Antenatal Exercises

Original Editor - Rubi Top Contributors - Rubi, Ruchi Desai, Kim Jackson, Candace Goh, Khloud Shreif and Rishika Babburu
One Page Owner - Rubi as part of the One Page Project

Introduction

Antenatal exercises aim at improving the physical and psychological well-being of an expected mother for labor and preventing pregnancy-induced pathologies by various physical means. It generally includes low impact aerobic exercises and stretching exercises.

During the first trimester, pregnancy brings certain changes in the body for example: morning sickness, fatigue or low energy levels, nausea and increased secretion of the relaxin hormone. Exercise helps to overcome these changes and improves the mood and energy level of the mother. Healthy pregnant women should exercise for at least 150 min per week or 20-30 min everyday in moderate to vigorous aerobic intensity.

Guidelines for Physical Activity during Pregnancy

For more information-

• Physiological Changes in Pregnancy
• Postural Changes during Pregnancy
• Physical Activity and Pregnancy

Advantages of Antenatal Exercise

• Reduces morning sickness.
• Reduces insomnia, anxiety and stress.
• Reduces other pregnancy-related complaints, eg: fatigue, leg cramps, oedema of extremities, etc.
• Prevents excessive weight gain during pregnancy.
• Improves muscle strength.
• Improves core stability.
• Maintains muscle length and flexibility.
• Improves glycemic control.
• Improves posture.
• Enhances relaxation.
• Prepares for physical demands of labour.

Contraindications

There are absolute contraindications and relative contraindications.

Absolute contraindications

• Ruptured membranes
• Premature labour
• Unexplained PV bleeding
• Placenta previa after 28 weeks
• Pre-eclampsia
• Incompetent cervix
• Intrauterine growth restriction
• Higher-order multiple pregnancy (e.g., twins, triplets etc.)
• Uncontrolled high blood pressure, type 1 or type 2 diabetes or thyroid disease
• Other serious cardiovascular, respiratory or systemic disorders

Relative contraindications

• Recurrent pregnancy loss
• Gestational hypertension
• A history of spontaneous preterm birth
• Mild/moderate cardiovascular or respiratory disease
• Symptomatic Anaemia
• Malnutrition
• Eating disorder
• Twin pregnancy after the 28th week
• Other significant medical conditions

Precautions

• Exercises should be performed under supervision.
• Avoid supine lying more than 5 minutes after 3 months of gestation.
• Do not hold your breath(Valsalva's maneuver).
• Do not change positions quickly.
• Stay hydrated at all times (before, during and after workouts).
• Follow proper warm-up and cool-down process.
• Ensure bladder emptying before workouts.
• Avoid exercises which demands higher balancing and different groups of muscles.

When to seek medical care?

• Excessively shortness of breath
• Chest pain or palpitations
• Dizziness
• Vaginal bleeding
• Abdominal pain
• Reduced fetal movement
• Painful uterine contractions(or prolonged uterine contractions)

Let's take a glance at the various form of exercises which can be performed during pregnancy!

Cardiovascular Exercise

• The intensity of the workout will be decided by an assessment on pre-pregnancy fitness level.
• It is important to choose any aerobic activity based on one's interests, such as walking, swimming, hiking etc.
• So if walking is the only cardio workout done by an individual, it can be practiced 20-30 minutes 3-4 times a week safely.

Stretching exercises

Pectoral stretch

• This exercise helps in the opening of the chest and prevents the development of round shoulders.
• Nudge the ball in the corner or near the wall.
• Sit in a comfortable position keeping the back on the ball.
• Keep your hands by the side or clasp them behind your head.
• Rest the head on ball and let the elbows expand and open your chest.
• Repeat 3 to 5 times.

Piriformis stretch

• Piriformis muscle plays an important role in pelvic stabilization and ADL's.
• Sit on the chair with neutral pelvis.
• Now keep your foot over the opposite knee and bend forward from the hips keeping your pelvis neutral until you feel the stretch.
• Hold it for 20-30 seconds.
• Repeat for the other side as well.
• Do 3 to 5 sets.

Hamstring stretch

• Shortening of hamstring can cause back pain and pelvic misalignment.
• This stretch can be performed in various positions and bilaterally or unilaterally.
• Sit in long sitting position, bend one knee and try to reach your extended leg as much as you can.
• Hold it for 20-30 seconds and repeat it for 3-5 times on each side.
• During first trimester, supine lying hamstring stretch can also be done.

Calf stretch

• The more the available length of Tendo achilies, the more force production during push off phase of walking and greater stability.
• Place rolled towel, mat or foam roller on the floor.
• Place ball of the foot on the towel, mat or roller and heel on the floor. keep the leg straight. hold this position for 20-30 seconds.
• Repeat on the other side and perform 3-5 sets on each side.

Strengthening Exercises

Wall push ups

• Place hands shoulder-width apart on a wall,
• Step your feet back so your body is in an inclined plank position.
• Slowly lower your chest, making sure your body stays in alignment.
• Exhale as you press back to the plank start position.
• Repeat 5-10 times.

Seated row back

• Sit or lean on a stability ball or bench with the adequate weighted dumbbell.
• Abduct your shoulders and bring your elbows almost your shoulder level.
• Exhale to engage as you push the elbows backwards and squeezing your shoulder blades together.
• Repeat it for 5-10 times.

Safety Considerations - Ensure you are sitting with a neutral pelvis and that the movement is from the arms, not the body.

both of theses exercises will prepare the expecting mother for breastfeeding and other baby carrying activities.

Bridging

• This exercise put more emphasis on the gluteus maximus and other larger postural muscles.
• Lie on your back, hands by your side, knee hip-width apart and heel under the knee.
• Keep your pelvis neutral, now squeeze your buttocks and lift the pelvis up.
• Hold it for 10-20 seconds, breath regularly.
• Come back to the starting position slowly.

Squats

• Great exercise for all the lower extremities muscle majorly focuses on gluteus maximus.
• Stand feet slightly more than hip width apart.
• Clasp the hands and bring them forward.
• Squat while exhaling and make sure knees won't go beyond the great toes.
• Press down and straighten the legs while going up.
• Ensure the stability.

Lunges

• This exercise put more emphasis on the gluteus,Hamstring and Quadriceps
• Stand straight, take one step forward.
• Now, lower yourself and try to maintain front leg vertical so that gluteus and hamstring will be loaded rather than quads.
• Pressing the leg down straighten yourself.

Activities of Daily Living

• Staying active is advisable in pregnancy until there is any risk associated.
• Walking, squatting, lifting and lunging activities should be included as far as possible, as it will prepare you for the Bib day!
• Make sure you are hydrated.
• Don't compete.
• Don't hold breath.
• While performing exercises, ensure that you won't exhaust yourself.
• Take enough rest intervals.