150 minutes of exercise a week in late pregnancy can cut the risk of women suffering post-natal depression

Interesting article from the Daily Mail’s Victoria Allen says……

  • Some women may see pregnancy as a chance to put their feet up and relax
  • But continuing to exercise while expecting a child is important, experts say 
  • A study found 15% of inactive women suffered from postnatal depression 
  • But just 3% of those who got 150 minutes of weekly exercise had symptoms

Read more: http://www.dailymail.co.uk/health/article-5710029/150-minutes-exercise-week-pregnancy-cut-risk-post-natal-depression.html#ixzz5GtUXaWvb

Seems more important than ever to keep up the exercise in late pregnancy x

Inside your pregnant body: hormones and other stuff to be aware of when working out

You won’t believe what goes on inside your pregnant body without you even realising!

If you are still feeling sick hopefully it will start to get better over the next couple of weeks. Chances are you haven’t noticed any drastic changes to your waistline yet, but you may have a bit of a bump, everyone is different. If you are an experienced exerciser make the most of the next couple of weeks before you have to start adapting your routine. If you are not an experienced exerciser then try and make active daily choices and do your daily exercisers (pelvic floor, bum and ab squeezes, see 3-Plan) and think about starting more regular, appropriate exercise once you have had the OK from your 12 week scan.

Try to remember how remarkable your body is. The journey to motherhood is incredible if you look at how your body changes and adapts to make its environment just right for your growing baby. This week we are going to look at what hormones are released in pregnancy and how they impact on exercise and the other changes that are going on inside your body that you should be aware of and reassured about in relation to safe exercising in pregnancy.

 

Hormones

Let’s look at four of the big players: relaxin, oestrogen, progesterone and insulin.

1. Relaxin

The role of relaxin is to relax the ligaments of the pelvis to enable the joints to separate to accommodate your growing baby. Later, for your pelvis to open up and your baby to be born.

However clever relaxin may be, it is not able to target the relaxing effect on just the pelvic area. It can cause joint laxity on ligaments and fibrous tissue anywhere in the body, including your back, hip joints, knees and ankles, which all become slightly more prone to injury. Its relaxing effect can also mean there is significant movement between pelvic joints which can range from mildly uncomfortably to excruciatingly painful.

Pregnant women may find that they have greater range of movement during pregnancy due to relaxin. This means it is really important not to overstretch when moving or stretching and stay within a normal range of movement. The effects of relaxin are less noticeable in first time mums; more so in subsequent and multiple pregnancies. It can take six months to return to normal levels (a small amount is always present in the body) but longer if you are breastfeeding, so relaxin is also a factor to consider in postnatal exercise prescription.

2. Oestrogen

Oestrogen has many important functions in pregnancy, including promoting growth of various bits and bobs like your uterus, breasts and your left ventricle (how marvellous!) It also has roles in regulating progesterone, the development of your placenta and baby and colostrum production.

Oestrogen also contributes to the increase in your metabolic rate and oedema (fluid retention), which both have an impact on your exercise programme. Regular exercise can help reduce fluid retention. Be mindful of your increased metabolic rate; you’ll need to take on extra calories if you are exercising (200-300 a day from healthy foods) and also have a slightly higher core temperature, so take care when working out not to overheat.

3. Progesterone

The roles of progesterone, like oestrogen, are many and varied. Levels of both increase steadily as pregnancy progresses. A function which will have a significant impact on working out is the way progesterone makes smooth muscle relax. This includes your oesophagus, blood vessels and digestive system (the reason for some of the delightful pregnancy ailments such as heartburn, varicose veins and piles).

Also impacting your exercise programme is the fact that progesterone helps to stabilise your blood pressure by relaxing your blood vessels and reducing venous return, meaning you may feel dizzy or light headed due to lower blood pressure.

It also increases your sensitivity to CO2, increasing oxygen levels when you breathe through an elevated breathing rate. This means you shouldn’t try and continue at pre-pregnancy exercise levels as you may be panting before you start!

Finally progesterone has the essential role of stopping important things happening before they should, including lactation and contractions.

4. Insulin

Insulin resistance increases in all women during pregnancy making their pattern of energy usage similar to that of a mild diabetic. This is actually your body’s way of making sure that blood glucose circulates for longer so that it can be properly absorbed by the placenta and the baby, so is not a bad thing! However, around 2-4% of women will develop gestational diabetes (which only lasts for the duration of the pregnancy) which may cause some birth defects and result in babies having to be delivered early by caesarean.

Gestational diabetes is usually treated through diet and exercise; overweight women are more likely to develop it. If you do suffer your Midwife will advise on treatment, but it will likely include healthy eating and regular exercise; what we should all be doing anyway!

The main thing to be aware of with exercise and pregnancy insulin levels is that regular training encourages increased insulin sensitivity, which could result in a drop in glucose being available to the baby during exercise. Just remember if you are working out to eat regularly and have a healthy snack before and after exercising.

