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Prenatal FAQs
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Background Information:

Why is prenatal exercise so important?

The myths about prenatal exercise

For beginning exercisers

How exercise affects pregnancy and labor

How exercise affects the baby


Exercise:

Guidelines for exercising during pregnancy

How to measure exercise intensity while pregnant

Warning Signs

High Risk or Bed-Rest Pregnancies

Kegels

Doing Abdominal Exercises

Carpal Tunnel Syndrome


Nutrition:

Weight Gain

Recommended Daily Allowances


Postnatal Exercise FAQs
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Postnatal Exercise Guidelines




All Topics
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Why is prenatal exercise so important?

According to the American College of Obstetricians and Gynecologists, “Becoming active and exercising at least 30 minutes on most, if not all, days of the week can benefit your health in the following ways:

     * Helps reduce backaches, constipation, bloating, and swelling
     * May help prevent or treat gestational diabetes
     * Increases your energy
     * Improves your mood
     * Improves your posture

     * Promotes muscle tone, strength, and endurance

Additional benefits include:
    * Improves your fertility
    * Prevents and treats pregnancy-induced diabetes
    * Improves calcium absorption (preventing hypertension, preeclampsia,
          and future osteoporosis
    * Improves immunity
    * Less excess weight gain
    * Gives you better control of your pelvic floor muscles during labor
    * Improves endurance, fitness level, and muscle control for a faster,
      easier, and less painful labor
    * Prevents or reduces the risk of labor complications
    * Reduces chances of a C-section
    * Reduces chances of birth defects
    * Increases the chance of a baby with high Apgar scores

For more information on the benefits of prenatal fitness, read Brigitta Gallo’s Expecting Fitness.



The Myths about Prenatal Exercise

There are many misconceptions about prenatal exercise mainly due to a lack of knowledge and education on the subject.  These myths have recently been disproved by modern medical research.

Some things prenatal exercise was thought to cause:
         * miscarriage
        * reduction of blood flow to the baby
        * overheating of the fetus
        * displacement or rupture of the placenta
        * entangled umbilical cord
        * breech position
        * increased risk of C-section
        * premature labor
        * fetal distress
        * low birth weight
        * difficult maternal recovery after birth


Always get your doctor’s consent when starting a prenatal exercise program.  If your doctor gives you permission to exercise, make sure you  exercise within your limits and start off slowly if it has been awhile since you have exercised.  There are many benefits to exercise during pregnancy.  See “Why is Prenatal Exercise So Important?” for more information.



For Beginning Exercisers

If it has been some time since you’ve exercised, it is a good idea to start outslowly.  Begin with as little as 5 minutes of exercise a day and add 5 minutes each week until you can stay active for at least 30 minutes a day.  Be consistent with your exercise because sporadic workouts may do more harm
than good. 


MommyShape Prenatal Complete includes modifications for beginning exercisers.  Start out with the “Warm Up” and “Cool Down” sections and slowly work yourself up to the other sections.  Listen to your body and do what feels good.  You may also supplement with walking, swimming, or stationary cycling.  If your doctor has given you permission, even the smallest bit of exercise everyday will help!



How exercise affects pregnancy and labor

The length of pregnancy has not been found to be significantlyaffected by exercise.  However, exercise has shown to have a positive effect on the length of labor.  Studies done by James F. Clapp III have shown that moms who exercise until the last day oftheir pregnancy will have a shorter labor.  The studies also showed that 65% of moms who exercise deliver in less than 4 hours
.

Moms who exercise during pregnancy have also been shown to have an easier labor and delivery, a better chance of natural vaginal delivery, and less likelihood of medical interventions.  Probably due to their stronger muscles, higher pain tolerance levels, more endurance, and the endorphins created through exercise, they also experience less painful labors. 

The MommyShape Program is specially designed with movements, breathing exercises, and relaxation techniques that provide a solid foundation for labor and delivery.  It is important to vary your exercise
using a program such as MommyShape Prenatal Complete, which includes different types of movement that will strengthen, relax,loosen, and stretch your body as well as center your mind.




How exercise affects your baby

When mommies exercise during their pregnancies, their babies seem to be more relaxed during labor and more able to withstand potential problems.  They also seem to be tougher, more fit, and calmer once they are born.  Body length, size of baby’s head, and lean tissue weight are comparable with babies from non-exercising mommies, but exercise throughout pregnancy usually results in a baby with less body fat.  This is good because this gives the baby a much smaller chance of growing up with a weight problem.  Babies fromfit mommies seem to have better working nervous systems- they are more independent, require less attention, sleep through the night, have less colic, and their mental development is accelerated.



