Pregnancy: No Excuse For Ditching Your New Year's Resolution To Get Fit

By Sonia Alvarado, CTIS Pregnancy Health Information Line CounselorReprinted with permission from CTIS

It's a New Year, which for many people also means a renewed commitment to personal improvement also called New Year's resolutions. High on the list of New Year's resolutions is either exercising more or starting an exercise routine. If you are not pregnant, most people take it for granted that maybe you should hop on the treadmill or dance your way to better health in rumba class (or another trendy exercise craze), but what about pregnant women?It was not that long ago that pregnant women in the U.S. were seen as delicate, weak, sensitive creatures that could not or should not lift grocery bags, children, exercise, or work. Pregnant women were seen as human incubators that could be harmed by too much exertion or physical stress. In fact, many people still hold on to these types of ideas, some of which are also culturally-based. At one time, the American College of Obstetrics and Gynecologists (ACOG) also had a view that exercise should be low impact, and that the heart rate should not exceed 140 bpm. This recommendation was a source of irritation to many healthy pregnant women who exercised regularly and did not appreciate having to cut down on their normal routines.

Recommendations for Pregnant Women
ACOG currently recommends pregnant women continue an exercise routine if they already have one. They also recommend that sedentary pregnant women see their doctors about getting started on appropriate exercises. Pregnant women are recommended to exercise daily, or at least, on most days of the week for 30 minutes or more. Certain women may have health issues that make it risky for them and in those cases the doctor may have other suggestions for strengthening muscles during pregnancy.The ACOG Education Pamphlet AP119 -- Exercise During Pregnancy reports that exercise has a positive impact on pregnancy and reduces common complaints such as backaches, constipation, bloating, and swelling. More specifically, it reports that exercise may help prevent or treat gestational diabetes, increases your energy, improves mood and posture, promotes muscle tone, strength, and endurance, and helps you sleep better.

What Do the Studies Show?
A review article published in 2010 in the journal Sports Medicine, looked at studies specific to pregnant women and cardiovascular adaptations during exercise, compliance with current recommendations and the effects of exercise on pregnancy outcomes.The authors report that regardless of whether pregnant women exercise or not, there is a change in heart rate that takes place from as early as two weeks of pregnancy and continues into the third trimester. There is an increase in blood volume that starts at between 10 and 20 weeks. This change, as well as others, however, has not been reported to be a barrier or disadvantage to exercising in pregnancy. Data suggests that pregnant women who exercise have a lower resting heart rate compared to non-exercising pregnant women and aerobically fit pregnant women have an improved V02, which means they take in more oxygen and use it better during exercise.When women exercise their heart rate increases, and so does the fetal heart rate. However, this has not been reported to be a risk to the development of the baby and may have advantages for the baby during delivery and after. Studies suggest that women who regularly exercise tend to have infants that are leaner, however, this has also not been reported to be a disadvantage. Very fit women also have advantages in labor, including a decreased risk for c-sections.

What About Yoga and Qi?
Qi gong (pronounced chee guhng) and yoga are both gentle exercises with a focus on stretching, breathing and bringing calmness of mind to the practitioner. Qi is also reported to have an additional emphasis on energy life force.There have been a few studies looking at the benefits of yoga on sleep during pregnancy, Qi and yoga on depression or anxiety in pregnancy, yoga on delivery-related stress and labor. The data on these exercises has been reassuring. The studies are generally interview-based and reflect how participants feel about their experience. For women who are interested in getting fit, but may not be interested in other types of exercise, this may be another option.

Which Exercises Should Be Avoided?
The ACOG Education Pamphlet AP119 -- Exercise During Pregnancy, recommends avoiding contact sports, downhill snow skiing and scuba diving during pregnancy. Sports with a higher risk for falling are generally not recommended.Whether your 2011 resolutions include walking, running, swimming, yoga, or Qi, I say, increase your chances of being successful! Try it with friends, your pets, include your significant other and your mother! Just make it fun and you're more likely to still be at it in 2012!.

Sonia Alvarado is a bilingual (Spanish/English) Teratogen Information Specialist with the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a state-wide service that aims to educate women about exposures during pregnancy and lactation. Along with answering women's and health professionals' questions regarding exposures during pregnancy/lactation via CTIS' toll-free hotline and email service, she's provided educational talks regarding pregnancy health in community clinics and high schools over the past decade. In addition, Sonia contributes to the service's website, develops training materials for new CTIS staff, and is the supervising Teratogen Information Specialist trainer. Sonia attended San Diego State University and has worked in Tuberculosis Control for San Diego County's Public Health Department. Sonia's work has also been published through several tuberculosis studies. In her spare time, she loves to volunteer with the March of Dimes as an expert speaker on themes related to pregnancy. CTIS Pregnancy Health Information Line is part of the The Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. California women with questions or concerns about pregnancy exposures can be directed to (800) 532-3749 or by visiting CTISPregnancy.org. Outside of California, please call OTIS counselors at (866) 626-OTIS (6847).References:

• The ACOG Education Pamphlet AP119 -- Exercise During Pregnancy
• Melzer et al: Physical Activity and Pregnancy Cardiovascular Adaptations, Recommendations and Pregnancy Outcomes.Sports Med 2010;493-507.
• Eun Sun Ji and Hae-Rae Han: The Effects of Qi Exercise on Maternal/Fetal Interaction and Maternal Well-Being During Pregnancy.AWHONN 2010;310-318.