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Today we know this…Pregnancy is a state of health!

In this era of prenatal fitness, most women know that exercise during a normal pregnancy is safe. Yet, when it comes to the particulars – Is it ok to work my abs? Do I have to stop running? Should I keep my heart rate low? Can I START exercising now? – these myths and misconceptions that hold women back seem to persist. I’m here to offer you a reality check on the fitness myths that just won’t die.

Pregnancy is the ideal time to get moving.
• When you’re considering activity during pregnancy, the real risk is inactivity. Inactivity, especially during pregnancy, contributes to excess weight gain, high blood pressure, increased aches and pains, and puts expecting women at a higher risk for Cesarean section and gestational diabetes.
• If you have no prenatal medical complications, as much as 60 minutes of moderate activity is safe for you to perform.
• There is no need to go any higher than a moderate rate of exertion as you can get all of the benefits from that pace.

Strength (resistance) training during pregnancy can lead to joint injury.
• While it’s an absolute truth that pregnancy fills your body with a hormone called relaxin, a low to moderate intensity strength program is safe…even for novices.
o In a 2011 study, 32 women tracked over 12 weeks showed no adverse affects while performing a low to moderate about of resistance training.
• Be mindful of your intensity to control blood pressure responses and make sure to let your doctor know if you experience any dizziness, headache or pelvic pain.
• Consider hiring a personal trainer who is experienced in prenatal training to help you get started on a safe program. Machines, free weights and body weight exercises are all ways to have a safe and healthful strength training program….and no, squats will not trigger labor!

Athletes can no longer train to the level they’re used to.
• Although your doctor (and hopefully your common sense) will not recommend an all out, full intensity workout, you can maintain your regular training program as long as you have no complications and your doctor gives you the “OK”.
• A recommendation of closer medical supervision may be a wise choice. Make sure you’re watching your core body temperature, stay hydrated, and avoid exercising in the heat of the day.
• Avoid working so hard that you can’t catch your breath but otherwise there is no need to limit your heart rate to the requisite 140 beats per minute. Decades ago, the American College of Obstetricians and Gynecologists (ACOG) recommended a ceiling of 140 heartbeats per minute for pregnant women, but the guideline was later withdrawn because heart rate differed so much from one woman to the next. Just listen to your body, make sure you can speak comfortably, be flexible and back off on days you don’t feel as energetic.

Running is unsafe during pregnancy. This is an easy one to debunk.
• You are not going to shake your baby loose, he or she is extremely safe in the amniotic fluid. As long as there are no changes in your joints and ligaments you can continue running. Again, listen to your body!

Core exercise is a no-go.
• Expecting women can absolutely perform core exercise. In fact, strengthening your core can lead to a better delivery experience and a faster recovery postpartum.

ACOG states, “Strengthening of abdominal and back muscles could minimize this risk (of low back pain) . Blood volume, heart rate, stroke volume, and cardiac output normally increase during pregnancy, while systemic vascular resistance decreases. These hemodynamic changes establish the circulatory reserve necessary to sustain the pregnant woman and fetus at rest and during exercise.

• Consider performing your abdominal exercise in a standing or kneeling or semi-upright position. Stand upright and exhale, drawing your naval in toward your spine (like you’re trying to pull up your skinny jeans!) and hold for 20 seconds. Inhale and repeat. Perform this exercise 10-12 times once or twice per day. You will thank yourself during those hours of pushing to bring your baby to the world.

The bottom line is that you are making life but that doesn’t mean that you need to put your life on hold. Throw out the old thought process that you need to be relegated to power walking and kegels (although those are SUPER IMPORTANT) and get moving!

• Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy”.
• The last guidelines stated that after the first trimester, laying flat on your back (supine position) should be avoided. In this updated version ACOG states: “Motionless postures, such as certain yoga positions and the supine position, may result in decreased venous return and hypotension in 10–20% of all pregnant women and should be avoided as much as possible.” They later describe this as avoiding being supine for a prolonged period of time. “…more than 60% of all pregnant women experience low back pain. Strengthening of abdominal and back muscles could minimize this risk.”
• Heart rate is still not listed as a reliable indicator of exercise intensity during pregnancy. ACOG states “…the use of ratings of perceived exertion may be a more effective means to monitor exercise intensity during pregnancy than heart-rate parameters.”
• Following delivery, they state; “Exercise routines may be resumed gradually after pregnancy as soon as medically safe, depending on the mode of delivery, vaginal or cesarean, and the presence or absence of medical or surgical complications.”

Getting Back to It: Exercise After Having a Baby

“The overriding knowledge is correct that most women’s bodies are very unstable at 6 weeks postpartum. Just because she is cleared by her physician doesn’t mean she is necessarily ready to run and jump. SOME women are though, so we cannot generalize EVERYONE. This is why we need to continually teach the “buffet”: 1. exercise 2. modification and then 3. challenge. To be responsible to the body that comes to us at 6 weeks, the main exercise should not be a burpee, for example. This sets the mom up for feeling like a failure or she does it when she’s not ready and can cause injury. Make the exercise something most can do, the give a progression and a regression.” Farel Hruska, Global Fitness Director, FIT4MOM

GENERAL RECOMMENDATIONS
• Begin pelvic floor rehab immediately: Kegels
• Weeks 0-2: Focus on gentle activity, begin pelvic tilts and small abdominal contractions
• Weeks 2-4: short walks, duration 5-15 minutes
• Weeks 4-6: maintain routine, don’t rush progression

RESUMING EXERCISE GOALS IN FIRST 6 WEEKS
• Rest recovery, bond with baby
• Stress management: exercise should be stress relieving not stress producing
• Focus on weight management not weight loss
• Adopt healthy lifestyle behaviors that can significantly impact health for decades
• Generally can resume exercise if uncomplicated delivery
• General recommendations:
• Moderate intensity exercise
• Nurse right before exercise
• If problems with infant fussiness post exercise, feed or pump beforehand
• Drink adequate fluids during exercise
• Wipe sweat from breasts before nursing after exercise
• Never sit down to feed without water -Baby should wet 5-6 diapers/day

WITH C-SECTION DELIVERY
• Stay fit as long as possible before C-section
• Gentle movement after aids circulation, healing
• Kegels, mild abdominal exercise first few days;
-Recovery process slower (e.g., driving, stairs)
-Postpone jogging, weights, crunches until 6 weeks
-Over-exertion may delay wound closure
-Avoid bending into a forward flexed posture

EXERCISE AND BREASTFEEDING
• Moderate exercise has no adverse affect on quantity or quality of breast milk
• Research has shown that infant growth is normal in the exercising mom;

POST PARTUM WEIGHT LOSS AND NUTRITION
• How the weight is lost after delivery:
-10-13 lbs. lost at delivery
-11-12 lbs. during first week
-2-3 lbs. lost from 3-6 months
• Body composition has changed and weight is not a reliable indicator of fitness
• Healthy food intake combined with exercise is preferable
• Changes in skeletal structure can often affect clothing sizes

BENEFITS OF POST-PARTUM EXERCISE
• Quicker return to normal routine and
activities of daily life
• Improved self-esteem, self-efficacy
• Less post-partum depression
• Better time management, coping skills
• Fewer chronic aches, pains, SUI (Stress urinary incontinence)
• Increased energy

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period