Your Choice Fitness - Prenatal/Postpartum Fitness

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Prenatal/Postpartum Fitness

Pregnancy and Exercise

Thankfully, through plenty of research and education over the last few decades, we now understand that pregnancy is a normal process and should not be treated as a disease. Therefore, regular exercise can and should be a part of a woman’s lifestyle even while pregnant or nursing as it provides many benefits to the mother and the baby. Of course, it is always recommended that the expectant mother consult with her health care provider honestly about any and all exercise programs and goals to address risk levels and possible restrictions. It is important to note however that most physicians do not receive extensive training in the significance of exercise in general, much less in regard to pregnancy. Therefore, expectant mothers are encouraged to seek the guidance of a fitness specialist to stay up to date on the latest research and to discuss any fitness related issues on a regular basis throughout pregnancy and during the post-partum period. The physical activity readiness questionnaire for pregnancy (PAR MedEx), published in the Canadian guidelines, can serve as a starting point for discussion between the expectant mother, her health care provider and the fitness specialist. (http://uwfitness.uwaterloo.ca/PDF/parmedx.pdf)

During pregnancy, what exercise is ok and how much?
As a general rule of thumb, most expectant mothers who are experiencing a normal or low risk pregnancy, can continue their normal exercise program until symptoms indicate otherwise (see side bar). Most women naturally change their exercise routine as their pregnancy progresses due to fatigue and body changes. Such variations can be achieved by changing the intensity, duration and/or frequency of the workout as needed. Research indicates that an increase in cross training is beneficial and non-weight bearing exercises (such as swimming and cycling) are suggested to decrease the risk of injury and maintain or even improve cardiovascular endurance. General strength training exercises can be continued, however it is recommended to use resistance bands and weight machine instead of barbells and dumbbells. It is a good idea to decrease resistance while increasing repetitions to avoid premature fatigue. And as always, pregnant or not, never hold your breath when performing an exercise! Women who maintain a regular exercise program throughout pregnancy are generally able to regain their pre-pregnancy fitness levels (muscular strength and cardiovascular endurance) within only a few weeks.
Of course, some precautions have to be taken. Due to changes in the center of gravity and an increase in joint laxity, exercises requiring a lot of balance and coordination should be gradually faded out of the exercise program as pregnancy progresses. Exercises that have a high risk of blunt trauma such as water skiing or contact sports should not be performed. Temperature regulation is also of higher importance during pregnancy for the safety of the expectant mother and the baby. Therefore, exercising in a cooler environment and frequent breaks with adequate fluid replenishment are recommended. Another topic that has historically been controversial is the question whether or not expectant mothers should perform exercises in the supine position (lying on her back). The fear is that the increasing weight of the uterus and the baby could compromise the venous blood flow to the heart and therefore limit oxygen supply to the uterus. While a definite answer has yet to be found, it is advisable to limit supine exercises and use modifications such as elevating the upper body when performing crunches or performing exercises in a side-lying position.
When can exercise be resumed
post-partum?
The answer to that question depends on several factors: the expectant mothers exercise program during pregnancy, the intensity and duration of labor and delivery, and whether or not medical intervention was necessary such as stitches or surgery. In short, every woman’s body is different in the response to pregnancy, labor and delivery, and the physical and mental changes that follow. Taking care of a newborn certainly comes with challenges as well. Therefore, the best advice to give here is to talk to your health care provider about possible physical limitations and to build a good support network to overcome social and/or time limitations. A regular exercise routine can be resumed gradually as soon as it is physically and mentally safe to do so.

The weight gain concern during pregnancy

As your health care provider has most likely already told you, weight gain is a necessary part of pregnancy. Aside from maintaining normal bodily functions, an expectant mother has to also provide enough energy for the developing baby. Therefore, the urge to restrict caloric consumption for fear of not being able to lose the weight post-partum should be resisted. Research indicates that the resting energy expenditure increases by approximately 5% to 7% by the second trimester, meaning more energy is needed to support the progressing pregnancy. In other words, expectant mothers do not just simply gain weight, those additional pounds are put to good use and are very active in supporting the development of the baby.

What about exercising while breastfeeding?

Research has shown that milk volume or nutrient content is not affected by exercise. Another noteworthy bonus is that, aside from all the other breastfeeding benefits to the mother and the baby, post-partum weight loss can be greater for breastfeeding women compared to non-breastfeeding women due to the increased caloric expenditure for breast milk production (if caloric intake is relatively the same).

From a practical standpoint (and speaking from experience), for many women it can be inconvenient and difficult to exercise while breastfeeding. However, with some patience and planning, it is well worth it and can be accomplished. Try splitting up your workouts into smaller sessions after feedings when the baby is likely to take a nap. Wearing two sports bras for added support and comfort is also a good option.

For more detailed information on this topic, women are advised to discuss their concerns with a lactation consultant recommended by their health care provider.

Warning signs to discontinue exercise during pregnancy