prenatal exercise
Mamas on Bedrest: Dr. Linda Burke-Galloway Reviews Updated Recommendations for Exercise During Pregnancy
June 28th, 2011
The post below was written by one of my idols and mentors, Dr. Linda Burke-Galloway. Dr. Burke-Galloway is an OB/GYN who practiced for years providing care to high risk pregnant women. She is now a nationally recognized patient advocate, a legal expert in cases involving high risk obstetrics and Medical Malpractice and is the author of The Smart Mother’s Guide to a Better Pregnancy. In this post from her blog, she reviews ACOG’s Guidelines for exercise during pregnancy.
Exercise while pregnant has always been a controversial issue. The days of of “eating for two” to justify inappropriate eating habits is passé. Nine years ago, The American Congress of Obstetrician-Gynecologists published guidelines regarding exercise and pregnancy. Essentially they recommended 30 minutes or more of moderate exercise each day for pregnant women in the absence of medical or obstetrical complications. The Center for Disease Control’s (CDC) recommendations for an “active lifestyle” does not exclude pregnancy.
In the June 2011 issue of Obstetrics and Gynecology, Gerald Zavorsky, Ph.D and Lawrence D. Longo, MD, wrote an excellent article on exercise and pregnancy. They recommend exercise intensity that increases the heart rate to at least 60% of its maximum capacity during pregnancy to reduce the risk of gestational diabetes. Other recommendations for pregnant women are as follows:
• Pregnant women aged 18 to 45 may do 8 to 10 muscular strength exercises for one to two sessions per week on nonconsecutive days. One aerobic training session can be replaced by a muscle strengthening session in the weight room or at home
• Use lighter weights and more repetitions. If you usually perform leg presses with 35 lb for 8 to 12 repetitions, try 20lb for 15 to 20 reps.
• Avoid walking lunges because they may rise the risk of injury to connective tissue in the pelvic area
• Be careful with free weights because they may involve the risk of hitting the abdomen. Use resistance bands instead that offer different amounts of resistance and varied ways o do weight training and should pose minimal risk to the abdomen
• Try not to lift while flat on your back. In the second and third trimesters, lying on your back may cause the uterus to compress a major vein that could limit oxygen received by the fetus
• Zavorsky and Longo recommend that you listen to your body. If you feel muscle strain or excessive fatigue, modify the moves and reduce the frequency of the workouts. “Pregnancy is not the time to perform heavy weight lifting.” Instead, they should do muscle strengthening exercises according to the prescribed guidelines because it will burn calories and increase the resting metabolic rate.”
As always, please consult your physician or healthcare provider prior to starting an exercise program and remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
While Dr. Burke-Galloway’s post is directed towards women having uncomplicated pregnancies, once again I want to reiterate that Mamas on Bedrest need to ”exercise” as well.
OB’s and Midwives emphasize the benefits of weight management, maintenance of cardiovascular endurance, maintenance of muscle strength and tone as well as a decrease in the overall aches and pains of pregnancy as the main reasons women should engage in regular prenatal exercise. Secondarily, they emphasize exercise as a way to ward off Gestational Diabetes and possibly Gestational Hypertension which may lead to pre-eclampsia. All of these benefits of prenatal exercise are even more important to mamas on bed rest, women who are at increased risk of these complications (if the don’t already have them!).
Very few OB’s recommend specific exercises for women on bed rest. For that specific reason I developed Bedrest Fitness. It is a simple yet effective set of exercises that women can do while in bed. I also want to add that women on bed rest should regularly stretch, I recommend hourly, to maintain circulation and to decrease the risk of developing bed sores as well as blood clots in the legs.
As Dr. Burke-Galloway stresses, always check with your health care provider before starting any sort of prenatal exercise program. If ysou have questions about exercise while on bed rest, send an e-mail to info@mamasonbedrest.com. And for those interested in more structured and supervised exercise for women on bed rest, join us this fall for online Bedrest Fitness Classes! Details and registration will be available soon!
