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Thursday, May 30, 2013

Pre/Post Natal Exercise: Q & A With An OB Nurse

I have a special post for you today!  

Being a member and employee for the last three years at my local YMCA has allowed me to develop many new relationships.  One of those relationships started a few years ago when I took an afternoon kickbox class.  The instructor was intense and I liked it.  I continued to take her class as my schedule allowed.  When I became pregnant she informed me that she also taught the pre-natal exercise class.  True to her form, she was intense even in her pre-natal class and true to my form, I still liked it.  

Um yea, a year later and it's still a problem.  I say "no thanks" to jumping jacks.  

Turns out that instructor, Mendy has been an OB nurse for 15 years. She has taught group exercises classes at the Y for almost 15 years and has been certified to teach prenatal classes for about 13 years. And she's a mom of two adorable girls.  She knows her stuff.  

As a gal in her thirties, I have a lot of friends in the "family building business" as I like to call it.  Most of my friends are either thinking of getting pregnant, pregnant or just had a baby so I thought I'd take the opportunity to pick Mendy's amazingly knowledgeable brain about pre and postnatal exercise.  Here is what she had to say: (remember, always consult your doctor before starting a new exercise routine, especially when pregnant.)

Q: As a pre-natal/postpartum exercise instructor I'm guessing you think exercising while pregnant is pretty important, yes?

A: As both an OB nurse and an aerobic instructor I feel exercise during pregnancy is so important. ACOG (American congress of obstetricians and gynecologists) thinks so also. They have guidelines set for pregnant moms for exercising. There are so many benefits ranging from the health of the mother to the health of the baby. My favorites are: you gain less weight, less fat, have faster labors, faster pushing times, less tearing, get back to your pre-pregnant weight faster, less aches and pains, better self esteem, less chance for gestational diabetes, better sleep and more energy.


Q:It appears to me that OB's are loosening the belt when it comes to pregnant women exercising. Are there general guidelines moms-to-be should follow?  What's your take on it?

A: The old rule for exercising during pregnancy was to keep your heart rate below 140 and to exercise 3-4 days a week. Now it is 6-7 days a week and no heart rate guideline. You monitor your workout with the talk test. Be able to say 3-5 words at a time. IF you can carry on a whole conversation, you can pick up the pace a bit. Other guidelines: don't do activities that have a high risk of falling like horseback riding, skating, etc. Keep well hydrated, stop if you feel faint, dizzy, bleeding or leaking of fluid. Make sure you get your doctor's or midwives permission before starting an exercise program.

As Mendy told me the first pre-natal class, "You can still work hard.  If you want to go take a walk in the park you don't need me for that."  I'm not joking.  Of course my definition of "intense" decreased as I progressed into the pregnancy.  

If only I could still use this excuse...

 Q: I know from first hand experience that your pre-natal class is not easy.  How would you recommend pregnant women monitor their intensity and at what level should they aim to work at?

A: See above for intensity monitoring. In my class, I push participants to get out of the box of thinking pregnancy is a delicate state. We are women! We are strong! If your pregnancy is really hard and some other physical condition or current pregnancy condition has limited you to walking, that is ok. You can do that on your own and don't need me. That is why I push people a bit more in class. It's ok to sweat during pregnancy. When you exercise, your baby exercises! Annie, I knew what you were capable of and so I pushed you more than most people. But as the pregnancy goes on, I let up. I have been there before, twice. I know that some days are harder than others. The most important thing is that you listen to your body.

Q:What are, if any the no-no's for expectant mothers when exercising? Any signs or symptoms women should keep an eye out for when participating in activity?

A: The guidelines discussed above also covered the no-nos. Things to remember: if you did it before pregnancy, most likely it's ok to continue. Things like running, spinning, lifting are good as long as you listen to your body. Keep in mind, you might need to decrease your intensity, speed, step height or weights as the pregnancy progresses. The other official guideline is to not do exercises flat on your back after the first trimester. I personally feel it's ok until about 20 weeks or until your body tells you its time to turn, but officially, it's not after the first trimester.