If you have existing diabetes make sure you discuss your management plan with your Midwife so they can give you appropriate advice and support.

 

Your changing body during pregnancy

As you can see from our quick run down on the hormones there are lots of changes going on in your body during pregnancy, but this doesn’t mean you can’t be active. However, there are a few things to bear in mind. Just to make sure you have all the key information:

Be reassured:

Cool as a cucumber During pregnancy your core temperature rises by approximately 0.6 degrees celsius. Your sweat point lowers, enabling you to dissipate heat from yourself and your baby. This, along with a slightly elevated breathing rate, means that you have a fab inbuilt cooling mechanism and overheating is unlikely.

Go with the flow Cardio exercise will not compromise blood flow to your baby. Provided you are working out at a sensible intensity and not for too long (i.e. over an hour and a half) your body will direct blood to your baby ahead of your working muscles. Stop if your muscles feel fatigued.

Added bonus You are still getting all the ‘normal’ benefits of exercise in addition to the ones related to pregnancy. You’ll be boosting your immune system, improving your cardiovascular and muscle fitness and endurance, releasing endorphins and, hopefully, improving your body image.

Put your hands up! Some people say that you shouldn’t raise your hands above shoulder height in later pregnancy, in case the umbilical cord gets wrapped around your baby’s neck. This is an old wives’ tale and you can ignore it. Carry on raising your hands as long as it feels comfortable. You only need to be cautious if you have issues with high blood pressure.

Don’t count on it An old school of thought used to say in pregnancy your heart rate during exercise should not go above 140 BPM. There’s no right or wrong and every woman is different. A bit of a sweat is OK, but try to keep your effort level moderate – at around 60–70 per cent of your maximum heart rate. Don’t measure your heart rate; go by how you feel and make sure you can still hold a conversation (see page xx)

Be aware

Back in action If you lie on your back (supine) when your bump is big it may put pressure on your vena cava and affect blood flow, making you feel light-headed. This is called ‘supine hypotensive syndrome’. Avoid lying on your back for any length of time and try side and seated positions instead.

Full of hot air During pregnancy your need for oxygen increases, meaning your breathing rate rises. Later in pregnancy it also becomes harder to take a big breath as your belly expands. Moderate your workout intensity so you can breathe comfortably.

Huff and puff Progesterone is a hormone that relaxes smooth muscle and makes you more sensitive to CO2. This may mean your breathing rate increases and you get puffed more quickly. If this happens moderate your intensity.

Working overtime Your resting heart rate (HR) and blood pumped per beat will increase. This means that you should moderate cardio activity as pregnancy progresses. Keep your heart rate up, but make sure you are working at a sensible intensity and not pushing yourself too hard. Also, warm up gradually and steadily decrease intensity at the end of your workout – to bring your heart and breathing rates down gently.

Vascular underfill When you are first pregnant your body becomes less able to quickly divert your blood to where it is needed. This can make you feel dizzy and faint. If you do, adapt your exercise and avoid quick and frequent transitions (floor to standing etc) and being still for long periods.

You won’t believe what goes on inside your pregnant body without you even realising! Hormone changes and incredible adaptations

Red blood cells

Pregnancy can be a tough time, but try to remember how remarkable your body is. The journey to motherhood is incredible if you look at how your body changes and adapts to make its environment just right for your growing baby. This week we are going to look at what hormones are released in pregnancy and how they impact on exercise and the other changes that are going on inside your body that you should be aware of and reassured about in relation to safe exercising in pregnancy.

 

Hormones

Let’s look at four of the big players: relaxin, oestrogen, progesterone and insulin.

1. Relaxin

The role of relaxin is to relax the ligaments of the pelvis to enable the joints to separate to accommodate your growing baby. Later, for your pelvis to open up and your baby to be born.

However clever relaxin may be, it is not able to target the relaxing effect on just the pelvic area. It can cause joint laxity on ligaments and fibrous tissue anywhere in the body, including your back, hip joints, knees and ankles, which all become slightly more prone to injury. Its relaxing effect can also mean there is significant movement between pelvic joints which can range from mildly uncomfortably to excruciatingly painful.

Pregnant women may find that they have greater range of movement during pregnancy due to relaxin. This means it is really important not to overstretch when moving or stretching and stay within a normal range of movement. The effects of relaxin are less noticeable in first time mums; more so in subsequent and multiple pregnancies. It can take six months to return to normal levels (a small amount is always present in the body) but longer if you are breastfeeding, so relaxin is also a factor to consider in postnatal exercise prescription.

2. Oestrogen

Oestrogen has many important functions in pregnancy, including promoting growth of various bits and bobs like your uterus, breasts and your left ventricle (how marvellous!) It also has roles in regulating progesterone, the development of your placenta and baby and colostrum production.

