Exercise and Pregnancy

Frequently, I am asked by pregnant clients, “What exercise is okay for me to do?”

Excellent question!!!

Very often during pregnancy, women want to begin exercise programs to ensure the health of their developing babies as well as themselves.  On first consideration, this sounds like and often is a good idea and recommended.

So, how to answer this question?

Before answering, there are some important considerations that need to be kept in mind.

My first response is, “What kinds of pre-pregnancy exercise have you been engaging in up until the present?”  This clues me in to how active they have been and currently are.  It also tells me what types of exercise they enjoy and are more likely to continue if deemed safe.

In accordance with the ACOG’s (American Congress of Obstetricians and Gynecologists) guidelines:

– 30 minutes/day on most days is recommended.

– Recreational and competitive athletes with uncomplicated pregnancies can remain active during pregnancy and should modify their usual exercise routines as medically indicated.  The information on strenuous exercise is scarce; however, women who engage in such activities require close medical supervision.

–  Previously inactive women and those with medical or obstetric complications should be evaluated before recommendations for physical activity during pregnancy are made.

–  A physically active woman with a history of or risk for preterm labor or fetal growth restriction should be advised to reduce her activity in the second and third trimesters.

Keeping these guidelines in mind, a customized exercise program can be formulated to meet the health and recreational requirements of the client.  Some women are professionally athletic, some are recreationally athletic at a very high and competitive level, some exercise 2-3 times per week at a gym and others take dance and or yoga classes one to several times per week.  Others still, are sedentary.  The range of how and how often women move their bodies is highly variable.

In general, if a woman is regularly active prior to pregnancy, she may continue at the same level unless:

–  It is extremely strenuous with or without twisting.

–  Involves high impact like jumping and or bouncing.

–  High altitude sports.

–  Heavy weight lifting.

–  Board and platform diving.

–  Competitive events.

–  Contact sports.

–  Scuba diving.

–  Exercise in hot, humid conditions.

There are also other activities that may become unsafe like horseback riding, Alpine skiing, exercises performed on your back, ice skating and volley ball.

Due to modern cultural pressures, often women feel they must exercise excessively during pregnancy in order to maintain their “figures.”

It is important to reinforce the benefits of exercise during pregnancy for purposes of health including:

–  Increase or maintenance of aerobic exercise.

–  Increase cardiac reserve.

–  Improve muscle tone.

–  Promote good sleep.

–  Prevent low back pain.

–  Reduce gestational diabetes.

–  Improve psychological aspects.

–  Easier labor and delivery.

–  Faster recovery from labor.

Education on the maintenance of health and the acceptance of the NORMAL changes that occur to a mother’s body during pregnancy should be reinforced.

Pregnancy can be a time of nescience.  There can be insecurity based on fear of the unknown.  An educational and supportive birth community can help ease insecurity and provide mom with the confidence she needs to fully experience and enjoy her pregnancy.

I am always delighted when client asks the question about exercise during pregnancy.  I am pleased to demystify any misconceptions about entering into or continuing on with exercise and movement.  I recommend that any pregnant woman who is unsure of what type of exercise to engage in consult with an appropriate professional healthcare practitioner who is an expert in Women’s Health and pregnancy for guidance.   Keep moving for health!!!

June 7, 2017

A Topic Few Wish to Discuss   

So often, I hear women complaining to me about experiencing the symptoms of vaginal itching.  They are stumped and frustrated by this symptom, asking what causes it and how can they eliminate it.

Vaginal “itching” can have many causative factors.  Itching can result from dryness of the skin.  This can happen as a consequence to hormonal change during menopause or even pregnancy.  It can be a sign of nerve irritation.  The pudendal nerve is one of the major nerves that course through the pelvis.  This nerve provides sensation to the vulvar and anal regions.  If the nerve is inflamed, it can cause the sensation of pain or itching or both to those areas.  Vaginal infections, such as yeast and or bacterial can also create an itching sensation.

What can you do?   See your healthcare provider to help determine the cause.  For dry skin, provided you are not allergic to any of these,  a natural emollient,  such as coconut, almond, olive oil or aloe vera can be applied topically to the area to moisturize and sooth the skin. Just as the skin on your face, arms, legs and other body parts can become dry and irritated, your vulvovaginal tissues can as well.    If your MD or other appropriate healthcare provider agree, topical hormonal creams, can also be applied as directed to help with hormone balance to the effected tissues. With nerve irritation and any associated pelvic muscle tension or spasm, physical therapy can be helpful to provide relief from inflammation via various modalities, manual techniques and gentle exercises.  Medications can also be prescribed by your healthcare provider to diminish the nerve pain.  If there is an active infection, it needs to be diagnosed and treated with the appropriate medication and possibly diet modification.

If you are experiencing this type of symptom, don’t hesitate to discuss it with your healthcare provider as there are many ways to address and treat the problem.  Why suffer in silence?