Guidelines for Exercise During Pregnancy

According to the American College of Obstetricians and Gynecologists, when you exercise, follow these general guidelines for a safe and healthy exercise program:

          * After the first trimester of pregnancy, avoid doing any exercises on your back.
          * Avoid brisk exercise in hot, humid weather or when you have a fever.
          * Wear comfortable clothing that will help you to remain cool.
          * Wear a bra that fits well and gives lots of support to help protect your breasts.
          * Drink plenty of water to help keep you from overheating and dehydrating. 
            I recommend 8 ounces of water before, 8-16 ounces during, and 8 ounces after exercise.
          * Make sure you consume the daily extra calories you need during pregnancy.



High Risk or Bed Rest Pregnancies

If you have any of the following, your physician will probably tell you that you are a “high risk” pregnancy or may order you on bedrest:


    * Cardiac, vascular, pulmonary, or thyroid disease
    * diabetes, seizure disorder, obesity, hypertension, anemia or other blood disorders
    * Problems with back, joints, or muscles
    * Persistent bleeding in the 2nd or 3rd trimester
    * If baby is in breech position in the last trimester
    * If you water has broken
    * If you have had three or more miscarriages
    * If you are carrying twins
    * Placenta Previa or Abruption

Even if you are placed in any of these categories, you can still do some modified exercises. Immobility will make you feel worse and make your labor more difficult.  Make sure to speak to a professional who can design a special program for you to make sure that you are safely staying active during your pregnancy.



How to measure your exercise intensity while pregnant

The extra weight you are carrying will make your body work harder than before you were pregnant. Try to exercise moderately so you don't get tired quickly. A good way of deterimning how hard you are working is the use the Rate of Perceived Exertion (RPE) Scale:

1. Very Light
2. Fairly Light
3. Moderate
4. Somewhat hard
5. Hard
6.
7. Very Hard
8.
9.
10. Very Very Hard


Stay between 5 and 8 in order to get a good workout, but don’t go beyond 9 otherwise it maybe harmful to you and your baby.  Basically, if you are able to talk normally while exercising, your heart rate is at an acceptable level. If you are able to sing out loud, then you are probably not doing enough.



Warning Signs

While you exercise, pay attention to your body. Do not exercise to the point that you are exhausted. Be aware of the warning signs that you may be overdoing it.


Stop exercising and call your doctor if you get any of these symptoms:

    * Vaginal bleeding
    * Dizziness or feeling faint
    * Increased shortness of breath
    * Chest pain
    * Headache
    * Muscle weakness
    * Calf pain or swelling
    * Uterine contractions
    * Decreased fetal movement
    * Fluid leaking from the vagina


If you are feeling any discomfort, you may need to modify the exercise further to fit your specific needs.  Stop practicing a pose or an exercise whenever it no longer feels good.



Kegel Exercises

Kegels are the most important exercises you will ever do during your pregnancy.  Even if you decide not to exercise at all during your pregnancy, just doing some kegel exercises every day will help with your labor, delivery, and recover.  Kegel exercises strengthen the pelvic muscles, and stronger pelvic muscles help prevent urine leakage during and after pregnancy as well as restore muscle tone after delivery.  Many pregnant women who avoid strengthening these muscles tend to experience bowel and bladder incontinence problems later on in life.

In MommyShape Prenatal Complete, there are kegel exercises in every section.  Your minimum target should be 5, 5, 10:  5 sets of kegels, 5 times a day, held for 10 seconds each. You should be doing your kegels everywhere you go, during your pregnancy as well as for the rest of your life.  Since nobody can see you doing them, you can do them anywhere...even while you are drivingyour car or standing in line at the store!



Abdominal Exercises and Diastasis Recti

Abdominal Separation, or diastasis recti, can occur during pregnancy because the abdominals are being stretched out. The vertical midline of the abdominal wall is called the linea alba.  It softensduring pregnancy and may even separate.  If this happens there will be a hole under your skin near your belly button.  It is painless, so you will need to feel for it to know that it is there.   Usually about 60% of women have diastatsis recti.  Once the baby is born, everything usually comes back together.  You should check for diastasis recti before every workout.

Lie on some pillows and place you’re your fingers along your linea alba right above your belly button. Contract your abdominals while pushing your fingers down.  A 1-2 finger gap is normal.  If you have more than a 2 finger gap, make sure to let your doctor know.  If your doctor still gives you permission, you can modify your ab workout by splinting your abdominals with your hands when doing ab work to keep your muscles from spreading further apart.

