Pregnancy: Activities to approach with care during pregnancy and what to do when baby’s overdue.

Pregnancy might seem like the perfect time to sit back and relax. You likely feel more tired than usual, and your back might ache from carrying extra weight.

But unless you’re experiencing complications, sitting around won’t help. In fact, pregnancy can be a great time to get active — even if you haven’t exercised in a while.

Why exercise during pregnancy?

During pregnancy, exercise can:

• Reduce backaches, constipation, bloating and swelling

• Boost your mood and energy levels

• Help you sleep better

• Prevent excess weight gain

• Promote muscle tone, strength and endurance

Other possible benefits of following a regular exercise program during pregnancy may include:

• A lower risk of gestational diabetes

• Shortened labor

• A reduced risk of having a C-section

Before you begin an exercise program, make sure you have your health care provider’s OK. Although exercise during pregnancy is generally good for both mother and baby, your doctor might advise you not to exercise if you have:

• Some forms of heart and lung disease

• Preeclampsia or high blood pressure that develops for the first time during pregnancy

• Cervical problems

• Persistent vaginal bleeding during the second or third trimester

• Placenta problems

It may also not be safe to exercise during pregnancy if you have any of these other complications:

• Preterm labor during your current pregnancy

• A multiple pregnancy at risk of preterm labor

• Premature rupture of the membranes

• Severe anemia

Pacing it for pregnancy

For most pregnant women, at least 30 minutes of moderate-intensity exercise is recommended on most, if not all, days of the week.

Walking is a great exercise for beginners. It provides moderate aerobic conditioning with minimal stress on your joints. Other good choices include swimming, low-impact aerobics and cycling on a stationary bike. Strength training is OK, too, as long as you stick to relatively low weights.

Remember to warm up, stretch and cool down. Drink plenty of fluids to stay hydrated, and be careful to avoid overheating.

Intense exercise increases oxygen and blood flow to the muscles and away from your uterus. In general, you should be able to carry on a conversation while you’re exercising. If you can’t speak normally while you’re working out, you’re probably pushing yourself too hard.

Depending on your fitness level, consider these guidelines:

• You haven’t exercised for a while. Begin with as little as 10 minutes of physical activity a day. Build up to 15 minutes, 20 minutes, and so on, until you reach at least 30 minutes a day.

• You exercised before pregnancy. You can probably continue to work out at the same level while you’re pregnant — as long as you’re feeling comfortable and your health care provider says it’s alright.

Activities to approach with care

If you’re not sure whether a particular activity is safe during pregnancy, check with your health care provider. Consider avoiding:

• Any exercises that force you to lie flat on your back after your first trimester

• Scuba diving, which could put your baby at risk of decompression sickness

• Contact sports, such as ice hockey, soccer, basketball and volleyball

• Activities that pose a high risk of falling — such as downhill skiing, in-line skating, gymnastics, and horseback riding

• Activities that could cause you to hit water with great force, such as water skiing, surfing and diving

Other activities to avoid include:

• Exercise at high altitude

• Activities that could cause you to experience direct trauma to the abdomen, such as kickboxing

• Hot yoga or hot Pilates

If you do exercise at a high altitude, make sure you know the signs and symptoms of altitude sickness, such as headache, fatigue and nausea. If you experience symptoms of altitude sickness, return to a lower altitude as soon as possible and seek medical care.

Staying motivated

You’re more likely to stick with an exercise plan if it involves activities you enjoy and fits into your daily schedule. Consider these simple tips:

• Start small. You don’t need to join a gym or wear expensive workout clothes to get in shape. Just get moving. Try a daily walk through your neighborhood or walk the perimeter of the grocery store a few times. Take the stairs instead of the elevator.

• Find a partner. Exercise can be more interesting if you use the time to chat with a friend. Better yet, involve the whole family.

• Try a class. Many fitness centers and hospitals offer classes, such as prenatal yoga, designed for pregnant women. Choose one that fits your interests and schedule.