LIsten to the Mamas on Bedrest Podcast Interview with Dr. Linda Burke-Galloway Here.
Mamas on Bedrest: Do You Have “Linguine Legs”?
March 8th, 2011Bedrest Coach Darline Turner-Lee is offering mamas on bed rest a free webinar on March 11, 2011 at 11am CST. The webinar will review the basics of bed rest exercise including getting into the correct position in bed, the use of pillows, the use of an exercise band to perform active and passive movements and a sampling of exercises mamas can do. To participate, send an e-mail to info@mamasonbedrest.com.
Mamas on Bedrest: This is how its done
March 2nd, 2011I have received numerous e-mails and inquiries from mamas on bed rest asking what exercises women can do while on bed rest. Others have inquired, Why do I even need to exercise while on bed rest?
In your normal daily life, you walk around, climb stairs, lift things, do household chores and engage in other vigorous activities. When you do these activities, your muscles contract and release, strengthening the muscles and enabling them to do more, i.e. get stronger. Every notice that once you begin working out, you’re able to carry heavier loads, push heavier things and move things further along? This is because the muscles become more developed with activity and are able to do more work as a result.
As muscles contract and release, they pull on the bones they are attached to. This is actually a good thing because the pull on the bones by muscles causes them to shed old bone cells and build new bone cells keeping your bones healthy and strong.
Finally, with activity, your heart pumps more. The more your heart pumps, the more blood is circulated around your body. Blood delivers much needed oxygen and nutrients to all the cells of the body as well as removes waste products and carries them to the kidneys, bowels and lungs to be released as urine, feces and expelled air. Your blood also acts as a cooling mechanism. When you more around a lot, your complexion becomes flushed-i.e. more blood is rushed to the skin surface to release heat and keep your body at an appropriate temperature.
So what happens when a someone is sedentary or on bed rest? 
Women on bed rest are not walking around, moving briskly or engaging in any vigorous activities. So the muscles are not regularly flexing and releasing. They are not building and getting stronger, on the contrary, they are breaking down and becoming weaker. As many of you on bed rest may have noticed, the firm shape that you once had in your legs is gone within weeks of being on bed rest. This is due to the lack of muscle stimulation leading to decrease in size and strength better known as atrophy. Over time, women on prolonged bed rest can lose significant muscle strength and actually need post partum physical therapy to do simply activities such as walk or even hold their babies for an extended amount of time. Many women also reported that they were not able to adequately labor following bed rest and had to have a cesarean section delivery.
Bed rest is also associated with bone demineralization or bone loss. Because the muscles are not pulling on the bones, old cells are not being removed and being replaced by new cells as rapidly as when women are active. Calcium and Vitamin D replacement via vitamins may help stem some of the bone loss, but many women suffer significant bone loss as a result of prolonged bed rest.
When we don’t exercise, we don’t increase our heart rates. As a result, our hearts don’t pump vigorously, we lose endurance and stamina. Many women note that they are winded just walking to the bathroom. When the heart doesn’t pump vigorously, blood is not circulated vigorously and pooling or swelling in distal extremities (the hands and feet) occurs. Blood pooling in the lower legs can be problematic if clots form (which is more likely in pregnancy due to the increased blood levels needed to support the pregnancy). Clots can eventually dislodge and then travel to the heart, lungs and brain and potentially be fatal.
Many of these negative side effects of bed rest can be alleviated with simple movements or exercises. Several are compiled in the DVD Bedrest Fitness. While this DVD is easy to follow it’s not for everyone.
Mamas on Bedrest and Beyond is happy to announce a series of informational webinars on exercise while on bed rest. These 30 minute sessions will address the basics of exercising while on bed rest, what you’ll need and how to position yourself in bed to do the exercises. Participants will need internet access, a webcam and a very light resistance exercise band. The webinars are free and will be limited to 10 participants per session. Webinars will begin on March 11, 2011.
If you’d like to participate in a free webinar to learn the basics of exercising while on bed rest, send an e-mail to info@mamasonbedrest.com to reserve your spot.
