Pregnancy and exercise: A common-sense issue
Pre-pregnancy fitness is an important factor
If you believe some of the popular fitness magazines, it's OK for some pregnant women to exercise regularly or even to run a marathon. But how much is too much?
While the issue of exercise for expectant mothers has been the subject of much debate, it really all comes down to common sense, says Mark DeFrancesco, MD, MBA, medical director for Women's Health Connecticut in Avon.
"Usually, exercise is fine, to the extent that the woman doesn't 'push the envelope' as much as she might have when she wasn't pregnant," he notes. "People who have been following a moderate exercise program can certainly continue to do it."
And just what constitutes pushing the envelope? "It's really a common-sense approach later in the pregnancy," he explains, "when a woman gets to be shaped differently enough that certain exercises would be impossible to do. You don't want to do anything that would threaten the safety of the baby in the womb, such as placing a heavy weight on the abdomen."
Other basic guidelinesIf a woman is otherwise healthy, she should still not allow her pulse rate to go over 140, whereas she might push herself harder than that if she were not pregnant, notes DeFrancesco. "Also, she should stay out of hot tubs and saunas."
The level of exercise the woman has maintained before her pregnancy must also be taken into consideration, says DeFrancesco.
"Again, this is common sense," he notes. "If you haven't done much before, you should certainly not start a brand new, rigorous regimen. You should gradually increase the level of your activity, but don't push it. Even if you were very active, you still might have to curtail things a bit."
Even if you follow these general guidelines, says DeFrancesco, you should be alert to signs of trouble. These include increased frequency of contractions or cramping, or vaginal bleeding. "If during your workout, you get very crampy, rest as soon as possible, drink extra fluids, and stop altogether if they do not subside," he warns. "It could be a sign of premature labor."
If there are a sufficient number of pregnant women in your company, it might even make sense to design a special class for them. Most trained exercise professionals would be qualified to do that, says DeFrancesco.
"I understand there are some programs that have gotten physical therapy professionals to come in and advise them, but if the individual who is running your program is a trained professional, they should be able in most cases to figure out an appropriately toned-down program for people who are pregnant," he says. "Anyone who knows a little bit of exercise physiology could develop a new program or adjust an existing one downward slightly."
Post-partum benefits likelyApparently, there may also be benefits to both the new mom and to the newborn if she picks up her exercise program after giving birth. A recent study published in Medicine & Science in Sports & Exercise, the official journal of the Indianapolis-based American College of Sports Medicine (ACSM), shows that exercising may not affect the immune system benefits passed through mothers' milk to their infants.
It had already been established in the literature that individuals can increase their overall immunity by exercising regularly, so a group of researchers set out to determine whether various levels of exercise would affect the amount of Immunoglobulin A (Ig A) in the milk of nursing mothers, thus increasing their infants' immunity.
The researchers studied women who regularly participated in 90 minutes of aerobic activity per week. While levels of Ig A and its subgroups were significantly lower 10 and 30 minutes after exercise, by the time 60 minutes had elapsed, the concentration of immunoglobulins had returned to pre-exercise levels.
"We knew that the immune properties of breast milk were well-defined," notes Janet Wallace, PhD, FACSM, who headed the research team. "What we didn't know was whether various levels of exercise would affect the production of immunoglobulins."
So how much exercise is good for new moms? According to the ACSM, that's still an open question. The organization recommends that aerobic-type exercise at an intensity of 60% to 90% should be conducted for 20 to 60 minutes three to five times a week for the development and maintenance of cardiorespiratory fitness in healthy adults. However, it maintains that further research is needed before specific recommendations can be made to nursing mothers.
(Editor's Note: For more on the benefits of breastfeeding, see this month's Health & Well-Being insert.)
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