Friday 4 October 2013

Pre and postnatal exercise guidelines – The latest information out now

Once upon a time, pregnant women were told to rest and put their feet up. Today more and more women are continuing to exercise, some right up until the day before they deliver. I’m not suggesting this is for everyone, personally I was sick every day (literally sick and throwing up) and sadly I did not have much energy for exercise. However, for most women training through pregnancy is an achievable goal that provides huge benefits for both mum and baby.

The main challenges for pregnant women include their changing shape, stability and back pain. The key to continuing a regular exercise routine, despite the added challenges, is to modify the type of exercises performed through all stages of pregnancy. Last week Fitness Australia released the National Pre and Postnatal Exercise Guidelines:
(http://fitness.org.au/visageimages/Fitness_Australia_Pre_&_Post-Natal_Exercise_Guidelines.pdf).
 
I was contacted late last year by Fitness Australia and asked to be part of the expert reference group to help oversee and produce these national guidelines. Along with Fitness Australia and two women’s health physio’s, Lisa Westlake and Dianne Edmonds, we came up with a clear set of guidelines to help trainers and group fitness instructors ensure they are taking proper care of new mums and mums to be.

A main point that we emphasise throughout the guidelines is that every pregnant woman is different and there is no one size fits all for exercise prescription. Pre and postnatal trainers need to be educated and know how to deal with common problems such as pelvic instability and pelvic floor weakness. In addition, these new guidelines also explain that women who are pregnant can safely start exercise, even if they had not exercised before becoming pregnant. A previous misconception was that women should only exercise during pregnancy if they had done prior to becoming pregnant. It’s all about doing the right kind of exercise and seeing a qualified trainer.
 
Here is a run down of recommended postnatal physical activities based on weeks after delivery. Remember to listen to your body and get the ok from your Dr or Women’s Health Physio before you get back into group fitness, PT or gym.
0-3 weeks
  • Pelvic floor exercises and post-natal specific core exercises
  • Walking
3-8 weeks

  • Walking
  • Swimming (once bleeding stopped)
  • Gym programs - maintain posture, light weights, no breath holding
  • Pelvic floor exercises and post-natal specific core exercises
  • Low impact aerobics or a post-natal class
  • Low intensity water aerobics classes (once bleeding stopped)
Note: Check for abdominal muscle separation.
8-12 weeks post-natal

  • As for 3-8 weeks, increasing intensity/weights
  • Progress post-natal abdominal bracing and pelvic floor exercises.
12-16 weeks post-natal

  • Abdominal and pelvic floor muscle testing prior to return to higher impact exercise / running / sport, and commencing regular abdominal exercise programs.
After 16 weeks post-natal

  • Return to previous activity if pelvic floor muscles and core control is back to normal.
A quick point to mention: If you are 16 weeks post-natal and have done no exercise since having your baby you cannot jump straight back into activities such as running, aerobics etc. You need to start slow and build up to high intensity / heavy weight exercises.

Finally some tips for new Mums. As a Mum, of an energetic one year old, I still feel the effects of sleep deprivation. Harrison did not sleep through the night until he was 10 months, it took its toll on me, but it did feel like heaven when he finally slept through. However, heaven didn’t last long, with teething and recent bouts of colds and flu we are often up during the night. So my tips are…
 
  • Rest, rest, rest! Don't underestimate sleep deprivation, you will be a better mum, wife and human being if you take time out for yourself.
  • Don't stress about housework. If you can afford it, get a cleaner (I wish I had one!) If you can't afford a cleaner make sure your partner or the rest of the family pulls their weight.
  • No matter how tired you feel exercise is always going to make you feel better. Prioritise rest first, but then make time for physical activity.
  • Weight loss should not be your focus shortly after having your baby, enjoy the precious moments with your new baby and be kind to yourself.
  • Breastfeeding helps the uterus contract and brings your stomach back to its original shape. So, if you can do it, stick with it as long as possible for your baby's health and your belly.     

Dr Denise Furness, PhD BSc RNut REP
Registered Nutritionist & Personal Trainer with Mill Park Leisure

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