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Pregnancy Fitness

Athletic activity is a regular part of many expectant mothers' lives. During pregnancy, physical fitness activities provided multiple benefits to body and mind: the enjoyment of the activity, better fitness and health, weight management, stress management, improved mood, and body benefits, including improved strength and decreased pain. Exercise can make labor easier, decrease back pain, and make child care less tiring. Although there are some important changes you must make to protect your child, with modifications, most types of exercise can be continued throughout pregnancy.

As with all aspects of pregnancy, there are many factors of which you need to be aware, especially if this is your first pregnancy. Remember, pregnancy is the beginning of a new stage of your life. You are responsible not just for yourself, but also for a wonderful child. This child's well-being and health depend on you. Using your skills in health management with exercise and fitness will preserve the health of both you and your baby.

Basic Guidelines
Once you suspect or know you are pregnant, you must start to listen to your body signals while exercising. Pay close attention to the four "F" fitness factors: fahrenheit, fluids, food, and fatigue. Ignoring these factors can cause problems with the development of your baby and the health of your pregnancy.

This refers to exercising in extreme temperatures. It is very important that you do not get overheated or feel hot while exercising. Your core body temperature actually rises while you exercise in extreme heat (over 80 degrees Fahrenheit). Problems with the neurological development of your baby can occur when your temperature goes up. For this reason, saunas, hot baths, and Jacuzzis are prohibited during pregnancy. This is particularly important during the first trimester. High temperatures also accelerate dehydration, another health risk during pregnancy.

To avoid dehydration, a cause of early labor, make sure you are drinking plenty of fluids—about two cups a day more than before. During exercise, always have water or a sports drink available. You should sip at least every 10 minutes, and drink 1 cup for every 20 minutes of exercise. Your blood volume increases significantly with pregnancy and requires more fluids to maintain it.

Because pregnancy is a higher state of metabolism and you burn sugars quicker than normal, you must provide your growing baby and yourself with enough fuel at all times. Before exercising, make sure you have eaten within the past two hours, and have a snack within the half hour after. If you are exercising for longer than one hour, it is recommended that you take a break and have a carbohydrate snack at least every half-hour during activity.

Because your baby's development depends solely on your body, it is much easier to feel fatigued during exercise. Do not push yourself through this. Stop when you feel tired, and especially if you are light-headed or short of breath. You might only be able to do one-third or one-half the exercise you did when you were not pregnant; some days, especially if you are active all day, you might not have energy to exercise at all. Rest if you are tired, and do not push your exercise to extremes. On these days, instead of a hard workout, consider a 20-minute walk, a gentle yoga class, or easy cycling. Sometimes, what you might really need is a nap.

The Four "F" Fitness Factors to Consider While Exercising During Pregnancy

Factor What to Consider Detail
Fahrenheit Avoid high temperatures. You should never exercise or even relax in heat or temperatures above 90 degrees. Saunas, hot baths, and Jacuzzis are prohibited.
Fluids Drink plenty! You should never let yourself feel thirsty to prevent dehydration.
Food Food is your fuel and is used up more quickly in pregnancy. During pregnancy, you use up your body fuel stores faster; a carbohydrate snack should be eaten within a half hour of exercise and during exercise longer than one hour.
Fatigue Rest is essential to your developing baby. Fatigue is your body telling you that you need rest. Listen to your body and modify (or skip) your workout when you feel you need rest.

It is very important to discuss your athletic and workout activities, as well as your work and home schedule, with your doctor. Unless you have a chronic illness or problems with past pregnancies, you will probably be advised that it is safe to exercise in moderation. When asked for specifics, most physicians follow the very conservative and strict American College of Obstetric and Gynecology Exercise Guidelines.

Standard American College of Obstetric and Gynecology Exercise Guidelines

These guidelines are designed to reduce health risks in all women. Athletic women who start at a much higher fitness level can usually tolerate more activity than these guidelines recommend, and no specific research has shown that impact activities are dangerous in healthy pregnancies. There are many accounts of women who jog for exercise throughout their pregnancies. Although this is not recommended for everyone and certainly very few doctors will admit that it is okay, there are also no specific studies to prove that it poses harm to the developing baby.

Still, moderation is an excellent adjective for all things in pregnancy; nothing, especially not exercise, should be done to excess. If you are a high-level athlete or exerciser who routinely does more than one hour a day of exercise, one hour a day should now be your maximum. Remember, even elite professional and competitive athletes can stay well trained with less activity during pregnancy because pregnancy is a constant "training state," stressing the body to physical limits in similar ways that exercise does. If you feel you are someone who is "addicted" to exercise and are not comfortable limiting yourself to one hour a day, you should see a counselor or therapist to determine why. Your mental health is just as important to the baby's health as your physical health is.

Basic Guidelines for Exercise in Pregnancy

Your body changes to nurture the health of both you and your growing baby. The priority is to optimize blood flow and its supply of oxygen, fluid supply, nutrients, and temperature control to your baby. Just as your organs function to do this for you, they work at their maximum to do this for your baby.

Your heart rate increases to handle the larger volume of blood it pushes throughout the body in order to reach the fetus. Heart rate increases as the pregnancy goes on. By the third trimester, your heart rate can actually increase 10 to 15 beats per minute to accommodate the baby. This is demonstrated by an increase in pulse rate both at rest and while exercising.

