Special exercises for pregnancy &the puerperium

1. Special exercises for pregnancy &the puerperium • Prepared by : • Hanaa Behar • Shoroq edaliy • Khetam elkhafarna • Hadeel abo quse • Sabren salama • Wesam khatab • Somya abo omra

2. Safe exercise in the childbearing year

3. The exercise in the childbearing year • The exercise needs of the disabled woman during the childbearing year that specific . • should be assessed individually ,so advice and • information can be given. • Exercising during the childbearing year is not harmful to either .

4. mother or baby if the pregnancy is normal and the mother healthy . • and can be positively beneficial if at a • mild to moderate level. • The aims of exercising in pregnancy • should be to maintain, or slightly improve, the woman's level of fitness.

5. Provided there are no specific obstetric or medical contraindications, fit women can safely maintain the same level of fitness during pregnancy.

6. Pregnant women should not undertake new, vigorous exercise, which could make them too warm, tired or breathless and regular exercisers should reduce the intensity and duration of their training as the pregnancy progresses .

7. Pregnant women should not undertake new, vigorous exercise, which could make them too warm, tired or breathless and regular exercisers should reduce the intensity and duration of their training as the pregnancy progresses .

10. All women should be encouraged to exercise at a moderate level to derive the associated health benefits. • A moderate level is that intensity which can be maintained while able to carry on a conversation.

11. The Borg Scale of Perceived Exertion or the Talk Test can be used, preferably at level 3–5. • This should be used in preference to a heart rate monitor, which is less reliable due to the pregnancy-induced increase in heart rate.

12. maintenance of cardiovascular fitness, respiratory and musculoskeletal .status • There are benefits to exercising in the childbearing year. The benefits according to the ACPWH may include:

13. maintenance of healthy weight range for mother

14. improvement of body awareness, balance, coordination and posture

15. improvement in circulation and lowered diastolic pressure .

17. an increase in both endurance and stamina

18. increased feelings of social and emotional well-being, when exercise is combined with social interaction.

19. a possible reduction in problems during labour and delivery. Labour may also be shorter and there may be fewer interventions (forceps, caesarean section)

20. evidence of neurological benefits to the baby and developing child

22. a reduction in common disorders of pregnancy

23. suggestion of a more rapid postnatal recovery as the woman is likely to be fitter

25. better glucose utilization by increasing insulin sensitivity,

26. suggested improved placental growth, increased fetal growth

27. However, further research on the benefits of exercise in pregnancy is needed and health professionals should remain up to date with current literature. • Most women will fall into one of the following four types of exerciser. Using the Borg Scale of Perceived Exertion is appropriate for all women, whatever their level of fitnessor ability.

29. . The occasional exerciser These women may recognize the benefit of exercising when pregnant and may wish to increase the level of intensity, duration and regularity.

30. .

31. The regular exerciser Guidelines for exercise in pregnancy (ACOG 2002) suggest that the woman who exercises regularly should: • . discuss her exercise programme with the obstetrician, GP, physiotherapist or midwife before continuing

32. • exercise at least three times per week for 20–30 min to improve aerobic capacity but discontinue contact or dangerous sports

33. • • self-regulate both the level of intensity and duration of exercise as the pregnancy progresses. This will help to keep core temperature below 38 °C.

34. always aim for low impact activity to reduce musculoskeletal stresses and wear supportive footwear

35. prevent dehydration by maintaining an adequate fluid intake and should avoid exercising during hot and humid weather or with pyrexia

36. ensure that they warm up and cool down for at least 5 minutes

37. not overstretch because of the hormonal effects on the ligaments

38. consult the relevant professional for advice on specific exercises, e.g. for the pelvic floor and abdominal muscles

39. avoid certain movements like low squats, cross-over steps, rapid changes of direction and ballistic exercise

40. avoid aortocaval compression by not exercising in the supine position (supine hypotension syndrome,

41. aim to pursue a variety of exercise activities in order to avoid overtraining

42. not exercise to the point of fatigue nor become breathless.

43. The athlete These women are often the most difficult to advise as they are often highly motivated and competitive. They should follow the advice of regular exercisers. A safe level of aerobic exercise for the athlete will depend on the chosen sport and degree of fitness attained.

44. The athlete will inevitably need to lower the intensity and length of her training sessions and they should be aware that the same warnings and contraindications apply as for the regular exerciser.

45. Advisors of pregnant women athletes regarding safe exercise should remember that research into strenuous activity during pregnancy is limited, so should Endeavour to keep updated of new information.

47. Antenatal exercise It is best to continue with familiar activities rather than begin new types of exercise and the woman should listen to her body when exercising and stop if she feels uncomfortable, fatigued or unwell

48. Basic exercise • Brisk walking during which the Borg Scale/Talk Test is correctly observed is an easy and accessible method of exercising for all.

50. NOT • Swimming is excellent exercise if aerobic changes are induced. • Exercising in water also raises the plasma beta endorphin levels significantly and has a beneficial effect on the respiratory cardiovascular and musculoskeletal systems.