Exercise During Pregnancy - 13 Rules

Exercise has great benefits, but during pregnancy you need to approach it with extra caution. Whether you're a regular exerciser looking to continue your regime during pregnancy, or a former couch potato looking to get moving, follow these 13 rules to keep yourself and your baby safe.

1. Check with your healthcare provider first

If you exercised regularly before getting pregnant and your pregnancy is problem-free, you can most likely continue working out as before — with modifications as noted below. There are exceptions to this general rule, so talk to your doctor or midwife about your fitness routine to make sure your activities don't put you or your baby at risk.

If you're starting from scratch as a non-exerciser, see our exercise guide for beginners, and talk to your healthcare provider.

2. Take in extra calories

Get the 300 to 500 additional calories a day you need during pregnancy, especially if you're exercising. Make sure to eat well to help nourish and strengthen your body.

3. Steer clear of dangerous sports

Avoid contact sports, as well as activities that might throw you off-balance, such as horseback riding or biking. Even if you're normally graceful, keep in mind that the increased levels of the hormone relaxin during pregnancy, which relax pelvic joints in preparation for childbirth, loosen all ligaments and joints, making you more susceptible to sprains and injury from falls.

4. Wear the right clothes

Wear loose-fitting, breathable clothing. Dress in layers so it's easy to peel off a layer or two after you've warmed up (or if you simply feel too hot). Make sure your maternity bra offers enough support, and choose athletic shoes that fit your feet properly and offer good support. If your shoe size has changed because of mild swelling, stash away your pre-pregnancy sneakers and buy a new pair.

5. Warm up

Warm-ups prepare your muscles and joints for exercise and build your heart rate up slowly. If you skip the warm-up and jump into strenuous activity before your body is ready, you could strain your muscles and ligaments and experience increased post-workout aches and pains.

6. Drink plenty of water

Drink water before, during, and after exercising. Otherwise, you can become dehydrated, which can cause contractions and raise your body temperature, sometimes to levels that are dangerous for you and your baby. James M. Pivarnik, Ph.D., of Michigan State University, says that while there's no official recommendation for how much water pregnant women should drink while exercising, a good guideline is to drink one cup (8 ounces) before you exercise, one cup for every 20 minutes of exercise, and one cup after you finish your workout. In hot and/or humid weather, you'll need more.

7. Don't lie flat on your back

Avoid lying flat on your back after the first trimester. This position puts pressure on a major vein called the vena cava, which will diminish blood flow to your brain and uterus, and can make you dizzy, short of breath, or nauseated. Some women are comfortable in this position well into their pregnancies, but this isn't necessarily a good gauge of whether blood flow to the uterus is affected. Placing a pillow under your right hip or buttock will allow you to be almost supine without compressing the vena cava.

8. Keep moving

Standing motionless for prolonged periods — as when you're lifting weights or doing yoga poses — can decrease blood flow to the uterus and cause blood to pool in your legs, making you dizzy. Keep moving by switching positions or walking in place.

9. Don't overdo it

Don't exercise to exhaustion. A good rule of thumb: Slow down if you can't comfortably carry on a conversation. In general, the best guideline is to listen to your body. When something hurts, that means something's wrong, so stop. You should feel like you're working your body, not punishing it.

10. Don't get overheated

Avoid letting yourself get too hot, especially during the first trimester when your baby's major organs are developing. Although there's no proof of a danger to humans, some animal studies suggest that overheating can cause birth defects.

Increased blood flow and a higher metabolic rate mean you'll feel warmer than usual when you're pregnant, and doubly so when you exercise. And since feeling warm is common in pregnancy, you may get overheated much faster than you normally would, even before your belly is big.

Signs of being overheated are largely individual, but pay attention if you're sweating a lot, feel uncomfortably warm, or feel dizzy or short of breath. On hot and/or humid days, skip your workout or exercise indoors in a well-ventilated, air-conditioned room. Wear loose, non-binding clothing and drink plenty of water.

