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Non-weight-bearing exercises are safe for pregnant women
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PHOTO: M. MOORTHY
IN GOOD SPIRITS Pregnant women who exercise tend to have better self-image
Once upon a time, doctors told pregnant women to take it easy and rest as much as possible. Now things have changed. We now know that most non - weight-bearing exercises (e.g. swimming, stationary bicycling) and walking are safe for pregnant women, beginning with 15 minutes of exercise three times a week and progressing as tolerated.
There are very few absolute contraindications to exercise during pregnancy.
Incompetent cervix, intrauterine growth restriction, multiple gestation (triplets), persistent second or third trimester bleeding, placenta previa after 25-28 week gestation, preeclamsia, pregnancy-induced hypertension, premature labour during current or prior pregnancy, premature rupture of membranes and risk of premature labour are absolute contraindications for exercise during pregnancy.
Relative contraindications to exercise include extreme underweight or maternal eating disorder, maternal arrhythmia (previously unevaluated) or cardiovascular disorder, mild to moderate respiratory disorder, previous spontaneous abortion, severe anaemia, twin pregnancy after 28 week gestation and any other significant medical condition.
Women with these conditions should be closely evaluated and followed up if they wish to exercise during pregnancy. All pregnant women should discontinue exercise until seen by a physician if they experience significant shortness of breath, vaginal bleeding, dizziness, headache, chest pain, amniotic fluid leakage, or decreased foetal movement during exercise.
Positive effects of exercise: Musculoskeletal discomfort during pregnancy, especially back pain, is common. The increased weight and lordosis associated with pregnancy increases the workload of the muscles in the lower back. Women who exercise tend to have fewer musculoskeletal complaints, including low-back pain, compared to sedentary women.
Pregnant women who exercise have better self-image and fewer depressive symptoms, both during and after pregnancy, than inactive women. Compared with sedentary women, pregnant women who exercise gain similar amounts of weight or less weight and may have a smaller amount of subcutaneous fat deposition. But, exercising women do gain enough weight to support a healthy pregnancy.
Physically active women return to pre-pregnancy weights faster than sedentary women. Exercise in the postpartum period does not adversely affect the new mother, lactation or infant growth.
Exercise during pregnancy is useful in preventing and treating gestational diabetes mellitus. Several studies show improved glucose tolerance and reduced insulin requirements in women with gestational diabetes who participate in low-intensity aerobic exercise or resistance exercise.
Pregnancy requires an increase of 300 calorie/day. Exercising women must replace calories used during exercise. In addition, pregnant women must drink plenty of fluids before, during and after exercise.
After the first trimester, exercises performed in the supine position or exercise requiring prolonged motionless standing should be avoided because these positions obstruct venous return and decrease cardiac output and cause hypo tension.
RAJIV M.
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