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Baby-prep your body

Online since 10.04.2018 • Filed under Feature • From Seventeen - April to June 2018 page(s) 10-11
Baby-prep your body

Karen Swanepoel, a physiotherapist and member of the Women’s Health Special Interest Group of the South African Society of Physiotherapy, offers some advice to women planning a new addition to the family.

The prospect of becoming a mom makes eventhe most disorganised person plan. Moms spend hours dreaming about the perfect nursery, buying baby outfits and planning every detail. But all too often, one of the most important physical aspects of motherhood is overlooked – have you planned and prepared your own body for this journey? Have you planned how you will recover from building and birthing a baby?

Training for two

Our bodies transform radically during pregnancy, and many mothers are not well prepared for the physical demands this can bring. Just getting your body back is not always that simple – it’s a journey that begins before pregnancy. Exercise increases your chance of a healthier pregnancy. Think of pregnancy and birth as a race you need to be prepared and fit for. You need more muscle strength to carry your growing bump and prevent aches and pains. A strong body that is prepared for the demands of a pregnancy can make a big difference to your experience. Stamina, strength and suppleness will make the journey more enjoyable, and it’s worth sweating it out to get the benefits.

The good news is that clinical research and current guidelines support the continuation of training throughout pregnancy to ensure maximal benefit for both mother and baby. Exercise during pregnancy has many benefits: less weight gain, shorter labour, improved placenta growth, decreased risk for pregnancy diabetes or hypertension, and a quicker recovery time after birth. There is even research that explains how the benefit of exercising during pregnancy continues into the first 12 months of your child’s life. Exercise also combats fatigue and can help prevent depression. A healthy body leads to a healthy mind! Many mothers think that they must train excessively hard to gain benefit, but the opposite is true. A session of at thirty minutes at least two to three times per week is sufficient. The intensity must be enough to make you breathe a little faster and get your heart pumping, but you must always still be able to hold a conversation comfortably.

This is referred to as the Borg scale of perceived exertion. On a scale of 0 to 20, you must train to a level where you experience it as only ‘somewhat hard’, which is more or less in the vicinity of 14/20, when 0/20 is rest and 20/20 is maximal effort. So, there is no pressure to perform. The guidelines advocate moderate intensity exercise – in other words, movement that is fun. There is no need to measure heart rate during the exercise, unless your gynaecologist deems it necessary, as your resting heart rate is already higher than before pregnancy, making it unreliable as a measurement of intensity during pregnancy.Avoid activities that increase your chances of falling, such as horse-riding or contact sports. Stick to activities such as walking, swimming, stationary cycling and weight training. Drink at least 250ml of water for every 30 minutes you train and avoid training in excessive heat to prevent dehydration.

Why your core matters most

Early in your pregnancy, a hormone called relaxin is released in the body. This hormone softens the ligaments and structures in the pelvis and spine, enabling your body to accommodate an evergrowing baby. The downside of this hormone I that some joints may have more laxity than normal, because the ligaments surrounding the joints allow more motion. That is the source of many aches in the lower back, buttock and pelvis area. A women’s health physiotherapist is trained to evaluate your pelvis stability and to suggest treatment options and exercises to improve the stability of the pelvic girdle. The two most important muscle groups that are affected by the pregnancy are the abdominal muscles and pelvic floor muscles. These two muscle groups play an important role in the stability of the female pelvis and prevent conditions such as urinary leakage and sagging of pelvic organs, including the bladder and rectum.

The splits and stretch

Stretching of the abdominal area is visible externally (and very obviously) as your tummy grows, but we should not forget that stretching also occurs to the muscles under the skin. During pregnancy, your ‘six pack’ muscles go through a big physical transformation. The Rectus Abdominus muscles slowly draw apart to accommodate the growing uterus. These muscles are located on both sides of your belly button and run from your ribcage all the way down to the pubic bone. When these muscles have split, mothers see a ‘doming’ of their bellies when they try to get up from bed. It is a normal part of every pregnancy. The medical term for this condition is Diastasis recti. And even though all pregnant mothers develop this, it can persist after pregnancy and can affect the way your core handles pressure during activities.

 

How does this impact mothers? These muscles need to be retrained to help control the pressure in the belly during activities. A mother needs to understand which activities push these muscles further apart. A physiotherapist is trained to teach modifications for activities and to demonstrate how to control the pressure in the abdomen. In the event of a caesarean section where the abdominal muscles are affected, this is even more essential so that mothers move more effectively without exerting unnecessary strain on tissues that have been through a tough time.

The foundation of staying dry

The pelvic floor muscles are muscles located between the pubic bone at the front and the tail bone at the back. Their strength plays an important role in supporting your pelvic organs (including that expanding uterus). They not only play a crucial role in cradling the baby inside the body but also need to be flexible enough to guide the baby out during birth. They need to respond to increases in pressure in the pelvis, for example when you sneeze, cough or jump. A lack of pelvic floor strength can lead to embarrassing symptoms such as urine leakage or uncontrollable passing of wind during activities. These problems are not just prevalent after birth but can in some instances begin during pregnancy. This is even more reason to get those pelvic floor muscles stronger as soon as possible. Your women’s health physiotherapist can teach you how to locate your pelvic floor and how to strengthen these muscles correctly during and after birth to ensure no future problems with the bladder or rectum.

Bouncing back after your baby’s born

Six weeks after birth (irrespective of mode of delivery), we suggest you go to a women’s health physiotherapist for an evaluation. A suitable programme can be designed to incorporate all the current problems you might be experiencing. Your physiotherapist will also be able to get you back onto your normal training programme, considering any conditions that are present and modifying activities for them.

As a rule, we advise mothers not to go back to gym for at least six weeks after delivery. The only exercises permissible in the six-week period after birth are walking and swimming. Nothing heavier than the baby should be handled until the six weeks have passed. In this time moms may continue pelvic floor exercises but must avoid abdominal training or gym exercises until after the six-week check up with the physiotherapist.

Karen Swanepoel is a physiotherapist in private practice in Bloemfontein. She completed her BSc Physiotherapy Degree in 2002 at the University of the Free State. She works in the field of women’s health physiotherapy and musculo-skeletal conditions. She enjoys blogging on her website www.regain.co.za. Your women’s health physiotherapist is trained to assist you in this unique period of your life. To find a physiotherapist with a special interest in women’s health, go to www.saphysio.co.za or call +27 (0)11 615 3170.

Seventeen - April to June 2018

Seventeen - April to June 2018

This article was featured on page 10-11 of Babys and Beyond Seventeen - April to June 2018 .

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