High Risk Pregnancy Exercise

Your doctor has pronounced you a “high risk” pregnancy or even worse rendered you on “bed rest”. There goes your workout and all efforts to remain as healthy and strong as possible! Wrong! Most “high risk” moms can with supervision continue some form of modified exercise throughout her pregnancy. Actually it’s even more necessary to exercise if you are bed ridden. Weakness and muscle atrophy from inactivity can be more detrimental to you and your baby than stopping all exercise. Strong muscles or proper muscle maintenance during pregnancy is vital for you to be able to handle not just your pregnancy, but the workout of labor and delivery, to prevent fetal distress, postpartum depression and for you to be healthy enough to take care of your newborn. You need and deserve all the energy and strength you can get! The more exercise (however modified and little that may be), that you are able to do, the more efficient your body will be at carrying your baby to term with the least amount of complications. Every little bit counts. Even if it’s just Kegel’s.

What is a HIGH RISK pregnancy?
“High risk” can mean many things. It includes just about anything that is not perfectly healthy and normal, that may or will complicate or possibly jeopardize the pregnancy causing premature delivery. It can range from very mild to sever problems requiring bed-rest. According to James Clapp III MD, MetroHealth Medical Center, Cleveland, the most acute reasons for stopping exercise all together are bleeding, placental abruption and broken membranes. Exercise can aggravate these conditions. However, in regards to early contractions, he says: - “as long as the cramps stop shortly after the woman stops exercise there’s no problem”….”if they persist for more than 20 to 30 minutes…. true labor may not be far off.”.

“High Risk” Categories:
A – you probably will not require any bed-rest, but will need monitoring, if you:
• Have gestational diabetes (exercise and nutrition can prevent and cure this).
• Have any joint, muscle or back pain
• Have a seizure disorder
• Have been sedentary, or are very overweight
• Are underweight
• Are older than 35 years of age
• Are a disabled person
B - You may not be ordered on bed-rest, but need extra monitoring if:
• You suffer from chronic hypertension
• You suffer from thyroid, cardiac, vascular, or lung disease
• Your baby is in breech position
• You are anemic
• You are a otherwise fit and healthy mother carrying twins

C - you may be ordered on bed-rest if:
• You’ve had three or more miscarriages
• You are carrying two or more babies
• There are signs of growth retardation
D - you will most likely be ordered on bed- rest at some time during your
pregnancy, if:
• You have “placenta abruption/ or previa” (the placenta has broken away/ or is covering your cervix)
• You have gone into premature labor before
• You have been diagnosed with a weak or incompetent cervix
E - you should go straight to the doctor and / or hospital if:
• Your water has broken
• Your are suffering from preeclampsia
• You have an amniotic fluid leak
• You are bleeding
• You’re having early regular uterine contractions (preterm labor)

What causes premature delivery?
Only 50% of premature deliveries have known causes. But research by the March of Dimes has shown that there is a correlation between risk level and factors such as socioeconomic status, medical history and lifestyle. Poor prenatal care, poor nutrition, stress, substance consumption (alcohol, cigarettes, drugs – legal or illegal), less than a year or more than 10 years between pregnancies, moms younger than 18/older than 35, an incompetent cervix etc…increase your risk level the most.
–“ Research has shown a possible link between stress and preterm labor. Taking action to reduce your stress through exercise or yoga can be beneficial”. Deborah Novak MSRD, Past Program Coordinator, March of Dimes, Los Angeles Chapter.

High Risk exercise guidelines:
For any “high risk” category you should not participate in just any regular exercise program. You must first and foremost consult with your doctor on what might be permissible. But even on bed-rest, you can safely work and stretch your entire body with light exercises, performed while seated or lying in your bed. With these Bed-rest Exercises you may be able to use light dumbbells, Dynabands and ankle weights for resistance. If you are ordered to move around as little as possible, do as many exercises in one position or on one side as you can, before switching, even if it makes for a strange workout. Do seated exercises first if you are allowed sit up, next, lie on the left side for a series of exercises, before turning to the right side. Switching sides can be a workout in itself!

For level A: With proper exercise prescription and supervision you should be able
to participate in a moderate but constant intensity
exercise program including walking, swimming, yoga and strength
training. Most “prenatal” yoga or exercise classes should be OK.
Exercise 5-6 days a week is a must if you have or are at risk for
gestational diabetes. Raul Artal MD professor of obstetrics and
gynecology at SUNY Health Science Center in Syracuse, endorses
exercise as a treatment for gestational hyperglycemia.
For level B: With proper supervision and exercise instruction you may continue
light exercise with proper supervision, including walking, swimming,
toning and yoga.
For level C: With a qualified* instructor, physical therapist or nurse you may be
able to do some light seated and side-lying “bed-rest” toning exercises
in bed, including Kegel’s, pelvic tilts, shoulder and abdominal
contractions. You may do other exercises targeting most body parts.
For level D: you will probably be rendered recumbent, especially if your cervix is
incompetent. However, with a qualified* and experienced instructor,
physical therapist or nurse you may still be able to do some light side-
lying “bed-rest” toning exercises in bed, including at least Kegel’s,
pelvic tilts, shoulder, abdominal contractions and stretches. You may
also do other exercises targeting almost all body parts – just one limb at
a time.
For level E: for amniotic fluid leaks, you may be able to follow level D’s advice.
For the other conditions: NO EXERCISE.

* Birgitta Lauren - 30 years in the fitness industry, Certified prenatal fitness specialsit, author of "Expecting Fitness", knowledge and expertise of the biomechanics and kinesiology of the pregnant woman’s changing body, as well as 18 years of experience working with pregnant women. Add a natural maternal instinct and an intuitive feeling and flexibility in modifying any exercise for any condition or situation.

www.expectingfitness.com