Sunday, March 17, 2013

The next waiting game II - moving through


Exercise is like nutrition:  everyone has a vague notion that it’s good for them, but not enough of us take it seriously.  Add to that in pregnancy, most women don’t feel like doing anything that takes them off the couch.  Then add the fact that for the months or years you’ve been trying to get pregnant, you’ve treated your body with kid gloves, fearing after every embryo transfer the slightest wrong move would dislodge the little guy whom you’re begging to cling to your uterine wall for dear life!
I started the topic of exercise as a suggestion for dealing with anxiety.  THe medical literature is filled with studies showing how exercise improves general mood, and can even improve clinical depression and anxiety.  
However, the benefits of exercise in pregnancy go way beyond.  A recent review of the data⁠1 regarding this stated, “Maternal benefits from exercise during pregnancy include improved cardiovascular function, a lower risk for gestational diabetes, improved strength and lean muscle mass, improved sense of well-being,  as well as reduction in bone density loss and physical discomfort”  Stretching exercises like yoga have been found to decrease the incidence of gestational hypertension, and increase antioxidant markers.  There is also evidence that mothers who exercise in pregnancy have longer gestational ages (it seems like a minus, but better for the baby), and infants with lower birth-weights.  There are ongoing studies which may show some neurodevelopmental benefits to babies as well.  
These statistics are not meant to add the the overload of information you are already inundated with, make you feel guilty, or make you go out and run a marathon.  I just want to reassure those of you who want to exercise that it is safe in most pregnancies, and encourage the rest of you to try some form of activity. If you are not already in the habit, try just going for a walk at lunchtime.  There are tons of videos now with 10 − 15 minute workouts, which is much easier to fit into your day.  Most cable systems have exercise videos on demand, or you can look into you-tube or your local library to try something without spending money.  Any exercise you did before you can adapt to pregnancy, which we will discuss.  My personal favorite is Zumba, or some kind of dance exercise.  I think these classes are great in pregnancy for several reasons.  First, it’s a great way to get a core workout without doing crunches, which you don’t want to later in pregnancy.  I love the latin steps with the hip and pelvic action - its a great way of loosening up that part of the body to prepare for labor, and I think pregnancy is a great time to get in touch with your femininity and sexuality.  Most women have some body issues in pregnancy, and after years of timed intercourse, or conceiving through un-intercourse, I think this applies even more.  
There are some precautions to be aware of.  First, you should not be working out at the same level you were before.  If you are on one of those fancy machines with a heart rate monitor, you want to be in the fat burn rather than the cardio zone.  If you are not monitoring your heart rate, just remember you should feel able to hold a conversation easily and if you feel too out of breath, then slow down.  One of the other changes in pregnancy is that all your joints are more relaxed, which means it’s easier to over extend or pull something.  Use good form and body mechanics, avoid twisting or stretching too much.  It may be intuitive, but avoid activities that are likely to cause injury;  the laxity in your joints also make it more likely you may loose your balance.  Lastly, avoid exertion flat on your back after you start showing (usually around 20 weeks).
Most of you are probably told in the first trimester not to do any vigorous exercise.  Unless you are on strict bed-rest, most of you can still do some gentle exercise like yoga or tai chi.  I think everyone should try yoga in pregnancy, because it is wonderful for dealing with some of the physical discomforts, and it is a great way to start practicing some relaxation.  Again, there are a lot of resources for trying yoga at home, and many places have classes.  If you are not ready to try something specifically for pregnancy, any gentle yoga should be fine as is or can be adapted.  I found tons of videos on you-tube, you can try http://www.youtube.com/watch?v=0bDo6ezueOI as an example.  If you are put on bed-rest later in the pregnancy, most women can still do some of the stretches done seated and on all fours.  
As with anything, these are general guidelines, please consult your health care provider for advice about your pregnancy, and any additional restrictions you may have.  

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1 Prather, et. al, “Benefits of Exercise During Pregnancy”, PM&R, 4-845, 2012

Thursday, March 7, 2013

A Brief Distraction


There will be no midwife’s advice this week.  Pail Bloggers asked for bloggers to submit answers to the following 20 questions, and I couldn’t resist.  So if you will allow me to be self-indulgent, there will be more useful information next post. 

1.  What is the last thing you threw in the garbage?  The bad ends of the vegetables I just cooked for dinner.  

2.  What is the #1 most played song on your Ipod?  I don’t have one, but I have a broadway playlist that I shuffle constantly. 

3.  What is your favorite quote?  From the Dalai Lama, “Religion and logic should never contradict.”

4.  What chore do you absolutely hate doing?  Washing dishes - because no matter how much time I spend, they never seem to be done.  Ever.  

5.  What is your favorite form of exercise?  I love Zumba - I now do it on my Wii and pretend I’m on Dancing With the Stars. 

6.  What is your favorite time of the day?  This doesn’t happen every day, but waking up at 5am on an overnight call shift and realizing I’ve been asleep most of the night. 

7.  What is on your bedside table?  Alarm, lotion, and an eye mask for napping during the day after a busy night call (see #6). 

8.  What is your favorite body part?  My kids’ little round bottoms!

9.  Would you use the power of invisibility for good or evil?  I would use any power for good.  Evil is only fun for a few minutes, good attracts good people, which stays fun. 

10.  If you could choose to stay a certain age forever, what age would it be?  Always my current age, because I seem to learn something every year.  (Although I would choose my 21 year old body).

11.  What is the first thing you would do if you won the lottery?  Start planning my next trip.

12.  What is your biggest pet peeve?  Abnormal hair configurations on men’s faces, (ie  the soul patch).  I have a fantasy of Apolo Anton Ohno where we make love all night, then I shave that stupid thing off him in his sleep. 

13.  If you could know the answer to any question, what would it be?  I doesn’t matter, because as soon as I find the answer to something, it just opens up 10 more questions. 

14.  At what age did you become an adult?  39, the year I became a mom.  I played grown-up alot before then. 

15.  Recommend a book, movie, or television show in three sentences or less.  Call the Midwife:  it gives voice to women of a little known profession, who give voice to women who have none. 

16.  What did you do growing up that got you into trouble?  Always mouthing off!

17.  What is the first album you bought with your own money?  Queen, “Play the Game” (on vinyl!).  It’s still one of my favorites. 

18.  If someone wrote a book about you, what would be the title?  “I’m not Loud, I’m Italian”.

19.  What story do you wish your family would stop telling about you?  My mother tells everyone she’s ever met about me having a big mouth when I was a kid. (See #16)

20:  True of false:  The unicorn is the greatest mythical creature.  State your case.  False.  Am I missing something, or is it just a horse with a horn?