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THE IMPORTANCE OF EXERCISING DURING PREGNANCY

THE IMPORTANCE OF EXERCISING DURING PREGNANCY

Say YES to pregnancy fitness! Do you know exercising during pregnancy leads to 30 significant benefits for the mother as well as the foetus and baby?

THE PHYSICAL BENEFITS OF EXERCISING DURING PREGNANCY

Exercising during pregnancy has many benefits for both mother and child. Physical benefits for the mother include improved cardiovascular function, lower risk for gestational diabetes, improved strength and lean muscle mass, reduction of bone density loss, reduction of swelling of extremities and reduction of varicosities [11, 13]. Even mild exercise will reduce weight gain during pregnancy. Exercise also brings a reduction of pregnancy-related physical discomfort and less fatigue because of enhanced sleep, adding up to an improved sense of well-being [11, 13].

Several studies have shown that regular exercise decreases depressive symptoms, reduces stress and anxiety and brings an increase in self-esteem and a positive body image [11, 13]. Women who exercise during their pregnancy are more likely to continue exercising postpartum [11]. The foetus of a woman who exercises, will have less body fat and therefore a lower birth weight [11]. When it comes to labour, women who have exercised during their pregnancy will experience a reduction of length of labour.

BENEFITS FOR FOETUS AND CHILD
Many benefits are also seen in the offspring of exercising women. Benefits for the foetus are a decreased resting foetal heart rate, improvement in the viability of the placenta, increased amniotic fluid level and an increased gestational age [13]. The foetus will also experience less stress. The foetus will be able to tolerate labour better [11]. After delivery, the child will likely have a higher Apgar score and a better ability to self-soothe [11]. Also, a leaner body mass with less body fat can be found in children of exercising mothers. This benefit can still be seen in children five years after delivery.Furthermore, these children have higher IQ’s (tested with the Wechsler scales) and a higher score when tested on oral language skills (corrected by confounders) [11, 5].

Most types of physical exercise don’t serve any danger for mother or child. However, activities that increase the risk of loss of balance or chance of trauma to joints or ligaments and activities that increase the chance of trauma for the foetus are discouraged 1 [4, 11].

The Mom in Balance Pregnant workout is a total body workout specially designed for pregnant women. The workouts are a combination of strength training, cardio training and relaxation, and are always given outdoors. All our pregnant workouts only consist of exercises that have been proven to be safe for pregnant women to perform; aerobic exercise, progressive strength training and stretching exercises [13]. The workouts are suitable and safe for both women that are experienced or not experienced in doing physical exercise, as there is no evidence that previously active or inactive women are at risk for adverse foetal or maternal events if they participate in physical exercise [4].

At Mom in Balance, we don’t do isolated abdominal muscle training, but we train the core as a whole. Since all pregnant women develop a diastasis rectus towards the end of their third trimester [9], and safety precautions when diastasis recti develop are to discontinue abdominal training [15], we avoid isolated abdominal muscle exercises altogether.

Our trainers also always remind our participants to have a proper breathing technique while doing resistance exercises, as an increase in abdominal pressure has a negative effect on diastasis recti [15].

In every workout, attention is given to the core muscles by doing functional exercises and special attention is given to the pelvic floor, in order to optimize its function. Our specially educated trainers make sure our participants don’t exceed their physical limits, and they advise our participants on the different high impact and low impact options. Women who experience pelvic floor related problems are advised by our trainers to avoid high impact exercises, as these can worsen existing pelvic floor related problems [3]. Our trainers make sure they are aware of the complaints their participants have and will give alternative exercises to the women that need them. Every woman will be able to exercise at her own level.

During the workouts, we alternate between cardio and strength exercises with various eight-minute blocks, due to the fact that a combination of aerobic training and resistance training has a proven positive effect on maternal health [12]. Strength exercises are performed at a high number of repetitions with a light to moderate load with short resting periods. With this training strategy, we aim for the improvement of muscular endurance [14].


PSYCHOLOGICAL BENEFITS

Apart from all the physical benefits mentioned above, there are also psychological benefits. Our participants also get the opportunity to share experiences with other inspiring pregnant women. To spend an hour every week with other like-minded women is very beneficial. They can give each other tips, share stories and give support.

