IN THIS CHAPTER
Examining activities that work for most pregnant women
Discussing activities that may work for you, depending on your circumstances
Touching on two out-of-the-question activities
Considering limited activities even when on bed rest
If you’ve mentioned to friends and family that you want to start or continue exercising throughout your pregnancy, you’ve probably already heard a laundry list of activities you shouldn’t do. Although some of that information may be accurate, some may also be old wives’ tales. This chapter helps you understand which sports and other activities are well-suited to pregnancy and which you want to avoid.
Before beginning any exercise program, talk to your healthcare provider about your plans to make sure that the activities you plan to do are safe for you and your baby.
Discovering the Best Ways to Stay Fit While Pregnant
Staying fit during pregnancy has never been easier or more fun! Whether you decide to keep your workout indoors or enjoy nature; join a gym or pool or work out at home; take a class or exercise on your own; go with basic clothing and equipment or outfit yourself with the latest and greatest stuff — and whether you’re new to working out or you’re an old pro — you can stay fit throughout your pregnancy in a way that fits your lifestyle and interests.
This section introduces you to the activities that women often find most comfortable and effective during pregnancy.
If you’ve never exercised before, check out Book 4, Chapter 4 which helps you get started. That chapter also helps you think about your own interests and personality when choosing an activity.
Gym balls, resistance bands, and low-weight bars or hand weights
An excellent way to increase strength and flexibility is to work out with the following:
· Gym ball: You’ve probably seen these in advertisements or in fitness magazines — they’re large balls that you sit on, lie on, or lean against in order to do a variety of exercises. Some are perfectly round, which means that part of the exercise you’re doing comes from keeping yourself from rolling off (thereby making the workouts even more challenging); others sit on a flat base, which many pregnant women prefer. As your abdomen grows and your center of gravity changes, staying on a rolling object can seem less and less possible!
· Resistance bands: Resistance bands are like extraordinarily large rubber bands, although they usually have special plastic or rubber handles that help you control them. When you pull up or out on your resistance bands, they resist your pull the way a heavy weight does. Doing workouts with resistance bands can make a variety of muscles much stronger.
· Weight bars or hand weights: Using weights — either individual ones that you hold in your hands or a long, weighted bar that you hold over your head or behind your neck — can quickly improve your strength and muscle tone.
If you combine workouts that improve strength and/or flexibility with workouts that challenge your heart and lungs (aerobic workouts), you turn your body into a finely tuned machine.
Fitness walking and running
Fitness walking is an excellent exercise for beginning and experienced exercisers alike, because you can control the intensity, duration, and frequency of your workout — walking faster, longer, and more often as you become fitter.
Running is another great way to get and stay fit but is usually reserved for women who were running before getting pregnant and who continue to progress normally in their pregnancies. Why? Running is a whole-body activity that can be very physically demanding — more so than you may be up for during your pregnancy. However, if you think running will be the best activity for you during your pregnancy and you haven’t been running up ’til now, talk to your healthcare provider about whether running makes sense for you. Keep in mind that you may need to modify your running pace and distance as your pregnancy progresses.
DANCING THROUGH THE TULIPS
Not every activity that’s healthy has to be considered a sport. Dancing, for example, can be an excellent way to become or stay fit during your pregnancy and after you deliver. Just find a comfortable surface (like carpeting or an exercise mat) in a private place (unless you want the neighbors to be your audience) and then tune in to your favorite playlist.
Gardening is another way to get fit that may not seem like exercise. If you’re pulling weeds, hoeing, raking, or shoveling, you’re getting an excellent workout. Just be careful when lifting and bending so you don’t injure your growing and changing body.
Swimming and water aerobics
Except for the discomfort you may feel wearing a swimsuit while you’re pregnant, you won’t find a better pregnancy workout than swimming or water aerobics.
In order to swim or do water aerobics, you need access to a pool, not a lake, a river, or the ocean, which could introduce infection into your vagina. Check with your local high school or YMCA to see whether a community pool is available in your area that offers convenient times for open swimming or offers water aerobics classes, especially ones designed for pregnant women.
Low-impact aerobics, Zumba, yoga, and Pilates
Low-impact aerobics (which is similar to high-impact aerobics but without jumps, kicks, deep bends, step-ups, and so on) and Zumba are popular ways to work out while pregnant, and you can probably find classes in your area. Call your local community health agency, high school, gym, and dance studio to see what they offer; ask, especially, whether they offer prenatal classes so you can work out with other pregnant women. If you can’t find a class in your area, you can set up your own workout area in your home and follow an aerobics DVD.
