prenatal exercise

Mamas on Bedrest: Running While Pregnant

June 4th, 2012

Jenny Wright jogged throughout her pregnancy. As a blogger for the British online newspaper The Daily Mail, Wright shares her experience, even being called “a Selfish Cow”, of jogging while pregnant. Following the flurry of comments, Wright wrote a follow up blog post addressing the naysayers entitled, My Perfect Baby Proves that Jogging is Safe.

I am a huge proponent of exercise during pregnancy. I am even a proponent of women running in the early stages of pregnancy. However, as pregnancy progresses, I am less of a fan. The increased levels of the hormone Relaxin, softening the ligaments and tendons, puts a pregnant mama at increased risk of injury. Additionally, pregnancy completely changes a woman’s center of gravity putting her again at increased risk of falls and injury. But my friend and colleague Kaisa Tuominen, a world class fitness instructor with extensive expertise in exercise science, public health and perinatal fitness provided an even more detailed explanation of the potential “cost” of Wright’s jogging while pregnant. Her entire blog post can be read here, and below is a summary.

Pelvic floor stress

As a general rule I (Kaisa Tuominen) discourage running during pregnancy. Not because pregnant women are fragile or because running is detrimental for the baby. The main reason for this rule is the pelvic floor. The hormonal status of a pregnant woman changes how her joints and tissues react to exertion. The pelvic floor is 80% connective tissue which becomes lax during pregnancy due to these hormones. Pregnancy ALONE is tough on the pelvic floor, weakening it little by little as the baby grows and exerts constant pressure on the perineal structures. When you add the impact and pressure caused by running the damage to the perineum is greater….In Jenny’s birth story I couldn’t help but notice that her baby did not rotate properly and she needed ventose to be turned manually. This is a typical situation of a pelvic floor that is weak.

Risk vs. Benefit

Physical activity and exercise are very beneficial, and truly essential, for pregnant women and unborn babies. There are numerous studies that show how fit women have healthier pregnancies, easier births, and recover faster. Babies are also positively effected by growing inside active women. Jenny is right when she says that being fit helped her get through hours of labor and birth without anesthesia. These benefits can be found by doing other types of exercise that are not detrimental to the pelvic floor. This is why I discourage running.

Ease Back into Exercise

 I would suggest that all moms take it easy in the beginning and only do postural and corrective exercises for the first month or so. It’s essential not to go too fast! I really hope Jenny does not return to jogging without rehabbing her pelvic floor first. In general women’s bodies are not ready for the intense impact from jogging for a few months postpartum. Generally it takes quite a bit longer. Again, risk vs. benefit. (See our posts on pre and post partum exercise here)

Thanks so much to Kaisa for providing these very salient points about jogging perinatally. Kaisa is an expert in perinatal fitness and has developed a program called The Postnatal Body Fix for mamas wanting a safe, effective post natal program that will help them regain their prenatal strength and fitness.

 

 

Mamas on Bedrest: Exercise is Safe During Pregnancy

May 18th, 2012

After coming across a MedScape article entitled “Many Pregnant Women Fear Exercising”, Bedrest Coach Darline Turner-Lee addresses the current information and guidelines for exercise during pregnancy. She reviews the Medscape article as well as the 2002 ACOG Guidelines for Exercise During Pregnancy, the most recent guidelines available from ACOG (and the position has been reaffirmed in 2009). Darline reviews do’s and don’ts to consider when exercising while pregnant, relative contraindications to exercising during pregnancy and ABSOLUTE contraindications to exercise during pregnancy. Finally, Darline shares some of the benefits of prenatal exercise, some great resources women can use when deciding how and when to exercise while pregnant and how even Mamas on Bedrest can exercise while pregnant.

Mamas on Bedrest (To Be?):8 Tips for Preparing for A High Risk Pregnancy

April 16th, 2012

“I purchased your Bedrest Fitness DVD. I am newly pregnant and am anticipating that I may have some complications based on my history. I’m gathering all the resources I can now.”

First and foremost, I am always thrilled to get e-mails from mamas telling me that they have purchased Bedrest Fitness and how it has helped or how they intend to use it. But this e-mail especially caught my attention because this is a very new mama who knows that she has a “complicated medical history” and is taking measures to be prepared for her pregnancy.

Some would say that planning for complications is “calling them into existence”. Personally, as a mama who had a complicated reproductive history prior to becoming pregnant, I have to disagree. I wish that I had had the information that I now provide to mamas. There are several simple things that mamas who have known complications in their reproductive history can do to enhance their chances of becoming pregnant and lessening complications during their pregnancy.

Start taking high potency prenatal vitamins. When you are pregnant, your body will have an increased demand for nutrients so as to not only sustain your health and well being, but to also grow and develop your baby. A good prenatal vitamin should not only contain the US RDA for nutrients, but also nutrients in adequate proportions to sustain mama and her developing baby. Read more about prenatal vitamins and we do offer individual consultations about on prenatal vitamins and supplements. Schedule a consultation by e-mailing info@mamasonbedrest.com.

