What is Antenatal Care? (Part 1)

June 7, 2015 | By | Reply READ MORE...

– Dr. Divisha Mody

Pregnancy is a time of tremendous musculoskeletal, physical and emotional changes for the lady and yet is a condition of wellness. Exercise programs during pregnancy and after childbirth are designed to minimize impairments and help the woman maintain or regain function while she is preparing for arrival of baby.

AIMS OF ANTENATAL CARE:

  • Learn safe body mechanics
  • Develop awareness and control of posture during and after pregnancy
  • Prevent/treat impairments and painful conditions associated with pregnancy
  • Promote /maintain safe cardiovascular fitness
  • Develop upper body strength for demands of child care
  • Learn relaxation skills to relieve stress of labour

CHANGES DURING PREGNANCY:

  • Weight gain of approximately 11 kg
  • Uterus becomes more of an abdominal organ rather than pelvic organ
  • Abdominal muscles are stretched
  • Blood pressure decreases in early trimester ,reaches its lowest level midway through pregnancy and then rises gradually from mid pregnancy to up to 6 weeks of delivery
  • Ligaments become lax
  • Postural changes occur like rounded shoulders, increased curvature of low back, walking with wider base of support

Antenatal Care

GUIDELINES FOR EXERCISE:

  • Get a physical examination from your gynaecologist before participating in any exercise program
  • Exercise should not exceed pre- pregnancy levels
  • Drink fluids before, during and after exercise
  • Include appropriate warm up and cool down
  • Avoid ballistic movements
  • Don’t allow any joint to go beyond its physiological range
  • Don’t hold your breath
  • Don’t do any exercise that causes pain
  • Don’t do any exercise where there is a possible loss of balance
  • Don’t exercise in hot humid environment
  • No contact sports e.g. horse riding, scuba diving, jumping should be done

RECOMMENDATIONS:

  • Never exercise to exhaustion
  • Wear appropriate clothing that do not cause overheating
  • Wear good shoes
  • Exercises like swimming ,yoga and stationary cycling are good form of exercises

WHEN TO STOP EXERCISE?

  • Any vaginal bleeding
  • Shortness of breath
  • Dizziness
  • Pain
  • Fainting
  • Palpitations
  • Headache

WHO SHOULD ABSOLUTELY NOT EXERCISE?

  • A woman who has an abnormal position of placenta
  • A woman having vaginal bleeding of any amount
  • Maternal diabetes or hypertension
  • A woman having history of miscarriage or premature labour
  • Intrauterine growth retardation
  • Any acute infection or fever
  • Multiple pregnancies

THE FOLLOWING CANNOT EXERCISE UNLESS ALLOWED BY THEIR DOCTOR:

  • Woman having anaemia
  • Extreme obesity /underweight
  • Breech presentation in third trimester
  • Thyroid disease
  • Extreme fatigue

COMMON PROBLEMS IN PREGNANCY:

Diastasis recti – This is separation of the rectus abdominal muscle. Any separation larger than two finger width is considered significant. One can have low back pain due to this and transitions from lying down straight to sitting position can be hampered. Every pregnant woman must be tested for this and only then exercises should be started.
Antenatal Care

Upper and Lower back pain – This occurs because of postural changes of pregnancy, increased ligamentous laxity and decreased abdominal function. Learning correct body mechanics is vital.
Antenatal Care

Sacroiliac joint pain – This could be caused again due to lax ligaments in a pregnant female. In early stages rest and ice, manual therapy techniques to correct asymmetry, gentle non weight bearing movements in the bed return the joint to its normal position. Work involving leaning forward should be avoided and avoid single leg standing activities. To know more about sacroiliac dysfunction go to this link – click here 

Carpal tunnel syndrome – This is a compression disorder caused due to fluid retention, hormonal changes or circulatory compromise. The pregnant female complaints of tingling or numbness in hands or weakness of the hand with pain could be present. Splints, ultrasound therapy and exercises to strengthen the hand are helpful.

Symphysis pubis dysfunction – This dysfunction is due to asymmetry that would have occurred at the pubic bone at the pelvis due to muscle imbalance and lax ligaments .Rest and reduction of nonessential activities. Pelvic support, water based exercise is a good option but breaststroke to be avoided.

EXERCISES TO BE DONE DURING PREGNANCY:

  • In the first trimester usually no exercises are advised .Only simple walking for 15-20 minutes is advised.
  • In the second trimester one should do exercises for the core strengthening, buttock strengthening and upper back strengthening.

Antenatal Care

  • In the third trimester more of duck walking, squats, lunges and relaxation methods should be done.

Antenatal Care
UNSAFE EXERCISES DURING PREGNANCY:

  • Both straight leg raising should be avoided as it puts undue stress on the low back more than it can tolerate. It can cause back injury or diastasis recti hence should not be attempted.
  • Fire hydrant exercise –This exercise is done in all fours position – like dog peeing. If the leg is elevated too high then it can stress the sacroiliac joint and low back hence should be done with caution.
  • Standing on one leg exercises can also cause balance problems because of increased body weight and shift in centre of gravity.

Antenatal Care
We at Physiorehab conduct special individual antenatal exercise programs for pregnant women keeping in mind their strength and fitness level. We also address their musculoskeletal complaints. It is very important for every pregnant lady to know the correct ergonomics and to have strong core muscles so that she can carry out her duties of child care post-delivery without pain. For further enquiries please mail us at info@physiorehab.in

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