Your pregnant clients may not be up to training for their first triathlon, but they don't have to skip their workouts altogether. In fact, consistent exercise will help clients as they prepare for childbirth and, later, as they return to prepregnancy activity levels. Benefits of regular exercise during and after pregnancy include the following (Garshasbi & Faghih Zadeh 2005; Mayo Clinic 2004):
* reduced incidence of back pain
* boosted energy
* fewer problems with constipation
* increased muscle strength and a superior cardiovascular condition, which can facilitate labor and delivery
* improved endurance, to prepare for the possibility of a longer labor
* improved mood states
* reduced postpartum recovery time
DESIGNING AN APPROPRIATE PROGRAM
Dealing with many of a pre/postnatal client's hormonal, metabolic, respiratory, cardiovascular and musculoskeletal changes is beyond the scope of practice for fitness professionals. Getting your client's exercise plan approved by her physician before getting started--and then maintaining an open dialogue with the physician throughout the pregnancy and postpartum period--is essential.
Any fitness professional who works with pre/postnatal women should be familiar with the guidelines developed by the American College of Obstetricians and Gynecologists (ACOG 1994b). Of course, there are always exceptions to guidelines; your client's doctor will let you know if any of the exceptions apply to your client.
Research suggests that during pregnancy, women can continue to derive health benefits from regular exercise (at least three times per week). No data indicate that limiting intensity or lowering target heart rates is necessary to avoid potential adverse effects. With a doctor's approval, some exercises may be continued at intensities similar to those maintained prior to pregnancy.
According to the ACOG guidelines (ACOG 1994b), a woman who does not have any specific risk factors for adverse maternal or perinatal outcomes can exercise throughout her pregnancy if she takes these precautions:
* Avoids exercise in the supine position after the first trimester (ACOG 1994b), since this position can lead to a reduction of maternal heart rate and decrease the flow of oxygenated blood to the baby.
* Avoids prolonged periods of motionless standing.
* Listens to her body. As the pregnancy progresses, there is less room for lung expansion, and the pregnant exerciser may "run out of breath" more quickly. Realizing that decreased oxygen is available, she should modify her exercise intensity and stop when fatigued.
* Chooses activities that minimize the loss of balance. The pregnant woman's changing body affects her center of gravity, so it is best to avoid single-leg movements and exercise on uneven surfaces. Non-weight-bearing exercises, such as cycling or swimming, minimize the risk of injury.
* Avoids any type of exercise that carries the potential for even mild abdominal trauma (e.g., downhill skiing, contact sports).
* Consumes an adequate diet. During pregnancy 300 additional kilocalories per day are required to maintain metabolic homeostasis.
* Ensures adequate hydration, appropriate clothing and optimal environmental surroundings during exercise to augment heat dissipation, especially during the first trimester.
Since many of the physiological and morphological changes of...
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