In previous years, women were encouraged to reduce exercise while pregnant due to concerns that it may have a negative effect on the outcomes of the pregnancy (e.g, poor foetal growth, premature delivery, miscarriage and musculoskeletal injury). However in current years, these concerns have not been substantiated and recommendations by The American College of Obstetricians and Gynecologists (2015) suggest that this approach was overly conservative. Currently, pregnant women are encouraged to accumulate a minimum of 20 to 30 minutes of moderate-intensity exercise on most—if not all—days of the week in the absence of medical or obstetric complications. It is important to consider that if women are new to exercise, they may need to set goals for working up to 20 to 30 minutes of moderate-intensity exercise and that the benefits of being physically active may occur with amounts below this target range.
At Blue Mama's We collaborate with pregnant clients during the goal-setting process helping them set realistic goals that focus on self-efficacy, enjoyment, and finding success, while working up to the specific exercise recommendations. Although there are many benefits to beginning or maintaining an exercise program while pregnant (e.g., improving or maintaining physical fitness, reduced risk of gestational diabetes in obese women, weight management, reduced risk of pre-eclampsia and cesarean deliveries, and enhanced psychologic well-being), it is still important for pregnant women to receive a thorough clinical evaluation before starting a new exercise program.
Examples of moderate-intensity physical activity include:
Examples of exercises that should be avoided during pregnancy include:
Activities with a high risk of falling
Pregnant women should not exercise if any of the following health conditions are present:
Risk factors for pre-term labour
Premature rupture of membranes
Fitness professionals should also be familiar with both absolute and relative contraindications to exercise.
Exercise Guidelines for pregnant clients:
Do not begin a vigorous exercise program shortly before or during pregnancy.
If you have been previously active, continue current program during the first trimester to a maximum of 30 to 40 minutes per day as tolerated.
With no previous activity, begin slowly with 15 minutes of low-intensity exercise and gradually increase to 30 minutes.
During the second and third trimester, the intensity and duration should be gradually reduced. Use the RPE scale rather than heart-rate monitoring.
Avoid bouncing while stretching, activities with a high risk of falling, deep knee bends, full sit-ups, double leg raises and straight-leg toe touches.
Avoid exercise in the supine position after the first trimester.
Avoid motionless postures (e.g., certain yoga positions and the supine position).
Avoid exercise in high temperatures and/or high humidity.
Modify exercise intensity if post-exercise body temperature exceeds 100° F.
Focus on hydration.
Utilize extended warm-up and cool-down periods.
Walking or running should occur on flat even surfaces.
Wear a bra that fits well to support the breasts.
Some pregnant women may benefit from a small snack prior to exercise to help avoid hypoglycaemia.
Warning signs that warrant stopping an exercise session and physician referral before exercise is resumed:
Shortness of breath
Muscle weakness affecting balance
Calf pain or swelling
Regular painful contractions
Amniotic fluid leakage
Returning to physical activity after pregnancy also has benefits (e.g., improved maternal cardiovascular fitness without affecting milk production or composition of infant growth) and is associated with decreased incidence of postpartum depression. Although some recovery time to regain strength is required, during the initial six weeks following delivery your client could begin to slowly increase physical activity as a means of relaxation, personal time, and regaining a sense of control. Nursing women should also consider feeding infants prior to exercise to avoid the discomfort associated with engorged breasts.
The following guidelines should be followed with the postnatal client:
Obtain physician clearance.
Start with walking several times per week.
Avoid excessive fatigue.
Wear a supportive bra.
Stop session if unusual pain is experienced.
Stop session if vaginal bleeding is more than normal.
Drink plenty of water.
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