Your blood increases in many ways: number of cells, volume (overall amount of fluid), and size of vessels. This allows it to more efficiently transport oxygen and nutrients to both mother and baby. Blood can also become slightly thicker, as it is carrying more nutrients and cells. This requires drinking increased amount of fluids to maintain proper blood flow.

Breathing can sometimes seem like work in pregnancy. Your breathing rate increases to supply oxygen to your baby and also to accommodate for your higher metabolism. Your body also becomes more sensitive to levels of humidity or change in air temperature, causing you to "overbreathe," or feel as if you are hyperventilating at times. Adding to your change in breathing is pressure on the breathing muscles (diaphragm and rib muscles) and lung space as your baby grows, making your lungs slightly smaller and less able to fully expand.

Temperature regulation is slightly impaired during pregnancy. Thicker blood and more red blood cells slow your body's natural cooling mechanism. Also, pregnancy hormones interfere with your normal thermostat that controls body temperature. This increase in temperature can be detrimental to a pregnancy, because research has shown that a fetus can develop abnormally if body temperature stays elevated for long. Therefore, you must avoid a rise in body temperature by not exercising in heat, wearing light clothing, and drinking cool fluids during exercise. If you have trouble judging your body temperature, check it with a thermometer while exercising; it should not go over 100 degrees. Exercising in heat also increases your risk of dehydration. Overheating should be avoided at all times, not just while exercising. It is for this reason that saunas, Jacuzzis, and hot tubs are prohibited during pregnancy.

Drinking more fluids is one of the most important changes you need to make to accommodate to pregnancy for many reasons, including preventing constipation, temperature regulation, maintaining increased blood flow, and higher breathing rate. Fluids are lost at increased amounts through digestion, sweat, in urine and stool, and through the lungs. Because your body system requires much more fluid when you are pregnant, it is very important to stay well hydrated.

During pregnancy, your body uses up its supplies of glycogen (stored energy) faster. The hormone changes of pregnancy require that you use carbohydrates as an immediate energy source during exercise, especially when exercise lasts longer than 45 minutes. With regular exercise, you need at least 400 to 500 more calories per day after the first trimester than you were eating before.

Body System Changes During Pregnancy

Body System Change
Heart Increased rate
Lungs Increased breathing rate, decreased lung space
Blood Increased cells, thickness, volume
Blood vessels Increased size and number
Metabolism Increases
Body temperature control Impaired
Glucose supplies Used more quickly

WARNING Dehydration can cause decreased oxygen and nutrient supply to the baby, overheating, and early labor.

Your growing baby experiences the same responses to exercise you do: heart rate and temperature go up and blood sugar supply goes down. Remember this as you are exercising and considering whether to run that extra mile in the heat (don't!). Also, when you exercise, more of your blood is going to the muscles to allow them to work, taking some away from your baby. Therefore, if you are a competitive or professional athlete who wants to stay as fit as possible, it is recommended to split your workout into two 30- to 45-minute sessions at two different times of the day to decrease an overload of stress on the baby.

Exercise Guidelines During Pregnancy

Muscles and joints change during pregnancy. They become looser and more stressed by your added weight and increased fluids in the body. Ligament looseness and increased joint flexibility occur because of the pregnancy hormones relaxin and progesterone. Also, as the baby grows, your center of gravity and sense of balance can be thrown off. This, along with ligament looseness, can lead to falls and ankle sprains as the joints lose stability, making racket sports, field sports, and running, jumping, or lunging sports more of a challenge and risk. Bouncy and forceful stretching should not be done to avoid overstretching or possibly tearing muscles, tendons, or ligaments.

Contraindications to Exercise
Medical problems that might restrict your exercise in pregnancy include heart or lung problems, infections, anemia, metabolic diseases, high blood pressure, bleeding, and problems with your cervix. If you have an eating disorder or trouble keeping weight on, your exercise should be limited. Problems with prior pregnancies or history of miscarriages might also impose restrictions on workout activity. Also, high levels of physical activity at work or home can limit exercise.

Reasons Not to Work Out in Pregnancy, as Determined by Your Doctor

Warning signs to stop exercising completely include bleeding or fluid from the vagina, unusual swelling of the arms or legs, headache, dizziness, light-headedness, stomach pain, back pain, nausea and vomiting, contractions, heart palpitations, and severe shortness of breath. If these symptoms continue after resting for one hour, call your doctor right away.

Warning Signs to Stop Exercising

In Summary Remember: Just as pregnancy is a time for growth of a baby, it is a time to preserve and maximize your own health. Regular exercise is an integral part of that, but it should be healthy exercise, not exercise to exhaustion. You should be eating well, including enough calories and a well-balanced diet. You should be in tune with your body and call your doctor if you have any questions or notice strange symptoms. Allow yourself rest if you are feeling tired, sore, or ill. Remember that pregnancy actually improves fitness and metabolic performance; you can maintain your high level of cardiovascular fitness with less exercise.

From The Active Woman's Health and Fitness Handbook by Nadya Swedan. Copyright © 2003 by Nadya Swedan. Used by arrangement with Perigee, a member of Penguin Group (USA) Inc.

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