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It is equally important to know the kind of exercises that can be performed and the duration as well as the extent of exercising according to the stages. Normally, during pregnancy, a woman’s weight increases by about 10-15 kg and, the basal metabolic rate and heat production also increases. Likewise, changes are also observed in the posture, gravity and balance and, the joints and ligaments become lax and hyper mobile. Apart from pressure changes, there is an increase in blood volume, heart rate, chest circumference and the size of the kidneys. Infact, pregnancy is not an illness. It is a time of tremendous musculo-skeletal, physical and emotional changes all of which can be considered as normal. Thus, exercising in pregnancy need to be planned and advised according to the health of an individual.
General Exercises in Pregnancy
In the first semester of pregnancy ranging between 0-3 months exercises such as walking, swimming, cycling, low impact aerobics, pelvic floor exercises and gentle abdominal exercises are recommended only if a woman does not have any health complications.
In the second semester starting from 3-6 months of pregnancy, walking , swimming , cycling , pregnancy backstretches , pelvic floor and abdominal bracing exercises and exercises on the back are recommended , but not for more than 5 minutes for each exercise.
From the third semester , 7-9 months , walking , swimming if comfortable , water aerobics , breathing exercises and exercises on the back are recommended , but not for more than five minutes for each exercise.
Advantages
- In early pregnancy, the continuation of exercises helps in preparing for the new baby, improves on emotional stability and helps to avoid the early symptoms of pregnancy.
- It also improves on the digestive problems such as gastritis, constipation, and helps in avoiding hemorrhoids.
- The breathing exercises help in easing the labour and delivery pains.
- Hip flexibility is important for normal labour without surgery.
- Abdominal exercises help to avoid muscle separation and make the pelvic muscles strong enough to carry the weight of the pregnancy and avoid prolapsing of the uterus.
Precautionary Measures
- Avoid overeating and exercising in very high temperatures.
- Avoid spas, saunas, hot bath, and overheated pools.
- Keep hydrated by plenty of water.
- Eat foods rich in carbohydrates at least 1-2 hours before exercising.
- Empty the bladder before exercising.
- To help prepare the body for exercises, and to prevent blood from pooling in the legs or causing cramps, perform warm-ups and cool-downs longer than normal.
- Avoid stopping suddenly while exercising as this can result in low blood pressure, fainting or light-headedness.
- Stop exercising if you feel a pain, discomfort, pelvic pressure, dizziness, lethargy, headache, nausea, excess fatigue, blurred vision, contractions and when the baby’s movements are reduced.
- It is preferable to exercise regularly at least 3 times a week.
- Refrain from exercising if you cannot maintain your balance due to overweight and shifting, which may result in a fall or injury to both the mother and the foetus.
Antenatal exercises: The following exercises are important.
- Posture (See illustration 1): Tuck the tummy in and stand tall while standing up.
- Rest: Try to rest for 30 minutes everyday by elevating your legs while sitting or lying and occasionally, bend and stretch the ankles.
- Cross leg sitting: Sit with the legs crossed for 10 minutes relaxing the hips, particularly when reading, watching TV, chatting or doing some domestic work.
- Pelvic floor exercise: While sitting, standing or lying, slowly pull up and tighten the muscles around the birth canal to the count of 5, hold and slowly release to the same count. Repeat 3 times. The exercise can also be practiced by stopping the stream when passing urine.
- Abdominal exercise :
(a) (Illustration 2 ) Tilting the pelvic lie as shown in the figure. Breathe in, and as you exhale tighten the tummy and flatten the back on the bed. This helps in shortening the distance between the pelvis and the lower ribs. The same exercise can be repeated while standing.
(b) Tummy curl-ups (See illustration 3): Lie as shown in the figure with hands resting on the thighs. Breathe in, exhale, then raise your head and shoulders and reach towards your knees, count to 5 and relax.
Oblique Abdominus (See illustration 4): Lie in a similar position as above. Breathe in, exhale, and then stretch your hands to the outside of the left knee, lifting your head and shoulders. Count to 5 and then relax. Repeat for the other side.
Note: There are certain exercises that are not safe in pregnancy and have adverse effects. They include bilateral straight leg raisings, hip extensions and unilateral weight bearing exercises.
Absolute contradictions for exercise programmes
Unless advised, pregnant women should not exercise in case of contradictions, such as bleeding in early pregnancy, a history of a previous miscarriage, placenta previa, rupture of membranes, premature and labour / contractions, ill health and intrauterine growth retardation.
Likewise , in certain cases , there is need to have supervised exercises and regular follow-up by a physical therapist in helping to avoid joint stiffness and muscular problems caused due to immobility and other pregnancy complications.
Author: Dr.Veronica Saldanha