Exercise is great for you both. Here'’s how to do it safely all through the season.
During my two pregnancies, I never felt more alive and in shape. Always active, I was determined to not become a slouch just because I had developed the shape of a Volkswagen Beetle.
Four days a week, I walked three miles around a nearby reservoir. Two nights a week, I did prenatal aerobics at Jane Fonda’s now-shuttered Beverly Hills Workout Studio (OK, so I’m over 30). Exercising with other pregnant women was a great incentive; it kept me fit, sane and on the go, especially during that less-than-fun ninth month. I doubt I could have endured two mind-bending labors had I not been working out.
I stayed in shape because I instinctively felt it was the best thing to do for my pregnant self. My doctor said that since I had been exercising before, it was all right to continue, as long as I didn’t overdo it. In other words, I should stop when tired and not add anything to my usual routine. Today, that attitude has become established as scientific doctrine. Working out not only is safe, research confirms, but also extremely beneficial for your body and state of mind.
Maternal benefits galore
Here are a few findings that support prenatal exercise.
- Women who stay fit improve posture and muscle tone.
- Prenatal exercise may give women more strength and stamina for the hard physical work of labor — provided the exercise is continuous, weight-bearing and pursued at 75 percent of the woman’s prepregnancy level. Second-stage labor has been shown to be shorter for exercising women (compared with nonexercisers), according to research by James F. Clapp III, M.D., a professor of reproductive biology at Case Western Reserve University in Cleveland. He speculates that exercise may make the uterus more elastic, thus speeding labor along. His research shows exercisers also were less likely to need pain medication and medical interventions such as forceps deliveries and Cesarean sections.
- Prenatal exercisers may have less risk of gestational diabetes because of more stable blood glucose levels.
- Cardiovascularly, the benefits are “dramatic,” says Michael Collins, M.D., an obstetrician-gynecologist in Portland, Ore., and a faculty member of Oregon Health Sciences University. “If you are aerobically fit, your ability to store oxygen and meet the demands of day-to-day activity is greater.”
- Studies confirm that active women feel a greater sense of control during pregnancy and have a better self-image. They’re even less likely to have negative feelings about sex when they’re pregnant.
What about baby?
That’s all fine for Mom — but what about the effects of exercise on baby? While there is much that medical experts still don’t know, because of ethical concerns about women participating in research that might harm their unborn babies, there’s reassuring news on that front, too.
In the largest study to date, published in the American Journal of Epidemiology in early 1996, researchers from the Missouri Department of Health surveyed nearly 3,000 women who recently had given birth, asking about their general health, work activities and exercise regimen. They found that the amount of exercise or daily activities an expectant mother engaged in did not increase the risk of fetal death or a low birth weight baby. Of their subjects, about 23 percent had exercised three or more times a week in their first trimester, 19 percent in their second trimester and 16 percent in their third trimester. More than half the women walked for a workout, while the rest did something else.
Earlier studies already had eased various concerns, such as the worry that exercise would cause a woman to suffer from hyperthermia (excessive overheating), which can trigger fetal distress and premature labor. In fact, women who exercise during pregnancy have been shown to dissipate heat more efficiently, because their well-trained bodies start sweating at a lower body temperature.
Best of all, a mother’s exercise may have benefits for her baby down the line, according to a new study by James Clapp. He compared the offspring of 20 women who did moderate aerobic exercise (greater than 55 percent of maximum capacity) at least three times a week for 30 minutes or more during pregnancy to the offspring of 20 women who only walked normally while pregnant. At age 5, the children of the exercisers had less body fat and higher scores on tests of general intelligence and oral language skills.
Only four years ago, the American College of Obstetricians and Gynecologists was advising pregnant women not to exercise longer than 15 minutes at a time, and to keep their heart rate below 140 beats per minute. Among other fears, doctors believed that strenuous exercise could trigger early labor or divert blood flow from the fetus. In 1994, though, after a review of the research, ACOG dropped the heart-rate and duration restrictions and affirmed that women could continue to do moderate exercise throughout pregnancy — with their doctor’s blessing, of course, and barring certain medical complications.
