Sunday, May 20, 2012

Workout, Shmerkout --- Why You Really Should Exercise During Pregnancy

The idea of working out during my pregnancy did cross my mind during my 1st pregnancy.  I knew it was recommended.  
But in general I didn't work out much at all before I got pregnant.  And I think I used that as a convenient excuse.  Basically, once I knew I had a baby inside, I honestly felt entitled to laziness.  And I often was surprised that anyone would expect me to do anything---I was pregnant for goodness sake, it's hard work making a person!  

     I pretty much did the exact opposite of work out.  I used it as a reason to "take it easy"---a.k.a. do absolutely nothing physically exerting, avoiding even easy tasks around the house.  
     I was so tired, nauseous and crampy during the first trimester that I thought I should spent the entire three months on the couch watching movies with a heating pad.  
      When the second trimester finally rolled around (it got pretty boring doing nothing all the time), I was so pleased to be doing anything that I guess I just assumed doing the dishes and laundry was exercise.  
      And by the time my third trimester hit, I was feeling so huge and my back was so sore that small bouts of walking (like into a store and back out) was exhausting.  But why wouldn't I be having a hard time walking around?  I had done nothing to prepare my body to be carrying this extra load.  My muscles were atrophying from being so sedentary, all while my body was expanding!  Not a good combo.  

     Like I said, I didn't do much working out before I got pregnant.  There were a few points in my life where I had done some workout DVDs, and it was always because I was trying to look better, never really with the right mind frame of general health.  So at this point, I kinda thought I was doing the noble thing of not trying to be vain, striving to look just right, during my pregnancy.  

      But, honestly, I really struggled with my self image during that pregnancy.  The bodily changes were overwhelming to me.  And if I were to be honest, I'd say I struggled with some depression over it.  

      I also went into the idea of Labor a bit too optimistically, or at least naive.  I read a lot about it.  And I knew it was going to be challenging.  But...well, I did the thing where I let all that knowledge stay just head-knowledge, and didn't let it become practical knowledge---meaning, I did nothing to prepare physically for the challenge.  Really, I did that because I wrongly assumed I would be one of those women for which labor would be a piece of cake.  There are some lucky women out there.  And I decided I would be one of them.  

     I ended up not going into labor on my own, and was induced at 42 weeks gestation.  It was much harder than I anticipated.  My head knowledge had fully agreed with all the stuff I had read about doing what your body tells you: getting into different positions because your body knows what it needs to do to help the baby move down.  I thought that was spot on.  Made perfect sense.  Well, guess what?  When I went to apply that head-knowlegde to reality, my muscles were on fire---feeling the burn of trying to keep up with the task of doing what felt right.  (For me, what was feeling the best was to do these squat-like bounces during each contraction.)  My out of shape legs were getting exhausted.  

     During the pushing stage I was shocked at how much WORK it was.  I remember clearly thinking, "Why didn't anyone tell me?!?  I should have been working out every day to get ready for this.  This is like running a marathon!!  I'm not prepared."  I also clearly remember promising myself I would never again claim that any workout was hard ever again, because now I know what hard is.  (I can't say this has actually stopped me from ever complaining again, but it was true, I've never worked harder in my life.)  

     I ended up needing a c-section.  And recovering definitely took physical vigor.  Having stronger muscles all around would have been ideal for aiding me in the process of carrying around my sore, tired abdomen.  

     In addition, once my baby was here, I was surprised to learn that it took physical stamina to care for her.  "All you need is love" wasn't quite the case.  You need a bit of muscle too.  Holding a baby for hours on end actually does take strong arms.  True, they weigh very little, but holding very little for very long is actually tiring.  (I once had a conversation with a very fit young man who told me how impressed he is with mommy-muscles, because his arms got tired holding his niece for just a little while, and yet moms can do it all day long.)  And let's not forget strong legs---babies love to make you walk.  Sitting isn't always an option.
And then all the baby gear!  Car seats, strollers, baby paraphernalia... those things take muscle to haul around.  Moms make it look easy when you observe them in passing.  But really, we get sweaty... often.
And just when your muscles get strong enough to carry your baby, your baby grows.  Eventually they are a weighty toddler who still wants to be picked up.  It's a continuing evolution.

