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Ante Natal Advice & Exercise

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Caring for your Back

Caring for your Abdominal Muscles

Caring for your Pelvic Floor Muscles

Ante Natal Exercise Advice

Stress, Tension and Relaxation

Helpful Links

 


 

The below advice and exercises are designed to help you reduce the strain on your body during pregnancy and make you more comfortable. It includes some gentle exercises and relaxation methods which you can practise from early pregnancy. There is also a section on safe levels of exercise which you can try throughout your pregnancy.

 

Caring for your Back

 

During pregnancy many women with healthy backs develop backache. This is due to hormonal and postural changes.

 

Your pelvis is made up of three bones and three joints. One of these joints is at the front and two are at the back. The bones form a protective cavity or basin for your bladder, womb and bowel. Your spine consists of many small bones (vertebrae). Ligaments and muscles support the joints of your spine and pelvis to give you stability and to help maintain good posture.

 

Hormonal changes during pregnancy soften these ligaments and your joints become less stable. The result of this is an increase in movement which can lead to aches and pains in your back and pelvis. Because of the weight of your baby and your altered centre of gravity, your posture will also change. This may place further strain on your back.

 

Here are some suggestions which may help you reduce the risk of strain and discomfort:

 

  • Sit correctly, and whenever possible, sit rather than stand when performing tasks. For example, ironing and preparing vegetables and so on
  • Make sure your work surface is at the correct height, both at home and at work
  • When shopping, carry evenly weighted loads in each hand
  • Try to avoid carrying your toddler on one hip. If you must, alternate the hip you use
  • Use the correct technique for lifting and avoid heavy loads
  • Find a comfortable sleeping position and make sure that you get in and out of bed correctly
  • Stand evenly with equal weight down through both feet
  • Sit on your bottom and don’t cross your legs
  • When rolling in bed, bend your knees one at a time, keep knees together, tighten your tummy and pelvic floor and roll
  • Get into your car by sitting on the seat and bring both legs in together. Do the reverse to get out

 

The following exercise will help reduce your backache. Try this exercise on your hands and knees while on your bed.

Pelvic Tilt Exercise

 

Caring for your Abdominal Muscles

 

These muscles will stretch naturally as your baby grows, and as a result they become weaker. It is important to care for these muscles in order to support your back, your baby and to maintain good posture. Our bodies have a particular tummy muscle which acts as a corset to support you and your baby as your baby grows.

 

The following exercise will help work the deep abdominal muscles.   

Deep Abdominal Exercise

 

 

Caring for your Pelvic Floor Muscles

 

The pelvic floor forms a broad sling of muscle, lying across the bottom of the pelvis. Through this pass the openings from the bowel, vagina (womb) and the urethra (passage from the bladder).

 

It is important to start practising exercises with these muscles as they are particularly important during pregnancy, labour and after the birth. They are the main support for your pelvic organs and provide control of the three passages. The weight of your baby on your pelvic floor during pregnancy and delivery will cause these muscles to weaken. This could result in symptoms such as leakage of urine when coughing, urgent or frequent need to pass urine or decreased satisfaction during intercourse. These muscles also provide a great deal of stability and support for your back.

 

The following exercise will help strengthen the pelvic floor muscles.

Pelvic Floor Exercises

 

 

Ante Natal Exercise Advice

 

Studies show mild to moderate exercise is good for you and your developing baby, provided the pregnancy is normal and you are healthy. This advice is aimed towards any woman in her child bearing year who wishes to exercise safely. The American college of Obstetrics and Gynaecology state that "in the absence of medical or obstetric complications, 30 minutes or more of moderate exercise a day, on most days of the week is recommended for pregnant women". Check with your GP, midwife, and/or women's health physiotherapist before starting a new exercise regime.

 

 

 

 

Benefits of Exercise in Pregnancy:

  • Keeps your heart, lungs, and muscles as fit as possible
  • Keeps your weight within a healthy range
  • Improves your posture, balance and co-ordination
  • Improves circulation
  • Increases strength and stamina
  • Improves physical and mental well-being
  • Prepares you for labour and delivery
  • Reduces aches and pains during pregnancy, such as pelvic or back pain
  • Become fitter and may help you to recover quicker after the birth    

 

Aims of Exercise:

Every woman will have a different fitness level before they become pregnant. Expectations of the fitness level you hope to achieve during and after pregnancy will also vary greatly from person to person. In general, your aim should be to maintain or moderately improve your level of fitness. In order to be able to exercise safely in pregnancy it is beneficial to understand the changes your pregnant body undergoes. Check with a women's health physiotherapist before taking up a new exercise.