Q:I know a lot of women (myself included) are so eager to get back to exercising after giving birth but OB's often suggest waiting until they are cleared at their postpartum check up.  What's magic about 6 weeks? What are the risks women take by jumping the gun and exercising too soon?  Are there activities women can safely perform until they are cleared by their doctor?

A: 6 weeks is usually when women have their postpartum check and that is why they say wait. There is no hurt in starting early as long as you listen to your body and start slow and gradually work your way up. I tell people walking is great. Start walking on day 1 around your hospital room and floor. Each day, walk a little longer and a little farther. Activity increases blood flow which helps things to heal faster. It can also decrease the risk of blood clots and other complications that can arise with inactivity. 

If you delivery vaginally, give yourself 2 weeks. Be sure to do your Kegal exercises and can hold it for 10 seconds, 10 times. This will make the pelvic pressure that most women feel after delivery, better. You can safely walk, push the stroller, elliptical, bike when its comfortable, etc. Just gradually incresase your time and distance and speed.

Q: In class you've shared with me some techniques for preventing and improving diastasis recti.  Can you explain what that is and any tips for prevention/improving this? 

A: Your abs can split during pregnancy or during labor. After a week, if you look down while trying to do a sit up and you see a long bulge in the middle of your abdomen, then your abdominals are probably split. This is from hormones and the pressure of the baby on your midsection. 

To decrease the split, lie on the ground with your knees bent. 
Inhale and as your exhale forcefully, suck in your abs like you are zipping up a tight pair of jeans. 
As you do that, literally push the muscles together. Put your hands on each side of the belly button, and push the skin and muscles together while you exhale. 

That's one repetition. Do about 20-30 reps in the morning and at night or anytime. You should start noticing a difference within a week. Until the abs go back together, you should avoid regular crunches or oblique work. 

You will be back to your old abs within no time. Oh wait, does that always happen? I guess I have to stop eating cookie dough for that to happen.  

Isn't she great?  If you're in the Des Moines area and expecting you can get more information about Mendy's pre-natal class at the YMCA Healthy Living Center here.  

Your turn: Did you, or are you exercising while pregnant? What was your favorite activity?  

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  1. What a great post! I will admit that I came to read this and roll my eyes when I saw the link on Twitter, wondering just how bad another version of a nurse dictating exercise during pregnancy guidelines would be. As a marathoner and mom of 9, I have heard so many obnoxious comments and misinformation about dialing things back during pregnancy and always get flack for returning so quickly to workouts afterward. Sadly most of them have come from medical professionals! It is SO refreshing to get an encouraging take on things from an OB nurse who knows what she's talking about!! (I've run into more than my fair share over the years that definitely did not, which makes me appreciate those that do even more!)
    Kudos to Mendy for being proactive about the importance of exercising during pregnancy and realistic about the fact that baby on board doesn't turn a woman into a special project who should do nothing more than walking. Obviously there are going to be exceptions for some women during pregnancy who need to take things easy, but I am grateful for someone preaching that being active is important and who is well informed that the old guidelines are outdated!
    Thank you for sharing!

  2. This was a great post! I luckily was able to workout regularly when pregnant up until my babe was 10 days late! I was able to jump back in at week 4 post baby. I was so happy to find a doc that said listen to your body!
    emma @ a mom runs this town . com

  3. Ah, I loved reading this!! I wanna make the short drive to take her class!

  4. I worked out very hard with my first pregnancy, well after 15 weeks. I had a complication in the beginning but after that I went back to being a marathon coach for a charity team, training 40 miles a week, and masters swim team. My labor was super easy and fast, delivered her in the parking lot, never made it in! I was able to do a 1/2 marathon 8 weeks after delivery. With my 2nd I had the same complication and not as much time in my schedule but I still had a high exercise level and I can not say her labor was as easy but I guess I can not complain with a labor that lasted less then 3 hours! Recovery was super easy. Exercising during pregnancy I think is so important.

    1. A marathon 8 weeks after delivery! Holy cow! I have a hard time imagining running a marathon at all let alone two months after child birth! Well done, well done. Thanks so much for sharing your (impressive) experience with pre and post natal exercise. Take care!