Listen to your body

As important as it is to exercise, it’s also important to watch for signs of a problem. Stop exercising and contact your health care provider if you have:

• Vaginal bleeding

• Dizziness

• Headache

• Increased shortness of breath before you start exercising

• Chest pain

Other warning signs to watch for include:

• Painful uterine contractions that continue after rest

• Fluid leaking or gushing from your vagina

• Calf pain or swelling

• Muscle weakness affecting balance

A healthy choice

Regular exercise can help you cope with the physical changes of pregnancy and build stamina for the challenges ahead. If you haven’t been exercising regularly, use pregnancy as your motivation to begin.

Overdue pregnancy: What to do when baby’s overdue

An overdue pregnancy can leave you tired and anxious. Find out what might cause an overdue pregnancy and what it can mean for you and your baby.

Your due date has come and gone — and you’re still pregnant. What’s going on?

Although your due date might seem to have magical qualities, it’s simply a calculated estimate of when your baby will be 40 weeks. Your due date does not estimate when your baby will arrive. It’s normal to give birth before or after your due date. In fact, your pregnancy must continue two weeks past your due date to earn the official label of postterm pregnancy.

You might be more likely to have a postterm pregnancy if:

• This is your first pregnancy

• You’ve had a prior overdue pregnancy

• Your baby is a boy

• You have a body mass index of 30 or higher (obesity)

• Your due date was calculated incorrectly, possibly due to confusion over the exact date of the start of your last menstrual period or if your due date was based on a late second- or third-trimester ultrasound.

Rarely, an overdue pregnancy might be related to problems with the placenta or the baby.

Whatever the cause, you’re probably tired of being pregnant, not to mention anxious. Rest assured, an overdue pregnancy won’t last forever. Labor could begin at any time.

Postterm pregnancy risks

Research shows that when pregnancy extends between 41 weeks and 41 weeks and 6 days (late-term pregnancy) as well as 42 weeks or beyond (postterm pregnancy), your baby might be at increased risk of health problems, including:

• Being significantly larger than average at birth (fetal macrosomia), which might increase the risk of an operative vaginal delivery, C-section, or getting a shoulder stuck behind your pelvic bone during delivery (shoulder dystocia)

• Postmaturity syndrome, which is marked by decreased fat beneath the skin, a lack of a greasy coating (vernix caseosa), decreased soft, downy hair (lanugo), and staining of the amniotic fluid, skin and umbilical cord by your baby’s first bowel movement (meconium)

• Low amniotic fluid (oligohydramnios), which can affect your baby’s heart rate and compress the umbilical cord during contractions

Late-term and postterm pregnancies can also pose risks, such as delivery complications:

• Severe vaginal tears

• Infection

• Postpartum bleeding

Keeping an eye on your pregnancy

Prenatal care will continue after you pass your due date. During visits, your health care provider will check your baby’s size, heart rate, position and ask about your baby’s movements.

If you’re more than one week past your due date, your health care provider might do fetal heart rate monitoring (nonstress test) and an amniotic fluid volume assessment or a combination of a nonstress test and a fetal ultrasound (biophysical profile). In some cases, labor induction might be recommended. Labor induction is the stimulation of uterine contractions during pregnancy before labor begins on its own to achieve a vaginal birth.

Giving baby a nudge

If you and your health care provider choose labor induction, you might be given medication to help your cervix ripen. Your health care provider might dilate your cervix by inserting into it a small tube (catheter) with an inflatable balloon on the end. Filling the balloon with saline and resting it against the inside of the cervix helps ripen the cervix. If your amniotic sac is still intact, your health care provider might break your water by creating an opening with a thin plastic hook.

If necessary, you might also be given medication to kick-start your contractions. A common choice is Pitocin, a synthetic version of oxytocin — a hormone that causes the uterus to contract.

Hang in there

You’re in the homestretch! Whether your health care provider suggests a wait-and-see approach or schedules an induction, stay in touch and make sure you know what to do if you think you’re in labor. In the meantime, do your best to enjoy the rest of your pregnancy.



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