Transcription:
Safely Exercising During Pregnancy

Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.

Caitlin Whyte (Host): Welcome to BayCare HealthChat. I'm Caitlin Whyte. There are so many questions when it comes to exercising safely during pregnancy. What exercises are still safe and how much exercise is still good. LaMor Silas is a pre and postnatal fitness specialist with BayCare and joins us to answer these questions and discuss some tips and need to knows of safely exercising during pregnancy.

Well, LaMor, let's start off with that big question right at the top - is exercising while pregnant safe?

LaMor Silas (Guest): Yes, absolutely. It's safe with a few considerations. I recommend you always check with your physician or health care provider first, as each woman's pregnancy is different. But for most of us who are healthy and fairly active, going into pregnancy exercise continues to be safe and very beneficial during pregnancy.

So, let's say that you have your physician's clearance now for exercise. I have a few tips on how to approach the exercise during pregnancy. Approach exercise during this period of your life with the goal of maintaining the level of fitness you're at pre pregnancy throughout your pregnancy. So now is not the time to go hard with strength or cardio or to try and lose weight.

You simply want to remain active and maintain close to your current level of fitness going into your pregnancy. If you start a routine or a fitness format that is completely new to you, sometimes women will start practicing yoga for example, and never had practiced it before pregnancy. So start out easy with new formats and speak with your teacher or your personal trainer about modifications specific to the pregnancy.

And if you're working out with weights currently also consider lowering the weight, especially in movements where your back is concerned. Remember, as your baby bump begins to grow your center of balance shifts, so safety first and foremost, in all you do.

Host: Well, then how much exercise is recommended while someone is pregnant?

LaMor: Well, the CDC suggests that during pregnancy doing at least 150 minutes of moderate intensity, low impact exercise each week is beneficial. So you can divide that into five 30-minute workouts throughout the week, or you could even do six or seven shorter workouts because even short workouts are beneficial. You don't want to exercise to exhaustion. So choosing a cooler time of day, possibly if you're exercising outdoors. Take more frequent rests between your intervals and maybe shorten the overall duration of your workout. In terms of the time that you spend in working out, you want to be consistent in your workout. So pick a time of day that most days of the week, you can get 15 to 20 minutes of exercise in.

Again, even short intervals are beneficial for your body and your mind in terms of reducing your overall stress. So finding a time that most days of the week work for you helps your body create its own biorhythm. And that's a really cool thing because then your body's going to want to be exercising at that time of day, most days.And that's a great motivator for you mentally. I would also like to say that in terms of carving out time for your exercise, some women who are pregnant, who already have children that you're caring for, or households that you're managing, or maybe even other family members that you're caregiving for, please do not feel selfish about taking time for your own exercise.

The better in health you are and the less stress you are feeling, the better you are at caring for your family. It's truly a win-win.

Host: Well, let's talk about the benefits a bit more. Of course, exercise is always beneficial to anyone at any time, really, but what are the benefits specifically during pregnancy to working out?

LaMor: According to the American Pregnancy Organization, exercising for 20 to 30 minutes, most days can benefit your overall health during pregnancy. The important thing here is to be active in order to get your blood flowing and to help reduce your stress levels. Exercising during pregnancy has the potential to reduce backaches, constipation, bloating, swelling from fluid retention. Think comfort here. Right. It can also help prevent or manage gestational diabetes. Exercising can increase your overall energy. It can help to reduce your stress levels. Ah, it's a mood booster and it can help improve your posture, which is a huge benefit as your baby bump continues to grow and your center of balance shifts and the weight that you're bearing in the muscles that support your spine take a bit more load. Exercising during pregnancy also helps promote muscle tone, strength and endurance. So it helps improve your overall ability going into the birthing process, not to mention making it a bit easier for you to get back into shape after your baby is born. And it also helps to promote better sleep.

Ah, another stress reducer. And while we're talking about the benefits of exercise, you might think of yoga as just for relaxation, but it is a form of exercise. Prenatal yoga is a great low impact exercise that can be highly beneficial for pregnant women. You can absolutely build strength, stamina, and tone muscles with prenatal yoga, along with the relaxation of mindfulness that allows you to learn, which are very beneficial in managing the physical and emotional changes you go through during pregnancy.

Host: So I'm sure exercising, like you do usually is much different during pregnancy. So can you tell us about some modifications for safety in fitness workouts for pregnant people?

LaMor: First and foremost, make sure that if you're going to a group fitness class or a yoga class that you tell your teacher, or if you're going to a personal training session, you talk with your personal trainer ahead of time and let them know that you're pregnant. No matter whether you just found out that you're pregnant or you're two or three months into it. Let them know so that they can give you specific modifications for the individual exercises that they're guiding you through. And just showing up a few minutes before a class or a session is perfectly fine, but here are seven general modifications that I recommend you adopt, right from the moment you know you're pregnant so that as your baby bump grows, these things just become habit and you don't really have to think about them.

Be sure to wear loose fitting, comfortable clothing, including a good support bra. Choose supportive, lace up athletic shoes that fit comfortably. Now keep in mind in pregnancy, your feet may swell during workouts, especially if you're working outside and you may find that you need to up-size in general, as your pregnancy progresses. A good fitting shoe is a smart investment as it allows for your comfort, unrestricted blood flow and better stability.

