DURING PREGNANCY

Increasingly research is suggesting that exercise during pregnancy has many physical and psychological benefits. For example, a study at the University of Carolina (USA) recently discovered that women who exercised during the second trimester had a 48% reduced risk of a pre-term birth.
The general rule of thumb is if you have been exercising before pregnancy, there are positive benefits to continuing as long as some guidelines are followed:

• Avoid overheating and if it’s hot outside, switch to inside training.
• Drink for two as well as eating for two. Much research has been showing that women often fail to drink enough fluids during pregnancy.
• Forget about your training diary and any goals or targets.
• Try close to home or somewhere easily accessible incase you suddenly get tired, need fluids or a toilet stop.
• Use your energy level as a guideline to determine how much, how often and what type of training you do.
• If in doubt, check with your doctor.

POST NATAL EXERCISE

Regular exercise after childbirth also offers a range of health benefits and can help you return to your pre-pregnancy shape and give you increased energy to cope with the demands of new motherhood and feel good about yourself. It is important to consult with your doctor or midwife before you start any postnatal exercise program.
Walking/Hiking is a great form of early post natal exercise as it will not only work your aerobic system and get you ready for more demanding exercise (for example, running) but also help to tone your muscles and develop some leg strength. Swimming and water running are also very good for you once you have been given the all clear from your doctor to return to the pool. These forms of exercise are particularly good as they are none weight bearing and therefore don’t stress your ligaments and joints which are more flexible/loose during and post pregnancy for up to 3months. This means you need to avoid any high impact exercises or sports that require rapid direction changes and vigorous stretching. Once you have done some hiking and you are comfortable sitting on a bike, cycling is another good form of exercise as long as the resistance isn’t too high.

Pilates and Yoga are popular forms of exercise post natal and can be very beneficial to helping your body return to it’s former shape and strength. Make sure you inform the instructor you are working with that you have just given birth as they will adapt some of the exercises in the early days to ensure you don’t do any damage while your body recovers from the birth. You can also begin exercises to tone your pelvic floor and abdominal muscles at home as soon as you feel ready. If you had an episiotomy or tore during birth, pelvic floor exercises can also help to speed your recovery.

Gentle Stomach Exercise
Pregnancy splits your abdominal muscles down the middle. It is important to make sure your muscles have healed before you do any vigorous abdominal exercises, such as abdominal crunches. In the meantime, you can tone your tummy by performing an exercise that strengthens the deepest muscle layer (transversus abdominus):

• You can perform these exercises lying down, sitting, standing, or on your hands and knees.
• Keep your lower back flat.
• Breathe out, and draw your belly button back towards your spine. Your lower back shouldn't flex or move.
• Hold this position and breathe lightly. Count to 10.
• Relax, and repeat up to 10 times per set.
• Do 10 sets, as many times per day as you can.
• You may like to perform your pelvic floor exercises at the same time (see below).

Stomach Exercise - Stage Two
Once the gap in your abdominal muscles has closed, you can progress to more demanding exercises. General guidelines include:

• Lie on your back, with bent knees and both feet on the floor. Put your hands on your thighs.
• Breathe out, contract your abdominal muscles and lift your head and shoulders off the floor. Slide your hands towards your knees. Only aim to get your shoulder blades off the floor.
• Keep your head and shoulders stable. Hold the position, then slowly ease your shoulders and head back to the floor.
• Repeat up to 10 times for one set.
• Perform around three sets per session.
• You may like to perform your pelvic floor exercises at the same time (see below).

Exercise for the lower abdominal muscles
The lower abdominal muscles are located below your belly button. To work these muscles gently, guidelines include:

• Make sure your abdominal muscles have healed. Until the gap is closed, only perform the ‘gentle tummy exercise’ option.
• Lie on your back with your knees bent and both feet flat on the floor.
• Contract your abdominal muscles.
• Slowly slide your feet away from you, aiming to straighten both legs. The idea is to straighten the legs without arching your lower back.
• If your back starts to arch, stop and slide your feet back towards your bottom.
• Aim for 10 repetitions per set.
• Perform around three sets per session.
• As your lower abdominal muscles get stronger, you'll be able to slide your feet further and further away.

Pelvic floor exercises
The pelvic floor muscles are tightly slung between the tailbone (coccyx) and the pubic bone, and support the bowel, bladder, uterus (womb) and vagina. Childbirth can weaken these muscles and cause problems such as incontinence later in life. To exercise them, you must first direct your attention to these muscles. To help you identify these muscles, they are the ones that you contract to stop urinating. Try to relax your abdominal muscles. Don't bear down or hold your breath. Gradually squeeze and increase the tension until you have contracted the muscles as hard as you can. Release gently and slowly. Then perform the exercises, which include:

• Squeeze slowly and hold for between five and 10 seconds. Release slowly. Repeat 10 times.
• Perform quick, short and hard squeezes. Repeat 10 times.
• Squeeze, then clear your throat or cough lightly. Repeat three times.
• Aim for five or six sets each day.
• These exercises can be performed lying down, sitting or standing.
• See the Better Health Channel article ‘Pelvic floor’ for more information, or consult with your doctor or physiotherapist.
  General suggestions for aerobic exercise:
• Give yourself sufficient time to get back into exercise and don’t force it or put pressure on yourself.
• Aim for slow, gradual weight loss of around half a kilogram per week.
• Wear a supportive bra.
• Avoid any activities that place stress on the unstable pelvic floor and hip joints until strength and stability has improved. Be careful about activities that require sudden changes in direction (for example, high-impact aerobics, running and contact sports). This varies depending on the type of pregnancy and delivery you may have had.
• Initially, even five to 10 minutes of exercise at a time is great and slowing increase the length of your workouts depending on how you feel.
• Drink plenty of water before, during and after exercise.
• If you experience pain, slow down or stop.
• Remember that it may take you months to return to your pre-pregnancy shape and weight, so don't be discouraged by slow progress.

Warning signs to slow down:
Don’t overexert yourself. Your body gives out warning signs if you are exercising too hard, and these signs may include:

• Increased fatigue
• Muscle aches and pains
• Colour changes to lochia (post-partum vaginal flow) to pink or red
• Heavier lochia flow
• Lochia starts flowing again after it had stopped.