Exercise is very important during pregnancy. If you stay active, you will feel better during pregnancy and at the same time tone the muscles that are used during labor and delivery. Walking is excellent exercise and requires no special equipment. If you are active in sports, continue to enjoy them. If you want to start or continue aerobic dance classes, it is best to keep your heart rate between 135-140bpm, and to practice low impact aerobics. Avoid activities or sports that could result in a fall. Examples of these activities include skiing, horseback riding, motorcycle riding, climbing ladders, etc. You should avoid saunas and hot tubs which can raise your body temperature. This can cause too much blood to go to the skin and may cause you to become faint or dizzy when you stand.

Reasons to exercise:

1. Essential to improve your physical condition to meet the extra burdens caused by stretching of muscles, laxity of ligaments, and loosening of joints in pregnancy.
2. Decreases fatigue, backache, and releases tension.
3. Improves self-image.
4. Decreases stress urinary incontinence (leaky bladder).
5. Decreases hemorrhoids, varicosities, gas, and constipation.
6. Can increase sexual enjoyment.

General Exercise Principles:

1. Start exercising slowly, and never throw or bounce your body.
2. NEVER do double leg lifts.
3. Never hold your breath while exercising! You should learn to breathe out with exertion. If you find yourself holding your breath, count out loud while you exercise.
4. Start slowly to give your muscles a chance to warm up before attempting anything.
5. GET REGULAR EXERCISE like walking, swimming, etc. Before starting an aerobic exercise program, check with your doctor.
6. Increase water intake.

Warm Up Exercises

1. Head Rotation-Do entire exercise twice, slowly. Hang head with chin on chest, roll chin up to shoulder, and back down to chest and to opposite shoulder. Repeat three times. Look at ceiling, roll chin to shoulder, up again, then to opposite shoulder. Repeat three times.
2. Shoulder Rotations- Round back shoulders forward. Rotate and raise them, making slow circles several times in each direction.
3. Backstroke- Stand tall, feet apart, knees slightly bent. Bend elbow, brush hands past ear, extend arm backward and down by thigh. Repeat, alternating arms as in backstroke.
4. Figure 8- Stand with feet apart, knees slightly bent, and hands on hips. Shift weight to right and make a circle front-to-back with hips. Next shift weight to left and circle front-to-back with hips. Return to center after each circle. The movement is a figure 8. Keep shoulders and head in alignment with feet. Do 5 times.
5. March in Place- march while lifting the knee high, so thigh is parallel to floor, and foot should also be parallel to floor to avoid leg cramps. Do 10-15 times.
6. Ankle Rotation- Sit on floor, legs extended in front of you. Slowly rotate feet in circles 5 times in each direction.
7. Leg Shaking- Sit, legs extended straight in front of you. Keep ankles on floor and gently shake both legs up and down, alternating for 15 seconds.

Pelvic Floor Exercises (Kegels)

Kegel exercises help support the weight of the growing uterus, prepare pelvic floor to stretch more easily during delivery, and promote healing of episiotomy. It is a good LIFETIME exercise for every woman to maintain strong support for uterus and bladder, and to prevent the need for surgery to correct a problem. It also increases sexual satisfaction.

To do Kegel exercises, tighten the vaginal opening and urethra as if you were trying to keep from urinating. Attempt to lift the whole tightened area up into the pelvis, hold for a few seconds. Slowly relax all these muscles. Contract-lift and hold-release. Do 10 times, 6 times a day. This exercise can be done while watching TV, waiting in line at the bank or grocery, etc.

Tailor Sitting

Tailor sitting helps stretch the muscles of the perineum and inner thigh. This exercise can be worked into daily life while doing activities such as watching TV, reading, folding clothes, etc. Do not do this exercise if you experience any pain in the area of your pelvic bones as separation of this fibrous junction can occasionally occur. To do Tailor Sitting:

1. Sit cross-legged on the floor, back comfortably rounded.
2. Place soles of feet together. With hands on ankles, pull feet comfortably close to your body. Using leg muscles only, gently press knees toward the floor and hold for 3 seconds. Do not bounce. Do not force with hands or arms. Repeat 5-10 times
3. Do alternate Isometric by sitting in the same position with hands placed under knees. Press knees toward the floor resisting with hands. Hold 3 seconds. Release. Repeat 5-10-times.

Rocking

1. Lie on back, knees bent, and feet flat on floor. As you exhale, flatten your back against the floor by tightening the buttocks and drawing in the lower abdominal muscles. Inhale and relax muscles. As you relax, the small of your back will lose contact with the floor.
2. On hands and knees, holding back flat, not sagging, and inhale. Exhale and contract lower abdominal muscles, tuck hips under, and raise the back in an arch. As you inhale, relax and let the back return to a flat position, not sagging. Repeat slowly and rhythmically.
3. Stand erect with feet apart, toes pointed straight ahead, and knees slightly flexed. Rock pelvis slowly upward by tightening the buttocks and lower abdominal muscles. Relax muscles and pelvis will rock down. Repeat this exercise frequently throughout the day.