Active for Two

Written by Christina Howells MSc, BSc Hons.

Over the last 15-20 years, emerging research has completely changed our understanding of prenatal fitness, moving us beyond the notion that reduced exercise is acceptable as long as you already exercise (Hinman et al, 2015). It is now well established that exercise during a healthy pregnancy with no complications is recommended and offers an ideal time to focus on your individual fitness and wellness in preparation for motherhood (ACOG 2015).  Women are now being encouraged to get Active for 2 and Aptaclub offers the perfect hub for advice and practical tips on exercise, nutrition and well-being, from conception through to your baby’s first year through to toddlerhood.

The American College of Obstetricians and Gynaecologist (ACOG) in 2015 stated that, “Women who begin their pregnancy with a healthy lifestyle (e.g. exercise, good nutrition, non-smoking, etc.) should be encouraged to maintain those healthy habits. Those who do not have healthy lifestyles should be encouraged to view pregnancy as an opportunity to embrace healthier routines.”

Starting a prenatal exercise regime will be one of the best things you can do for yourself and your future baby. Keeping active will make it easier to deal with common symptoms such as tiredness and back ache. What’s more, the fitter and healthier you are during pregnancy, the less likely you are to gain excess weight, which is a key risk factor for gestational diabetes mellitus.

The long and short of it is…

If your pregnancy is straightforward and your doctor or midwife has given you the go-ahead, you can carry on exercising and even start something new such as yoga, swimming or strength training. Your motivation is likely to be higher as you are now caring for two and with more frequent access to medical care there is continued support and health monitoring. Your body will undergo physiological changes during pregnancy and it’s time where you have the potential to transform your health in very positive ways, before and after your baby is born.

How do I know how much is enough and what is too much?

Exercise during pregnancy should be moderated by how your body feels, which will be different for each individual. If you think about it, is “moderate” going to be the same level of intensity for a professional athlete as it is for somebody who attends a couple of exercise classes a week or not exercised much before? It most certainly won’t! Don’t compare yourself to others is rule number one. We are all individuals and your pregnancy is unique to you.

One key point to remember is: The bigger the belly, the less the intensity. By the third trimester, the intensity needs to be decreased. You should adapt a low level of continuous exercise due to increased heart rate and stroke volume. Remember to drink more, take breaks in your session as you need them, wear loose clothing, and avoid excessive exposure to heat.

How do I motivate myself?

I advise developing a method for managing your time such as simply making regular exercise dates with your diary. This allows you to accomplish more at work and at home and for yourself. Poorly managed time can lead to feelings of frustration, stress, sugar cravings, low mood, poor sleep, and it won’t improve your pregnancy fitness. It’s also important to find an activity that you enjoy. This may sound obvious but exercise that you dislike, find boring, or find uncomfortable, is unlikely to become a regular part of your life. Of course, as your fitness level improves, your appreciation of particular activities could well change – be prepared to change your mind as well as your exercise routine.  Remember, the key with exercise is consistency.

What if I don’t feel 100%?

While exercise is recommended throughout pregnancy, if you’re not feeling your best or something doesn’t feel right, then you should always listen to your body and take a break. Pregnancy is not the time for a “pushing through” mentality – it is the time for moderation and maintenance. As you move through each trimester remember: the bigger the belly, the less the intensity.

What about flexibility

From trimester one, you will produce the hormone relaxin. This causes the ligaments in your pelvis and pubis syphilis to relax and become more flexible, preparing you for childbirth. This circulating hormone will also have the same effect on other ligaments throughout your   body, making you more flexible than before – so take care not to over stretch.

Is resistance training ok?

Building strength and endurance will allow you to adapt to the changes your body is going through during pregnancy, giving you a sense of strength and power at a time when you may feel out of control with how your body is changing. Exercise that builds muscle prepares you for being a mother, when you will find yourself lifting and carrying your baby amongst a lot of other new activities that go with motherhood. Particularly important is to focus on the posterior muscular chain, strengthening the upper and lower back, as you are likely to find yourself frequently in positions that have you rounding forwards, especially through the later stages of pregnancy and when caring for a new-born. Pulling exercises (Exercise 1) are ideal to promote better alignment and posture as well as stretching and opening through the chest.  You can incorporate a simple doorway stretch (hands on each side of an open door, elbows back, body leans forward) several times a day. It’s also extremely important to keep the glutes awake and active so that they stabilise your pelvis, which is especially important in the later part of pregnancy when they can become sleepy; glute bridges (Exercise 2) are excellent exercises to perform during the first trimester and squats (Exercise 3), which can be performed throughout your pregnancy, are perfect glute and core exercises. These are functional movements that reflect daily tasks such as squatting down to pick something up off the floor, picking your baby up, sitting to and standing from a chair.

The main rule with resistance training, as well as yoga and pilates, is to focus on form – If you’re not sure how to do the exercise safely and effectively then ask. Learning good technique now will set you up perfectly for post-natal recovery and the rest of your life.

What about cardio?

The NHS recommends at least four 30-minute exercise sessions per week. The stronger your cardiovascular system, the less tired you will feel and the better you will be able to cope with daily activities.