     Having a baby is one of the most intense experiences of life, and preparing for it physically will give you an advantage.  Whether your labor is a smooth natural delivery, an induced labor, or a cesarean birth, having worked out during your pregnancy will give you a definite edge on making it through the experience and recovering with greater ease.  
     From my perspective, I would tell you to train for it like you are training for a marathon.  Train like you are in boot camp.  Train with all your might.  Hopefully you are that woman with the piece of cake labor (and if so it will be even "cakeier" after your preparation) but if you train you will be prepared for anything!  And the results will be outstanding during your prenatal and postpartum days as well.  Trust me, there will be no regrets.  

     Women who exercise during their pregnancy tend to have a more positive outlook than those who do not.  It is well known that exercise releases endorphins, improves mood and provides additional energy.  The same is true for expecting moms who may feel like they hardly have enough energy to make it from the bedroom to the kitchen.  Exercise during pregnancy can improve mood and give an expecting mom more energy to be able to handle the many things she needs to do before baby arrives.  Since exercise will also help keep her in shape and control her weight, it will also help her get back into shape quicker after delivery.  It helps to avoid prenatal depression, which is especially true if you exercise outdoors because bright light has antidepressant effects.  Many moms feel depressed and unattractive after delivery.  But some who exercised have reported feeling happier with their bodies and seem less apt to experience symptoms of depression.

Exercise benefits for moms include:
  • Reduced risk of developing gestational diabetes and pregnancy-induced hypertension (high blood pressure)  
  • Improved self-image.  Women who exercise throughout pregnancy have a better body image than those who sit out the nine months.  
  • Decreased incidence of loss of bladder control during pregnancy and postpartum.  
  • A reduction in common pregnancy complaints such as hemorrhoids, constipation, leg cramps, back pain, water retention, etc.  
  • Less leg swelling.  Your body retains more fluid during pregnancy, and your growing uterus puts pressure on your veins, impairing the return of blood to your heart.  Exercise can limit swelling by improving blood flow.  
  • Improved sleep quality
  • You learn to chill out---with its emphasis on breathing, mental focus and movement, prenatal exercise helps stressed-out moms-to-be to stay calm, which can teach you to relax rather than tense up when you feel discomfort, a helpful skill during labor.  
  • Provides the mother the strength and endurance she will need for labor.  Childbirth is extremely exerting, but can be easier to deal with if the body is kept strong.  
  • A reduction in the active stage of labor (the time from 4cm to 10cm dilation).  A landmark study found that among well-conditioned women who delivered vaginally, those who had continued training throughout their pregnancy experienced active labor for 4 hours and 24 minutes compared with 6 hours and 22 minutes for those who had quit training early on.  Two hours less of hard labor is nothing to sneer at!  
  • Statistically fewer obstetric interventions during delivery (forceps, vacuum extraction).  
  • Bouncing back faster after delivery---compared with new moms who were inactive during pregnancy, those who exercised are more likely to socialize and enjoy hobbies and entertainment post-baby.  They just seem to cope better with the demands of new motherhood.
  • A quicker return to pre-pregnancy weight.  
  • Lower risk of postpartum depression.  
  • A reduction in bone density loss while breastfeeding.  

And, umm...I seriously had no idea but...this is awesome:
Research has also shown benefits for the babies of moderately exercising mothers:
  • A study in 2011 showed that babies born to mothers who exercised while pregnant were found to have healthier hearts than other infants both in utero and a full month after delivery.  
  • Your baby develops an improved tolerance to stress and, as such, can handle the stress of labor much better than the baby of a sedentary woman (i.e., fewer drops in heart rate with each contraction).  
  • The infants are less cranky and less likely to have colic.  
  • They tend to be better sleepers.  
  • They have less body fat at birth.  Some early research suggests that the benefits of lower body fat may translate into a reduction in the incidence of heart disease and diabetes in adulthood.  
  • Such children have greater neurodevelopment scores in oral language and motor areas when tested at age five.  Some research indicates that kids of moms who work out during pregnancy have better memories in addition to higher scores on intelligence and language tests.  

Carrying out a prenatal and postpartum fitness program is one of the best lifestyle and health choices you can make.  Before you begin (or continue) an exercise program, always get clearance from your caregiver.  