 

A guide to exercise intensity level in pregnancy is to use the BORG ‘Talk Test’. You should be working hard enough to have to breathe through your mouth instead of your nose, but not so hard that you are unable to carry on a conversation (level three to five on the BORG scale).

 

If you exercise more strenuously than level five, it is possible that your health and that of your baby may be put at risk. Most women will automatically limit the intensity level they work at to a level, which is safe for their baby.

 

BORG Scale of Perceived

Exertion Guidelines

Talk Test

0 Nothing at All

 

Can easily carry on a conversation

1 Very Easy

2 Easy

3 Moderate

 

Should be able to carry on a conversation

4 Somewhat Hard

5 Hard

6

7 Very Hard

Cant talk continually

8

 

Cant talk at all

9

10 Maximal

 

Contra-Indicators to Exercise:

Do not exercise during your pregnancy if you have:

  • Serious heart, lung, kidney or thyroid disease
  • Diabetes Type 1, if poorly controlled
  • History of miscarriage, premature labour, or if your baby has been or is too small for your date
  • High or low blood pressure, discuss with your GP
  • Acute infectious disease

 

Note, it is still safe to do the abdominal exercises and pelvic tilting exercises

 

 

Precautions to Exercise:

The following conditions may require some caution and you should seek appropriate medical advice before starting any exercise.

    • Asthma
    • Diabetes Type 1 – discuss with your doctor
    • History of miscarriage
    • Increased blood pressure before pregnancy
    • Early placenta previa – discuss with your doctor
    • Vaginal bleeding
    • Reduced fetal movements
    • Anaemia
    • Extreme overweight or underweight
    • Heavy smokers

 

Exercise Programs:

If you do not exercise regularly at the moment you may feel you want to take up some kind of exercise now that you are pregnant. Always avoid starting something new until after the 13th week of your pregnancy. Start with reduced weight bearing exercises such as swimming, aquanatal or static cycling (exercise bike). Increase your exercise programme gradually as you feel your exercise tolerance improves.

 

If you exercise regularly at present you should:

  • Discuss your exercise regime with your midwife, consultant, GP, or women's health physiotherapist before continuing
  • Exercise at least three times a week for 20-30 minutes to improve aerobic capacity

 

If in any doubt, seek advice.

 

When Exercising Remember To:

  • Avoid lying on your back when exercising, from 16 weeks of pregnancy, as the weight of your baby can press on your blood vessels and make you feel unwell
  • Drink plenty of water to avoid dehydration
  • Work within your own limits to avoid getting too hot or breathless
  • Listen to your body – stop exercising if you are at all uncomfortable, tired, feeling unwell, if you have tummy, back, calf or pelvic joint pain, vaginal bleeding, shortness of breath, dizziness, feeling faint or persistent severe headache
  • Avoid high impact activity when pregnant
  • If possible find an exercise class which caters for pregnancy
  • Be cautious in the gym – ask for help regarding which machines to use and how to use them correctly
  • Avoid being competitive
  • Avoid contact sports
  • Make sure you warm up and cool down for at least five minutes
  • Don’t overstretch because of the hormonal effects on the ligaments
  • Avoid low squats, cross over steps and rapid changes of direction.

 

If in any doubt ask a women's health physiotherapist for advice.

 

If you are interested in continuing your exercise program prior to pregnancy or would like to start an exercise program during your pregnancy, please contact our Physiotherapy Department for further advice or an appointment.

 

Stress, Tension and Relaxation

Some women feel extremely tired, others develop aches and pains which are not due to specific illness, but are related to tension.

 

Tension causes an increase in blood pressure, heart rate and rate of breathing which can lead to a feeling of panic. Knowing how to prevent tension is a valuable skill which everyone could use when life is more challenging than normal.

 

Learning a relaxation technique and using it regularly has been shown to reduce mildly increased blood pressure. Women who learn relaxation and use it in labour generally cope better with pain and feel more in control. During pregnancy, practising relaxation will help you to rest more effectively and can help you get back to sleep again if you waken during the night.

 

Use the Relaxation link below and try to have a session at least once every day using comfortable positions.

 

Helpful Links

For advice please refer to the list below

 

https://pogp.csp.org.uk/publications/fit-pregnancy

https://pogp.csp.org.uk/publications/fit-birth

https://pogp.csp.org.uk/publications/mitchell-method-simple-relaxation

 

Reproduced with permission of Pelvic Obstetric and Gynaecological Physiotherapy (pogp.csp.org.uk)