Antenatal exercises aim to prevent back pain and prepare mothers physically and psychologically for delivery. Exercises include pelvic floor exercises to strengthen muscles, back and abdominal exercises to improve posture, and ankle rotations to reduce swelling. Proper form, such as breathing smoothly and gradually increasing intensity, should be followed. Exercises can begin at 16-20 weeks and provide benefits like improved circulation and energy, though some conditions like heart problems contraindicate exercise.
Antenatal exercises aim to prevent back pain and prepare mothers physically and psychologically for delivery. Exercises include pelvic floor exercises to strengthen muscles, back and abdominal exercises to improve posture, and ankle rotations to reduce swelling. Proper form, such as breathing smoothly and gradually increasing intensity, should be followed. Exercises can begin at 16-20 weeks and provide benefits like improved circulation and energy, though some conditions like heart problems contraindicate exercise.
Antenatal exercises aim to prevent back pain and prepare mothers physically and psychologically for delivery. Exercises include pelvic floor exercises to strengthen muscles, back and abdominal exercises to improve posture, and ankle rotations to reduce swelling. Proper form, such as breathing smoothly and gradually increasing intensity, should be followed. Exercises can begin at 16-20 weeks and provide benefits like improved circulation and energy, though some conditions like heart problems contraindicate exercise.
stresses of pregnancy and childbirth, should be taught as a priority, • Common consequences of pregnancy and child birth are the physical problems of pelvic girdle and low back pain or incontinence. Purposes of antenatal exercise • Antenatal exercise aims at preventing low back pain and enhancing physical and psychological preparation for delivery by means of joint stretching and muscle strengthening. Guidelines for antenatal exercise
• Breathe smoothly, work gradually according
to capability • Work twice or thrice a day and repeat each set of movements ten times in every session • Antenatal exercise may begin when pregnancy reaches 16 to 20 weeks • Physiotherapist may make modifications to the exercise according to physical conditions • Always wear loose fitting clothes or clothes that you are comfortable in. • Drink lots of water before and after exercising • Stop immediately if you experience pain while working out • Always avoid overdoing exercise • Keep moving, Standing motionless at a spot may decrease the blood flow and may make you feel dizzy Various Benefits Of Antenatal Exercises:
• It improves the circulation in both mother and child
• It helps reduces pains experienced during pregnancy like cramps and back ache • It improves stamina and helps increase energy to meet the growing demands of the body • It helps you to control weight gain • It also reduces stiffness in muscles, swellings, aches and pains • It increases circulation and thus decreases swelling of varicose veins • It is good for overall wellbeing of mother and child Contra indications • Cardiovascular, respiratory, renal or thyroid disease. • Poorly controlled type 1 diabetes • Risk of premature labour, • Cervical incompetence, • Risk of IUGR and premature labour reduce activity after 12 weeks • Placenta previa • Sudden swelling of ankles, hands or face. Warnings • Abdominal pain • Leakage of amniotic fluid • Pelvic girdle pain may lead to difficulty in walking • Vaginal bleeding • Shortness of breath, faintness, tachycardia • Calf pain • Reduced fetal movements Position for Antenatal Exercises The position that pregnant women adopt for exercises should be carefully considered . Women should not be asked to lie flat in the later second and third trimesters because of the danger of supine hypotension. Supine hypotensive syndrome is characrerised by pallor, tachycardia, sweating, nausea, hypotension and dizziness and occurs when a pregnant woman lies on her back and resolves when she turned on her side. The aorta and inferior venacava are central vessels, the largest artery and vein. Instead, a half- lying position with the back raised to an angle of approximately 35 degree can be used. Types of antenatal exercise
• (1) Pelvic floor exercise
• • Don’t hold breath. • • Don’t clench buttocks. • Tighten back passage as if you were trying to stop passing wind. Now tighten the muscles would use to stop a flow of urine. • Do both together and should feel back passage, vagina and front passage all lift and close at the same time, exercise while standing, sitting or lying down. Strengthen your pelvic floor muscles during pregnancy
