Physical activity during pregnancy

The importance of physical activity during pregnancy Physical activity is beneficial for both the unborn child and the mother Increase the likelihood of a long-term, healthy lifestyle It is important to drink plenty of water and pay close attention to your body and how you feel

Pregnancy changes how your body responds to exercise There are 5 main areas that you may notice changes, which are: Breathing: body requires more oxygen, your belly presses on your lungs, shortness of breath Heart rate: harder and faster Body temperature: sweat at a lower body temperature Balance: more unbalanced Joints: the hormones released during pregnancy can make your joints more relaxed

Here are some fun and safe exercises that are great during pregnancy

Video: great core workout for pregnant moms http://www.youtube.com/watch?v=rU4bMJu4uFA

The myths about exercising during pregnancy Low birth weights Not enough blood getting to the fetus Neural tube defects It will hurt the unborn child However none of these myths have any evidence to back them up

Recommendations for physical activity during pregnancy The most current guidelines recommend moderate (30 or more minutes of exercise per day at least 5 days a week), low impact, aerobic exercise at least three times per week Mild to moderate - not physically active before pregnancy Brisk walking, bicycling, vacuuming, gardening, or any activity that causes small increases in breathing or heart rate Moderate to high - physically active before pregnancy Incorporating vigorous exercise and light weight training (jogging, running, lifting light weights, etc.)

Benefits to exercising during pregnancy - mother Decrease the risk of preeclampsia by lowering blood pressure Reducing gestational weight gain Improving placenta growth and blood flow to the area Reducing swelling Reducing the likelihood of operative delivery Reducing the risk of gestational diabetes Improving overall mood Reducing pregnancy discomforts (back pain, leg/ankle/foot swelling, etc.) May also have a role in preventing chronic diseases such as type II diabetes and hypertension

Gestational diabetes Mellitus (gdm) Gestational Diabetes Mellitus (GDM) is a type of diabetes obtained during pregnancy. Studies show that 40% of mothers who are diagnosed with GDM are diagnosed with type II diabetes within 4 years. Being physically active during pregnancy - 48% reduction in the diagnosis of GDM If the women were active before and during pregnancy - 60% reduction in the diagnosis of GDM The more one exercised and the more vigorous the exercise, the greater the reduction of risk of GDM

Gestational weight gain (gwg) Gestational Weigh Gain (GWG) refers to the amount of weight that the mother has gained during pregnancy. Increased GWG and weight retention increases the cases of obesity, diabetes, and hypertension Most women with an increased GWG give birth to an over weight infant. Therefore, pre- pregnancy overweight and obesity may be passed on from the mother to her offspring.

Preeclampsia Preeclampsia refers to hypertension (an increase in blood pressure) during pregnancy. Preeclampsia is the second leading cause of death during pregnancy and delivery Preeclampsia can cause many complications during the course of pregnancy, including preterm delivery Women who exercise at least 25 times per month have a 33% to 35% decrease in risk of preeclampsia

Reduced risk of caesarean delivery Exercising during pregnancy reduces the risk of caesarean delivery and reduces complications during the procedure, such as: Infections of the uterus Surgical wound complications Heart and lung conditions Stroke Longer hospital stays Higher readmission rates

Reduced risk of depression and anxiety Exercise, whether during pregnancy or not, reduces the risk of depression and anxiety by increasing self-esteem and perceptions of self-worth. Pregnant women who exercised during their pregnancy reported that the best benefit was their improved mood and increased self-esteem

Benefits to exercising during pregnancy - fetus Women who exercise during pregnancy are benefiting, not only themselves but their unborn child as well. The most significant benefits to the fetus are: A healthy birth weight Reduced risk of being born preterm/premature

Birth weight Exercise during pregnancy leads to healthy birth weight by reducing the risk of delivering an overweight child without increasing the risk of delivering an underweight child Reduces the risk of delivering an overweight child by 30% It is plausible that this normalization of birth weight may translate into improved child health outcomes

Reduced risk of being born preterm/premature Exercise during pregnancy can decrease the risk of preterm delivery by improving placentation and increasing blood flow to the fetus Women who engaged in vigorous activity during the first trimester had significantly less chance of giving birth to preterm infants. This effect was even greater when women continued to exercise vigorously into the second and third trimester.

Unsafe physical activities during pregnancy Check with your health care provider when choosing physical activities during pregnancy. It is generally recommended to avoid: Anything that may cause injury or put you at risk for falling Any activity that may cause you to get hit in the belly Bouncing movements Scuba diving Exercising at high altitudes (more than 6000 feet) Exercising outside on hot/humid days Saunas, hot tubs, and steam rooms

Contraindications to exercise in pregnancy However, there are some circumstances when the risk of exercise outweighs the benefits, such cases include: Heart problems Lung disease Incompetent cervix Pregnant with multiples (at risk of premature labor) Ongoing second- or third-trimester bleeding Placenta previa (when the placenta attaches itself at the lower areas of the uterus) after 26 weeks of gestation Premature labor during the current pregnancy Ruptured membranes Preeclampsia (pregnancy-induced high blood pressure)

Contraindications to aerobic exercise in pregnancy In the same sense, there are some exercises that should not be performed under certain circumstances. In the case of aerobics, this includes: Severe anemia (low blood cell count) Heart problems Respiratory problems (Ie. chronic bronchitis) Poorly controlled type 1 diabetes Extreme morbid obesity Extreme underweight (body mass index < 12) History of extremely inactive lifestyle Placenta previa (when the placenta has attached in the lower areas of the uterus) Poorly controlled hypertension (high blood pressure) Physical limitations Poorly controlled seizure disorder Poorly controlled hyperthyroidism (over active thyroid) Heavy smoker

Signs to stop exercising in a normal pregnancy If a normal, healthy pregnancy has been obtained but any of the following symptoms are present, exercise should be terminated immediately and you should see your doctor: Vaginal bleeding Ruptured membranes Shortness of breath at rest Dizziness Severe headache Chest pain Muscle weakness Calf pain or swelling (need to rule out thrombophlebitis – swelling of the vein due to blood clot) Preterm labor Decreased fetal movement Amniotic fluid leakage

Video: exercise during pregnancy http://www.youtube.com/watch?v=2LTj7FZ520k

WEBSITES THAT PROMOTE PHYSICAL ACIVITY DURING PREGNANCY www.walksport.com/home.htm http://babyfit.sparkpeople.com/register.asp www.babycenter.com http://yoga.about.com/od/prenatalyoga/ www.strollerfit.com/ www.activevideos.com/prenatal.htm

REFERENCES Mudd, L. M., Owe, K. M., Mottola, M. F., & Pivarnik, J. M. (2012). Health benefits of physical activity during pregnancy: An international perspective. Med Sci Sports Exerc, 14. Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy: a systematic review. Current Opinion in Obstetrics and Gynecology, 24(6), 387-394. Wadsworth, P. (2007). The benefits of exercise in pregnancy. The Journal for Nurse Practitioners, 3(5), 333-339.