Pregnancy Exercises - Prenatal and Postnatal
"In pregnancy the aim should be to maintain or moderately improve the level of fitness”
Table of Contents
Exercising during pregnancy offers endless benefits, for both the mom and baby. These are some of the benefits of exercise in pregnancy:
- Improves general fitness level & healthier weight
- Reduces risk of insomnia, stress, anxiety and depression
- Decreases the risk of:
- Gestational diabetes by 30%
- Pre-eclempsia (high blood pressure in pregnancy)
- requiring C-section
- Diastasis Recti
- Pelvic girdle pain & other joint problems (or helps to control them)
- Incontinence
- Possible shorter labour
- Less risk of preterm labour
- Better postnatal recovery
One of the exercises that is safe throughout pregnancy is prenatal Pilates. It is customized to the needs of the mother and baby. Pilates is safe and like all exercise, boosts your physical and mental health. It focuses on maintaining and improving stability, in addition to strengthening the entire body mainly the core and pelvic floor area which are very important and highly affected during pregnancy. It helps you to focus on better posture, alignment and body awareness. Pilates in turn helps to relieve back and hip pain and alleviate symptoms of pubic synthesis, a common pregnancy condition.
In prenatal Pilates we focus mainly on the transverse abdominis, the core area. Prenatal pilates concentrates on building and reinforcing this support system. We also incorporate deep breathing techniques, as well as a mind-body experience, this is very important to prepare mothers for labor and childbirth. Deep breathing is also essential for the mother as a relaxation technique to deal with stress and anxieties that come about with pregnancy
Postnatal exercises
Postnatal Pilates is one of the best forms of self-care that mothers can do. It promotes total-body alignment, better posture and enhances awareness of your “new” post-baby body. This works hand in hand to avoid issues such as low back pain, pelvic pain and neck pain. The breathing technique during Pilates oxygenates both the muscles and the brain, which helps to improve general well being. This energizes your body from head to toe, something that proves especially essential for sleep-deprived parents.
Benefits of Exercising in the postnatal period:
- Helps with weight loss/ prevention of obesity
- Improves energy level and better quality of sleep
- Recovery and/ or prevention of incontinence
- Restoring core strength and shape
- Maintaining healthy bone structure
- Reduces the risk of postnatal depression and anxiety
- Improves general psychological well being
- Enhances recovery rate
- Improves fitness levels, muscle tone and strength
- Decreases or improves joint pains and postural problems
Pilates or another form of moderate exercise after birth is a safe and effective way to address any aches and pains still lingering from pregnancy and from the physical and mental demands of being a new mother. Since Pilates is a mind-body approach it helps the physical, emotional, spiritual and psychological well being.
When to Stop
Sometimes, although we wish to remain active, it is best to refrain from continuing exercise. This is usually advised by your gynaecologist, GP and/ or midwife. These are usually the general reasons where one should refrain from continuing unless given the go ahead by health professional.
- Vaginal bleeding
- Shortness of breath with minimal exercise
- Dizziness and headaches
- Chest pain and/or palpitations
- Calf pain or unusual swelling
- Abdominal pain
- Excessive fatigue
- Amniotic fluid leakage
Back and Pelvic Girdle Pain (PGP) during Pregnancy
What is PGP?
PGP describes pain in the joints that make up your pelvic girdle; this includes the symphysis pubis joint (SPJ) on the pubic bone or below the tummy at the front and/or the sacroiliac joints (SIJ) at the back. It’s also known as SPD (Symphysis Pubis Dysfunction), but this when only the symphysis pubis is affected, which is not usually the case.
Common Symptoms:
- Difficulty walking
- Pain when standing on one leg (e.g. climbing stairs & dressing)
- Pain and/or difficulty moving your legs apart (e.g. getting in or out of the car)
- Clicking or grinding in the pelvic area
- Limited or painful hip movements (e.g. turning over in bed)
- Difficulty lying in some positions (e.g. on your back or side)
- Pain during normal activities of daily life, even just walking
- Pain & difficulty during sexual intercourse
Possible Causes
Sometimes there is no obvious explanation for the cause of PGP. Usually, there is a combination of factors causing PGP including:
- A change in the activity of the muscles of your tummy, pelvic girdle, hip & pelvic floor due to physical changes such as increased weight caused by the pregnancy. This results in the pelvic girdle becoming less stable & painful
- History of past injuries around the pelvic area
- The effect of pregnancy hormones such as relaxing, which causes ligaments, joints & tendons to become lax, therefore, less stable
- Sometimes the position & weight of the baby may also produce symptoms related to PGP
PGP Management
Avoid:
- Heavy lifting & chores that involve hip twisting such as washing the floor & vacuuming
- Activities & exercises on one leg. E.g. Sit down to dress & undress
- Deep squats & lunges beyond 90 degrees
- Over crossing your legs at the ankles, knees & hip areas or wrapping your feet around the legs of the chair while sitting
- Staying in the same position (stand up & move about every 30 minutes)
- Staying on the sofa or sitting in bed
- Activities that produce more pain. When doing exercises stay in the pain-free range
Try to:
- Wear appropriate footwear, supportive trainers. Avoid Flip flops, heels or walking barefoot
- If you have an exercise ball, spend some of the time sitting on it instead of a chair
- Place a pillow between the knees when sleeping on your side
- Exercise regularly especially pelvic floor training, abductors, core & glutes training
- Incorporate some stretching in your exercise regime. Start slowly with pain free exercises, progress slowly, preferably with your physiotherapist’s guidance
- Exercise in water (avoid breaststroke in the beginning)
- Consider using a pelvic support belt if it helps
The discomfort of PGP & the difficulty with normal activities may have a negative impact on your emotional wellbeing. Seeking help & advice as early as possible will help your pain, but if you are experiencing any emotional effects of PGP, help & support are available from the medical team (gynea, midwives, physio) looking after you.
If PGP persists after your baby is born, it is important that you discuss its impact with your partner (and/or your family). In particular, you should discuss how best to care for your baby/toddler & how much help you need.
Kegel Exercises During and After Pregnancy
Kegel exercises help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles during your pregnancy, you can develop a better ability to relax and control the muscles in preparation for labour and birth. Kegel exercises are also highly recommended during the postpartum period to promote the healing of perineal tissues, increase the strength of the pelvic floor muscles, help these muscles return to a healthy state, and increase urinary control. Therefore, they help in preventing urinary incontinence, which is a common problem during and after the birth and even later on (menopause) in women’s life.
Weak pelvic floor also increases the chances of low back pain and hip pain. Using Kegel exercises helps you to understand how to activate your pelvic floor muscles. This is also a foundation for low back pain and hip exercises.
How can you do Kegel Exercises?
To do Kegels, imagine you are trying to stop the flow of urine (do not do it while actually passing urine) or trying not to pass gas. When you do this, you are contracting the muscles of the pelvic floor and are practicing Kegel exercises. While doing Kegel exercises, try not to move your leg, buttock, or abdominal muscles. In fact, no one should be
able to tell that you are doing Kegel exercises. You can do them anywhere! It is important that you:
- Do not clench your buttocks or your tummy muscles.
- Do not hold your breath.
- Do not squeeze your legs together.
Slow Exercises: Gradually tighten the muscles and hold while you count to 10. Try to do 10 of these holding exercises with 10-20 seconds rest in between each hold. They help muscles support your bladder and bowel.
Fast Exercises: Tighten and relax the muscles quickly. Try to do 10 of these exercises. This helps muscles stop urine leaking when you sneeze or laugh.
