Prenatal Exercise Tips and Guidelines

Exercise can be a very effective and enjoyable part of your pregnancy, but remember,
pregnancy is not the time get in shape and whatever form of exercise you do, you
need to take certain precautions. Exercise should make you feel healthier and
energetic while helping to keep your body strong. It may even reduce nausea,
fatigue, backache and leg cramps, symptoms that most pregnant women experience.
Before starting any exercise program, remember to check with your physician first.

Here are some tips and guidelines to follow when exercising during pregnancy.

- Go at your own pace. Respect your own bodies capabilites and do not push too
hard. Go as slowly as you need to, but keep going. If you led a sedentary lifestyle
previous to pregnancy, you should begin an activity of very low intensity and increase
very gradually. You should also avoid competitive activities.

- Regular exercise should be performed at least three times weekly.

- Always warm up and cool down. A warm up prepares the joints and muscles for
more strenuous exercise and lessens the likelihood of strain or injury. A cool down
brings the heart rate and the respiratory system back towards resting levels.

- Your heart rate should not exceed 140 beats per minute (23 beats for 10 seconds)
during exercise.
- Strenuous activities should not exceed 15 minutes in duration.
- Avoid bouncy, twisting or pounding movements to protect maternal joints and
- Stretches should be long, slow and gentle, not bouncing. Take care not to
overstretch as the joints are more relaxed during pregnancy due to hormonal
- Caloric intake should be adequate to meet not only the extra energy needs of
pregnancy, but also of the exercise performed.
- Drink plenty of water before and after exercise to prevent dehydration, and if
necessary, activity should be interrupted to replenish fluids.
- After the 4th month of pregnancy, the added weight of the uterus can depress the
major vein bringing blood back to the heart when exercising on your back. If you
feel any discomfort or dizziness while on your back you should avoid these exercises.
Modify them so you are supporting your body with your arms, or are on your side.
- Care should be taken to gradually rise from the floor to avoid dizziness.
- Do not exercise in hot, humid weather or when you have a fever.


These exercises can be done after your baby is born while still in the hospital. Begin
them within 24 hours. Start with two repetitions and increase them at your own pace.
Perform them at least twice a nay.

Pelvic Boor exercises - Continue to do your kegel exercises. They will help
an episiotomy heal and will help the perineal, vaginal and rectal muscles get
toned and strong. Do them even if you've had a cesarean birth.
Ankle circles - will help prevent swelling in the legs and promote circulation.
Pelvic tilts - will help get your abdominals back in shape and will relax and
stretch the lower back.
Single leg stretches - help with the circulation in your legs. Lie on the bed
with both knees bent and soles of the feet on the bed. Exhale and slide one
leg out. Inhale as you bend your knee back to the starting position.
Head circles - to relax the muscles around your neck and shoulders. Roll
your head from side to side, forward to the other side and back.
With your physician's consent you can probably start more strenuous exercise 4-6
weeks after a normal delivery. If you have had a cesarean birth, it may take 10 to 12
weeks or longer.


The Pelvic Floor

If you can imagine a base that has to support all your pelvic organs - your
bladder, uterus and bowel, for example - that's the pelvic floor.

Specifically, the pelvic floor is the group of muscles attached to the pelvis (the
hip bone) at the coccyx (tail bone), lower pelvic sides and pubic bone (in the front).
These muscles are always under pressure, but this pressure becomes even more
intense under the weight of an enlarged uterus during pregnancy.

Another set of muscles equally important to remember during pregnancy are
called sphincters. These are muscles that surround the passages - the anal passage,
vagina and urethra, - through the pelvic floor.

During pregnancy, it's extremely important to keep the pelvic floor and
sphincter muscles in good shape since the constant pressure of a heavier uterus can
create strain. Many women experience problems with bladder control in late
pregnancy and after delivery. Exercising the urethral sphincter can improve control.

Exercising rectal muscles can prevent hemorrhoids which result from blood
congestion in the rectum. Toning the muscles of the vagina helps form a firm elastic
canal for childbirth. Both will lead to an easier delivery and to better healing
afterwards. These exercises are called "Kegeling" and are described as follows:

Trying to control the flow of urine will help strengthen the urethral sphincter.
Urinate in spurts, stopping the flow in mid-stream; this will help strengthen the
urethral sphincter. When you're able to exert this much control, interrupt the flow
several times during each urination.

This exercise can be done in any position, but try this one for starters: sit on a hard
chair and lean forward with your feet apart on the floor. Now try to tighten all the
sphincter muscles - anal, vaginal and urethral - from back to front, in succession.
While it's difficult to separate these muscles from one another, it's much easier to
contract them in succession. When all three are tightened, hold the position for one
or two seconds and then release the muscles in a wave-like motion, from front to

Again, this exercise can be done in any position. Imagine you're on an elevator
going from the first to the tenth floor of a building. Now contract your pelvic
muscles a little at a time, tightening them at each floor until you reach the tenth floor
at the count of ten. Descend and then gradually release your muscles, loosening them
at each floor. By the time you reach the first floor - and not before - you should be
back to normal muscle tension. Don't stop at the ground floor. Release the muscles
even more, moving down to the basement and the sub-basement of your imaginary
building. Then contract the muscles again, until you're back up to the first floor.

Lowell General Hospital, 295 Varnum Avenue, Lowell, Massachusetts 01854, Main Telephone: (978) 937-6000
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