Exercise During Pregnancy

• Back Pain
• Exercise
• Muscle Toning
• Relaxation
• Problems Sleeping

Good posture during pregnancy is very important.  It relieves backaches, breathing difficulty and makes you feel and look better.

Correct posture can prevent or relieve back pain.  To assure good posture, the following tips should be helpful:

• Stand tall – stretch the top of your head toward the sky.
• Pull your head back and center it over your body.
• Tuck your chin in slightly.
• Pull shoulders back.
• Gently pull in abdomen.
• Tuck your buttocks in and under.
• Keep knees relaxed; do not lock them back.

To prevent back pain, we suggest the following:

• Use your leg muscles to lower and raise yourself.  Slide yourself to the front edge of the chair and then raise your body with your leg muscles.
• When you have to stand in one spot for a long time, place one foot upon a low object such as a footstool.  Alternate which foot you place up frequently.
• When getting up from a lying position, always roll to your side before trying to sit or stand, then to your knees and upward.
• Make sure the surface at which you are working is high enough.

Exercise in Pregnancy

Moderate physical activity is extremely beneficial for most expectant mothers and their babies.  However, pregnant women who are high risk may have to cut down or even eliminate physical exercise.

The type of exercise you do depends on your health and how active you were before you became pregnant.  This is not a good time to take up a new sport.  If you were active before pregnancy, you can continue to exercise in moderation.  If you are just beginning an exercise program, build up slowly.  The following activities are especially good forms of exercise in pregnancy:

• Swimming
• Brisk walking
• Prenatal exercise classes

Remember to:

• Start with a warm-up period.
• Do not let your pulse exceed 140 beats per minute.
• Finish with a cool down period.
• Limit your exercise period; take a break after 30 minutes.
• Exercise regularly - not erratically.
• Compensate for the calories you burn.
• 100 to 200 calories for each 30 minute exercise period is recommended.
• Replace fluids used.
• 8 ounces per each 30 minute exercise period.
• If you do group exercise, make sure your instructor knows you are pregnant.
• Do not work out on an empty stomach.
• Wear the appropriate clothing:
  • Cotton underwear
  • Fabrics that breathe
  • Well-fitting athletic shoes.
• Do everything in moderation
• Stay cool
• No saunas or hot tubs!

Muscle Toning

All exercises should be done slowly and deliberately.  Jerking or bouncing movements may strain joints.  Progress at your own rate, start by doing each exercise three or four times, slowly building up to 10 times.  No exercise should be performed to the point of fatigue.  Rest and relax as needed.  Pointing toes inward may cause cramps in calf.  If you become uncomfortable doing the exercises while lying on your back, consider the side lying position as an alternative.

A. Kegel Exercises (Strengthens pelvic floor muscles that support the organs in the pelvis.)

• Determine correct technique.  In a sitting or lying position, place a finger in your vagina and squeeze around it.  When you feel pressure around your finger, you are using the correct muscle.  At the same time, do not bear down or squeeze your thigh, back, or abdominal muscles.  Always breathe slowly and deeply.
• Squeeze the muscle for a count of four and relax for a count of four.  Gradually increase to a count of eight or ten.
• Do the exercises for five minutes one time a day.

B.Tailor Sitting (This exercise helps to condition muscle of the inner thigh and pelvic floor that should be flexible during delivery of your baby.  It also releases tension in the upper back.)

• Sit on the floor and bring your left foot towards you so it touches your body.
• Bring the right foot toward your left foot but do not cross your ankles.
• Lean forward slowly until your knees touch the floor.  Sit this way, back straight, knees almost touching the floor for a few minutes several times a day.  This exercise should be started early in pregnancy.

C. Pelvic Rocking and Pelvic Tilt (This exercise helps relieve abdominal pressure during pregnancy and lower backache in early labor.  Can be done in the following 3 positions.)

Hands and Knees Position

• Start with head up, back sunken in by pushing stomach toward floor.
• Tighten buttocks, pull pelvis forward, and straighten back.  Tuck chin in.
• Relax to original position.  Repeat several times.

• Place hands under table top or counter, stand in normal position, feet flat on floor.
• Rise onto tiptoes, drop shoulders, tuck in buttocks, tilt pelvis up, and pull up gently on the table.
• Release.  Repeat several times.