Quit Smoking. Smoking has no benefits to health. Smoking is especially detrimental to a mama and her baby. If you are contemplating getting pregnant or are newly pregnant and smoke, you must quit. Speak with your health care provider TODAY to discuss smoking cessation options.

Address and stabilize chronic health conditions. Pregnancy is a major  stresser to a woman’s body and will alter the function of all of her major organ systems. If a woman has a pre-existing condition such as diabetes, depression, rheumatoid arthritis or any one of a wide variety of medical disorders, it is critical that these conditions be as stable and tightly controlled as possible entering into and throughout the pregnancy.

For example, if a woman is diabetic, she should get her blood sugars in tight control (if possible) prior to becoming pregnant. She and her OB will need to work closely with an endocrinologist and diabetician to ensure that the mama maintains blood sugar control throughout her pregnancy and minimizes complications and/or damage to her liver, pancreas, kidneys, heart and most especially her baby.

Lose Weight/attain Ideal Body Weight. If at all possible, mama should be at or near ideal body weight prior to becoming pregnant. Additional body weight increases a mama’s chance of having complications during her pregnancy such as gestational diabetes and pregnancy induced hypertension. If a woman is overweight and is contemplating pregnancy, especially if the weight is due to a prior pregnancy, she will significantly lower her risk of complications if she loses weight prior to becoming pregnancy.

Eat Well. Many women use pregnancy as a time to indulge in whatever they want to eat. “I’m eating for 2?” they say. The truth is that a pregnant women needs only to increase her daily caloric intake by about 500 calories in order to adequately nourish herself and her developing baby. What is more important is what she eats. Mamas should limit high fat, sugar laden processed foods and opt instead for whole grains, lean cuts of meat and fresh fruits and vegetables. Sodas should be eliminated and caffeine limited to not more than one 8-12 oz caffeinated beverage daily. Mamas should try to drink 6-8 eight oz glasses of water daily (minimum).

Alcohol. Alcohol is a sticky topic. While many health care providers will allow a woman to have an occasional drink, I am of the opinion that women who are pregnant or who may become pregnant should not drink. Some call my stance hard core or overly dramatic. However, a developing fetus has no need whatsoever for alcohol! If anything, depending on the stage of development, alcohol is detrimental. If you are anticipating getting pregnant I would suggest that you avoid alcohol. However, the decision is yours and you should discuss this issue further with your obsetrician if you have questions.

Sleep. In America especially, we don’t get enough sleep. Sleep is often substituted for getting more work done, watching TV, cleaning the house (especially if you are a mama!) or caring for children. If you are pregnant or contemplating getting pregnant (and even if you are not!!), getting 7-9 hours of sleep daily is critical to establish and maintain normal circadian rhythms, for hormone production and output, for restoration of bodily functions and for maintainence and repair. As many mamas note, early on in pregnancy all you can do is sleep. This is nature’s way of making sure your body’s energy is conserved and utilized to grow and develop your baby.  If you are planning for or in the midst of pregnancy allow yourself 7-9 hours of sleep daily and take naps as necessary.

Exercise. Exercise is a critical component to good health in every individual. What is often overlooked is the benefit of exercise during pregnancy. Even today, in 2012, there are obstetricians who advise their patients against exercising during pregnancy stating (false) evidence that exercise will somehow harm the baby. Now this is not to say that there aren’t activities that pregnant mamas should avoid such as skiing, rollerskating, contact sports, scuba diving and anything that wil cause mama to significantly overheat, put her at risk for direct trauma to her abdomen or compromises her metabolic function (such as scuba diving which puts her oxygen consumption at risk). Exercise during pregnancy helps mamas maintain healthy weight gain, maintain adequate muscle mass, maintain strength, ease soft tissue (tendons & ligaments) discomfort, help with posture, aid in sleep, aid in insulin uptake and function (helping to avoid insulin resistance and gestational diabetes) and overall help mamas feel good.

Exercise is possible for mamas on bed rest. These mamas, who are at increased risk of muscle loss, bone loss, metabolic distubances, acid/base disturbances and numerous aches and pains from being in bed, benefit greatly from daily movement. Bedrest Fitness was designed with mamas on bed rest in mind! It is a set of modified prenatal execises that mamas can do daily from the comfort of their own beds. Most mamas who have done them have reported that they were able to maintain muscle tone, strength and move more easily and freely after their bed rest experiences.

So if you are planning to get pregnant or a newly pregnant mama and are thinking you may have problem or just want to be prepared as best possible for your pregnancy, labor and delivery, these 8 tips will set you well on  your way to a healthy and happy pregnancy and hopefully to a beautiful healthy and happy baby!