Also hydrate before, during and after workout. Even if you have to leave a class to go to the bathroom and come back, I'd rather you hydrate and keep that going during, before and after your workouts. Make sure you're eating a well-balanced diet that supports a good level of energy and a light snack beforehand will help your energy level and may help prevent lightheadedness and queasiness during the workout.

Also choose exercises where you are stable and balanced. So exercising on a flat level surface is also going to help you to prevent injury. Now is not the time to engage in activities that require bouncing and jumping and rapid changes in direction, twisting motions and those exercises where you're down on your belly.

Also, if you're doing weightlifting and weight training, don't go heavy with the weights. Remember, you just want to maintain your level of fitness that you're at as you begin your pregnancy. So maybe consider going a little bit lighter, maybe doing one or two more rounds of repetitions. And lastly, after doing floor exercises, and again, remember no belly down work, make sure you get up slowly and gradually to prevent becoming dizzy. Even if the rest of the class is moving at a different pace than you, move slowly to get up and down off the floor.

Host: Well, you mentioned yoga and that's my workout of choice. I love yoga. So can you talk about some modifications for practicing yoga safely?

LaMor: Again, make sure that you let your teacher know that you're pregnant, so he, or she can better guide you for safe options during the class. And as I also mentioned earlier, it's good to adopt these modifications right from the time that you know you're pregnant. So as your belly grows and your sense of balance shifts, these modifications are just habit to you.

So seven tips to remember are all the same nutrition and hydration tips I mentioned earlier apply here. No belly down poses. So those poses like Cobra where you're on your belly. Instead of Cobra, you could choose an all-fours cat cow movement. Maybe instead of bow pose where you’re belly down and you're reaching back to hold your ankles and arch your back - choose instead, coming at that from a kneeling bow pose where you're just holding one ankle. You can be very creative here in coming up with options and working with your teacher for things that you can do while others in your class are on their belly. So no belly down poses. Limiting your twists. And when performed, do the twist slowly and focus on twisting from the chest upward through the shoulders.

So what I mean by that is no pelvic and lower back twists. So no twist where you're laying on your back, because you don't want your lower back and the pelvic floor engaged in that twisting motion. Also no inversions like headstands, shoulders stands, plow, wheel. Inversions, like a low bridge - one of my favorite poses is to prop my lower back on a block and just rest in that restorative bridge - that's okay. And downward facing dog where you're on your hands and feet. That's okay too generally provided you don't stay in either one of those poses for a long period of time and provided you don't have medical conditions such as high blood pressure or dizziness, right, where those head below the heart postures might bring some discomfort.

So while some women do choose to do inversions during pregnancy, I like to approach the choices from the principles of exercise science. I'm always doing a risk benefit analysis. So is the risk of doing a pose worth the benefit? And you can have a beautiful yoga practice without inversions, and then pick them back up again after postpartum recovery. The next tip I have is no long periods lying on your back. Right? So maybe taking that final relaxation laying on your side, seated at a wall, maybe seated in a chair. Many poses that you're used to doing on your back can be modified to do on all fours or side lying. So again, this is where it's very important that you let your teacher know.So she, or he, can give you options. And then when you're in standing poses, like mountain or forward fold, consider having your feet slightly wider than your hip bones. Very often we're instructed to keep our feet in line with our hip bones, but for pregnancy, it's really nice to have the feet slightly wider so that your belly has a bit more space when you go up and down from that mountain to forward fold. Also knees a bit wider when you're in child's pose allows for the hips to open up a little bit more comfortably. And my last tip here is for those individuals who practice hot yoga, now is the time to step away from that. You've got to remember that your body temperature is already elevated due to the increased blood flow that you share with your baby.

And your baby has its own temperature in that little oven, we call a womb. So no artificially heated rooms during pregnancy, wait until after your postpartum recovery to resume that.

Host: On the subject of adapting workouts, are there any medical conditions your fitness specialist or doctor may need to be aware of in these situations?

LaMor: Well, always discuss any concerns that you have with aches or pains or shifts and differences that you're feeling in your body with your physician or medical provider. Make them aware of any issues you're experiencing. And then talk with them about the forms of exercise that you're wanting to continue during pregnancy and have that nice dialogue with them.

But in general, some conditions that I have seen individuals go through during pregnancy are these - high blood pressure. So if someone develops high blood pressure during pregnancy, omitting poses and workout routines where the head is below the heart. For example, a forward fold now becomes maybe hands to shins or thighs with your head level with your heart.

If you're experiencing low blood pressure, omitting poses or work, weightlifting, where your arms are overhead for long periods of time and make sure you get up and down from the floor very slowly. You've got to consider that when your arms are overhead, your heart has to work that much harder to pump blood against gravity up into the air, into your arms. If you have low blood pressure that is putting even more load on your heart. So again, omitting poses or work where your arms are overhead for long periods of time. And then, you know, balance is going to be a bit off because your center of gravity is shifting with your growing belly.

