Baby Steps to Fitness

We've come a long way from the days when pregnancy was considered a time of extremely delicate health. These days, many women continue to work full time right up until the baby is born and the time spent in hospital after delivery is usually brief.

In fact, the pendulum has swung so far that we run the risk of forgetting some of the physical realities of pregnancy and the postpartum period that simply can't be ignored. Maintaining an active lifestyle is always beneficial, but there are a few important health considerations during pregnancy and shortly after the baby is born.

First, let's look at the impact of pregnancy. Women often feel tired and nauseated in the first trimester, while in the third trimester weight gain can affect balance and cause fatigue and sore muscles. Women who gain an unusual amount of weight or who are carrying more than one baby will likely feel these third trimester symptoms sooner. All of this means that some activities just aren't advisable, enjoyable or even possible.

Another reality, which many women aren't aware of, is that hormonal changes associated with pregnancy result in "hypermobility," or laxity of joints that continues after the baby arrives and for as long as the woman breastfeeds (some experts believe hormonal changes can even last for some time after breastfeeding ceases). This hypermobility results in less muscular control and ligament stability, which can lead to injuries. During pregnancy, you're more likely to twist your ankle or stumble due to your knees ‘giving out' and this obviously has an impact on any weight-bearing activities you want to do.

The overall mantra for fitness during pregnancy is that while you should be able to continue to some degree with your usual activities, it's not usually a time to start something new. If you've never been fit, don't start a vigourous program when the pregnancy test comes back positive.

On the other hand, if you've always maintained an active lifestyle, there's no reason to stop, barring special circumstances that your physician will advise you about. In fact, it's best to check with your physician or primary care provider about any activities that you plan to undertake during pregnancy.

The big question is, what degree of activity is safe, even if it's something you normally do. Overall, exercise during pregnancy should be done to maintain your condition, not as training to achieve a higher level.

The key thing to remember is that if you can't breathe, neither can your baby. Women who are pregnant must be careful, when doing any activity, not to get short of breath. It's also important to avoid any exercises that require you to be flat on your back, because that position can cut off oxygen supply to the baby.

When I became pregnant with my second child, I was a runner. Concerned about jarring, I switched to using a cross-country ski machine and made sure that my breathing stayed within a normal range (able to comfortably hold a conversation while exercising, also known as 'the talk test.') I also did Pilates exercise right up until my due date, because I had done it prior to my pregnancy.

From what I've read, the jury is still out on whether being active during pregnancy results in an ‘easier' labour and delivery, but there's no doubt in my mind that a fit, active woman will recover her shape and strength faster after the birth than someone who has been completely sedentary.

That brings me to the postpartum stage, which is all too often ignored. It seems all the attention is on the baby and the mother's own recuperation is often taken for granted. Again, there are some physiological realities that must be taken into account. Don't forget the laxity or hypermobility of joints will continue as long as breastfeeding takes place and possibly longer. Also, many women experience weakness and instability in their pelvic and lumbar (lower back) regions, which can lead to a number of health problems. All this is taking place at a time when you are probably doing more lifting than ever before, as you place and remove your child in and out of car seats, bassinets and cribs.

It's essential for postpartum women to regain stabilization of the back and pelvis to avoid chronic pain, not to mention prolapse of the uterus, and bladder incontinence in future years.

There are specialized education and exercise classes for women that focus on rebuilding the pelvic floor and abdominal muscles. ProActive offers them periodically as a four-week course led by trained physiotherapists and kinesiologists. When we talk with women about this course, we like to make the point that while prenatal classes are primarily about the baby, postpartum education and exercise is about you.

After all, one of the best gifts you can give to your new baby is your own good health.