1. Chapter 10 Pregnancy

2. Learning Objectives Learn about physical activity during pregnancy. Identify the benefits of physical activity during pregnancy. Identify the physiological changes that occur during pregnancy. Identify physical activity guidelines for pregnant women.

3. Women who have achieved cardiorespiratory fitness before pregnancy should be able to safely maintain that level of fitness throughout the pregnancy and postpartum period, although they may have to modify their exercise regimen. KEY POINT

4. Benefits of Physical Activity for Pregnant Women Improves circulation Improves balance Reduces swelling Eases gastrointestinal discomfort Reduces leg cramps (continued) Strengthens abdominal muscles

5. Benefits of Physical Activity for Pregnant Women Improves posture Alleviates backache and joint soreness Improves sense of well-being Builds endurance, resulting in perception of less painful labor Eases postpartum recovery

6. Women who are physically active during their pregnancy can experience a number of benefits that will help them feel better and provide additional stamina and strength so that they can recover from childbirth more quickly than women who aren’t active. KEY POINT

7. Physiological Concerns During Physical Activity When Pregnant Reduced uterine blood flow Hypoxia Hyperthermia Reduced carbohydrate availability Miscarriage and pregnancy outcome

8. Physical Changes During Pregnancy Breathing Heart rate and circulation Stomach and intestines Kidneys and bladder (continued)

9. Physical Changes During Pregnancy Muscles, joints, and posture Metabolism Breasts Pelvic floor

10.  A pregnant woman’s cardiac output increases by 40% to 50% to meet the needs of the growing uterus and fetus. Yet her cardiac reserve diminishes. This causes her to tire more quickly, especially during vigorous activity.  During pregnancy, ligaments relax and joints become looser and more mobile. As a result, women are more prone to injury in the third trimester. The joints of the pelvis and back are particularly prone to soreness. KEY POINTS

11. Warning Signs to Stop Exercising Vaginal bleeding Abdominal or chest pain Leaking or gushing from vagina Sudden swelling in hands, face, or feet Severe, persistent headache Dizziness or light-headedness Noticeable reduction in fetal activity Painful, reddened area in the leg (continued)

12. Warning Signs to Stop Exercising Severe pain the pubic area or hips Painful or burning urination Irritating vaginal discharge Oral temperature over 100ºF Persistent nausea or vomiting Uterine contractions Heart palpitations Shortness of breath

13. Guidelines for Physical Activity During Pregnancy Check with your physician first. Exercise at least three times per week. Don’t exercise on your back after the first trimester. Modify the intensity; “listen” to your body. Don’t jeopardize your balance. (continued) Avoid activities that can cause abdominal trauma.

14. Guidelines for Physical Activity During Pregnancy Warm up and cool down every time you exercise. Be careful not to overheat. Eat enough calories for the extra energy you need both for your pregnancy and for exercise. From the American College of Obstetricians and Gynecologists.

15. Safe Exercises When Pregnant Walking Swimming Bicycling Jogging (continued) Low-impact aerobics

16. Safe Exercises When Pregnant Racket sports (through first two trimesters) Light-weight strength training Aerobic equipment Other activities (e.g., golf, step exercises through first two trimesters)

17. Unsafe (Contraindicated) Exercises When Pregnant Diving of any type (sky, hang, SCUBA) Contact sports such as soccer, rugby, field hockey, and basketball Jumping into water feet first Skiing (downhill and water) Horseback riding