Sunday, February 3, 2019

Safety Precautions for Exercise During Pregnancy

The New 2019 Canadian Guideline for Physical Activity Throughout Pregnancy gives the following advice 

  • Avoid physical activity in excessive heat, especially high humidity.
  • Avoid activities which involve physical contact or danger of falling.
  • Avoid scuba diving.
  • Lowlander women (ie living below 2500m) should avoid physical activity at high altitude (>2500m). Those considering physical activity above those altitudes should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and fetal outcomes.
  • Those considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and fetal outcomes.
  • Maintain adequate nutrition and hydration- drink water before, during and after physical activity.
  • Know the reasons to stop physical activity and consult a qualified healthcare provider 

Reasons to stop physical activity and consult a qualified healthcare provider 

  • Persistent excessive shortness of breath that does not resolve on rest.
  • Severe chest pain.
  • Regular and painful uterine contractions.
  • Vaginal bleeding.
  • Persistent loss of fluid from the vagina indicating rupture of membranes.
  • Persistent dizziness or faintness that does not resolve on rest.

What are the contraindications to exercise during pregnancy?

What are the contraindications to exercise during pregnancy?

The first list is Relative Contraindications.  This means that whether or not you should be active is relative to other factors and you will work with your healthcare provider to decide what is the best choice for you.
  • Recurrent pregnancy loss
  • Gestational hypertension
  • A history of spontaneous preterm birth
  • Mild/moderate cardiovascular or respiratory disease
  • Symptomatic anemia
  • Malnutrition
  • Eating Disorder
  • Twin pregnancy after the 28th week
  • Other significant medical condition

The second list is Absolute Contraindications.  This means that you should not exercise during this pregnancy if you have any of the following:
  • Ruptured membranes
  • Premature labour
  • Unexplained persistent vaginal bleeding
  • Placenta previa after 28 weeks’ gestation
  • Pre-eclampsia
  • Incompetent cervix
  • Intrauterine growth restriction
  • High-order multiple pregnancy (ex. triplets)
  • Uncontrolled Type I diabetes
  • Uncontrolled hypertension
  • Uncontrolled thyroid disease
  • Other serious cardiovascular, respiratory or systemic disorder
These lists come from the 2019 Canadian Guideline for Physical Activity Throughout Pregnancy.

Why Frequency Matters

One of the most notable prenatal exercise guideline changes for 2019 is Frequency.  Where as the previous guidelines from 2003 recommended 3-4 days/week, the new 2019 Canadian Guideline for Physical Activity Throughout Pregnancy recommends exercising at least 3 days of the week, but ideally most days of the week. 

Why the change?

First, after an extensive research review, the guideline panel could demonstrate that being active most days of the week during pregnancy is safe.

Second, the panel could confidently declare that exercise during pregnancy can reduce gestational diabetes, gestational hypertension and preeclampsia by 40%. This benefit is directly related to frequency.

If you have had gestational diabetes, you know that one of the things your healthcare provider asked you to do, was move your body daily.  This is because exercise helps to stabilize blood sugar and regulate insulin.  It also helps with healthy weight gain, which is a life-style factor for developing gestational diabetes.

Third, regular exercise is more effective than sporadic exercise when it comes to preventing and managing depression and anxiety.  Aim to do something each day.  It can be a simple as a walk or as organized as attending a Fit 4 Two class

If need some motivation to exercise more frequently, consider registering for more than one Fit 4 Two class a week.  Our participants tell us that registering for 2-3 classes a week helps them to stay on track.  If you do not live where we offer programs, check out our online fitness programs

Pelvic Floor Success

The pelvic floor is made of several muscles that support the bladder, uterus and rectum while allowing the urethra, vagina and anus to pass through.  This prevents pelvic organ prolapse while allowing for normal body functions like urination, menstruation, sexual intercourse, vaginal birth, passing gas and bowel movements.

A healthy pelvic floor:
  • functions well with or without conscious contraction and relaxation. 
  • can contract and release consciously and unconsciously
When doing pelvic floor exercises, it is important to remind yourself:

  • Contract on the exhale.  Work with your breath.
  • Release and expand on the inhale
  • The release is as important as the contraction
  • Working with your breath will take practice
  • Try different positions
  • When you are starting out, 50% success is 100% success
When we inhale, our lungs will with oxygen and our diaphragm bears down. This increases the pressure inside our torso in all directions.  We call this increased intra-abdominal pressure. It is difficult to obtain a quality pelvic floor contraction when working against intra-abdominal pressure.  Instead, we inhale to expand and exhale to contract.. 

Another benefit of working with our breath, often called 'core breathing', is that we can give equal focus to the contraction and the relaxation/expansion. Historically, the emphasis was put on the contraction alone. We know now that being able to consciously release our pelvic floor is just as important as being able to consciously contract it. 

Here are are couple of our favourite pelvic floor exercises.  All our Fit 4 Two classes include pelvic floor work.  If you haven't tried a class, please join us for a free trial.  If you do not live in an area that Fit 4 Two serves, check out our online programs. 

The Jelly Fish
Visualize a jelly fish contracting and expanding.  Your pelvic floor is a jelly fish. Inhale to prepare 1-2, 3, 4.  Exhale, slowly contract your jellyfish. Inhale, slowly expand your jellyfish.  Exhale contract 2, 3, 4.  Inhale expand 2, 3, 4. Do 10X.

The Diamond
Visualize a line from your pubic bone, to your right sitting bone, to your tail bone, to your left sitting bone, back up to your pubic bone.  This will make the shape of a diamond.  Inhale 1,2,3 4.  Exhale contract your diamond, 3, 4.  Inhale expand your diamond, 3, 4.  Exhale diamond comes up, up, up.  Inhale diamond goes down, down, down. Do 10X.