The floor of your pelvis is formed by very
elastic muscles which act like a small trampoline to support your baby during pregnancy. These muscles may become weak leading to a leakage of urine when you cough or sneeze. Many women have this problem during pregnancy. Exercise now to strengthen your pelvic floor, do at least 80 exercises each day. Each day you need to do:
• Slow exercises – tighten, hold (aim for up to 10 seconds) and
relax. • Fast exercises – tighten and relax quickly. Repeat up to 10 times. • How often? – Always do a mixture of fast and slow exercises after you have emptied your bladder. Make this a lifetime habit. • Protect your pelvic floor: Make a habit now of always pulling up pelvic floor before lift, carry, push or pull light to moderate weights. • Lift and squeeze as you cough or sneeze. (2) Back and abdominal exercise • Abdominal muscles – ‘Nature’s perfect corset’ • 4 pairs of muscles arranged in 4 layers – it is only possible to show 2 layers in the diagram: the Rectus and Transvers muscles. • The Rectus muscles run vertically up and down the centre of tummy. • The Transvers muscles are the deepest horizontal muscles encircling your waist. • The Oblique muscles crisscross diagonally on sides. • These muscles work together to hold your spine firm, tilt your pelvis upward and to pull your tummy in tight. These muscles bend and twist spine. • During pregnancy tummy muscles will soften, separate and lengthen to accommodate growing baby. This is a natural change due to pregnancy hormones circulating in body. The gap (linea alba) will gradually close after birth. • Need to do tummy exercises to prevent over- stretching and encourage closure of the separation after birth. • Weight gain in pregnancy • Excessive weight gain results in storage of fat which is hard to lose after the birth. • Sit on a chair with back against the seatback • ﹣ Breathe naturally • ﹣ Tighten the abdomen and then press the pelvis downwards to flatten low back against the • seatback. Hold for 5 seconds, and relax this exercise helps by correcting the low back and pelvic posture. • It strengthens your abdominal muscles and prevents back pain. • Note: Practise good posture in daily activities (3) Ankle exercise
• ﹣ Sit on a chair with back against the seatback
• ﹣ Start with one ankle and turn the foot upwards and downwards. Each up-and-down movement is counted as one time. Repeat ten times • ﹣ Rotate the ankle to draw an inward or outward circle. Each circular movement is counted as one time. Repeat ten times • ﹣ Repeat the same steps at the other ankle • ﹣ Ankle exercise helps reduce leg swelling and varicose vein, thus alleviating the problem of leg cramps. Exercises to prevent backache • Bad posture, stretched tummy muscles and a growing baby can lead to backache during pregnancy. Overstretched tummy muscles can contribute to back pain and constipation. Good posture • Stand tall • Bottom tucked in • Tummy in - always • Relaxed knees • Pelvic floor up Standing
• For good standing posture, the centre of the
head, shoulders and hips should fall in a line when viewed from the side. Standing tall, with shoulders relaxed, tummy gently drawn in and bottom tucked under, knees straight but not locked, and weight evenly distributed on both feet is advised. lying • Sleep is a very valuable commodity during pregnancy and health professionals can advise and help women to find a comfortable position. • Most women will choose to lie on their side to sleep. Side-lying with pillows under the top forearm and knee is usually a comfortable position, and a small pillow under her waist supporting the increasing weight of her abdomen will help to maintain lumbar spine and pelvic girdle. Sittting • The pregnant mother should choose a comfortable chair, which supports both her back and thighs. • She should sit well back and if necessary place a small cushion or folded towel behind the lumbar spine for additional comfort. • Equal weight should be placed on each of buttocks to prevent strain on the pelvic ligaments Lifting and carrying • Lifting heavy should be avoided during pregnancy if at all possible. Twisting or bending while lifting is a particularly high-risk activity. • working activities Women should be encouraged to make sure their seating and workstation is suitable, particularly is sitting for any long time. Regular changes positions is beneficial. In case of constant standing she should ensure she sits at regular break times and be very careful if her work involves lifting or great physical effort. These exercises can be done when kneeling, sitting or standing.
