Promoting Comfort in Pregnancy

Physical and hormonal changes are largely responsible for the common discomforts of pregnancy.

During pregnancy, the body’s center of gravity is altered by the increase in weight, and a change in weight distribution. Hormones, particularly one called Relaxin, contribute to the looseness of ligaments that support the pelvic joints and join the uterus to the pelvis and abdominal wall.

It is important to maintain good posture and avoid undue muscular strain, and stress on pelvic and spinal joints.

Correct Posture for Standing

~ Feet almost parallel, a few inches apart
~ Knees straight, but not locked
~ Buttocks tucked under
~ Head held high and back, chin tucked in
~ Abdominal wall pulled up and in
~ Shoulder blades pulled back
~ Arms hanging relaxed by sides

Avoid

~ High heels and shoes that are too big or too small
~ Constricting clothing such as girdles, garters and knee-high nylons
~ High platform-type shoes
~ Shoes with slippery or unstable bottoms
~ Learn the correct way to put on support hose if they are necessary.

Getting out of bed

Lying on your side, bend knees, push with arms to straighten elbows, and as you sit up, slowly swing legs over side of bed.

Lifting

Never bend from the waist, bend from hips and knees, keeping back straight. Avoid heavy lifting or carrying because of unstable pelvic and spinal joints.

Squatting

Stand with feet and knees well apart. Keeping head and spine straight, bend knees and gently lower body to squatting position. Heels may lift off floor. To stand again, push up with legs to straighten knees.

Kneel Squatting

Stand with one foot placed well forward. Keeping head and back straight, bend knees, lowering yourself onto back knee, which rests on the floor. To stand, push up, straightening legs.

Always place hands on nearby supports for extra balance and control; e.g., in squatting, climbing stairs, sitting down. Avoid standing for long periods, or sitting with knees crossed as this adds to congestion of circulation in legs and pelvis. When possible sit with legs elevated to facilitate venous return.

Exercise Guidelines

~ It is important to exercise regularly and consistently. Make exercise a habit! To get the most benefit, an exercise session should last 20-30 minutes.
~ Walking is an excellent exercise!
~ Stop exercising if you feel pain. Modify your exercise program to eliminate any exercise that causes discomfort.
~ Whenever possible, finish eating 1 to 1 1/2 hours before you exercise. This will prevent discomfort from a full stomach. Eat a good meal, as exercise uses more calories during pregnancy, and your blood sugar can drop.
~ Don’t diet during pregnancy. Dieting is very dangerous for your baby. It is essential that you eat a well balanced, nutritious diet.
~ Drink water or juice before and after you exercise to replace fluids lost through exertion and to provide you with sugar to prevent low blood sugar.
~ Do not perform two exercises in a row that require you to lie on your back. Change position after each exercise to ensure good circulation to your baby.

Exercises to Avoid!

~ Double leg raises – raising and lowering legs together puts too much strain on the lower back and abdominal muscles.
~ Full sit ups – can strain the lower back and abdominal muscles due to pulling on the ligaments that help support the uterus.
~ Jumping, hopping, skipping and bouncing can cause strain on the hip and pelvic joints. These activities could result in pain. Your center of gravity shifts as the baby grows and joints (especially the hips, knees and ankles) are looser and less stable. Be sensible and listen to the messages your body sends you.

Exercises to Help Minimize Discomforts:

These exercises are best done twice a day, six times each:

Pelvic Tilt

~ to relieve backache
~ to increase abdominal muscle tone
~ to improve posture
This exercise can be done in many positions:
~ Lying on back, knees bent together, feet flat on floor (not after 4th month)
~ Lying on side, knees bent
~ Standing
~ Sitting
~ On “all fours”, kneeling on hands and knees.
Tighten abdominal muscles by pulling stomach in. Flatten the small of the back and hold flat. Then tighten buttock muscles to tuck imaginary “tail” between your legs. Pelvis is gently tilted upwards and the curve of the back flattens considerably.

Tailor Sitting

Stretches tight inner thigh muscles. Sit on floor, back straight, feet crossed at ankles.

Tailor Press

Relaxes and lengthens the inner thigh muscles. Sit on floor in the tailor position and press both your knees toward the floor while providing resistance with your hands underneath the knees.

Tailor Reach

Eases the tightness in the shoulders and upper back and relieves pressure under the rib cage in later pregnancy. Sit on the floor in the tailor position and stretch your arms over your head – reach higher with the right, then higher with the left, and so forth.

Calf Stretching

Relieves cramps in calf muscles. Stand barefoot on floor, holding onto chair or some support in front. Slide the foot of the cramping leg back along the floor, keeping the knee straight and heel on the floor. Front knee will bend.Lying on bed, legs straight, have husband or friend push heel and sole of the foot up toward the knee with one hand, while holding the knee down and straight with the other.

Warning Signs to Stop Exercising

You should stop exercising and contact your health care provider if you have any of the following:
~ Pain
~ Shortness of breath
~ Uterine contractions
~ Vaginal bleeding/fluid loss
~ Rapid heartbeat
~ Pounding, racing or irregular heartbeat
~ Dizziness
~ Faintness
~ Pubic pain
~ Absence of fetal movement

What Are Kegel Exercises?

Kegel exercises are simple exercises that strengthen your perineal muscles. These are the muscles around the vagina and urinary opening, that help to support the uterus (womb), bladder and rectum.Try to do each exercise 100 times each day.
~ Exercise 1
Tighten the muscles, hold them tight for two to three seconds, then relax.
~ Exercise 2
Tighten the muscles and release five times as quickly as you can.

Why Are Kegel Exercises Important?

The Perineal muscles can become weakened by:
~ Childbirth
~ Decreased estrogen levels during and following menopause
~ Increased pressure on the muscles, such as during running and coughing

When the perineal muscles are weakened, you may notice the following:
~ An uncomfortable feeling of pressure or heaviness
~ Leaking of urine when laughing, coughing, running or doing exercise
~ Bulging of the bladder into the vagina (cystocele)
~ Bulging of the rectum into the vagina (rectocele)
~ Dropping of the uterus into the vagina

How To Do Kegel Exercises

You can find the perineal muscles by stoping and restarting the flow of urine. If you can do this, you can control and strengthen your perineal muscle. Kegel exercises can be done anywhere at any time. No one can see you doing the exercises. You can exercise while watching TV, driving a car, doing housework, lying in bed, or while you’re at work. Developing a routine helps you to become more consistent; e.g. do the exercises during every stop light, during commercials on TV, after using the bathroom, etc.

These exercises may seem difficult or tiring at first, but with practice, the muscles will get stronger.
~ Try to tighten the muscles a little more strongly each day.
~ Keep the muscles of the abdomen, thighs and hips relaxed.
~ Do these exercises everyday.
~ If continuous exercise causes fatigue, try exercising for one or two minutes, then rest for several minutes before continuing.

Correct posture for standing

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