What type of exercise should you do?
     That depends on what interests you and what your doctor advises.  Many women enjoy dancing, swimming, water aerobics, yoga, Pilates, biking, or walking.  Swimming is especially appealing, as it gives you welcome buoyancy (floatability or the feeling of weightlessness).  Try for a combination of cardio (aerobic), strength, and flexibility exercises, and avoid bouncing.  

      And every prenatal exercise program should have daily “core” training that works on strengthening the abdominal and lower back muscles and the muscles of the pelvic floor.  Strengthening the core muscles will help with potential problems such as incontinence and back pain.  In addition, these are the muscles needed during labor, the “baby pushers.”  Labor is one of the most intense experiences of your life and preparing for it physically will give you an advantage.  But even if you have a scheduled c-section, having strong core muscles and pelvic floor will prove a major advantage as you recover from your surgery.

      For me personally, I've definitely changed my tune towards working out between my first and second pregnancy.  I worked really hard to get in shape before we got pregnant again.  I started swimming and found it to be an excellent workout for me.  (It was really, really difficult initially.  But before I began, it just sounded like something I could do, and something I would enjoy.  And after I put the effort forward, I found I could do it.  And after even more effort, I found I really do enjoy it.)

      During this pregnancy, I have made a conscious effort to stay active.  I constantly have in mind the idea of being prepared for this delivery.  My ultimate goal is a successful VBAC, but even if another cesarean birth were to happen, I won't regret one bit of this effort I'm exerting because I know how much work both types of deliveries require.  And, happily, I'm much better prepared physically this time around.  

      To be honest with you, it was too hard for me to fit in formal exercise during my first trimester. A combination of morning sickness, mixed with the fact that my husband was finishing his PhD and was literally working around the clock, made it too hard for me to get to the pool, since I needed someone to watch my toddler while I was away.  But overall I did stay more active in my daily life.  (Toddlers are good for ensuring that!)  And as soon as our life became more stable, I joined a pool in our new town and got straight to work.  In addition, I've made a point to take more walks.  I've also made sure to fit more stretching, dancing, and labor-aiding movements into my daily life.  

      I can't even tell you how much of a difference I've already experienced as a result of this pregnancy's healthier lifestyle.  It's night and day.  Some of the ease of this pregnancy compared to last could be attributed to the fact that my body has some experience under its belt.  But I know it's more than that.  I regularly forget that I am pregnant even now, well into my third trimester.  
     At 34 weeks pregnant I was grocery shopping with my toddler and in the check out line was asked if I'd like carry out service.  My automatic response was "Oh no we are fine."  It flew from my lips.  I was taken aback by the fact that it was even offered to me.  I wondered, "Do they offer this to all mom's of toddlers?"  Then my belly just happened to catch my eye as I started to move my cart, and I remembered, "Oh yeah, I'm pregnant.  That must be why they offered."  And then I felt a bit guilty for my instantaneous response, because perhaps I came across as snippy and offended.  Of course I was not offended, just completely unaware of why I would need any help at all.  That would have never happened during my first pregnancy.  I was constantly aware of my altered state.  
     This pregnancy has come so much easier for me physically.  My legs feel so strong and able, making my belly so much less noticeable.  My back has yet to ache (I was constantly aching through my whole third trimester last time).  I have had no shortness of breath.  I can get up and down from any position with barely any difficulty, I'm just a little slower than before (I literally got stuck on the floor a couple of times last time.)  I haven't had any heartburn (not sure if that's from exercising, but it's yet another thing that's been easier this time.)  Outside of toddler care, I've slept awesome this pregnancy.  And I've had much more energy this time around compared to last time.  
     In addition, my outlook of my body is totally different.  Last time I felt so disheartened by the changes, but this time I am really impressed and amazed at the changes.  I'm proud of my body.  I'm excited to be transformed.  I'm unafraid of the postpartum period.  I know that part of my outlook is solely from having been through it once before, and having the confidence that comes from seeing my body recover once already.  But my new positive outlook also comes from the knowledge I now have of how strong I am, and how capable I am.  And that knowledge came because I've been continuously using my body in a strong and capable way.  
      Emotionally, I have clearly seen the benefits of endorphins during this pregnancy.  At some points they are all that have held me together during such a tough and transitional time of my life: moving to a new state, knowing NO ONE, caring for a toddler in this situation, all while striving towards a VBAC when it's not an available option at my nearest hospital.  
     And in addition to all the added physical and emotional stability exercise has brought me this pregnancy, it has given me the added bonus of just looking better this time.  As much as that wasn't a motivation for me, it still is an outcome of my decisions.  Consistently working out (in addition to a healthier diet this time) has helped me to gain less weight, as well as keep my changing shape relegated to mainly to my belly (instead of placing the weight everywhere like last time.)  And that has enabled me to wear my regular clothes longer and have more options in what I can wear and where I can shop.  Which, let's be honest, is really nice.  

