Exercise can be a great way to maintain control of your changing body during pregnancy. Be sure to keep close contact with your obstetrician during your pregnancy for optimal care. The American College of Obstetrics and Gynecology (ACOG) guidelines state that in the absence of either medical or obstetric complications, exercise of 30 minutes or more is recommended on most or all days of the week. Exercise can decrease the chance of excessive weight gain, low back pain, varicose veins, and water retention. If you feel fatigue, pain or discomfort, decrease or stop activity.
Be sure to ask your physician about exercise and your heart rate and the type of exercises you are allowed to perform. You will probably be given guidelines according to the week of your pregnancy. You may be advised not to exercise on your back after 20 weeks because of weight of the baby on major blood vessels in the back of the abdomen.
Strengthening pelvic floor muscles, which surround the vaginal, urethral and anal openings, are supportive of the lower abdomen and pelvic region and can also help control pressure in the region caused by lifting, coughing, sneezing and laughing . Better muscular control and blood flow from healthy and fit pelvic muscles can help with the actual muscular control during birth, decrease the chance of hemorrhoids, decrease the chance of urinary stress incontinence and may increase satisfaction during sexual activity. A proper pelvic floor exercise (Kegel exercise) involves tightening and lifting of the pelvic floor. Avoid holding your breath, bearing down or holding your thighs toghter during the exercise.
Alway be careful not to overexert and overheat your body. Watch your heart rate and take precautions to avoid falls. The change in your body will affect your center of gravity, your balance and your coordination. You will also reach a point where you need to avoid laying on your back because of the weight of the baby on blood vessels in your abdomen. The change in your body may also cause muscular aches and pain and low back pain from the extra weight of the baby pulling downward and stressing the low back. The middle and upper back muscles also tighten under strain from balancing the forward tilt of the upper body. Relaxin, a hormone, that prepares your pelvis for expansion of cartilage necessary for delivery may also affect cartilage of other joints and make them vulnerable to injury or aches and pains. Relaxin begins to work at about 4.5 months and may have a prolonged effect with breastfeeding and associated elevated level of progesterone. Sharp pain can occur in the low back, sacrum, gluteal region, in the groin or directly on the pubic bone. It may be necessary to visit an orthopedic specialist and physical therapist to evaluate and treat pain in the hip, groin or back region.
Remember important postural tips:
When sitting or standing keep your ears aligned over your shoulders, usually with a slight chin tuck. Keep your shoulder blades retracted, which means keep them back so they attempt to meet toward the spine.
When standing, keep your knees slightly bent to help reaction forces with the ground stay in your legs instead of bouncing in your low back. When you are standing straight up, it is important to hold the pelvis in a posterior pelvic tilt, which means tucking your tail under. Pelvis is Latin for water basin. The anterior pelvic tilt would pour water out the front of the basin. The posterior pelvic tilt would hold water in the basin or would spill it out the back. Avoid having your weight on one leg more than the other for a prolonged period.
When you have to reach and lean forward, it is best to allow a forward pelvic tilt with bent knees and loosened hamstrings. The extra hanging weight of the baby can increase the curvature of the low back (hyperlordosis), so you may need to support your upper body weight with a hand on one thigh or a hand on a kitchen counter, etc. Strong gluteal muscles and strong abdominal muscles will help control the anterior pelvic tilt, but once pregnancy begins, it is more difficult to develop big gains in strength in the gluteal and abdominal muscles.
During sleeping and lying on your side, it can help to keep a pillow between your knees.
Important Facts and Nutritional Tips
Pregnancy requires an additional 300 calories per day.
Nursing requires and additional 500 calories per day.
Calcium needed is 1,000 mg per day.
Folic acid needs are 600 mcg per day.