If you’re used to doing high-impact or step aerobics, your pregnancy continues to progress normally, you aren’t experiencing any discomfort (as discussed in Book 4, Chapter 2), and your healthcare provider doesn’t object, you can continue with higher-impact aerobics throughout your pregnancy. You may be able to modify your routine by reducing the height of the step and the height of your kicks.
Yoga, on the other hand, is a gentle way to work out that strengthens and sculpts your body, and many yoga studios offer special classes for pregnant women. A few yoga poses may not work well for you during pregnancy, but for the most part, yoga and pregnancy go well together. Yoga is also a terrific way to calm your mind, so if you start to feel stressed, give it a try. If you can’t find a class in your area, set up a yoga studio in your own home with a mat and a good DVD.
As always, avoid exercise environments that are hot, such as those found in hot yoga (Bikram) classes. Your body won’t be able to regulate heat loss effectively, and that can be dangerous to your baby.
Pilates is another low-intensity exercise to try. As in yoga, the movements are slow and gentle, but they tend to be a little more rigorous than yoga. Pilates equipment is rather expensive, so look for a class in your area and talk to the instructor about accommodations during your pregnancy.
Cycling
Because cycling is a seated activity that actively works your heart and a variety of important muscles (legs, butt, back, and so on), it’s very popular among pregnant women. You can cycle indoors (on a stationary bike) or out. Whether you can cycle outdoors depends on your experience, how well you’re able to balance as your pregnancy progresses, and whether the temperature is moderate (without excessive heat or humidity). Avoid high-traffic routes to avoid being exposed to excessive amounts of exhaust. Check with your healthcare provider to get additional feedback and advice.
Cycling indoors doesn’t have to be a boring experience, especially if you can ride while watching Netflix or Hulu. Riding indoors while lifting light hand weights also works your upper body, creating an incredible total-body workout.
Indoor machines
If you have access to indoor exercise machines, either at home or in a gym, you have an excellent way to exercise indoors, away from the cold, rain, and heat. Whether you choose to use a treadmill, weight machine, elliptical, or rowing machine, you’re going to get an excellent workout in the comfort of your home or a gym.
Cross-training
Cross-training is combining two or more types of exercises into one workout; it can also mean working out with one type of exercise on one day and another type of exercise on another day. Cross-training is an effective way to work a variety of muscles and ease the boredom that may come from one particular type of workout.
Considering Additional Activities, Depending on Your Background
Traditional wisdom has been that pregnant women should avoid the following activities because of the risk of falling or getting hit, potentially harming the baby. Chances are, however, that if you’re already doing these activities, you’re pretty darned good at them and don’t have much risk of falling or otherwise injuring yourself or your baby. If you’re already participating in these activities, keep in mind that you need to modify your workout for comfort and safety as your pregnancy progresses, and always make sure your healthcare provider is on board with your exercise regimen. As long as you and your baby are doing well, you may be able to continue with your pre-pregnancy exercise activities throughout your pregnancy. Remember that your healthcare provider must be aware of exactly what type of exercise you plan on doing, especially if it includes one of the following activities:
· CrossFit or boot camps: Do these only if you’re already experienced and plan to scale back the intensity as your pregnancy progresses.
· Cross-country skiing: Avoid hills and difficult trails.
Contact sports (such as soccer, volleyball, basketball, and hockey): Contact sports are almost always off-limits to pregnant women because of the risk of falls and other injuries. Be sure that your healthcare provider understands exactly what sort of contact sport you have in mind.
· Downhill skiing: Continue downhill skiing only if you’re an expert skier.
Keep in mind that you can’t control those skiing around you, and falls are common. Also, most ski places are located at high elevations, and that can cause issues related to reduced oxygen availability — dangerous for mother and baby.
· Figure skating: Steer clear of jumps and backward skating.
· Horseback riding: Avoid any jumps or risky riding.
· Mountain biking: Stay on flat, stable surfaces.
See Book 4, Chapter 2 for more safety precautions that you need to consider. If you have any concerns about doing any activity, avoid it — pregnancy is only 40 weeks of your life, and your chosen sport can wait that long.
If you’re new to exercise, don’t take up any of the activities listed in this section. They all require either a high fitness level or a superb sense of balance (or both) and aren’t for the uninitiated. Instead, choose from the activities listed earlier in “Discovering the Best Ways to Stay Fit While Pregnant.”
Before taking part in these activities, talk with your healthcare provider. Your skill level, as well as other factors, may determine whether these activities are safe. Always use common sense and err on the side of caution.