Having “ME-time” is important to have balance in life. Women are caregivers and should be reminded that they can care best
for others when they take great care of themselves [1]. Time spent relaxing on your own as opposed to working or doing things for others, is seen as an opportunity to reduce stress and restore yourenergy.To have an hour just for themselves, will help our participants to be more relaxed during their day to day life. 85% of our participants tell us they get more energy because of their weekly sports routine. Psychological well-being also improves because of exercising outdoors [8].

RESOURCES
1. Bane, S.M. (2015). Postpartum Exercise and Lactation. Clinical Obstetrics and Gynecology, 58(4), 885-892.
2. Bastiaenen, C.H.G., Hendriks, E.J.M., Pool-Goudzwaard, A.L., Bernards, N.T.M., van Engelenburg-van Lonkhuyzen, M.K., Albers-Heitner, C.P., van der Meij, J., Grupping-Morel, M.H.M. & de Bie, R.A. (2017). KNGF-richtlijn Zwangerschapsgerelateerde bekkenpijn. (Royal Dutch Society for Physiotherapy). Nederlands Tijdschrift voor Fysiotherapie, 119(1), supplement.]
3. Bø, K. (2004). Urinary Incontinence, Pelvic Floor Dysfunction, Exercise and Sport. Sports Medicine, 34 (7), 451-464.
4. Charlesworth, S., Foulds, H.J.A., Burr, J.F. & Bredin, S.S.D. (2011). Evidence-based risk assessment and recommendations for physical activity clearance: pregnancy. Applied Physiology, Nutrition, and Metabolism, 36, 33-48.
5. Clapp, J.F. (1996). Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy. The Journal of Pediatrics, 129(6), 856-863.
6. Clapp, J.F. (1990). The course of labor after endurance exercise during pregnancy. American Journal of Obstetrics and Gynecology, 163(6 pt 1), 1799-1805.
7. Ilic, K.P., Segedi, L.M., Skevin, A.J., Macuzic, I.Z., Grobvic, V., Nurkovic, J., Jovanovic, M. & Jeremic, D. (2017). The influence of various risk factors on the strength of pelvic floor muscle in women. Vojnosanitetski Pregled, 74(6), 557-563.
8. Loureiro, A. & Veloso, S. (2014). Outdoor Exercise, Well-Being and Connectedness to Nature. Psico, 45(3), 299-304.
9. Fernandes da Mota, P.G., Pascoal, A.G., Carita, A.I. & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy, 20(1), 200-205.
10. Mottola, M.F. (2002). Exercise in the Postpartum Period: Practical Applications. Current Sports Medicine Reports, 1(6), 362-368.
11. Paisley, T.S., Joy, E.A. & Price, R.J. (2003). Exercise During Pregnancy: A Practical Approach. Current Sports Medicine Reports, 2, 325-330.
12. Perales, M., Santos-Lozano, A., Ruiz, J.R., Lucia, A. & Barakat, R. (2016). Benefits of aerobic or resistance training during
pregnancy on maternal health and perinatal outcomes: A systematic review. Early Human Development, 94, 43-48.
13. Prater, H., Spitznagle, T. & Hunt, D. (November 2012). Benefits of Exercise During Pregnancy. American Academy of Physical Medicine and Rehabilitation, 4,845-850.
14. Ratamess, N.A., Alvar, B.A., Evetoch, T.K., Housh, T.J., Kibler, W.B., Kraemer, W.J. & Triplett, N.T. (2009). Progression Models in Resistance Training for Healthy Adults. Medicine & Science in Sports & Exercise, 41(3), 687-708.
15. Wolfe, L.A. & Davies, G.A.L. (2003). Canadian Guidelines for Exercise in Pregnancy. Clinical Obstetrics and Gynaecology 46(2), 488-495.
16. Woodley, S.J., Boyle, R., Cody, J.D., Morkved, S. & Hay-Smith, E.J.C. (22 December 2017). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. The Cochrane Library. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007471.pub3/full

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