1. Level 3 Award in Pre / Post Natal Exercise Programming Design

2. Aims of the session
By the end of the session the learner should have an understanding of
The effects of contra-indications to exercise for the pre / post natal client

3. Learning Outcomes
By then end of the session the learner should be able to
List 2 absolute and 2 relative contra-indication to physical activity
List 3 warning signs relating to exercise

4. Contra-indications to exercise
Health and fitness professionals should carry out a careful screening of every expectant mother wishing to exercise during pregnancy, The GP or Mid-wife will regularly monitor the pregnant woman’s blood pressure, You as there trainer should do the same!

5. Contra-indications to exercise
There are 4 main contra-indications that need evaluating prior to beginning or resuming exercise during pregnancy;
Significant physical injury,
An acute bout of illness or chronic underlying disease,
The onset of persistent or recurrent localised pain,
Abnormal or heavy vaginal bleeding.

6. Contra-indications to exercise
The (ACOG) American College of Obstetricians & Gynaecologists has published a list of exercise contra-indications for pregnant woman,
Absolute – we don’t undertake any exercise with the client,
Relative – we can undertake exercise but with an increased level of care and concern should be adopted, with closer supervision

7. Contra-indications to exercise
ABSOLUTE CONTRA-INDICATIONS
Haemodynamically significant heart disease
Restrictive Lung Disease
Incompetent Cervix / Cerclage
Multiple Gestation at risk for premature labour
Persistent second or third trimester bleeding
Placenta praevia after 26 weeks gestation
Premature labour during the current pregnancy
Ruptured membranes
Pregnancy-induced hypertension (pre-eclampsia)
Unit 1, Q5a

8. Contra-indications to exercise
RELATIVE CONTRA-INDICATIONS
Severe Anaemia
Unevaluated maternal cardiac arrhythmia #
Chronic Bronchitis
Poorly controlled type 1 Diabetes
Extreme morbid obesity
Extreme underweight (BMI <12) #
History of extremely sedentary lifestyle
Intrauterine growth restriction in current pregnancy
Poorly controlled hypertension (pre-eclampsia)
Orthopaedic limitations
Poorly controlled seizures
Poorly controlled thyroid disease #
Heavy smoker
Unit 1, Q5b

9. Contra-indications to exercise
The (ACOG) American College of Obstetricians & Gynaecologists also identifies a number of warning signs to stop exercising;
Vaginal bleeding,
Breathlessness before exertion begins,
Dizziness,
Headaches,
Chest pain,
Muscle weakness,
Calf pain or swelling (need to rule out thrombophlebitis),
Pre-term labour,
Noticeable decrease in foetal movement,
Amniotic fluid leakage.
Unit 1, Q8, (P20 man)

10. Contra-indications to exercise
We can also identify some key signs of over-training;
In the Mother
In the Baby
Fatigue
Little or no movement after exercise session
Pain
A reduced growth rate over time
Loss of motivation
Susceptibility to injury and common infections
Now complete Unit 1, Q7, explain when you would refer a pre-natal client

11. Quick Quiz

12. Quick Quiz

13. Presentation
Your task is to research the following, and put this in a powerpoint presentation, which needs to be submitted to myself.
Absolute
Relative
Haemodynamically significant heart disease
Unevaluated maternal cardiac arrhythmia
Incompetent Cervix / Cerclage
Extreme underweight (BMI <12)
Placenta praevia after 26 weeks gestation
Poorly controlled thyroid disease
Pregnancy-induced hypertension (pre-eclampsia)

14. Homework
Research question 9 from your LAP, about stretch marks and weight gain,
Then how would you reassure/give advise relating to these issues

15. Learning Outcomes Can you now state
List 2 absolute and 2 relative contra-indication to physical activity
List 3 warning signs relating to exercise