Babies born to fit mums have greater cardiovascular capacity from the start and lean babies are less likely to become overweight or develop diabetes. Great choices are walking, hiking, swimming, recumberlant bike, ellipitical trainer, aqua aerobics and low impact classes.

What about my pelvic floor?

The pelvic floor muscles form a sling-like band that surrounds and forms the base of your vagina, anus, and urethra, and will also bear the weight of your developing baby. Strengthening these muscles during and after pregnancy is extremely important so that they provide the correct support and improve your bladder control.

To find these muscles, imagine trying to stop your stream of urine – this is your pelvic floor muscle. Like all muscles in the body, the more you use and exercise them, the stronger they become; they are going to need some stamina now that you’re pregnant. The best way to do this is to:

Sit, stand, or lie, with your knees slightly apart. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Try lifting and squeezing them as slowly as you can for a count of 5-10 seconds. Rest and then repeat, aiming to build up 10 slow contractions at a time, holding them for 10 seconds. Your pelvic floor muscles also need to react quickly, such as when you sneeze, cough, laugh, or make sudden movements that put pressure on the bladder. By working on quicker contractions, you will become more efficient at engaging these muscles during sudden stresses. To achieve this, draw up the pelvic floor and hold for 1 second only and then release for 1 second, repeating 10 times. Aim to do a set of slow contractions followed by a set of quick contractions morning and night.

Why is hydration important?

All your body’s processes depend on water. During pregnancy, this becomes even more important due to increased blood volume, which allows you to supply your baby with nutrients and oxygen through the placenta whilst removing waste products. Keeping your hydration in check will help prevent or reduce fatigue, constipation, headaches, and oedema.

What about lying on my back?

Once you get into your second trimester, especially past week 16, exercise lying on your back – and even lying on your back for prolonged periods of time – is not recommended. The increased growth of your baby will result in greater potential for your uterus to press on your main vein, reducing blood flow back to the heart. This can result in dizziness and shortness of breath, as well as affecting blood flow to your baby.

Where can I find expert advice about my pre-conception, pregnancy and post-natal exercise and nutrition?  

Aptaclub is an online resource created to provide advice and support for women throughout their pregnancy.  Aptaclub offers extensive information from their team of professionals and experts. Aptaclub’s Active for 2 provides you with exercise advice, from yoga to swimming and running.

Tips to Remember:

• Hydration before, during, and after workouts is important.
• Keep your exercise moderate – a good way to gauge this is you should be able to carry a conversation during your workout.
• This is not the time to achieve a personal best or set world records.
• Treat each day as it comes; more than ever, pregnancy is the time to listen to your body, so don’t push it.
• Be consistent with activity, keeping in mind that during pregnancy a little exercise goes a long way. Rest assured that your baby and your body will thank you for performing at all.
• Avoid exercising lying on your back post week 16.

The Exercises

Exercise 1

Band Pull Apart

This is a perfect exercise to help keep your posture in check by strengthening your posterior deltoids and upper back muscles.

Position: Strand with your feet hip width apart holding a long light looped resistance band in front of you at chest height, hands shoulder width apart. Your pelvis in neutral so to avoid arching your back and shoulders pulled down.

How you do it: Pull the band apart squeezing your shoulder blades together being mindful not to arch the lower back. Return to start position. Repeat 8-10 times x 2 sets.

Exercise 2

Hip bridge

This is an excellent exercise for the first trimester to wake up sleepy glutes important in supporting your pelvis during your pregnancy.

Position: Lying on your back, neutral spine, abdominals engaged. Bend your left knee towards your chest holding it with both hands.

How you do it: Drive down through your heel as you engage your right glute to raise the hips. Return all the way to the ground under control. If you feel the move in the hamstring then move your heel a little closer to your butt. Repeat 15-20 each side x 2 sets.

Exercise 3

Squats

The squat is a fundamental functional movement, which translates into helping your body move more efficiently when performing everyday activities such as getting in and out of a car, picking your baby up, even walking. In the first two trimesters I suggest working with a resistance band, which will strengthen the glute medius, an important muscle for supporting the pelvis during weight bearing.

Position: Standing feet hip width apart with your toes pointing forwards or slightly turned out (you may find this more comfortable from trimester 2).

How you do it: Route down through your heels as you sit your hips slightly back and down focusing on keeping the chest lifted and core engaged. Return under control to the start position.

For more information about the ‘Active For 2’ campaign, visit the Aptaclub website
https://www.aptaclub.co.uk

Advertorial brought to you in association with Aptaclub.

References

American College of Obstetricians and Gynecologists (2015). Physical Activity and Exercise During Pregnancy and the Postpartum Period. 

Diabetes UK: https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-storage/migration/pdf/DiabetesUK_Facts_Stats_Oct16.pdf

Hinman,S.K et al (2015). Exercise in Pregnancy: A Clinical Review. Sports Health. 7(6): 527–531.

Harrison, C.L. et al (2016). The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health. Reproductive Medicine 34(2):e28-37.

NHS: https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/

Sanabria‐Martínez G et al. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta‐analysis. BJOG 2015;122(9):1167-74.