Sunday, April 26, 2009

Myth Busting: Fitness in Pregnancy

"Pssst!" I looked over at the woman laying next to me on the hard gym floor, both of us in a cesspool of our sweat courtesy of the bootcamp class we were doing. At first I wasn't sure if her noise was just a loud exhale during a sit-up but then she continued. "Aren't you not supposed to do these?"
"Huh?" I grunted and kept on sitting up and laying back down. (sidenote: If aliens watch us they must be so confused.)
"I thought you couldn't do sit-ups when you're pregnant?"
Ah. And there it was. You think people have lots of opinions about your exercise routine now, just wait until your pregnant. (And then, if you think that's bad - wait until you have the kid. Perfect strangers will stop you in the grocery store on an 90 degree day to inform you haven't put a hat and socks on your baby.) The thing is, most of them are very well meaning. But there's a lot of confusion out there about what exactly is safe for us two-fer humans on the gym floor.

Prenatal Fitness is Good
A lot of the confusion stems from the fact that the guidelines given pregnant women by their doctors have changed a lot since our great-grandmothers were dropping babies in the fields between harvesting the turnips. I won't go through the back and forth of all that has transpired - except to say that really nobody eats turnips anymore, if they can help it - but will sum up the current medical conclusions. These days doctors acknowledge that a) exercise is good for all people and b) pregnant women are people. Ergo: Pregnant women benefit greatly from exercise just like all people do. Pregnancy is not illness or a "condition" - it's just part of life. So the trick lies in deciding how best to reap the numerous benefits of prenatal exercise while minimizing risk to Mommy and Jelly Bean. For a great in-depth and very research oriented look at prenatal fitness, I highly suggest reading Dr. James F. Clapp's book Exercising Through Your Pregnancy. Yeah, yeah, I know the cover has a crazy looking 80's woman in day-glo on the front cover but the research is solid.

Myth #1: Pregnant women must keep their heart rate under 140
I hear this myth more often than I hear any other. It has even earned me a very stern lecture by an older woman who stopped me mid-run to chastise me. And yet it's not true. This rule used to be the recommendation by the American College of Obstetricians and Gynecologists but as of 1994, it is no longer. Now, they recommend more sensibly to just listen to your body and don't exercise to exhaustion. "The changes in the 1994 guidelines largely are the removal of somewhat arbitrary restrictions on exercise session duration and maternal heart rate, as studies have demonstrated that earlier cautions were unwarranted, and that women tended to naturally adjust their exercise intensity with respect to the developing pregnancy." Aw, see? They trust us now! And, as Gym Buddy Megan put it, "I get my heart rate over 140 just carrying the laundry up the stairs."

Myth #2: Pregnant women must not lift anything over 20 pounds
Any pregnant woman with a toddler is now snorting her breakfast of pre-chewed cheerios and back-washed milk. Unless you are Mariah Carey, daily life routinely requires women to lift more than 20 pounds and that doesn't change just because the color of your urine does. (Side note: Did you know pregnancy changes your pee color? Now you do!) And yet I've even had doctors tell me this. However, according to the ACOG, unless you are under some kind of restriction like bed rest or pelvic rest (code for "no sex, sucka!") then there is no restriction on how much weight you can lift. This applies to both dumb bells and dumb groceries. Of course normal cautions apply here: use proper form when lifting, don't lift more than you know you can handle, always use a spotter and don't try to carry your 4-year-old, your two-year-old and a gallon of milk up a flight of stairs. (I dropped the milk and our stair well stank of rotten milk pretty much until we moved.) Also, if you feel like you're getting weaker, be sensible and just lower your weight. Blame your hormones and save the superhero antics for after the baby is born.

Myth #3: Pregnant women can't do ab exercises
This one actually has some truth to it. If pregnancy really changes one thing on your body, it's your abs. And so while you can still safely exercise them, you will have to make modifications. In the first tri, you can pretty much do whatever you've been doing. By the 4th month though, your jelly bean is large enough to be putting pressure on some of your major veins, especially when you lay on your back. You'll know if this is happening because you'll feel light headed and nauseous. This just means that you need to figure out a different way to do abs. There are lots of exercises you can do standing up or on an incline bench with your head higher than your feet. By about the third trimester, if you're like me, any ab work just hits your hip flexors. At this point, my abs usually have separated and so I quit ab work until they come back together at about 8 weeks post-partum. Fun test: sit up half way and then stick a finger in your belly about 2 inches below your belly button. If you can feel a ditch and fit two fingers in it, your abs have parted ways and you shouldn't work them anymore.

Obligatory disclaimer: I am not a doctor nor do I play one on TV, although I do play one with my kids on ocassion. Always ask your doctor before starting or modifying an exercise routine, especially when you are pregnant. Pregnancy changes everything. It really does. So if you feel like you can't work out - don't. Don't feel guilty about it. And if you still want to run marathons and you were a marathoner before you got pregnant? Then do it. And don't feel guilty about that either. The whole key here is to listen to your body and just do what feels good. You know the difference between good hurt and bad hurt. Always stop if there's bad hurt.

Here's the official position of the ACOG:
If you were physically active before pregnancy, you can remain active during pregnancy. If there are no complications, 30 minutes or more of moderate exercise every day is healthy. You should avoid activities with a risk of falling, such as basketball, gymnastics, or horseback riding. You also should avoid deep scuba diving because of the risk of decompression. If you were not active before getting pregnant or you have a medical condition, you should talk with your doctor to plan a safe exercise program.

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