Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that physical activity may prevent gestational diabetes (diabetes that develops during pregnancy), relieve stress, and build more stamina needed for labor and delivery.
Benefits of prenatal exercise
Regular exercise (at least 3x/per week) during pregnancy is extremely beneficial as exercise leads to,
Potentially easier pregnancy and labour
Improves cardiovascular fitness
Decrease the risk of gestational diabetes
Promotes faster recovery from labour
Helps in the prevention of low back pain during pregnancy and weight gain
Also counteracts post-partum depression
Moderate – severe depression following birth; may occur soon after delivery or up to 1 year later, most commonly within the first 3 months
Importance of prenatal exercise
Reduce the risk of developing poor postural patterns during pregnancy
Reduce stress on upper and lower extremities
Reduce the risk of developing varicose veins, oedema
Minimize pelvic floor muscle dysfunction
Reduce or prevent the development of rectus abdominis diastasis
Breathing and relaxation exercises in preparation for labour
Reduce the risk of developing musculoskeletal pathologies during/after pregnancy
Guidelines for Exercises
Avoid any vigorous exercise in hot and humid weather or during febrile illness
Avoid jerky, bouncy motions
Ensure good footwear and non-slippery surface to prevent falls
Exercise should include a warm-up period and a cool-down period at the end of an exercise session
Maintain adequate hydration levels during exercise
Ensure proper body mechanics of posture and lifting
After the first trimester of pregnancy, avoid exercise in a supine position
Women with a history of sedentary lifestyle should begin with low-intensity exercises and progress gradually
Maximum heart rate should not exceed 140-150 bpm
Contraindications to Exercise
Gestational diabetes
Multiple pregnancies
Pregnancy-induced HTN BP >140/90
Diagnosed heart disease ICH, RHD
Vaginal fluid loss/Amniotic fluid leakage
History of miscarriage or preterm deliveries
Abnormal fetal position eg breech during 3rd trimester
Intrauterine Growth Retardation (IUGR)
Abnormal placental function or position
Anaemia
Acute infection
Prenatal Exercise Class by Physiotherapist
General Sequence of Events
Warm-up
Stretching
Upper limb and Lowerlimb strengthening
Lumbo-pelvic stabilization exercises
Pelvic Floor Exercises
Relaxation/Cooldown exercises (eg diaphragmatic breathing)
Educational information e.g. foods to prevent constipation; avoid straining PFM
Positions to Avoid
After the first trimester: supine position is associated with a 9% decrease in cardiac output due to pressure on the inferior vena cava
Inferior vena cava lies on the right side, therefore, the best position is left side-lying or semi-sideline
ACOG recommends "no exercise be done in the supine position after week 16”
However, low-intensity supine exercise does not significantly affect cardiac output until after week 35.
The ACOG guideline of 16 weeks for all exercise is on the conservative side, but err on the side of caution and allow only 1-2 minutes of supine exercise at a low intensity after 16 weeks.
If dizziness or light-headed is experienced, roll onto the left side, then slowly sit up.
Avoid sitting up straight from bed à preferably “log roll” to left and sit up using arms to push the weight off the bed
Pavitra Sumanarathna
References
https://www.acog.org/
https://www.webmd.com/baby/guide/exercise-during-pregnancy#1
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