To cool off quickly, stop exercising, take off layers, and change your environment: seek out air conditioning or step into a cool shower. Hydrating is key, too, so drink lots of water.

11. Get up from the floor slowly

As your belly grows, your center of gravity shifts. That's why it's important to take great care when you change positions. Getting up too quickly can make you dizzy, and may cause you to lose your footing and fall.

12. Cool down

At the end of your workout, take a few minutes to walk in place and then stretch. Heart rate increases during pregnancy and it may take as long as 15 minutes for your heart to return to its resting rate following a workout.

13. Make it a habit

Make a commitment to work regular exercise into your schedule. Keeping up a routine is easier on your body than periods of inertia interrupted by spurts of activity. According to the American College of Obstetricians and Gynecologists, you can safely engage in 30 minutes or more of moderate exercise on most, if not all, days of the week as long as you have your healthcare provider's go-ahead.

Reviewed by Vicki Lee Edge, M.D., August 2006

Safe Nursery Checklist by the Consumer Product Safety Commission

Use this checklist as your guide when buying new or secondhand nursery products, or when you evaluate the product now being used by your baby or young child. 
You may want to add other features to check, or add other children's products. 

Cribs

___ Slats are spaced no more than 2-3/8 inches (60 mm) apart.

___ No slats are missing, loose or cracked.

___ Mattress fits snugly - no more than two fingers width between edge of mattress and cribside.

___ Mattress support is securely attached to the headboard and footboard.

___ Corner posts are no higher than 1/16 of an inch (1-1/2 mm).

___ No cutouts in top edge of headboard and footboard.

___ Drop-side latches cannot be easily released by a baby.

___ Drop-side latches securely hold side in raised position.

___ All screws, bolts and other hardware are present and tight.

Crib Toys

___ No strings or cords should dangle into the crib.

___ Crib gym or mobile has label warning to remove from crib when child can push up on hands and knees or reaches 5 months of age, whichever comes first. Note: Some mobiles have two parts: one without strings, like a music box, that can stay on the crib, and the mobile that should be removed from the crib.

___ Components of toys are too large to be a choking hazard.

Gates and Enclosures

___ Openings in gate are too small to entrap a child's head or neck.

___ Gate has a pressure bar or other fastener that will resist forces exerted by a child.

High Chairs

___ There is a "crotch" strap that must be used when restraining a child in a high chair.

___ High chair has restraining straps that are independent of the tray.

___ Tray locks securely.

___ Buckles on straps are easy to fasten and unfasten.

___ High chair has a wide base for stability.

___ Caps or plugs on tubing are firmly attached and cannot be pulled off and choke a child.

___ Folding high chair has effective locking device.

Playpens
___ Playpens or travel cribs have top rails that will automatically lock when lifted into the normal use position.
___ Playpen does NOT have a rotating hinge in the center of the top rails.
___ Drop-side mesh playpen or mesh crib has warning label about never leaving a side in the down position.
___ Playpen mesh has small weave (less than 1/4 inch openings).
___ Mesh has no tears or loose threads.
___ Mesh is securely attached to top rail and floorplate.
___ Wooden playpen has slats spaced no more than 2-3/8 inches (60 mm) apart.


Rattles/Squeeze Toys/Teethers
___ Rattles, squeeze toys and teethers have handles too large to lodge in baby's throat.
___ Squeeze toys do not contain a squeaker that could detach and choke a baby.
___ Avoid rattles with ball shaped ends.


Toy Chests
___ Toy chest has no latch to entrap child within the chest.
___ Toy chest has spring-loaded lid support that will not require periodic adjustment and will support the lid in any position to prevent lid slam.
___ Chest has ventilation holes or spaces in front or sides, or under lid.


Walkers
___ Walker has safety features to help prevent a fall down stairs.


Back Carriers
___ Leg openings are small enough to prevent child from slipping out.
___ Leg openings are large enough to prevent chafing.
___ Frame joints in the folding mechanism.
___ Carrier has padded covering over metal frame near baby's face.


