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Pregnant? Don't Forget to Exercise
It wasn't all that long
ago that the moment a woman learned she was pregnant, exercise
was out and pampering and rest were in.
It was imperative, the thinking went, that the mom-to-be do
nothing to risk her baby's development.
Today, doctors say not only is it OK to exercise, but women
should stay active as a way to ensure a smoother, healthier pregnancy
and delivery, while possibly reducing the risk of gestational
diabetes.
Dr. Mary Jo O'Sullivan, a gynecologist and professor emeritus
at the University of Miami in Florida, said that in the past, "women
were catered to when they became pregnant," because it was assumed
physical activity would harm the fetus.
But recent research has found that fetal heart rate and birth
weight don't suffer when a healthy woman exercises moderately.
Nor does exercise harm the placenta, the organ that grows on
the wall of the uterus and supplies blood and nutrients to the
baby, O'Sullivan said.
"In a basically healthy woman, a moderate exercise program does
not seem to have a significant impact on the pregnancy as far
as the fetus is concerned," she said.
Karen Fehr, division chairwoman of health and exercise science
at Paradise Valley Community College in Phoenix, added, "Exercising
helps women to have the energy levels and endurance to maintain
strength during the changes in the body due to pregnancy."
What's more, exercise can help reduce some of the typical pregnancy
discomforts, such as backache, constipation, fatigue, bloating
and swelling. And it boosts a woman's mood, energy level and
self-image, while improving her posture and sleep, according
to the American College of Obstetrics and Gynecology.
Fehr added, however, that exercise has to be tailored to a pregnant
woman. For instance, pregnant women shouldn't exercise on their
backs because the baby's weight can press too much on the lungs
and arteries. Also, exercises have to account for changes in
balance and body mechanics because of the extra weight of the
stomach and lower center of gravity. Also important is proper
exercise technique, she added.
During pregnancy, a hormone called relaxin is released into
the body to relax the uterus to make room for the growing fetus.
But this hormone also relaxes all the other connective tissue
in the body, like the ligaments and tendons that surround the
joints.
"These hormones can cause joint laxity," Fehr said, so women
need to be careful when putting stress on their joints.
Three years ago, in response to questions about exercise during
pregnancy, the American College of Obstetrics and Gynecology
issued a set of guidelines to help women and doctors.
In general, said O'Sullivan, who helped prepare the guidelines,
swimming and walking are recommended, as well as aerobic activity
at half the level of pre-pregnancy.
Not recommended, according to the guidelines, are contact sports
or activities that carry a risk of falling, both of which could
cause harm to a fetus. These include sports such as soccer and
basketball, rigorous racket sports, and activities such as downhill
skiing or horseback riding, she said.
The guidelines also list physical conditions that preclude any
exercise, like high-risk pregnancies, second or third trimester
bleeding and heart disease, and conditions that call for caution
in exercising, like severe anemia, poorly controlled high blood
pressure or type 1 diabetes, obesity, or a previously sedentary
lifestyle.
O'Sullivan said that, despite the booming interest in exercise
among women, very few actually exercise during pregnancy.
"This is a very rough estimate, but no more than 15 percent
of pregnant women are exercising," she said, "and those who do
are in a higher socioeconomic group, who are generally thin,
and who are exercising pre-pregnancy."
Besides the heart, there are three muscle groups women should
focus on during pregnancy -- the muscles of the back, the pelvis
and the abdomen, according to the University of Michigan Health
System:
- Strengthening abdominal muscles makes it easier to support
the growing weight of a baby. And you'll be better equipped
to push with more strength and effectiveness during labor.
- Building up pelvic muscles will allow the vagina to widen
more easily during delivery. It may also help prevent urinary
problems after delivery.
- Working on back muscles will make them stronger, improve
posture, and lessen the strain of pregnancy on your lower back.
Fehr, who first designed an exercise class for pregnant women
about 15 years ago, said a big trend in pregnancy exercise today
is yoga classes.
"Yoga has become so popular that we offer it instead of regular
fitness classes. Yoga offers stress reduction and encourages
mental well-being, but you do have to supplement it with cardiovascular
exercise," she said.
For more on exercise during pregnancy, visit the University
of Michigan Health System .
SOURCES: Mary Jo O'Sullivan, M.D., professor emeritus, University
of Miami, Miami, Fla.; Karen Fehr, M.S., division chairwoman,
health and exercise science, Paradise Valley Community College,
Phoenix; American College of Obstetricians and Gynecologists
Reference
Source 62
March
15,
2005
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