Physical preparation in Pregnancy
Specific therapeutic aims of physical preparation include the prevention or relief of common discomforts such as backache, the promotion of a speedy post natal recovery and the prevention of future gynaecological and orthopaedic problems.
Exercise sessions should be designed to stimulate interest and awareness about the body. They should also facilitate physical and mental relaxation.
Exercise in pregnancy may lower diastolic blood pressure and may prevent gestational diabetes. The risk of pre term labour is reduced in women who exercise regularly.
Walking: Walking in fresh air remains the most natural and simplest form of exercise and should be encouraged whenever possible.
Cycling: Cycling is another popular form of exercise that allows for good mobility of lower limbs with the body weight supported. It is a easy way to travel, although short distances are preferable. Cycling uphill should be strictly avoided.
Swimming: Swimming is an excellent exercise as water relieves the effects of gravity on the body and muscles can be strengthened and the flexibility of joints be retained without undue fatigue. Breast stroke is usually most popular, but has tendency to aggravate back ache. Leisurely back strokes with gentle supporting arm movements is often comfortable.
Aquanatal exercises: Exercise in water raises the plasma beta endorphin levels significantly and has a beneficial effect on the respiratory, cardiovascular and musculo-skeletal systems.
Pilates: Pilates is a scheme of exercises that offer both mental and physical training. It targets deep postural alignment and works to develop balance, central posture, and abdominal and back muscle strength.
Energetic and Competitive sports: Activities such as squash, high impact aerobics, horse riding, jogging, and skiing are best avoided in pregnancy. Strenuous keep fit exercises like sit-ups and double leg lifts should never be performed as they may cause ligamentous strain and subsequent birth problems. Pregnant women should also avoid lifting heavy boxes or objects.
Back care is another important part of preparation of pregnancy. Your back carries an enormous load during pregnancy and it is necessary to take good care of them or else you will end up suffering severe back aches in the pregnancy and beyond.
Pregnant women should choose a comfortable chair that supports both back and thighs. She should sit well back and if necessary place a small cushion or folded towel behind the lumbar spine for additional comfort. Equal weight should be placed on each buttock to prevent strain to pelvic ligaments. The seat height should allow the feet to rest on the floor or a small foot stool may be placed under the feet. Legs should not be crossed.
While standing posture should be as tall as possible with both the abdomen and buttocks tucked in. Women should try to imagine being pulled up from top and back of head. Weight must be evenly distributed on both legs to prevent undue strain on pelvic ligaments. High heels will throw the balance of pregnant women too far forward and are best discarded in favour of medium or low heeled shoes that will also support. Shoulders that are relaxed and down help to prevent back aches.
Equal pressure on all parts of the body will lead to good posture in the lying position. Lying flat on the back must be discouraged because of the danger of supine hypotension due to pressure from gravid uterus on the inferior vena cava. Three or four pillows or a wedge or beanbag will raise the head and shoulders sufficiently to avoid that risk. Lying on the sides is a common position with pillow on the sides and under knees. This position is not advised if you have pelvic problems.
If you suffer from pelvic pain then lying on your sides with knees bent and top leg supported by bottom leg is a good sleeping pose. Ensure to use a pillow between your legs.
When you get up from bed, you should always bend your knees, roll over to one side, and then use your arms to sit or kneel. This will prevent strain on both the back and abdominal muscles.
Household activities: Many tasks such as ironing or preparing food can be done sitting instead of standing. Working surfaces need to be at correct height to prevent backache due to stooping. Alternatively you can use a small stool to work at higher work surfaces.
Women should pay attention to their seating if they are going to spend a lot of time sitting as in office jobs. Placing a small cushion or a folded towel in the lower back will encourage a good posture and regular change of task and alteration of posture are beneficial. If the work involves prolonged standing then women must ensure that they sit at sufficient intervals and practice leg and foot exercises whenever opportunity arises.
Women should avoid lifting heavy or awkward objects during pregnancy. If lifting is unavoidable, then object or toddler must be held up straight. That way the strain is taken by the thighs muscles, not those of the back. All twisting movements performed while lifting are dangerous and should not be performed.
Relief of Aches and Pains
Back and pelvic pain
This is a common problem in pregnancy. Back ache can be eased by encouraging a good posture, the practice of transverses exercises and pelvic tilting exercises while sitting, standing and lying.
Women complaining of severe pain in more than one area of pelvis should go for medical advice. Sciatica like pain may be relieved by lying on the side away from the discomfort so that the affected leg is supported .Pillows should be placed strategically to support the whole limb.
Prevention of cramps is helped by practicing foot and leg exercises. To relieve sudden cramps in the calf muscle whilst in the sitting position women should hold their knees straight and stretch the calf muscles by pulling the foot upwards at the same time. Alternatively standing firmly on the affected leg and standing forward with either leg will stretch the calf muscles and solve the problem.
Rib stretch or discomfort
Discomfort around the rib cage can often be relieved by adopting a good posture or by specifically stretching one or both arms upwards depending on which arm is affected.
This concludes our article on physical preparation during pregnancy.
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