Bassinets and Cradles
___ Bassinet/cradle has a sturdy bottom and a wide base for stability.
___ Bassinet/cradle has smooth surfaces - no protruding staples or other hardware that could injure the baby.
___ Legs have strong, effective locks to prevent folding while in use.
___ Mattress is firm and fits snugly.
___ Wood or metal cradles have slats spaced no more than 2-3/8 in. (60 mm) apart.


Carrier Seats
___ Carrier seat has a wide, sturdy base for stability.
___ Carrier has non-skid feet to prevent slipping.
___ Supporting devices lock securely.
___ Carrier seat has a crotch and waist strap.
___ Buckle or strap is easy to use.


Changing Tables
___ Table has safety straps to prevent falls
___ Table has drawers or shelves that are easily accessible without leaving the baby unattended.


Hook-on Chairs
___ Chair has restraining straps.
___ Chair has a clamp that locks onto the table for added security.
___ Caps or plugs on tubing are firmly attached and cannot be pulled off to choke child.
___ Hook-on chair has a warning never to place chair where child can push off with feet.


Pacifiers
___ Pacifier has no ribbons, string, cord or yarn attached.
___ Shield is large enough and firm enough so it cannot fit into child's mouth.
___ Guard or shield has ventilation holes so baby can breath if shield goes into mouth.
___ Pacifier nipple has no holes or tears that might cause it to break off in baby's mouth.


Strollers and Carriages
___ Stroller has wide base to prevent tipping.
___ Seat belt and crotch strap are securely attached to frame.
___ Seat belt buckle is easy to use.
___ Brakes securely lock the wheel(s).
___ Shopping basket is low on the back and located directly over or in front of the wheels.
___ When used in carriage position, leg hole openings can be closed.

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For further information, write: U.S. Consumer Product Safety Commission Washington, D.C. 20207 The US Consumer Product Safety Commission protects the public from the unreasonable risk of injury or death from 15,000 types of consumer products under the agency's jurisdiction. To report a dangerous product or a product-related injury, you can go to CPSC's forms page and use the first on-line form on that page. Or, you can call CPSC's hotline at (800) 638-2772 or CPSC's teletypewriter at (800) 638-8270, or send the information to info@cpsc.gov. Consumers can obtain this publication and additional publication information from the Publications section of CPSC's web site or by sending your publication request to publications@cpsc.gov. If you would like to receive CPSC's recall notices, subscribing to the email list will send all press releases to you the day they are issued.

Life Before Birth

"Hello baby, is it dark in there?"
If researchers  want to know what a fetus can see—not to mention smell, hear, taste and touch—they have to go right to the source. Unfortunately, the unborn are not the world's greatest communicators.

To find the answers, researchers study animal fetuses, healthy human newborns only hours old and premature infants finishing their pre-natal development in an incubator. What they've learned about the fetal experience and the development of the senses not only expands our understanding of the human body, it's also helping to up the premies' chances for a healthy, normal life.

Across the animal kingdom, senses come online in a very specific order that doesn't vary much from one vertebrate to another. The first sense fetuses experience is touch. Then come the chemical-based senses—taste and smell. The ability to hear develops fourth. And finally, so late that many animals are born lacking it, comes sight.

Humans, with our relatively long gestation periods, are one of the few species that can see before we're born. Not that there's very much to see.  And, yes, it is, in fact, rather dark in there.

"(Babies in the womb) can tell the difference between dim and very dim. That's what they'd see if mom removed outer clothing on a sunny day," said William Fifer, Ph.D., head of the fetal/infant development lab at Columbia University's division of developmental psychology.

Scientists have watched fetuses on ultrasound turn their heads away from bright lights held up to their mother's stomach, Fifer said. And they've seen the brain waves of premature infants spike in response to a flash of light, or a change in visual stimulus—switching a card from vertical stripes to horizontal, for instance. Sight isn't much of a sense at this point, but it's enough.
Enough for what? That's where things get interesting. See, senses don't work via some neurological "off/on" switch. It's more like building muscle. You have to exercise to get results. The more you work out the new sense, the more neuron connections are formed and the sense improves. But if you don't use it, you lose it. Literally.