UNDERSTANDING THE LIMITATIONS OF ALTITUDE
Some pregnancy fitness experts advise you not to train at altitude during your pregnancy unless you already live in an area of high altitude. Research has confirmed that women who’ve been training at sea level before pregnancy struggle to train at high altitudes throughout their pregnancies. (Heck, anyone who’s been training at sea level — pregnant or not — struggles to train at high altitude!)
If you live at a low elevation, talk to your healthcare provider before exercising at a high elevation to find out whether it’s a good idea for you. If you’re cleared to train at altitude, keep a close eye out for the following signs of altitude sickness:
· Lightheadedness
· Nausea
· Dizziness
· Extreme fatigue
· Racing pulse
If you experience any of these symptoms, stop exercising. If the symptoms continue (or even begin to occur) when you’re training at a lower elevation, contact your healthcare provider.
Steering Clear of Certain Activities
Two activities are absolutely, positively off-limits to you during your pregnancy, which means that no matter how much you want to continue or try them, you just can’t without risking your baby’s health. Plan a water vacation next year and try the two activities in this section at that time.
Scuba diving
Scuba diving — deep-sea diving with breathing gear strapped to your back — is absolutely out of the question at any time during your pregnancy. The intense underwater pressure (pressure that you don’t necessarily feel because of the equipment you’re using) is harmful to your baby.
If you’re a die-hard scuba diver, ask your healthcare provider whether you can snorkel during your pregnancy. Snorkeling is done in shallow waters, so your baby doesn’t have to withstand the deep-sea water pressure.
Waterskiing
Waterskiing presents two challenges that make it off-limits:
· If you fall while skiing — and many people do — the force of the impact on your abdomen is incredibly high, putting your baby at great risk. In addition, during a fall, a jet of water can enter your vagina at a high force, possibly causing damage.
· You risk infection from contaminated lake or river water entering your vagina. For this same reason, don’t swim in a lake, river, or ocean while you’re pregnant.
Finding Activities Even When You’re on Bed Rest
If a symptom or condition keeps you from exercising — or if your doctor or midwife sees a change in your baby’s health during your pregnancy — you may get a directive from your healthcare provider to spend weeks (or even months) in bed, with little time standing or walking. For an active woman, bed rest may feel like the kiss of death, and you may be concerned that all your fitness gains in the first two trimesters will be wasted during a period of bed rest. However, bed rest doesn’t have to mean that you completely stop exercising your muscles and stretching. With the thumbs-up from your healthcare provider, the exercises and stretches in this section can help you maintain some of your strength and flexibility.
Don’t do any of the exercises listed here if you haven’t first shared them with your healthcare provider and received the go-ahead. The purpose of bed rest is to help you and your baby get back to a more normal pregnancy, so unless your doctor or midwife tells you that these bed-rest exercises are acceptable, don’t put yourself or your baby at risk. If you’re doing these exercises while on bed rest, your healthcare provider must carefully supervise you. Stop any exercises if you experience warning signs or symptoms, and consult with your healthcare provider immediately.
If you’re feeling down in the dumps and could use some support from women who can feel your pain, or if you just want more information about bed rest and high-risk pregnancies, visit www.sidelines.org.
Stretching
Gently stretching several times a day improves your circulation and minimizes muscle tightness and discomfort. Do the following stretches up to three times per day for one or two sets of 10 to 12 repetitions (reps), starting off with less than that (one or two sets of 5 to 10 reps once or twice per day) and building up:
· Make circular motions with your ankles, wrists, neck, and shoulders (like giant shrugs) and with your arms outstretched to your sides. Be gentle. Start with small circles and gradually increase the diameter without going beyond what feels comfortable.
· Bring your chin to your chest, hold for 3 seconds, and then lift your chin back up. Also do the same stretch to each side of your neck, bending your neck so that your ear nearly meets your shoulder.
· Extend your arms in front of you, bend your elbows, and extend your arms out again.
· Lift each arm all the way up and down.
· Lying on your side or back, stretch your arms as far above your head as you can and push your heels downward (away from your head) as far as you can to get a whole-body stretch.
Strengthening muscles
Strength training is not only possible while you’re on bed rest, but it’s also a great way to keep from losing muscle mass during this time of inactivity. You want to do the following exercises in one or two sets of 10 to 12 reps, two or three days per week. Keep some light weights (1 to 3 pounds) or cans of vegetables or soup near your bed so that they’re ready when you are. Avoid lifting anything that requires a lot of effort; you should be able to do 10 to 12 reps without straining.
Bicep curls
This exercise works the biceps, the muscles on the inside of your arms, above your elbows. The biceps are the muscles you notice the most when you’re wearing a tank top — fit celebrities often have biceps you’d kill for.
