Freitag, 18. Mai 2012

Keeping up your activities through pregnancy and preparing for birth


Pregnancy is a time of major change to the body and expectant mothers often aren’t sure how to adapt activities and exercise accordingly. This leaflet outlines how to adapt your fitness regime and provides activities to prepare for birth.


You can buy a version of this information as a PDF leaflet, that is an A4 printable and foldable leaflet. The leaflet is a great reference point for mums-to-be or hand-out for birthing professionals. Cost: 50 p.

BEFORE STARTING ANY NEW ACTIVITIES CHECK WITH YOUR DOCTOR OR MIDWIFE TO ENSURE YOURS IS A LOW RISK PREGNANCY.
There are many advantages to keeping active during pregnancy, including:

  • Keeping up energy levels and improved sleeping pattern
  • Can relieve pregnancy discomforts, swelling, sickness, constipation, varicose veins, leg cramps
  • Stronger muscles and greater endurance can ease deliver and labour time and improve recovery time for mum and baby
  • More efficient placenta during pregnancy and birth which ensures oxygen and food supply to baby     
  • Relaxed, strong muscles and the ability to keep correct alignment alleviates back and joint pains, strengthens the pelvic floor.
  • Ensures healthy weight gain and reduces risk of gestational diabetes.
Adapting exercise for pregnancy
GUIDELINES:

  • Always keep well hydrated. Drink a glass of water or squash every 20 min during exercise.
  • Have a light snack within the hour before exercise to make sure your blood sugar level does not fall too low.
  • Keep your exercise moderate. If you over-exert yourself, your muscles compete with babies food supply. On a scale from 1 - 10 (1 = no exercise and 10 = as hard as you can work) stay within 5 - 6. You should be able to hold a conversation when exercising.
  • Train to maintain fitness levels not dramatically improve them.
  • Stick to what your body knows. Donʼt start new types of exercise. If you havenʼt been exercising, keep fit by walking or  attending ante-natal or aqua-natal classes, which are based on  functional, everyday moves.
  • Due to increased production of the hormone relaxin, which  loosens ligaments in preparation for birth, be careful with high impact sports or over-stretching as joins become more unstable
  • Avoid forceful twists straining your already stretched tummy muscles, e.g. as in tennis or golf strokes
  • Don’t exercise when you are feeling unwell and stop exercising if you start feeling unwell, light headed or very tired.
  • Avoid exercise in hot and humid conditions to avoid overheating.
  • Wear a sports bra or several bras on top of each other
  • If you feel dizzy when lying on your back, roll onto your side as baby may be lying on a major vein, constricting your blood’s  circulation back to your heart.


AMOUNT OF EXERCISE RECOMMENDED 

Regular activity 3 - 5 times a week for 20 - 60 min at moderate level is recommended throughout a low risk pregnancy.


Research: Women who continue to perform weight-bearing exercise throughout pregnancy have been shown to have a shorter, often unaided labour and delivery and faster recovery after the birth. Positive effects of exercise on fitness during labour are particularly pronounced if you can exercise right up to full term (Clapp, J.F., 2002). Weight bearing activities are any movement where you support your whole body weight. Walking is the most accessible weight bearing activity.





Activities in preparation for birth


AEROBIC ENDURANCE

Walking in alignment is the kindest and most efficient whole body movement, ideal for training the heart and lungs. It’s free and keeps pressure on your joints low. Speed up for a minute or two until you feel slightly out of breath and slow down again - simulating contraction. Aqua-natal is another low impact way to keep up endurance right up to the birth. Endurance is an important factor for birthing success and recovery.  




ALIGNMENT

Keeping your whole body especially the pelvis aligned is one of the most effective way to prepare for birth. Keeping the pelvis neutral (see picture below) when sitting and walking will increase the birthing space, improve pelvic floor strength and help keep your abdominal muscles strong. Keeping the weight of your body in your heels and feet facing straight ahead will prevent, knee, hip and foot pain and helps keep your pelvis aligned. It is NOT possible to keep beneficial alignment in HIGH HEELS. 