"You need sensory stimulation of some sort, or the nerve connections never form," Fifer said. "Kittens blindfolded after birth never develop sight."

Sensory stimulation is important in other ways as well, helping fetuses learn. For instance, duck embryos peep to themselves while still inside their eggs. As they do that, they begin to recognize what a duck voice sounds like.

"A researcher named Gilbert Gottlieb found that, if he de-vocalized a duck embryo, then after birth it wouldn't be able to tell the difference between the maternal calls of a duck or a chicken," said Jeffery Alberts, Ph.D., professor of psychology at Indiana University. "They have to hear themselves in the egg and stimulate their own auditory systems. That's how they get it to be tuned enough to complete development."

Monkey hear, monkey do
Human babies in the womb use their senses to learn, too. Christine Moon, Ph.D., professor of psychology at Pacific Lutheran University, studies auditory development in humans. She does her research by staking out the maternity wing at a local hospital, popping in on new families right after babies are born. If the parents are interested, infants as young as eight hours old can be tested to see how they respond to different sounds. The babies wear headphones and are given special pacifiers hooked up to a computer.

Turns out, babies suck harder on the pacifiers when they hear sounds that are familiar to them from before birth. Newborns prefer their mother's voice over anyone else's (even dad's). They prefer hearing phrases from books they were read while in the womb, compared to new stories. They're even already favoring one language over another.

"Babies prefer the sound of their mother's native language to others," Moon said. "Interestingly, they can distinguish between languages in the same rythmic class, like Spanish versus English. But they can't tell the difference between similar sounding languages, like English and Dutch."

Mothers' speech seem to matter in other ways as well. Moms who don't mumble or slur their words together have children that can better recognize consonants at 6-to-8 months, and have bigger vocabularies at 10-to-12 months, compared to their peers. This, and other research, has led Moon to theorize that language acquisition is a process that begins before we're even born.

Seeing a better future
All this has big implications for infant health.
We know now that sensory experiences before birth play a role in making sure senses develop properly and that fetuses learn important post-birth behaviors. That's helped researchers better understand what happens to fetuses exposed to alcohol.
Too much alcohol makes for a fetus that doesn't move around much and interacts less with its environment. That means less sensory experience and, thus, less cognitive development. Like the de-vocalized duck embryo, a fetus exposed to alcohol can't teach itself. That sensory deprivation can even have physical impacts.

"One of the things the fetus experiences from alcohol exposure is reduced swallowing movements. So it doesn't have that stimulation of the gastro-intestinal system to help that system develop normally," Jeffrey Alberts said.

Studying fetal senses has also helped doctors develop better ways of caring for premature infants. These babies end up lacking a lot of the sensory experiences they need for normal development—the movement of being inside their mother, the smells and tastes of the womb, their mother's voice—while simultaneously experiencing bright lights and loud noises that they wouldn't normally. Imagine falling asleep in a hammock on a tropical night, and waking to find yourself being grilled under the light by a noir police detective. That shock makes a difference in babies' development, and helps put them at risk for a variety of cognitive and motor disorders, William Fifer said.

Sensory research has led to darker rooms for pre-term infants, turning down the harsh lights that can harm their not-quite-ready-for-primetime eyesight, Fifer said. It's also prompted hospitals to begin monitoring the babies' brain waves and testing their hearing, looking for early signs that the baby in question might need therapeutic intervention.

"It's only in the last few years that we've been checking that as a matter of course," he said. "Now many nurseries measure brain activity because we know that if you see problems early on you can make a bigger difference."

SOURCE

Maggie Koerth-Baker at 6:30 AM April 7, 2010   

Main image courtesy Flickr user lunar_caustic, via CC.
Photo of 18-hour-old baby participating in a speech/language perception experiment, ,courtesy Christine Moon.