D. Knee Chest Exercise (This exercise relieves pelvic pressure.)

• Kneel, keeping knees apart.
• Place arms and head on floor (on pillow).
• Keep back straight and abdominal muscles slightly tightened.
• Maintain position for a few minutes, then straighten and relax.
• Repeat as needed.

E. Pelvic Twist (This exercise strengthens pelvic and abdominal muscles.)

• Lie on the floor, knees up, feet flat on the floor. Arms out at right angles to your body.
• Keep feet together and arms and shoulders flat, then roll your hips to the right until your right knee touches the floor.
• Roll to the left in the same way; repeat slowly, right to left, several times.

Relaxation

People today are becoming more interested in the mind/body connection.  Relaxation techniques are one way of dealing with increased stress.  Stress is a normal part of life.  It is helpful in motivating us to get things done and challenges our minds and bodies.  Severe stress, on the other hand, is not healthy and often causes unpleasant physical symptoms such as sleep problems, upset stomach, or muscle pain.  Plan to spend 10 minutes a day doing some form of relaxation.

Deep breathing – This can be done at any point in the day when you have a few minutes to yourself.  Simply take five or more breaths, letting the air slowly fill your lungs.  Place your hands on your abdomen below the waist.  You should feel your body rise and fall with your breathing (if not, you are not breathing deeply enough).  Imagine you are blowing away the stresses of the day as you exhale.

Music – Choose some relaxing music (often classical or sound tracks with no words) of your choice.  Find a comfortable place to close your eyes and concentrate on the music or think about a relaxing place or event.

Relaxation Exercises – Tapes specifically made to guide you through relaxation exercises are often available at libraries or book stores.

Resting Position

Try to get comfortable and peaceful - empty your bladder, remove or loosen tight clothing.  If possible, lie on a firm bed or on the floor.  Lie on either side with the arm on that side behind you, other arm flexed and in front of you.  Leg on the side you are lying on is down, other leg in front of it and flexed, and back slightly curved.

Legs and Lower Abdomen

• Begin with the foot of the top leg.  Push your foot down, bending at the ankle and relax.  (If you have a tendency to cramp the muscle of the back of your leg, do not push down too far.)
• Bending at the ankle, pull your foot up toward your head and relax.
• Bend your knee just enough to feel the muscles in the back of your thigh and relax.
• Straighten your leg from the knee and relax.
• Tighten your buttocks and relax.
• Tighten the muscles of the floor of your pelvis or the area between your legs.
• Do the same technique with the other foot.

Arms (start with the arm you are lying on)

• Make a tight fist and relax.
• Straighten your elbow and relax.
• Hunch your shoulder up toward your ear or push it into the pillow and relax.
• Do the same with the other arm.

Face

1. Make a round "O" with your mouth and relax.
2. Wrinkle up your nose and relax.
3. Make a frown and relax.
4. Raise your eyebrows and relax.
5. Close your eyes tight and relax.
6. Then let your eyes close slowly and begin your abdominal breathing, thinking "in" and "out" as you breathe at your own rate.

After you have learned the relaxation in steps, try relaxing suddenly and instantly, so that you may be able to use controlled relaxation during the first stage of labor.

NOTE:  After such complete relaxation, a sudden upright position may bring dizziness.  Bring the slowed circulation back to normal by moving the legs and arm turning over and sitting up slowly.

The purpose of progressive relaxation is to improve the ability of muscles to relax by tensing them first.  Even when extremely tired and/or suffering from insomnia, these techniques can help you become relaxed.  Your mind should be focused on quiet natural breathing.  Practice one to two times per day.

Often in the last weeks of pregnancy, problems with sleep occur since your abdomen is large and it is hard to get comfortable.  You may try the following:

• Try the progressive relaxation techniques.
• Exercise during the day but not before going to bed (especially avoid exercise periods two hours before bedtime).
• Take a warm bath.
• Have a light snack before bedtime to keep your blood sugar level up.
• Lie on your side with pillows under your abdomen and between your legs.
• Try to resolve all worries or problems and clear your mind.
• Backrubs, soothing music, or light reading may help you relax.
• Establish a “routine” bedtime and wake time.
• Consider alternative sleeping sites such as a recliner or sofa.

If you feel you need additional help, please let your health care provider know.  Often your childbirth educator will be able to help you with these comfort suggestions during the Prepared Childbirth Preparation Classes.