          









PELVIC FLOOR

A strong pelvic floor, will help channel the baby into the pelvis during labour and help it turn before emerging. Traditionally, pelvic floor exercises consist of squeezing the pelvic floor muscles as if to stop urinating and pulling them up and in, Slowly first and then with fast twitching moves. It is beneficial to know how to squeeze and particularly release the pelvic floor. However, too many pelvic floor exercises and sitting on your sacrum with your pelvis tucked under result in a tight and weak pelvic floor.This leads to a decreased birthing space as a tight pelvic floor pulls the sacrum into pelvis. To lengthen and strengthen the pelvic floor and open the birthing space, sit on your sitting bones and exercise the buttock muscles to pull the sacrum backwards with e.g. the squat.




THE SQUAT

With your feet a little wider than hips-width and the outside of the feet parallel and straight ahead, bring weight into your heels and lower. Try and keep your shins as vertical as you can by leaning forward with the upper body and only lower until you start tucking your pelvis. Come back to an untucked position and hold or push back up through your heels.


HINT: Try and squat carefully onto a chair/toilet when sitting down and off it again when standing up without using your arms








ABDOMINALS

Keeping your deep abdominal muscles strong throughout pregnancy will support your lower back and prepares them to support contractions during labour. 

On all fours, with hands below shoulders and knees below hips, relax your tummy and keep a neutral back with a gentle hollow in your lower back. After an out-breath, lift your tummy towards to your spine, lifting your baby towards your body. Keep this position for a couple of breaths and release tummy towards the floor. Let your tummy relax but try and prevent your ribs from poking out. Repeat. 

HINT: You can repeat this when walking, standing, sitting anywhere.


(c) Restorative Exercise, Inc.


STRETCHING
Increase length and strength of muscles affecting hip mobility
One of the tightest area are the back of our legs, which restricts mobility of our hip joint and can cause the pelvis to tuck under. 
The double calf stretch increases the length of the calves and hamstrings and encourages a neutral pelvis and spine. 
Step with the front of the feet onto a rolled up towel/mat. Heels stay on the floor. Feet are hips-width apart facing straight ahead. Lean forwards from the hip and hold onto a chair, sofa or ball Only lean as far forward as you can without tucking the tail bone under. The weight of the body rests in the heels and legs are fully extended. See if you can push the buttocks behind your heels. You can do this exercise to start without the rolled up towel.




(c) Restorative Exercise, Inc.


RELAXATION
Regain energy and control between contractions and make contractions more efficient by breathing naturally and releasing muscle tension. 
Practicing efficient and calming breathing
Bring both hands to either side of your ribcage. Breathe slowly in through the nose and feel how the ribcage expands to all sides. Slowly breathe out through the mouth and gently push the ribcage back together. Keep breathing as slowly and calmly as possible. As labour progresses, you will breath faster through your mouth. The expanding rib cage is still a great point of focus. 
Practicing letting go of tension
Birthing hypnosis and birthing pools/baths or birthing massages are a great way to release tension and speed up labour. Practice releasing tension with each breath:
  1. Breathe in as described above and with the out-breath relax your face, head and neck. Add a cue word in your mind e.g. Relax, Release 
  2. With the next out-breath relax your face, head and neck and add shoulders and arms. Repeat your cue word.
  3. Breath out and start relaxing with the head and neck then shoulders and arms and add your tummy area
  4. Repeat adding the pelvis with the next breath and finally the legs and feet. Always starting with the head until you relax the whole body with each breath, adding a cue word in your mind.
  5. To check for tension held in parts of your body it helps to tense the muscles when breathing in and letting go on the out breath.



You can buy a version of this information as a PDF leaflet, that is an A4 printable and foldable leaflet. The leaflet is a great reference point for mums-to-be or hand-out for birthing professionals. Cost: 50 p.

 


Further Reading:
Cherry Baker (2006) Pregnancy and Fitness. A&C Black. London
Katy Bowman (2011) Every Woman’s Guide to Foot Pain Relief. BenBella Books Inc. Dallas.
James F Clapp III MD (2002) Exercising Through Your Pregnancy. Addicus Books.
Judy DiFiore (2003), The Complete Guide to Postnatal Fitness 2nd ed. A&C Black. London.
Useful organisations:

The National Childbirth Trust:
The Active Birth Centre

Rewlea Swimming
The Register of Exercise Professionals

Natal-hypnotherapy/Hypnobirthing
Relevant blogs:
MumsKeepFit:
The path you take:
http://pathyoutake.blogspot.ca/
Katy says:
For more information contact:
Pre- and Post-natal fitness instructor:
Christine Shuttleworth  
Blog: mumskeepfit.blogspot.co.uk/

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