By Cora Tomowich, MScPT, Hons B Kin
So, you just found out you are expecting a baby – congratulations! Pregnancy can be such an exciting and fun-filled time! There is the anticipation of motherhood, the excitement of feeling the baby kick, picking names, and deciding on how to decorate the perfect nursery. Many new mums also spend a lot of time reading books about what to do when the baby arrives or search on Pinterest for awesome shower planning ideas. In fact, most new mums will spend the majority of their pregnancies thinking about how to prepare for the baby, but what about preparing themselves?
As a new mum, you are about to experience a profound change to your body, one that goes beyond weight-gain, stretch marks, and morning sickness. It’s not enough to think only of the baby’s health and needs; you must also consider your body’s needs as well. So, let’s make pregnancy and birth a happy time for both of you! Here are a few tips on how to get yourself ready:
1. Become aware of your core
When thinking about the core, most people think about the six-pack abdominal muscles; however, these do not make up the true core. Instead, the core is comprised of four muscles/muscle groups that, when functioning properly, all work together to create a solid foundation upon which the rest of the body can properly work.
The first deep core muscle is the diaphragm, which allows us to breathe and is located at the base of the ribcage. The second is the pelvic floor muscle group, which lines the base of the abdomen and creates a kind of piston action with the diaphragm as it moves through breath excursion. The third is the transverse abdominus muscle, which wraps around the body like a big weight belt. The last muscle group of the deep core is multifidus, which ascends the vertebral column from sacrum to neck connecting segments and protecting the spinTo function like a well-oiled machine, the deep core muscles need to be aligned in a way that optimizes their availability during movement. Much like a house needs strong walls to hold up a roof, the body needs the deep core. Since posture can change quite a bit during pregnancy and birth, optimal alignment can become greatly compromised. Many new mums develop poor postural habits during pregnancy and after birth that eventually lead to issues of urinary incontinence, pelvic or low back pain, shortness of breath, chronic constipation, pain during intercourse, etc. Often times simple postural cuing and gentle exercises can make all the difference to how well the core can function as a solid foundation for the rest of the body.
2. Be mindful of your diet
As much fun as it may be to give in to every pregnancy craving, it is not always the best idea to do so. Many new mums end up gaining a lot more weight than is necessary in pregnancy, which can be a heavy load on the core muscles, legs, feet, and low back. Significant weight gain due to poor eating during pregnancy can also cause unnecessary increases in the mother’s cholesterol and triglyceride levels, as well as, blood pressure and heart rate.
Another common issue amongst women who are pregnant is chronic constipation. A hormone called progesterone is produced in high quantities during pregnancy and can cause the muscles of the colon to relax and therefore make the passing of stool more difficult. It is important to ensure that stool remains soft and that you are not straining to eliminate. Chronic constipation and straining can lead to pelvic organ prolapse and micro-damage to pelvic floor muscles. It is very important that the first bowel movement after labour is soft and easily passable, otherwise, excessive strain could be put on a pelvic floor that has already gone through the inherent challenges of giving birth.
Over-consumption of sugar and excessive weight-gain can cause some new mums to develop gestational diabetes. This is a specific type of diabetes that occurs during pregnancy when the mother cannot produce enough insulin to adapt to the effects of hormonal changes and a growing baby. The result is an increased blood sugar level, which can lead to surrounding tissue damage if not properly addressed. Gestational diabetes can also predict a 10-year incidence of type II diabetes mellitus. Not fun.
During pregnancy and post-partum recovery, it is highly recommended that you consult with a nutritionist or naturopath to ensure you are eating a healthy diet and giving your changing body the proper sustenance it needs to do its job well.
Once upon a time we used to think that there would be significant harm to the fetus if a mother exercised while pregnant. We also believed that she would be at greater risk of sustaining an injury to herself if she experienced any kind of physical exertion. I’ve also heard that we once thought a fetus could be dislodged from the uterus if a mother reached her arm above her head. Fortunately, these myths have since been proven incorrect.\
We now know that exercise during pregnancy can in fact be quite beneficial to the mother as she prepares for birth. Studies show that there can be improved aerobic and muscular fitness, prevention of pregnancy-induced glucose intolerance or hypertension, improved cardiac functioning, and an increased sense of well-being and body connectivity during pregnancy and birth. On the flip side, there are many associated risks of not participating in regular exercise during pregnancy. Excessive weight gain, increased risk of gestational diabetes, varicose veins, and/or a deep vein thrombosis are a mere few. But how much or what type of exercise is appropriate during pregnancy?
Using the Borg’s Rating of Perceived Exertion Scale, the target level of exertion during pregnancy should be between 12 and 14 (I.e., “somewhat hard”). Suggested exercises include brisk walking, swimming, cross-country skiing, stationary cycling, and Aqua Fit. It is not advised to participate in any high risk or overly strenuous activities such as scuba diving, downhill skiing, gymnastics, or horseback riding. Pregnancy is also not a time to take-up break-dancing or to begin training for the Ironman race. Ideally, new mums should choose activities with which they are familiar and minimize the risk of balance loss and/or fetal trauma.
There are some strict contraindications to exercising during pregnancy, such as, ruptured membranes, preterm labour, incompetent cervix, more than three babies in gestation, placenta previa, persistent spotting or bleeding, maternal malnutrition, and/or other significant medical conditions. As a new mum, you should see your OBGYN to complete the Physical Activity Readiness Medical Examination (PARmed-X) for Pregnancy; thus ensuring an appropriate exercise prescription that suits your unique needs and interests.
Your pelvic health physiotherapist can also recommend a lot of great exercises to get your core ready for the physical demands of pregnancy and birth, but I’ll get to that in a moment…
4. Sip fluids throughout the day
One of the best ways to maintain good hydration is to maintain regular fluid intake throughout the day. Instead of guzzling all of your fluids all at once, try sipping water or herbal teas slowly every half hour or so. A good way to ensure you are well hydrated is noticing a pale or light yellow colour to your urine – not clear. If you are noticing clear urine, it could be a sign that you are drinking a bit too much and you may want to take it down a notch. Speak with a nutritionist to ensure you are drinking the right amount for your body’s needs.
5. Consult with a pelvic health physiotherapist
Okay, so I might be a little biased on this one but the recommendation still stands. As a pelvic health physiotherapist, I see a lot of new mums and we work extensively on strengthening the pelvic floor and other deep core muscles in preparation for pregnancy and birth.
There are a plethora of exercises that I love to use with my patients that enable proper core recruitment and perineal preparation. I also discuss and teach optimal birthing positions that allow for free movement of the sacrum and tailbone, while also offering protection to the perineum and pelvic floor muscles during the stages of labour.
As a pelvic health physiotherapist, I can accurately assess and treat your specific pelvic floor/deep core needs and prescribe appropriate prenatal and post-partum exercises that help to build and maintain strength as your body changes. We look extensively at each layer of the pelvic floor and create a home program that is both challenging and fun!
So there you have it… Lots to do to prepare for baby but also lots you can do to prepare yourself. Please feel free to call our clinic anytime with any questions or comments you may have, we’d love to hear from you!