Oestrogen also contributes to the increase in your metabolic rate and oedema (fluid retention), which both have an impact on your exercise programme. Regular exercise can help reduce fluid retention. Be mindful of your increased metabolic rate; you’ll need to take on extra calories if you are exercising (200-300 a day from healthy foods) and also have a slightly higher core temperature, so take care when working out not to overheat.

3. Progesterone

The roles of progesterone, like oestrogen, are many and varied. Levels of both increase steadily as pregnancy progresses. A function which will have a significant impact on working out is the way progesterone makes smooth muscle relax. This includes your oesophagus, blood vessels and digestive system (the reason for some of the delightful pregnancy ailments such as heartburn, varicose veins and piles).

Also impacting your exercise programme is the fact that progesterone helps to stabilise your blood pressure by relaxing your blood vessels and reducing venous return, meaning you may feel dizzy or light headed due to lower blood pressure.

It also increases your sensitivity to CO2, increasing oxygen levels when you breathe through an elevated breathing rate. This means you shouldn’t try and continue at pre-pregnancy exercise levels as you may be panting before you start!

Finally progesterone has the essential role of stopping important things happening before they should, including lactation and contractions.

4. Insulin

Insulin resistance increases in all women during pregnancy making their pattern of energy usage similar to that of a mild diabetic. This is actually your body’s way of making sure that blood glucose circulates for longer so that it can be properly absorbed by the placenta and the baby, so is not a bad thing! However, around 2-4% of women will develop gestational diabetes (which only lasts for the duration of the pregnancy) which may cause some birth defects and result in babies having to be delivered early by caesarean.

Gestational diabetes is usually treated through diet and exercise; overweight women are more likely to develop it. If you do suffer your Midwife will advise on treatment, but it will likely include healthy eating and regular exercise; what we should all be doing anyway!

The main thing to be aware of with exercise and pregnancy insulin levels is that regular training encourages increased insulin sensitivity, which could result in a drop in glucose being available to the baby during exercise. Just remember if you are working out to eat regularly and have a healthy snack before and after exercising.

If you have existing diabetes make sure you discuss your management plan with your Midwife so they can give you appropriate advice and support.

 

Your changing body during pregnancy

As you can see from our quick run down on the hormones there are lots of changes going on in your body during pregnancy, but this doesn’t mean you can’t be active. However, there are a few things to bear in mind. Just to make sure you have all the key information:

Be reassured:

Cool as a cucumber During pregnancy your core temperature rises by approximately 0.6 degrees celsius. Your sweat point lowers, enabling you to dissipate heat from yourself and your baby. This, along with a slightly elevated breathing rate, means that you have a fab inbuilt cooling mechanism and overheating is unlikely.

Go with the flow Cardio exercise will not compromise blood flow to your baby. Provided you are working out at a sensible intensity and not for too long (i.e. over an hour and a half) your body will direct blood to your baby ahead of your working muscles. Stop if your muscles feel fatigued.

Added bonus You are still getting all the ‘normal’ benefits of exercise in addition to the ones related to pregnancy. You’ll be boosting your immune system, improving your cardiovascular and muscle fitness and endurance, releasing endorphins and, hopefully, improving your body image.

Put your hands up! Some people say that you shouldn’t raise your hands above shoulder height in later pregnancy, in case the umbilical cord gets wrapped around your baby’s neck. This is an old wives’ tale and you can ignore it. Carry on raising your hands as long as it feels comfortable. You only need to be cautious if you have issues with high blood pressure.

Don’t count on it An old school of thought used to say in pregnancy your heart rate during exercise should not go above 140 BPM. There’s no right or wrong and every woman is different. A bit of a sweat is OK, but try to keep your effort level moderate – at around 60–70 per cent of your maximum heart rate. Don’t measure your heart rate; go by how you feel and make sure you can still hold a conversation (see page xx)

Be aware

Back in action If you lie on your back (supine) when your bump is big it may put pressure on your vena cava and affect blood flow, making you feel light-headed. This is called ‘supine hypotensive syndrome’. Avoid lying on your back for any length of time and try side and seated positions instead.

Full of hot air During pregnancy your need for oxygen increases, meaning your breathing rate rises. Later in pregnancy it also becomes harder to take a big breath as your belly expands. Moderate your workout intensity so you can breathe comfortably.

Huff and puff Progesterone is a hormone that relaxes smooth muscle and makes you more sensitive to CO2. This may mean your breathing rate increases and you get puffed more quickly. If this happens moderate your intensity.

Working overtime Your resting heart rate (HR) and blood pumped per beat will increase. This means that you should moderate cardio activity as pregnancy progresses. Keep your heart rate up, but make sure you are working at a sensible intensity and not pushing yourself too hard. Also, warm up gradually and steadily decrease intensity at the end of your workout – to bring your heart and breathing rates down gently.

