Exercise is important in pregnancy as long as you don’t have another medical condition such as high blood pressure or a heart condition, etc. I tell my patients to listen to their bodies. Don’t start doing something radically different just because you are pregnant and don’t stop doing an activity unless it hurts or it becomes difficult. Stop contact sports after the baby is no longer confined to the pelvis (i.e., after 12 weeks). The rationale is that the fetus can be traumatized once the uterus has expanded outside of the boney protective pelvis and into the abdominal cavity.
I always think of one particular patient as an example of exercise during pregnancy. She taught aerobics in the days of high impact and bounced through all three pregnancies until going into labour while teaching on all three occasions.
Some general rules that I have touched on may be universally applied. So keep active as tolerated but don’t suddenly try to do something radical that is going to stress your body.
If you are a competitive athlete, then you will need to maybe slow down as the pregnancy progresses. For those who have not been active, you can begin a walking program and increase your distance and pace as you tolerate it. Remember that you should keep well hydrated because you produce more heat during pregnancy. Limit your activity during hot humid weather.
Exercise mild to moderately three times a week for thirty minutes as tolerated. If you weight train, then modify this by reducing your weights and increasing the number of repetitions. Avoid lying on your back without something like a wedge beneath you to create an angle to avoid compromising blood flow to the baby. This becomes more crucial as the pregnancy progresses.
Learn to recognize signs that indicate that you need to stop or slow down. These include dizziness, rapid heart beat, swollen ankles, swollen feet, swollen calves, headaches, nausea, vomiting or vaginal bleeding.
Learn the correct procedure for lying down or getting up. To lie down, first bend your knees. Then kneel down on one knee while placing your hand on the other thigh for extra support. Then bring the other knee down so that you are kneeling on both knees, and at the same time lean forward so that your arms and hands are partially supporting you. Now take your weight on your arms to help you slide onto your side. Then ease your way onto your back using the strength of your arms. When getting up, reverse the steps that you used to lie down.
Stretching exercises
These will reduce muscle tension, but they will also improve flexibility. Each person has a starting point of flexibility, so if you feel pain during a stretch, stop it or do it less rigorously. The general rule for stretching is to breathe with each stretch. This helps you relax. Hold each position for 20 to 60 seconds. Always follow a stretch on one side by the same on the other side. And remember, if it hurts, you are doing it wrong.
Shoulders and back stretch
Face the wall with your knees slightly bent and your feet apart and in line with your hips. Place your hands against the wall above your head. Then tilt your pelvis inward towards the wall.
Shoulders and chest stretch
Stand sideways, close to a wall. Bring your arm up to the wall at shoulder height with your palm against the wall, but not pushing against it. Repeat with the other arm.
Calf stretch
With your hips square and your feet facing the wall, extend one leg behind you. Balance your body leaning with your forearms against the wall. Repeat with the other leg.
Quadriceps stretch
Leaning against the wall with your palm, bend your opposite knee and grab hold of your foot with your hand on the same side. Repeat on the other side.
Hamstring stretch
Sit on a desk, couch or bench and stretch one leg out to a fully extended position. Keep your back straight and bend forward slightly from your lower spine. There should be a tightening or burning of the muscle in the back of the upper leg. It is not necessary to reach to your feet. Repeat on the other side.
Back stretch
This relieves back pain in pregnancy. Kneel on your hands and knees, with your elbows slightly bent. Keep your back flat. Then round your back up at the same time that you tighten your abdominal and buttock muscles. Slowly relax and allow your back to return to the flat position. This can be repeated up to 10 to 15 times.
Strengthening exercises
In order to prepare for childbirth, you need to strengthen your muscles. There are various types of exercises to help with this.
Kegel exercises
Kegel exercises strengthen the vaginal and perineal areas for birth and after birth. They can be done standing or sitting, until you are more than 4 months pregnant, when you should do them standing.
Tighten the muscles around the vagina and anus, as you would if you were waiting to urgently use the bathroom. Hold this contraction for as long as is comfortable. Increase the time that you do this to 8 to 10 seconds and try to reach a goal of doing this about 25 times a day.
Squatting is a position often used in labour. It uses many muscles groups, so you need to strengthen them all to make it easier on these groups when they are really needed. Position your back against the wall for support. The feet should be comfortably placed away from the wall and more than hip-width apart. Keep them flat on the floor. As you squat, use the wall for back support and allow your buttocks to move down to the floor. If you have knee trouble, do not try a deep squat as this will cause your kneecap to really hurt. You should try to hold a squat for 30 to 60 seconds.
Wall Pushups
Stand facing the wall and place your hands out in front of you against the wall at shoulder height, and shoulder-width apart. Keep your back straight, your pelvis tilted down, and your knees slightly bent. Now bend at your elbows and bring yourself closer to the wall. Breathe in at the same time. Then extend your elbows and push your body away from the wall. Breathe out while doing this. This will strengthen the triceps and pectoralis muscles.
Thigh stretching and strengthening exercises
Stretching the inner thigh muscles will help you during labor. Sit with your legs apart with your back against a wall for extra support if needed. Your knees should be out and your feet touching at the soles. Place your hands under the knees and gently press both knees towards the floor without using your hands. Hold this for 10 to 20 seconds.
Then repeat, but this time, use your hands to resist the downward motion of your knees. Do this for 10 to 20 seconds.
Abdominal exercises for stomach-muscle strengthening
Stomach-muscle separation is also known as rectus muscle diastasis. This may occur in any pregnant woman as the uterus expands, resulting in pressure behind the abdominal muscles. If the tissue between the two bands of rectus muscle weakens too much, a softness occurs between these two bands in the midline. If you lie on your back with your knees bent and lift your head off the floor by 15 to 20 cm, you can see this. It is not a big deal and is common. It will not affect your ability to do your strengthening exercises.
Stomach muscle tightening
Lie on your back with knees bent. Breathe out while pulling in your abdominal muscles and pressing the curve of your lower back into the floor. Then relax and breathe in. This may be increased to 8 to 10 repetitions.
Modified crunches
If you are in your first trimester, lie flat on your back. If you are in your second or third trimester, keep a 45-degree incline. Keep your knees bent. Breathe in and place your hands on your abdomen. Lift your shoulders slightly off the ground, and breathe out while pushing your lower back into the floor. Hold this position for two normal breaths and then slowly lower your head to the floor and relax. Start with six repetitions and increase with time as tolerated.
