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To expectant mothers: Exercise within reason

September 14, 1999

BY DR. JAMES BRAGMAN

Editor's note: Dr. James Bragman is the newest medical columnist for the Body & Mind section of the Detroit Free Press.

He is board certified by the American Board of Internal Medicine and Geriatrics and has completed review courses in sports medicine. He is a clinical assistant professor of internal medicine at Wayne State University.

His West Bloomfield practice is 50 percent internal medicine, 30 percent geriatrics and 20 percent sports medicine.

He is an avid sports participant who has held a state ranking in squash for many years.

His media activities include appearances on local TV stations to discuss medical issues and he is the medical expert on the CNN-Radio Network, contributing five 60-second reports each week.

In the coming months, he will address sports medicine topics, including today's report on exercise and pregnancy.

With the ever-increasing interest in exercise, it is not surprising that more women want to maintain their peak levels of conditioning during pregnancy. Within the past 10 years, a substantial amount of research has concluded that it is safe to exercise during pregnancy with reasonable guidelines.

Two benefits of a regular exercise program during pregnancy are the maintenance of an active lifestyle, which acts as a great stress reducer, and the continuance of the pleasure of exercise.

Physiological advantages include improved posture, muscle tone and balance, possible shortening of labor, healthier offspring, increased postpartum fitness, less maternal weight gain and improved blood sugar control in women who experience gestational diabetes.

Despite the benefits of an aerobic workout, there are signs that warrant discontinuing exercise. Reasons to terminate exercise include pain precipitated by exercise; vaginal bleeding; ruptured membranes; induction of labor; absence of fetal movement associated with or followed by exercise; sudden swelling of the hands, face or ankles; extreme shortness of breath; dizziness or vertigo, and insufficient weight gain. Exercise should not be undertaken with suspected fetal distress, pregnancy-induced hypertension or if the woman is carrying more than three fetuses.

Indicators for termination of exercise include uncontrolled diabetes, a history of being a heavy smoker, experiencing preterm labor or a previously sedentary lifestyle.

The American College of Gynecologists offers regular exercise during pregnancy three to five times per week is better than intermittent activity.

Pregnant woman exercising during their first trimester should drink plenty of water, wear loose clothing and exercise in a well-ventilated environment. Women should be aware of decreased aerobic capacity during pregnancy, and they may need to modify the intensity of their program.

Finally, pregnancy requires an additional 300 calories a day to maintain a nutritional balance for mother and child.




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