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Keeping Fit During Pregnancy

Back in the 19th century, pregnancy was considered a delicate condition that required confinement to the chaise longue in one's private sitting room. Today's wisdom is quite the opposite: Physical activity can do both you and your baby a world of good.

A woman who exercises is bound to weather the physical stresses and strain of pregnancy better. Moreover, working out helps you fight fatigue more effectively and motivates you to eat more nutritiously. The endorphins (feel-good chemicals produced by the pituitary gland) released during a fitness routine can give you a more chipper outlook even as your hormones take you on a roller coaster ride of mood changes. And by strengthening back and abdominal muscles, you can help ease back pain, a common complaint as ligaments stretch and your weight load increases.

Some ob-gyns have also found that expectant mothers who exercised regularly have an easier or shorter labor with fewer medical interventions. (Don't let the dream of a perfect delivery be your only motivation, however: The finding that prenatal exercise makes for better labor remains controversial, since many factors influence the length and course of labor.) Whatever the nature of your delivery turns out to be, it certainly stands to reason that mothers accustomed to physical exertion are better prepared for the rigors of childbirth.

One thing you shouldn't use an exercise program for right now, of course, is weight control. Losing weight by any means is not recommended during pregnancy.

Expect Differences 

Even if you're accustomed to regular exercise, don't expect to sweat in exactly the same way you did pre-baby. Your heart rate is higher now, for example, which means you won't have to work out as vigorously to get the same aerobic result. In fact, you'll want to take care not to overexert, since the pregnancy hormone hCG makes it much easier to get overheated now. Also, the strain on your respiratory system may make you feel winded. Another caveat: As the months go by and the hormone relaxin kicks in, your joints and ligaments soften, which may leave you more prone to falls, sprains, and other muscular injuries. All this on top of a swelling belly that throws off your center of gravity  -- and your balance.

What do these changes mean for your current routine? It's hard to issue a one-workout-fits-all dictum for expectant women. Too much depends on your pre-pregnancy condition, the nature of your activities, and how your pregnancy proceeds in terms of complications or health risks. There are guidelines, however, that can help you begin an exercise program or modify the one you do now. Regardless of the workout you choose, one rule applies to all expectant moms: Always  -- and that's with a capital A  -- review your exercise plans with your doctor or caregiver.

Starting out

"Moderation" is the operative word when you're expecting. If you weren't in shape before, now is not the time to kick off an ambitious new program. But that doesn't mean it's too late to start some type of exercise. Begin slowly  -- try parking your car farther from the office and walking the difference or meeting a friend for a daily after-lunch stroll (the buddy system is a powerful reinforcer). Or use your pregnancy as motivation for trying an easy prenatal class or an exercise that's easy on your joints, such as swimming or yoga.

Even if you're a triathlete, you'll need to make baby-friendly modifications in your exercise routine. Overdoing it can divert blood and oxygen away from Junior and make you overheated, which, like having a high fever, can affect the little guy's development. Most experts recommend keeping your heart rate below 140 beats per minute. (To find your heart rate, locate your pulse at your neck or wrist, count the beats for six seconds, then multiply by ten.) Listen to your body: If you're too breathless to talk while working out, you're pushing too hard; never exercise to the point of exhaustion; and if you feel tired or achy the next day, ease up.

Stop exercising and alert your doctor immediately if you experience any of the following: rapid heartbeat, dizziness, faintness, pelvic pain, cramping, bleeding, or shortness of breath.

Good form

About three or four months into your pregnancy, after morning sickness has subsided (hopefully) and you start feeling more like your old self, you'll probably take more pleasure in exercising. Remember, however, you're clearly not the same as you were before, and you need to follow a few new rules.

One is that you shouldn't lie flat on your back. After the fourth or fifth month, the weight of the uterus can restrict blood flow. Another important warning is one you've always seen but probably never paid much attention to: Watch your step. As your center of gravity shifts and your surefootedness begins to fail, take extra care  -- or eliminate altogether  -- activities that involve hopping or quick changes of direction, such as step aerobics, tennis, and jogging.

