Currently at the BBD studio we usually have several pre-natal clients which has motivated this article as the same questions tend to reoccur.

Pregnancy can very easily become an excuse not to exercise and at a time in her life when a woman needs her health and fitness she instead become deconditioned!
Certainly at the beginning you will probably feel nauseas and in no mood for exercise but later you are not sure exactly what it is even safe to do.

While exercise alone does not ensure a complication free labour and delivery, training prior to and during pregnancy enhances the strength and endurance needed at this time and will also contribute to a quicker recovery.

Because the body undergoes so many changes during pregnancy, most pre-natal women often skip exercise or are reluctant to start for fear of knowing what is right and wrong in their ‘condition’. So what should you be doing? How much? What needs to be different to your regular exercise regime?

Just as each one of us is different, each pregnancy is different. For example, one woman may suffer ‘carpel tunnel’ (weak painful wrists) throughout pregnancy, another may not at all. Exercise programs need to be tailored and modified as the pregnancy progresses and the body changes, and associated symptoms come and go.
If you know the precautions to take then you can attend and adapt your usual group exercise class or your usual workout to your new requirements and hopefully here we will give you some guidelines so that you can do this. Alternatively you may be able to find and attend a prenatal group exercise class. However in some areas these are hard to find -Cairo being one such place! In this case personal training may suit you as you can work at your own pace and level and know that what you are doing is exactly right for you.

Pregnancy should not be used as an excuse to become deconditioned at a time when you health is all important. Prenatal exercise will increase aerobic capacity (general fitness!) as well as improving energy and endurance (you are increasingly carrying around more weight!), improving digestion and elimination and improving circulation (poor circulation can be a problem during pregnancy).Exercise also leads to more restful sleep –something else that is particularly important during this stage of your life!

Improved muscular strength and endurance will increase muscular efficiency during labour and there will also be an improved range of motion, balance, co ordination, flexibility and mobility, all which can suffer during pregnancy. Improved muscle tone can not only help control weight gain but support the joints which become more flexible due to a change in hormones during pregnancy. Pregnancy can sometimes lead to permanent postural deviation and associated discomforts. Exercise can help improve posture and so prevent this. There is also the improved support of the pelvic organs.

Exercise is known to reduce tension, anxiety and fatigue and enhance feelings of well-being and self image. What better time to obtain these?
A speedier recovery will help with the increased energy demands of the newborn and less depression.

Obviously any women planning to exercise during pregnancy should get medical clearance from her doctor and after that, listen closely to her body as every pregnancy is different. Whether with a personal trainer or group aerobics instructor keep the person supervising your workout up to date with any changes and when in doubt, ask the fitness professional or your doctor. Make sure your exercise instructor is qualified in pre natal fitness and a medical history should include prior medical or orthopedic conditions. For example, the increased weight gain of pregnancy may really affect a participant with an already weak knee.

There are many reasons for NOT exercising during childbirth and I am not going to list them all here as your doctor will inform you if he considers it unsafe

However if you are generally healthy and experiencing a normal pregnancy then there is no excuse! It is better to begin an exercise program before you are pregnant as you will be able to exercise better for longer during your pregnancy. More care needs to be taken if you are totally deconditioned and an exercise novice!

So what do you need to know concerning the changes in your body and what precautions regarding exercise do you need to take?

Relaxin, estrogen, progesterone and elastin increase during pregnancy which is needed as the ligaments in the back need to be more flexible due to increase mass and weight at the front of the body. This means however that ALL joints are capable of over stretching so deep stretching to maximum resistance during exercise is not recommended during pregnancy. Also for example, when participating in cardiovascular exercise beware that ankles may easily over stretch
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Pelvic joints soften and widen which causes an unstable pelvis and change in gait (the way you walk) especially during the 3rd trimester. The separation of the joint between the two pubic bones and sacroiliac joints may even cause pain and make walking difficult at this time. This means excessive bouncing and jarring should be avoided and deep flexion of the knees as it will cause stress on already relaxed knee ligaments
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Blood volume increases up to 50% so there are increased demands on the cardiovascular system. The resting heart rate may increase as much as 15 beats per minute. Working heart rate should be measured by perceived exertion rather than traditional formulas and heart rate monitors. Pregnant women reach maximal cardiac output at a lower level of physical work than non-pregnant women So do not expect to be able to work at the same rate as pre- pregnancy! The uterus displacing the diaphragm means it is harder to take a deep breath. Pregnant women are also more susceptible to low blood pressure so cooling down properly is all the more important. Feelings of dizziness, nausea or lightheadedness may be signs of this.
Dizziness, nausea and lightheadedness may also be due to the fact that the enlarged uterus may compress on the vena cava, the large vein which returns blood to the heart. If the participant is lying in a supine position (on your back!) the fetus pushes on it, interrupting the blood flow. Therefore, roll onto your side to alleviate the symptoms and find alternative workout positions to lying on your back! It is recommended that after 20 weeks of gestation, no exercise in the supine position should be attempted

Water retention can lead to swollen wrists or ankles leading to reduced mobility. This compresses nerves running through the wrist causing pain so exercise involving weight bearing wrist flexion (as in on all fours or push ups against the wall) may produce pain.

Pregnant women are not as efficient as non-pregnant women at exchanging heat. Core temperature and the metabolism increase. So pregnant women sweat more! Still, exercise can help to dissipate this additional heat. This means it is very important to drink water before, during and after exercise, despite the concern with urinary frequency.

Diabetes can occur in the 2nd trimester when increased glucose appears in the urine or the baby is bigger than the gestational age. Exercise is the most overlooked and crucial treatment for controlling diabetes.

The weight of enlarged breasts can pull the shoulders forward so include strengthening chest muscles as part of your workout program.

60% of women find that the recti (stomach muscles) separate at sometime during pregnancy as most of the weight of the uterus falls on the abdominal wall and hormones have already softened the central seam. This is usually painless although can result in chronic back pain as the job of the abdominals is to support the lower back. Abdominals do need to be worked during pregnancy into the 2nd trimester to give support to the back. During pregnancy the curve in the back is exaggerated so abdominal work will help back pain and the hip flexors also need stretching as they shorten as the abdominals on the opposite side lengthen.

The separation can be corrected after giving birth by performing curl ups, splinting the abdominal wall by pushing the hands on both sides of the stomach if the separation is more than two finger widths. (Half to one finger width is considered normal). Oblique (waist) work such as trunk rotation (twisting) should be avoided until the separation has healed. If there is more severe separation (three finger widths or more) then compression work rather than contraction should be used, for example, pelvic tilts. If you are not sure if your muscles are separated or you need advice on ‘splinting’ during curl ups then seek the advice of a professional.

As I mentioned before, the earlier to begin exercise the better, preferably pre-pregnancy if possible which means you will probably be able to exercise more successfully during each trimester.
For more information regarding exercise and pregnancy or for a pregnancy workout’ to suit you, call Anna Louise