Thursday, October 4, 2012

Exercise in Prenatal and Postnatal Care


“Should I exercise while I’m pregnant?”
The answer is yes. A well-structured prenatal fitness program can make pregnancy both healthier and easier. 



Benefits of exercise during pregnancy
Psychological well being
-Increased sense of control and relief tension
-Control of excess weight gain.
-Decreased water retention.
-Improved posture and appearance.
-Decreased incidence of back pain.
-Decrease complications during labor.
-More rapid postpartum recovery. 

Enhance your mood:  Exercising before you are pregnant can give you an all-around better feeling. Physical activity changes the brain chemistry and stimulates endorphins, which directly affect your mood. Combined with the blessings of better sleep and reduced stress, you just may find yourself in a good state of mind.

Step-1 planning for pregnancy
The best time to start planning and implementing your pregnancy health, weight and exercise program is immediately after we’ve decided to try to become pregnant.
Having a strong, fit and healthy body will not only prepare us for the strength and stamina required during our pregnancy, but it will also increase our chances of conception and make for a generally easier pregnancy, labor and most importantly birth!
Research shows that being significantly overweight during pregnancy has potentially detrimental effects on the health of both the mother and their unborn children.
Step-2 Personal Training and pregnancy
When starting an exercise program at any stage in your life especially during pregnancy, using a Fitness professional experienced with pre and post natal clients is a must at least six months prior to your planned pregnancy.
This will make sure you are exercising correctly, appropriately and safely at all times.
As well as being providing motivation, encouragement and support, a good personal trainer will be fully versed in the safety aspects of exercising while pregnant and can provide valuable advice on things like nutrition, proper exercise technique, and plan suitable and practical exercises aimed directly at preparing us for giving birth.

Step-3 Exercises and pregnancy:
For instance

1. Squats-
This exercise is done using chairs to assist with the technique, help with balance and reduce range of motion. Place one chair against a wall. Sit on it with another chair in front of you, with the back facing you. Place your feet about shoulder width apart angled at approximately 45 degrees. Grab the top of the chair in front of you, using it to help with your balance on the up and your abs tight. Push up down movement of the squat.
Stand up using your legs, keeping your knees at the same angle as your feet. Do not lock your legs out. Keep your knees slightly bent at all times. Then squat down, lowering yourself towards the seat of the chair. Keep your back straight and your abs tight. Push up through your legs just before you are about to touch the seat.

2. Lunges
Lunges during pregnancy can be done using a chair to help with balance. Stand next to a chair, placed on your left hand side. Put your left hand on the top of the back of the chair. Step back with your left leg into the lunge position, keeping your front knee in line with your second toe and your back knee under your hip. Keep your feet on parallel lines as wide as your hips. Always keep your back straight and remember to push up through the heel of your front foot. Repeat on the other side.

3. Horse Stance
This exercise is performed on all fours, hands under shoulders, spine parallel to the floor, thighs perpendicular to the floor. Tighten your abs and push your lower back up into a flat position. Hold for 1-3 minutes. Great to help maintain your core strength during pregnancy!

Repeat exercises 1 and 2 with 15 - 20 reps x 2 sets 2- 3 times a week

Some other important exercises of during pregnancy
-Low impact aerobics
-Water aerobics
-Walking
-Kegels
-Pilates
-Yoga
-Cycling
-Swimming

Kegels- Help prepares body for labor and Strengthen pelvic floor muscles.

Yoga-  Help with breathing and relaxation.
-Energizing
-Stress relief
-Improve posture
Note:  Avoid position lying on the back.

Swimming- Uses large muscles group of legs and arms..
-         No strain on ligaments.
-         Feeling of weightlessness.
-         Improved circulation.
-         Water temp should be 18-25 Celsius

Stop exercising when you experience-
-Vaginal bleeding
-Dizziness
-Decreased fetal movement
-Amniotic fluid leakage
Step-4 Strength training and pregnancy
Strength training is now recommended by the American College of Obstetricians. 
• Making pregnancy easier • Helping avoid excessive pregnancy weight gain • Decreasing time in labor • Making labor easier • Quicker recovery after giving birth • Reduces tiredness • Better control over body-fat fluctuations • Increased strength to perform daily activities during and after pregnancy. • Strength to cope with the lifestyle changes of a new baby.
Step-5 Postnatal exercises guidelines
It is very important to start slowly and listen to your body. It is important to start being active, but do not over do it. It takes about six weeks for uterus to shrink back to normal size. If you had stitches from tearing, you will need to wait until they heal, if you had a c-section, you will need to wait until your doctor removes the stitches and approves for physical activity.

Exercise Schedule-
1 day after normal delivery, 2-3 days after c-section

-Walking
-Simple abs contraction

After 1 week
-Slowing increases walking length
-Breathing exercises

After 6 weeks-

1. Pelvic floor exercises (Strengthen your tummy muscles)
-Breathe in and as you breathe out, tighten your pelvic floor muscles. The feeling is one of squeeze and lift. Imagine that you are stopping yourself from passing wind. Once you have tightened your pelvic floor, gently pull your belly button in and up. You should feel your tummy muscles tighten.

2. Pelvic tilt (Strengthen your pelvis and back)
-Lie on the floor or your bed. Place a pillow under your head. Bend your knees by sliding your feet up towards your bottom.
-Tighten your pelvic and pull in your lower tummy muscles, before squashing the small of your back down into the floor or bed. Hold this for a count to three and then arch your back away from the floor or bed.
Note-
Don’t exercise in a hands-knees position for the first six weeks. There is a small risk that a little clot of air can form at the site where your placenta was attached.

Get your body back after: Maintaining fitness during your pregnancy will prepare your body for an easier time of rebounding back to the way you want it. It also helps keep off unnecessary weight gain during your pregnancy which would only make bouncing back more difficult. 
It took nine months to grow your baby and it may take you up to nine months to return to your pre-pregnancy shape. Be sensible and take it slow.

References-
1.  Acsm book
2. Acsm obstetricians.


Dr. Meenakshi Sharma,
Fitness Manager,
Your Fitness club





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