Prescriptions
Talk to doctor before exercising during pregnancy

Despite morning sickness, swollen feet and sore backs, many pregnant women want to continue to exercise. This is fine, provided your physician gives permission. Let me repeat that. Advice in this column is in no way meant to replace your doctor’s guidelines. However, it is important to note that even the American College of Obstetricians and Gynecologists approves and recommends activity during pregnancy for most women. So, if your doctor says it’s OK, go for it.

However, be sure to remember that activity during pregnancy can be much more complicated than activity at other times of your life. You should definitely not exercise if you experience these conditions:

High blood pressure.

Preterm rupture of membranes (when your "water" breaks too early).

Preterm labor in your current or previous pregnancy.

"Incompetent cervix" (ask your doctor about this condition).

Persistent bleeding (be sure to tell your doctor about this).

Intrauterine growth retardation (a baby who fails to grow).

Exercise during pregnancy is complicated by a changing center of gravity that can affect your balance, changes in your blood supply that affect your heart and heart rate, hormonal changes that cause your joints to be lax or stretch easily, and other related annoyances, such as that dreaded tiredness that can occur for the entire pregnancy.

In response to this, the American College of Obstetricians and Gynecologists has developed the following recommendations:

Regular, low-impact exercise (at least three times per week) at a mild to moderate intensity is preferred.

After the first trimester, exercise that involves lying on your back is not recommended.

Prolonged periods of motionless standing should be avoided.

Working to breathlessness should be avoided (you should be able to talk while exercising).

You should not exercise to exhaustion.

Non-weight-bearing activity that minimizes the risk of falling - chair exercises, riding a stationary bike or swimming, for example - are recommended.

Any activity which could put you at risk for a fall or a blow to the stomach should be avoided, especially in the third trimester. This includes one-leg yoga postures, surfing, bicycling, horseback riding, softball and volleyball.

I would add that it is important to exercise in an environment where there are other people around. This is not the time to embark on a solo hike of the Napali coastline. It is also good to join a class where you can be active with other women who also are pregnant. If nothing else, this will at least give you a group of people who are willing to listen to your complaints with a sympathetic ear.

Nothing to hide

If you are self-conscious about wearing exercise clothes, don’t be. Remember, pregnancy is a natural thing and all of our moms were pregnant once, right?

It is also important to note that pregnancy is not a time to strive for fitness. Pregnancy is a time when the health of your baby should take precedence.

If you have not exercised at all previously, your physician may recommend that you wait to begin a program until after giving birth. Remember, you are going to gain weight and your body will change. Activity should not be used to combat this normal body process. Weight can be lost later and, believe it or not, your body can regain its original shape. You should not diet or attempt to lose weight during pregnancy. Put those surf shorts away and use them as a goal after giving birth.

Don’t worry. That low-intensity activity is not going to cause your baby harm. Ann Cowlin, director of Dancing Thru Pregnancy, and an instructor at Yale University, has reassured me on this point. "If a woman is eating well, drinking plenty of fluids and doing a suitable amount and type of exercise, she will gain the weight she needs to grow a healthy baby. In fact, her pregnancy may be more comfortable if she exercises regularly."

Classes available

Exercise during pregnancy classes are held at Kapi‘olani Medical Center for Women and Children, many of the YMCAs and Kaiser Permanente. Copies of the ACOG guidelines can be obtained by calling (202) 638-5577. They are written for physicians, though, so don’t expect them to be light reading.

Don’t forget to enjoy the wonder of it all. The fact your body can stretch to accommodate a baby and still be able to swim the length of Ala Moana Beach Park is a pretty amazing thing.

Angela Wagner is a free-lance writer who also works for the Queen’s Medical Center as a health educator specializing in diabetes and exercise, and for the state Department of Health as a program manager in the Health Promotion and Education Branch.

Hawai‘i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, ‘Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.

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