sure if I was going to lose one or both of you that day.”
To put this in perspective, we had this discussion about 2 months ago. My daughter will be 9 in October. He has been carrying around this fear and angst for nearly 9 years. No one ever asked him how he was doing after the birth. Sure, people congratulated him but for the most part, all eyes were on me and my daughter. I had been cut and had hemorrhaged. She had been in the NICU. He was just the dad. Yet, he most likely had the most vivid memories of that night and they are not good ones. It was a scary. It was bloody and for someone who likes order and control and nice neat processes, this was the complete antithesis. Another explosion of his “internal hard drive”.
Today there are many books and resources to help dads with the pregnancy and birth process. I so recommend that everyone read Dr. Bruce Linton’s post “From Man to Dad: How Fatherhood Changes Men” on Pregnancy.org. While his post does not address traumatic birth specifically, it does address many issues that face men as they become fathers. Dr. Linton has some other wonderful information on his website FathersForum.com.
Hearing my husband’s recollection of my daughter’s birth has really put it in a different perspective for me. We cannot forget that dads have also “given birth” and with that process there may have been some very scary, harrowing and even near death moments that dad experienced-more so than mom. It’s important to check in with dads and make sure that they are doing okay because many dads who experience births like my husband did are at risk for post partum depression.
Given my line of work, it’s embarrassing to admit that I didn’t recognize my husband’s pain for nearly 9 years. So I write this blog to all the mamas, family members, friends and loved ones to raise their awareness about birth trauma in men and its potential to lead to post partum depression in dads. Ask dad how he is doing; ask open ended questions and observe dad’s response. If dad seems quieter than normal, more detatched or perhaps inappropriate it may be that he is masking depression. Be aware and help dads get help.
Daddy & His Girl!
For more information or assistance, e-mail email@example.com.