Using props, the wall, a nearby chair, a ballet bar for steadying yourself, placing your workout space or your yoga mat near those places where you can easily hold on if you need, and then move more slowly and mindfully. When you're working out with weights, pick up the weights with care. I also know of individuals who can experience back pain and sciatica when they're pregnant.

Avoid twisting motions in general is going to help you to minimize back pain. And with sciatica, when that nerve flares up, you need to consider that when the nerve is flaring up, it's inflamed, it's already heated. Now is not the time to do a deep stretch. Make it a soft, easy stretch, but do make stretching and yoga a regular part of your exercise routine to help minimize issues like back pain and sciatica.

You may experience swelling in the feet and legs also as your pregnancy develops. Choosing well-fitting shoes is going to help. Wearing loose fitting clothing is going to help. Hydrating is going to help and then making sure that you're not working out in overly hot settings and then taking time throughout your day to elevate your feet is going to also help with swelling in the feet and legs. And then also blood sugar levels and gestational diabetes are two other conditions that sometimes occurs during pregnancy. Tending to your overall diet and the medication plan possibly that's been prescribed by your physician is first and foremost.

And then remember a light snack before class can help with nausea, with queasiness, with your overall management of blood sugar levels, and then take rests during your class or workout, even if others are not. This is your workout. Nobody else's. You do what honors your body and your baby.

Host: I love that. That's such a good reminder. Well, wrapping up here, talk to us about pelvic floor health. How important is that to maintain during pregnancy?

LaMor: Yeah, so awareness of the pelvic floor and giving attention to the strength of our pelvic floor, pregnant or not, has several health benefits. A strong pelvic floor can help minimize incontinence. A healthy pelvic floor helps to increase blood flow into the sex organs in the pelvic region. And then it also contributes to our overall core stability. Oftentimes we think of our cores just being our ab muscles at the front of the belly, but there are many core muscles at the back body, the front of the trunk, as well as the pelvic floor is a core muscle that helps with our overall stability in moving, changing direction, lifting. And of course, carrying the load of our growing baby and preparing for labor.

Your physician or health care provider may have some specific exercises they recommend that you perform to both strengthen the pelvic floor or to relax your pelvic floor, because you can have an overly tight pelvic floor. You can have an overly relaxed pelvic floor.

Your physician will be able to guide you into specific exercises. There is also a field of pelvic floor physical therapy that is now growing and becoming more widely available in our communities that may be recommended to you as postpartum recovery as well. But for all of us, a simple thing that we can do is the process of deep diaphragmatic breathing because unknown to a lot of people is that the diaphragm muscle that is instrumental in our fully deep oxygenating of our blood is energetically coupled with the pelvic floor diaphragm. When we do something as simple as be mindful of our breathing and breathe in to that lower part of the belly, which helps that diaphragm to tighten itself and strengthen itself downward towards the belly, opening up the lungs and really oxygenating fully the lungs; we have the opportunity of also tightening and toning the pelvic floor.

If you'd like, we can give that a try and those of you that are listening, all I ask is that you just sit comfortably and breathe and we'll take a few breaths together. Just notice your breathing in and out through your nose. And as you begin to inhale, I'd like you to let your belly protrude forward so that you feel that inhale coming down from your nostrils all the way down into your belly and then feeling it elevate and opening up wide into your ribs and then lifting up high into that chest space. And then as you breathe out, drawing that navel inward, so you feel the belly draw inward, you feel the ribs narrow and the chest to relax. So let's feel that a few more times. Just notice how that breath comes in fully to the lower part of the belly.

And what we're doing here is toning that diaphragm underneath the lungs. And now as we breathe in, I'd like you to lift your pelvic floor slightly that perineum or triangle area between the sex organs and the rectum. Just feel that little tug and lift upward. And then as you exhale fully relax that space down.

And then as you inhale again, feel that basement floor, if you will, of your pelvic floor, kind of lift up to that first floor. And then as you exhale, relax that first floor back down to the basement and just soften that pelvic floor. Let's do that two more times, a little lift and tug upward of the pelvic floor as that diaphragm tugs itself downward to the belly. And then as we exhale that diaphragm underneath the lungs floats up and the pelvic floor diaphragm relaxes down.

So just something that we can do throughout our day to not only calm and self-soothe with our deep diaphragmatic, three-part breathing, but also to strengthen and relax our pelvic floor at the same time.

Host: Oh, that's wonderful, LaMor. Thank you so much for that. As we, you know, close out this episode, is there anything else you want pregnant mamas out there to know?

LaMor: I would like all expectant moms to know that you are super women. You are creating a life and in doing so, take time for yourself. Because in doing that, you can care much more for your growing baby and enjoy the cycle of pregnancy. This is a wonderful time in your life.

Host: Absolutely. Well, LaMor, thank you so much for joining us. Some great tips here to keep mamas moving out there.

Find out more about us online at BayCareMaternity.org. And please remember to subscribe, rate and review this podcast and all of the other BayCare podcasts. For more health tips and updates, follow us on your social channels. This has been another episode of BayCare HealthChat. I'm Caitlin Whyte. Be well.