Vascular underfill When you are first pregnant your body becomes less able to quickly divert your blood to where it is needed. This can make you feel dizzy and faint. If you do, adapt your exercise and avoid quick and frequent transitions (floor to standing etc) and being still for long periods.

Can I carry on running throughout my pregnancy?


Lucie half marathon

Why should I carry on running in pregnancy?

 Running is fantastic cardiovascular exercise and will help keep your heart and lungs fit and strong. In addition to all the usual benefits from exercising during pregnancy:

  • A shorter labour, with less likelihood of complications – I had quite enjoyable pregnancies with no sick days from work, straightforward and short labours (both under 5 hours) vaginal deliveries and a very quick recovery, was active within a couple of days!
  • Less likely to suffer from nausea and morning sickness
  •  Improved core strength and stability
  • A stronger back and reduction in back pain
  • Better posture
  •  Stronger pelvic floors
  • Better circulation, less likely to suffer from varicose veins, swelling and high blood pressure
  • Stronger bones
  • Avoid excessive weight gain and easier to get back into shape after the birth
  • More energy and self-confidence – lift your mood and feel great!
  • Strengthen the muscles used in childbirth
  •  It will help you sleep
  • Improved cardio-vascular fitness and muscle tone
  • Lessen the likelihood of developing gestational diabetes

With all of those benefits, why would you not exercise?! After pregnancy you will retain a lot of these benefits, in addition to finding it easier to lose excess weight and tone up. With running having some time outdoors and time to yourself are also great feel-good benefits.

One of the most common things I hear is that it is not safe to run during pregnancy. There is no one-size-fits-all response to this. It largely depends on your pre-pregnancy fitness level and running experience. If you have never been a runner do not start during pregnancy. If you have done a little bit of running I would suggest keeping it at a moderate intensity (jogging rather than running) and no more than 30 minutes a couple of times a week. If you haven’t done any running for at least a couple of months then do something else. If it feels at all uncomfortable then do something else. If you are an experienced runner then there is no reason you cannot carry on running during your pregnancy.

I carried on running…but was always safe and sensible

 I love all kinds of exercise, especially aerobics and other fitness classes, but running really is my all time fave and I ran up to the end of the second trimester with both of my pregnancies. After that it began to feel a bit uncomfortable, but that’s just me. Every woman is different and should listen to their own body. Some women continue to run throughout their pregnancies right to the end and some just don’t feel right running from the outset. Do what feels right for you. I also did my first full marathon when my first baby was 8 months old!

 Here are some points about running safely and sensibly during pregnancy:

  •  Avoid overheating
  • Eat before and after exercise, (a snack, not a three course meal) around an hour either side should do it
  • Wear a good bra and trainers when you are working out
  • Be aware of running conditions – look after your personal safety, stick to well-lit areas and avoid rough or hilly terrain
  • Your pre-pregnancy exercise and fitness levels will determine what level you can exercise at
  • Remember your pelvic floor exercises (even if you are having a c-section) as running does put extra pressure on these muscles
  • Adapt your running plan as your pregnancy progresses, see below
  • Warm up and cool down gradually
  • Stretch the muscles you used in your workout when you get home (all the big leg muscles)
  • Try to maintain a good posture (all the time!)
  • Stay well hydrated
  • Take care not to overstretch or push yourself too hard; the hormone relaxin makes your joints more prone to injury

Advice for running throughout your pregnancy: 

running in the first trimester

 During trimester one you can carry on as usual, as long as the intensity is not very high (i.e. intervals, sprinting), the duration isn’t too long (i.e. longer than 90 minutes) and you are not working harder than what you have been used to.

running in the second trimester

During trimester two you should start decreasing your intensity and duration once it starts to feel like it is becoming harder. Remember, you should be comfortably be able to maintain a conversation when you are working out. Your body is changing and although you can carry on running (although it should be ‘jogging’ – not too fast!) you should gradually start to adapt your workouts.

 running in the third trimester

During trimester three you may be able to carry on jogging if it still feels ok, but make sure you listen to your body and move on to a lower impact activity if it doesn’t feel right. Your bump may make you feel unbalanced or you may have some pelvic aches. Cross training, power walking, cycling and swimming are all great alternatives. If you do continue to jog then, once again, work at a comfortable intensity for a sensible duration and maybe build in some walk/jog sessions, alternating between each for five minutes at a time.

 Safety comes first:

In summary, if your pregnancy is low risk and you feel fine, don’t be frightened to continue something you enjoy, but remember running is high impact and you may feel more comfortable moving to gentler activities later on in your pregnancy with a view to taking up running again once you have had your baby. It’s up to you – every woman is different. Definitely ignore anyone that tries to criticise you jogging with a bump; we need to change the way people perceive pregnant women – start the revolution!

More about running in pregnancy here