Pregnancy is a special time in any woman’s life. Regular mild to moderate exercise during pregnancy can be beneficial in many aspects. The majority of healthcare professionals concur that exercising during pregnancy can provide many benefits, including optimized body weight, improved cardiovascular fitness, muscular strength and endurance and reduced risk of future injury.
Pregnant women who exercise can reduce their risk of conditions commonly encountered during pregnancy, including gestational diabetes, hypertension, pre-eclampsia and complications of delivery and recovery.
Certain contraindications to exercise should be observed. Absolute contraindication includes severe cardiovascular, respiratory or systemic disease, untreated and uncontrolled high blood pressure, diabetes or thyroid disease. Additionally, torn membranes or premature labor and frequent bleeding after the first trimester are also absolute contraindications. Relative contraindications also exist and should be cleared with an obstetrician before continuing or beginning an exercise program. They include history of repeated miscarriage or premature labor, diabetes, bleeding during the first trimester, very poor fitness and/or moderate obesity, extreme underweight, breech presentation after 28 weeks, palpitations or arrhythmias and anemia or iron deficiency.
For those planning to become pregnant, it is best to start an exercise program six to eight weeks ahead of time. For a complete guide to exercise during pregnancy, I would highly recommend the American Pregnancy Association’s website under the “Pregnancy Wellness” page. I would also suggest the guidelines put forth by the Journal of Prenatal Education published in 2000. The guidelines are for healthy women. If you have an illness or injury, you should refrain from exercise until you are cleared by your obstetrician.
When women become pregnant, the body begins to produce a hormone called relaxin, which helps to increase laxity in the ligaments of the pelvis in preparation for delivery. As such, there is an increased risk of sprains and strains. Additionally, if low-back or pelvic problems existed in the past, they may become problematic again with the production of relaxin. To prevent injury, the same safe lifting techniques that are observed when one is not pregnant should be observed during pregnancy. In fact, they become more important due to the addition of relaxin into the body.
When lifting, always use a wide base of support and squat. Simple back-strengthening exercises are important and will go a long way toward preventing injury. These exercises should be reviewed by your obstetrician and can be taught by qualified clinicians specializing in women’s health.
Should you begin to experience low-back problems when you are pregnant, first realize that you are carrying your own body weight in addition to your child’s weight. Muscular fatigue is to be expected and can be the attributed cause of your discomfort. However, if this discomfort becomes frank pain, then an immediate evaluation is very important.
The pregnant women I have treated were experiencing the cumulative effect of muscle fatigue and/or sprains or strains due to increased relaxin and poor body mechanics. Pelvic misalignments are also common at the sacroiliac joint for the same reason. Treatment typically involves simple stabilization exercises and gentle massage to ease the discomfort of the muscular fatigue. Most women respond quickly because they are motivated to stay healthy and tend comply with the treatment plan.
Taking time to understand proper exercise and injury prevention techniques can go a long way toward making the experience of pregnancy a memorable one. Take time to research available resources and make a consorted effort to start an exercise program before pregnancy. It will make it that much easier when you are expecting.
— Sevak Khodabakhshian is a doctor of chiropractic with Thousand Oaks-based Omega Rehab & Sport, where a team of physical therapists, chiropractors and athletic trainers applies an active-care approach to healthcare. He can be reached for comments, questions or suggestions by e-mail, at Sevakk@omega-rehab.com.