• 1 Transversus Abdominus - ‘Nature’s belt’
• Sit comfortably or kneel on all fours with a level spine. • Breathe in and out, then gently pull in the lower part of the abdomen below the umbilicus keeping the spine still and breathing normally . • Hold for up to 10 seconds then relax gently, repeat up to 10 times. • 2 Pelvic Tilting or rocking • Do this in a half- lying position, well supported with pillows, knees bent and feet flat. • Place one hand under the small of the back and the other on top of the abdomen. • Tighten the abdominals and buttocks, and press the small of the back down on to the underneath hand. • Breathe normally, hold for up to 10 seconds then relax. Repeat up to 10 times. Pelvic tilting can also be performed sitting , standing or kneeling. (3) Lower limbs relaxation exercise • ﹣ This exercise enhances the flexibility and strength of inner thighs and pelvic muscles. It helps mother to get accustomed to the delivery position and prevent thigh spasm during delivery • ﹣ Sit on a stable low chair against a wall and spread your thighs sideways. Hold for 5 seconds and relax • Note: 1. It is suitable for pregnant women with tight thighs • 2. Do not pull apart the thighs • 3. Please note that this exercise is not suitable for those with pain over the pubic bones (5) Breathing exercise
• ﹣ Breathing techniques for pain relief
during labour. Exhale before inhale is • suggested • A. Abdominal breathing • ﹣ Suitable for mild pain • ﹣ Breathe in through the nose and feel the abdomen expand. Then breathe out through the mouth. • B. Lower costal breathing • ﹣ Suitable for medium pain • ﹣ Put your hands on the lower rib cage. • Breathe in through the nose and feel your chest expand. Then breathe out lightly through the mouth • C. Apical breathing • ﹣ Suitable for severe pain • ﹣ Cross your hands below the • clavicles with your mouth slightly open. Breathe in through the nose and the mouth. Breathe out lightly as if trying to flicker the flame of a candle without blowing it out, and feel the upper lungs moving slightly up and down During contractions, try to relax and control your breathing In between contractions, rest and relax as much as you can in the most comfortable position Simple ways of caring for your body • DO • • Rest as often as you can with your feet up slightly higher than the level of your hips. • • To get out of bed, draw tummy in, keep knees together, roll on your side and push up on arms. • • Take some exercise every day. • Walk briskly for 20-30 minutes, if able. Swimming is a very good • exercise - swim at a comfortable pace. Stop and rest often. Leave the pool after 20 minutes. • DON’T • • Do not stand still or sit for long periods. • • Do not stoop. When lifting, should • bend knees, keep back straight and pull up pelvic floor as you take the weight of the object. • • Do not lift or carry heavy weights. • Toddlers can be too heavy to carry • - encourage them to be independent. Stress, tension and relaxation • Some people feel extremely tired, others develop aches and pains which are not due to specific illness, but are related to tension. Tension causes an increase in blood pressure, • heart rate and rate of breathing which can lead to feelings of panic as well as overloading the systems of the body. Knowing how to prevent tension is a valuable skill which everyone could use when life is more challenging than usual. • Learning a relaxation technique and using it regularly has been shown to reduce mildly increased blood pressure. Women who learn and use it in labour generally cope better with pain and feel more in control. During pregnancy, practicing relaxation will help you to rest more effectively and can also help you to get to sleep again if you wake during the night. Planning a scheme of Relaxation
• Mother can relax in either a sitting or lying
position. Using a pillow, make sure head is supported as well as your arms and legs. • To be effective, relaxation must be practiced regularly, and it is important. Squatting exercise • The exercise stretches the perineal muscles. • The mother must squat and keep her feet flat on the floor. Do this 15 minutes per day. Tailor sitting • This exercise stretches the perineal muscles and strengthens the thigh muscles. • A) sit flat on the floor with legs out stretched, knees are gently pushed to the floor untill the perineal muscles begin to strech. • B). Hold this position for increased amounts of time each time performed. • Walking • Walking is a good cardiovascular exercise and is one of the best exercises for pregnant women as this does not put much pressure on knees and ankles. You can walk all through nine months and it fits into your schedule easily. • Jogging • Running or jogging is the quickest exercise to work up your body and heart. A 15 minute jog is also a good exercise and depending on mother schedule can extend run to 30 minutes also. • Swimming • It is considered as the safest exercise for pregnant women by many fitness experts. It concentrates on large muscle groups like arms and legs and is a good cardio exercise. It also makes pregnant women feel weightless even with the added extra weight. • Yoga • With all those postures and stretching, yoga helps you to maintain muscle tone and makes your body flexible. However, keep in mind not to overdo stretching and don’t hold the postures for longer duration as it is not healthy.