     These benefits have all been so amazing that I can't imagine ever doing a pregnancy without them again.  And I haven't even seen the effects for me in regards to delivery and postpartum yet!  
     I can't recommend working out during pregnancy enough!  It's outstanding in comparison to the alternative!  And I'm speaking from experience.  

Update: After having worked out through my pregnancy and then giving birth...I've come to the conclusion that working out is the best way to prepare for labor. Here are my tips on how to do that most effectively.

* Click here for more of my healthy pregnancy tips.

(Update 7/18/12: After staying active through my pregnancy and employing other helpful things (from my healthy pregnancy tips), I did go on to have a safe and healthy VBAC. Because of my fitness level and my healthy diet, I also was able to keep my weight gain down to 32 lbs this time, as opposed to the 41 lbs I gained in my first pregnancy. 

Update 1/26/13: I know this is anecdotal but my second baby has been a great sleeper (much better than her older sister) and has been the happiest baby I have ever met! I feel its quite possible my exercise routine played into that.
You can read my birth story here. She definitely handled the stress of labor great. During my first labor (which to be fair included pitocin) my oldest daughter's heart rate remained a concern throughout the second stage of labor.)


  1. I know I'm commenting a long while after you posted this, but I have a question. I exercised regularly before getting pregnant (I was actually doing Insanity!), and was hoping to continue exercising during my pregnancy. However, my morning sickness is horrendous. I literally puke or am on the verge of puking every time I move. Stand up off the couch? Gotta puke. Get out of bed? Gotta puke. Roll over in the middle of the night? Gotta puke. I am just so defeated and have no idea how to even start thinking about exercising again when just sitting on the couch is nauseating. My doctor gave me a prenatal vitamin with B6 to help, but I never have enough food on my stomach to take it without throwing it right back up. Please help if you can!

    1. Oh wow, I really feel for you. Morning sickness is so rough. I personally, didn't get it so bad that I threw up, I just felt like I might throw up ALL the time. So I don't have much in the way of advice for that. I would continue to talk to your doctor about it. I know they have pills they can prescribe for pregnancy nausea (a friend of mine is one them right now), or at times they can admit you for very bad nausea and dehydration. My sister in law took unisom for her morning sickness. I'd keep checking in with your doctor to see if those ideas might work for you.
      Also, I am a huge believer in seeing a chiropractor during pregnancy for all sorts of reasons, one being: it has been shown to reduce nausea. Personally, I didn't learn about prenatal chiropractic awesomeness until I was about half way through my second pregnancy, so I don't have personal experience with it helping nausea. But I know it helped me in so many other ways. (I have a post about it.) It would be worth looking into.
      I also loved Hypnobabies for my delivery. (I have a post on that too -- both found in the "Healthy Pregnancy" tab at the top of the page.) And once again didn't learn about it until I was about half way through, so I can't attest it this myself, but they have a track that is supposed to help with nausea. If we have more babies, I'm going to give it a try. I find the tracks very peaceful and calming, so if nothing else it would be a nice break in the day.
      As far as working out right now...don't beat yourself up. I didn't work out during my first trimester (just wasn't up to it) and I didn't feel like it was a detriment to me and my goals at all. Most women feel much better by the second trimester, and then you can get back into a workout regimen. The first trimester can be a really tough time, and giving yourself grace until you are through it is totally ok.

  2. For me the worst was being uncomfortable from 7 months on. Bed, sofa, was all miserable. Wish I'd known about chiropractic care early on. It might have given me some relief.

  3. Thanks for writing this. I'm pregnant with my first child and this is the motivation I needed to get moving.

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