1. Sit up with your hands by your sides.
2. Hold weights in your hands with your palms facing up.
3. Take a breath and then exhale as you slowly lift your hands to your chest.
Keep your elbows as stationary as possible.
4. Inhale as you slowly lower your hands to your starting position.
5. Repeat.
Shoulder raise
This exercise strengthens the muscles around your armpits and shoulders.
1. Straighten your arms by your sides, holding light weights.
You may need to rise up a bit in your bed.
2. Take a breath, and then exhale as you slowly raise your arms to shoulder level (or as high as you can go).
3. Inhale as you slowly lower your arms to your starting position.
4. Repeat.
Modify this exercise by raising the weights with your arms straight out in front of you.
Chest press
The chest press works your chest and the muscles around your armpits.
1. Lie on your back with several pillows propping you up so that you’re in a semi-reclining position, and grip a light weight in each hand.
2. Put your hands on your chest, facing outward.
Make sure the backs of your hands are sitting against your chest.
3. Take a breath, and then exhale as you slowly press the weights out and away from your chest until your arms are straight.
4. Inhale as you slowly lower your hands to your starting position.
5. Repeat.
Triceps extension
This exercise works the triceps, the muscles on the outside of your arms, above the elbows.
1. Hold a light weight in your right hand.
2. Lift your arm above your head so that your bent elbow is next to your ear and your hand is near the back of your shoulder.
If you’re in a sitting position, lean forward before lifting your arm.
3. Take a breath and exhale as you slowly straighten your elbow so that your hand is above your head and your arm is straight.
4. Inhale as you slowly lower your arm to your starting position.
5. Repeat.
6. Follow the same steps for the left arm.
Abdominal press
This exercise helps you maintain abdominal strength during bed rest and also helps get your tummy back into shape after you deliver.
1. Sit or lie on your side.
2. Take a deep breath and exhale, slowly pulling your belly button toward your spine.
3. Hold the position for 3 seconds (count elephant-1, elephant-2, elephant-3).
4. Inhale and slowly release for a count of 3.
5. Repeat, working up to 10 to 12 reps.
Tummy leg slides
This exercise tightens your tummy and works your leg muscles.
1. Sit comfortably with pillows supporting your back and with your knees bent and your feet resting on the bed.
2. Take a deep breath, and as you exhale, tighten your tummy. Keep your tummy tightened as you slide one leg out (knee straight) and then slide your leg back in (knee bent).
Use a count of 3 to slide out and then in. Exhale as you slide your leg out and inhale as you slide in.
3. Repeat.
4. Follow these same steps for the other leg.
Exercising your pelvic floor muscles
Kegel exercises (exercises for your pelvic floor muscles) are essential for pregnant women. You can perform these simple exercises while on bed rest, getting the go-ahead from your healthcare provider in advance, of course.
Doing pelvic floor exercises with control strengthens the pelvic floor muscles and, at the same time, gets you used to what it feels like to contract and relax your pelvic floor, which comes in handy at pushing time during delivery. These exercises are simple to perform after you get the hang of which muscles to contract.
One way to locate your pelvic floor muscles is to notice the muscles that contract when you stop your flow of urine. Use the urine stop-and-start test when sitting on a toilet to figure out how to locate and isolate the pelvic-floor muscle group. After you’ve figured out how to contract your pelvic floor muscles, use the following exercise to strengthen them.
To do the pelvic floor exercise:
1. Slowly contract your pelvic floor muscles throughout a count of 5.
2. Hold for 5 seconds and then release for a count of 5.
As you do Kegel exercises, keep these suggestions in mind:
· Start with 10 to 20 slow repetitions (reps), twice a day, and build up to 25 or more reps, twice a day. If your pelvic floor muscles fatigue quickly, do fewer reps each time, but do the exercises more than twice a day.
· Remember that no one can tell you’re doing these exercises, so you can do them anywhere. In fact, try to use certain activities (for example, driving to work, brushing your teeth, or taking a shower) as your cue to do your exercises.
· 
Contract your pelvic floor muscles each time you lift, laugh, sneeze, or cough to provide support.
Don’t fatigue your muscles to the point of being unable to perform any more pelvic floor contractions. If you’re unable to hold for 5 seconds, alternate slow contractions and holds with the quick-contraction technique: Contract your pelvic floor muscles by quickly squeezing and releasing, repeating for 20 or more reps. Keep in mind, however, that the longer you hold each contraction, the more effectively you build pelvic floor strength, so your ultimate goal is to build your reps and contraction hold times from 5 seconds to 10 seconds or more.
The muscles of the pelvic floor provide support for the pelvic organs. Keeping these muscles strong helps prevent conditions such as incontinence and prolapsed organs.