Standing tall 

Who would expect that you'd need to learn to stand and sit up all over again just because you're pregnant? But in a way, that's the case, especially during the second trimester. Good posture and careful movement become even more important as your bulging uterus and relaxed musculature cause your spine's natural curve to increase. This change, combined with the added weight of your breasts and your shifting center of gravity, can lead to an aching back.

The best defense is good posture, whether you're sitting, standing, walking, or exercising. It also helps to sleep on a firm mattress (if yours is more than ten years old, it may be ready for retirement). Wear shoes with a wide, low heel, such as supportive sneakers or sturdy lace-up shoes that you can adjust if your feet swell. If you sit at a desk for long periods, tuck a firm pillow between the small of your back and the chair, and elevate your feet on another chair, a box, or even a stack of books.

The Home Stretch

By the eighth or ninth month, you probably won't be able to maintain the same routine that you followed earlier in pregnancy. (Your sheer size can make getting out of a chair seem like a workout.) However, try to keep up with basic exercises, such as stretches, along with easy aerobic activities like walking or swimming. Cutting back to just three times a week instead of five or seven, taking more frequent breaks, or reducing your overall exercise time or distance can help you stay motivated.

The main thing is to continue doing something. You'll improve your mood as well as your strength for labor. Exception: You're excused from your workout schedule for the last couple of weeks before your due date. Like an athlete resting before a big event, you need to save your energy for the big day.

Postpartum fitness 

Most physicians feel it's unwise for new mothers to begin a vigorous exercise program until six weeks after they've given birth. Even then, you should get the green light from your doctor. (You'll probably find yourself too worn out during the first few weeks to bother with leotards and sneakers, anyway.)

If you've had a c-section, wait at least two weeks before attempting even simple stretching exercises, and get your doctor's advice about when you can begin abdominal work (usually four to eight weeks postpartum). If your incision hurts or pulls at any time during exercise, you're probably trying to do too much, too soon.

If you delivered vaginally, you can start the following simple exercises as early as the day after giving birth. (If you had an episiotomy, however, be sure to let your body heal before exercising.) And remember, your joints and ligaments may still be stretched out, so watch your step: Balance is still an issue.

Deep abdominal breathing Take a deep breath, then exhale slowly as you pull in your stomach muscles. Repeat throughout the day. You can do this while lying in bed, sitting, or walking, to help restore abdominal tone.

Basic stretching While lying in bed or standing, stretch your arms over your head and extend your legs out as far as possible. When you feel up to it, you can also resume the pregnancy stretches.

Kegels These pelvic-floor strengtheners help to restore vaginal tone and prevent incontinence.

Walking Start in the hospital by ambling down the hall to the nursery. Slowly increase the distance you cover, as well as your pace.

How to Protect Your Pregnant Body

Posture
Good posture and taking care with the way you move can help you avoid some common pregnancy injuries.

Standing Imagine the top of your head being pulled toward the ceiling. You'll automatically tuck in your chin, straighten your neck, lift your shoulders, and tuck in your stomach and buttocks. Take care to distribute your weight evenly on both legs.

Getting out of bed Rise slowly to prevent dizziness. While still lying down, swing your legs over the side of the bed. Then use your arms to push up your body and slide to your feet. Never bolt straight up from the waist, jackknife-style.

Lifting If you must lift a heavy object, bend at the knees, not at the hips, and keep the object close to your body. It can be difficult to hold large objects closely when you have a big belly, though, so be careful and ask for help when you need it.

Carrying children To prevent back strain, avoid carrying an older child on your hip. When lifting a child, have him stand on a stool or chair so you won't have to bend so far down.

Chill out after your work out
Relaxation techniques can also lower your heart rate and blood pressure, in addition to soothing muscles and helping you maintain an even keel mentally.

Progressive relaxation Lie down on your side and breathe deeply. Isolate individual muscle groups, tense them, and release as you exhale.

Touch relaxation Ask your partner to use gentle pressure to massage different parts of your body.

Meditation Position yourself comfortably and breathe deeply as you close your eyes and focus on an object or an image. Dim the lights or play soft music if it helps you concentrate.

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