That doesn’t mean that health debates don’t still remain. Some fitness experts still feel that exercise puts women at greater risk of joint injury, due to the effects of the pregnancy hormone relaxin, which loosens the cartilage in the pelvis joints so the baby’s head can pass through the birth canal. Scientists have not been able to show that relaxin affects other joints in a pregnant women’s body, however. While pregnant women may be more susceptible to joint injuries, relaxin is not the culprit: It’s women’s heftier size in late pregnancy, says Michelle Mottola, Ph.D., director of the R. Samuel McLaughlin Foundation Exercise and Pregnancy Lab at the University of Western Ontario in London, Ontario, Canada.
Much more study of exercise and pregnancy remains to be done. “We’re still lacking good information for the highly trained woman,” says James Pivarnik, Ph.D., a professor of exercise science and osteopathic surgical specialties at Michigan State University. Experts also are largely unsure about how much exercise pregnant women should do, but at least part of the answer lies with the individual’s conditioning and motivation.
“We’ve had women continue to run and do marathons while pregnant,” says Collins, who works with prenatal exercise therapists in Portland, Ore., “but we don’t espouse that. Pregnant women aren’t always aware of the warning signals of overheating or dehydration.”
The new rules
No matter how fit you were before becoming pregnant, be sensible about your pregnancy exercise program. Consult your physician for guidance, and if you’ve been sedentary, start slowly.
“If you’re unconditioned, this is not the time to begin doing extremely heavy exercise,” says Robert McMurray, Ph.D., a professor of exercise, sports science and nutrition at the University of North Carolina at Chapel Hill. The best aerobic exercise for women who have not been active is swimming, water jogging or plain old walking, according to McMurray.
Follow these other basic rules:
Be consistent Three or more workouts a week is preferable to the occasional one.
Warm up and cool down Consider that a regular part of your exercise regimen.
Listen to your body If you start to feel dizzy or tired or short of breath, take a break.
Don’t push too hard In pregnancy, your body must work harder to deliver oxygen to the fetus. Take the “talk test” as you exercise — if you can carry on a conversation comfortably, you’re fine.
Watch your heart rate Although the heart rate normally increases by about 15 beats per minute during pregnancy, if it goes above 150 during exercise, you may be overdoing it. At that point, blood may be shunted away from the uterus and the fetal heart rate may lower or even rise.
Stay cool To avoid hyperthermia, stay hydrated and don’t work out in extreme outdoor heat or in a hot, stuffy room.
Now that you know exercise is good for you, on these pages we offer a great strength workout, starting on page 57, which will give you a full-body tone-up while conditioning the key abdominal and pelvic muscles that will be most taxed during pregnancy and delivery. Designed by Gail Black, R.N., a certified personal trainer and Susan Cannady, R.N., co-founders of Fitness for Two in Huntington Beach, Calif., the program can be used throughout all trimesters with minor modifications.
“Women should prepare for labor just like any athletic event that utilizes strength, stamina and relaxation,” says Black. As a bonus, you’ll keep your arms and legs looking great, even as your belly gets bigger.
We’ve also included expert tips, along with important precautions, on some great cardiovascular exercise you can do indoors as well as out this winter, including swimming, cardio work on machines, hiking and a variety of snow sports activities. Don’t be intimidated by the cold; winter is actually the perfect season to exercise, according to Collins. “In contrast to summer, you don’t have to be concerned about overheating,” he says. “While you’re pregnant, your core body temperature is about a degree higher, so you tend to warm up quickly and stay warm.”
Remember: Pregnancy is not the time to improve your fitness, but to maintain it. Start exercising now, and when you’re in labor or carrying around your new little bundle of joy, you’ll be glad you did.
1. Military press Sit erect on the edge of a sturdy chair, knees bent and feet flat on the floor, separated about hip-width apart. Hold a dumbbell in each hand, elbows bent, forearms parallel and palms facing each other. Contract abdominals and squeeze shoulder blades together to help maintain your sitting posture. Straighten your arms up and overhead without locking your elbows, keeping arms separated. Then bend your elbows, lowering them to the starting position. Repeat. Weight: 3–l0 pounds. To modify: As you need more support, sit back on the chair seat. If you feel pain in your shoulders or wrists, decrease the weight. Strengthens shoulders, upper back and triceps.
