Unit 28

Reasons to discontinue Exercise

1. Any vaginal discharge 2. Sudden swelling of the ankles, hands, and face 3. Persistent, severe headaches and/or visual disturbance; unexplained spells of faintness or dizziness 4. Swelling, pain, and redness in the calf of one leg (phlebitis) 5. Elevation of pulse rate or blood pressure that persists after exercise 6. Excessive fatigue, palpitations, chest pain 7. Persistent contractions (more than 6 to 8 per hour) that may suggest onset of premature labor 8. Unexplained abdominal pain 9. Insufficient weight gain (<2.2 pounds per month during last two trimesters)

Exercise Guidelines for Pregnancy

1. During pregnancy, women can continue to exercise and derive health benefits even from mild to moderate exercise routines. Regular exercise (at least 3x per week; max 30 min). 2. Women should avoid exercise in the supine position after the first trimester. Prolonged periods of motionless standing should also be avoided. 3. Women should be aware of the decreased oxygen available for aerobic exercise during pregnancy. Pregnant women should stop exercising when fatigued and should not exercise to exhaustion. Weight-bearing exercises may under some circumstances be continued at intensities similar to those prior to pregnancy. Non-weight-bearing exercises, such as cycling and swimming, will minimize the risk of injury and facilitate the continuation of exercise during pregnancy. 4. Morphologic changes in pregnancy should serve as a relative contraindication to the types of exercise in which loss of balance could be detrimental to maternal or fetal well being, especially in the third trimester. Further, any type of exercise involving the potential for even mild abdominal trauma should be avoided. 5. Pregnancy requires an additional 300 kcal/d in order to maintain metabolic homeostasis. 6. Pregnant women who exercise during the first trimester should augment heat dissipation by ensuring adequate hydration, appropriate clothing and optimal environmental surroundings during exercise. 7. Many of the physiologic and morphologic changes of pregnancy persist 4 to 6 weeks postpartum. Thus, prepregnancy exercise routines should be resumed gradually based upon a woman's physical capability.

Sensible Exercise

Can be a safe and productive undertaking for both a pregnant woman and her fetus

Exercise for Pregnancy and Postpartum

Starting point depends on fitness level before pregnancy Little experience: 10 mins or less of easy aerobic movement in order to assess tolerance Progress naturally as she builds cardio and muscular endurance

A pregnant woman should:

Stay adequately hydrated Keep the intensity level of her exercise at a moderate level Avoid wearing clothing that is impermeable to water Be acutely sensitive to the environmental conditions that exist at the time of the exercise session (particularly the ambient temperature and relative humidity levels) Keep the duration of her exercise session to 30 minutes or less to avoid impairing blood flow to the exerciser's uterus Avoid prolonged (i.e., longer than five minutes) bouts of exercise in the supine position Eat a nutritionally sound diet to ensure adequate levels of glucose are available