This is not a reason to stop all abdominal exercise, only to modify them.  The MommyShape workouts contain modified abdominal workouts that are safe for pregnancy. Working your abdominals will make your labor easier and could help speed your recovery after birth.



Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a compression of the median nerve, which goes through the carpal tunnel in your wrist.  In your last trimester, tendons and soft tissue in your carpal tunnel may swell, causing your thumb and first two fingers to feel numb and tingle.  

Flexing your hand down for thirty to forty-five seconds at a time and applying ice may help.  Wearing wrist splints at night can also be helpful.  Should you suffer from Carpal Tunnel Syndrome, either avoid exercises such as push-ups and tricep dips or do these exercises using fists instead of open hands. 



Weight Gain

During pregnancy, the average recommended weight gain is about 25 to 35 lbs.  Of course,it varies from person to person.  For an underweight women, it is most desireable to gainat least 28 to 40 lbs.  For an overweight person, 15 to 25 lbs., and for a very over weight person, only 15 lbs.  Using exercise and nutrition, you can monitor and control your weight gain to make sure you and your baby are staying healthy during your pregnancy.



Recommended Daily Allowances

Protein:                     4-5 servings

Carbohydrates:             6+ servings

Calcium:                 4-5 servings

Iron-rich Foods:             1-2 servings

Vitamin C:                 2 servings

Green Leafy or Yellow        3 servings
Vegetables and fruits:

Other Vegetables         2 servings
and Fruits:

Water:                     8-10 Glasses

Fat:                     1 serving


From Brigitta Gallo’s Expecting Fitness.



Postnatal Exercise Guidelines

Start off slowly!  Except for the fact that you can now lie on your back and belly, you should still treat your body as a pregnant body for the first two to three months. It takes about six weeks for your uterus to shrink back to normal size.  If you had stitches from tearing, you willneed to wait until they heal.  If you had a C-section, you’ll need to wait until your doctor removes the stitches and approves exercise. 

That being said, you can start kegel exercises as soon as possible (you should do them even if you had a C-section!).  Abdominal exercises can start a day after your delivery, including pelvic tilts and simple ab contractions while lying in bed.  If had a C-section, you’ll need to wait until your doctor approves any ab exercises.

Start walking around in short distances the next day after your delivery and slowly lengthen your walks as your body is healing.   After a healthy pregnancy and vaginal delivery, you can start mild cardiovascular exercises, yoga and sculpting exercises about 10 days after delivery. If you had a C-section, wait about 14 days.

It is very important to start slowly and listen to your body.  You know what’s best for your body.It is important to start being active, but to not overdo it.  If you exercised during your pregnancy,you’ll probably be able to start exercising sooner. Once your baby is 2 months and older, you can also start to incorporate him or her into your workout.


General Postnatal Schedule:

1 days after normal vaginal delivery, 2-3 days after C-section:
    * Kegels
    * Walking
    * Simple ab contractions
    * pelvis tilts

After 1 week:
    * Slowly increase walking length
    * Continue kegels, ab contractions, & pelvic tilts
    * slowly add in various breathing and movement exercises from “Warm-Up” and “Cool Down”
      sections of MommyShape Prenatal Complete

After 2 weeks:
    * Continue kegels, ab contractions, & pelvic tilts
    * Take regular easy walks & increase intensity as you see fit
    * Continue with the various breathing and movement exercises from “Warm-Up” and “Cool Down”
      sections of MommyShape Prenatal Complete
    * Start slowly with sculpting exercises.  You can do SOME of the beginner sculpting exercises
      from the “Sculpt & Stretch” section of MommyShape Prenatal Complete (note: most of the exercises
         in this section will still be uncomfortable and unsafe for you to do).  Start off with: plank position,
         bridge, shoulder push-ups, bicep curls, small arm circles, and downward dog.  Make sure to start off
         very slowly and add on exercises as you see fit.




Sources & Recommended Reading
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Gallo, Birgitta, and Sheryl Ross, M.D.  Expecting Fitness. Los Angeles, CA: Renaissance Books, 1999.

Berk, Bonnie.  Motherwell Maternity Fitness Plan.  Champaign, IL: Human Kinetics, 2005.

Lang, Annette.  Prenatal and Postpartum Training Fan.  Cresskill, NJ:  Benefit Health Media, LLC, 2006.

Clapp III, James F.  Exercising Through Your Pregnancy.  Omaha, NE: Addicus Books, Inc., 2002. 

The American College of Obstetricians and Gynecologists, www.acog.com

Healthline Pregnancy Guide, www.healthline.com