2. Seated row Sit erect on the floor, legs extended in front of you, knees slightly bent, heels on the floor. Wrap a resistance band around both feet and hold one end in each hand. Keep your elbows bent close to your sides, palms facing each other. “Choke up” on the band to increase resistance. Pull band toward waist, using middle back muscles, until elbows are just behind you. Don’t lean forward. Return to starting position and repeat. To modify: Hold the band closer to the ends. Strengthens shoulders and middle back.
3. Upper-back squeeze Sitting cross-legged on the floor, hold the ends of a resistance band in each hand at chest height, palms facing forward, wrists in a neutral position. Your arms should be slightly bent and hands slightly wider than your shoulders. Without using your biceps, squeeze shoulder blades down and together to bring the band toward your chest; this will move your elbows just behind your shoulders. Release gently to starting position and repeat. To modify: Sit in a chair with your back supported. Strengthens upper and middle back, and rear shoulders.
4. Press-back Stand close enough to a wall that you can place your forearms on it at chest height for support and still keep your back in a neutral position. Tie a small loop in the center of a resistance band, placing 1 end around your right ankle and the other around your left foot at the arch. Keep your body weight on your right leg, knee slightly bent. Bend your left knee to a 90-degree angle so your calf is parallel to the floor and your knee is under your hip; you still have the band around your arch, with tension on it. Press your left leg backward without arching your back; contract your buttocks and hamstrings. Release to starting position, do reps, then switch band position and repeat with right leg. To modify: If you can’t maintain the position without arching your back, do the exercise lying on your side, just prior to doing exercise 7. Do this exercise first without the band to establish good form, then add the band, Strengthens buttocks and hamstrings.
5. Plié with full squat Stand facing the back of a chair, feet slightly wider than hip-width apart, toes turned out. If you need to, hold top of chair for balance. As you progress, place hands on hips. All levels: Contract abs; drop tailbone toward floor. Lift chest and relax shoulders. With body weight toward heels and back straight, bend at hips and knees and lower into a plié, maintaining back position. Return to starting position. Repeat. After the last rep, hold onto chair for support and lower into a squat; keep heels on floor and buttocks close to heels. Hold at least 30 seconds; build up to 5 minutes. To come out of the squat, let go of chair, sit on buttocks, then roll onto side and all fours. Bend 1 knee and stand. To modify: Hold chair for balance during plié. While squatting, do a Kegel; hold it for 10 seconds. Build up to l0–20 Kegels. Strengthens thighs and buttocks; increases leg and pelvic flexibility for labor.
6. Pelvic tilts Kneel on all fours, feet flexed, toes on the floor. Keep your knees in line with your hips, hands in line with your shoulders. Contract abdominals so that your spine is in a neutral position; relax your shoulders. Contract even further to tilt your pelvis down and forward. Release and repeat. To modify: If your wrists hurt, rest on your fists rather than the palms of your hands. Strengthens abdominals.
7. Side-lying abduction Lie on your left side, head supported on your upper arm. Bend legs at a 45- to 60-degree angle, pelvis in neutral position. For added resistance, hold dumbbell on right thigh (or place a resistance band, tied in a loop, around both ankles). Keeping hips squared and right knee forward, toes relaxed, lift your leg slightly higher than hip height without rolling forward or backward. Lower to starting position, do reps and repeat with other leg. To modify: Don’t lift leg so high. Place a pillow over your arm as a head rest. Strengthens outer hips.
8. Ab training Sit cross-legged against a support that makes contact with your entire back. Let your arms relax at your sides, or place them on your belly to feel your breathing and abdominal contractions. Inhale, expanding your belly. Then exhale slowly, contracting your abdominals inward. Count out loud for 30 counts to make sure you’re not holding your breath. Then, with your belly pulled fully inward toward your spine, contract your abs again, now with small inward pulses for l0 slow counts. Strengthens abdominals.