pregnancy

A fit pregnancy

Staying active during pregnancy is the best thing for you – and your baby, Cindy Tilney tells us.

While exercise may not be what you feel like doing when you’re expecting, experts agree that it has a host of benefits – besides being a natural mood-lifter, there’s no denying how good it is for you. “In pregnancy, it’s always better to exercise than not – even with a chronic disease such as diabetes,” says personal trainer Shelley Lewin, who offers specialised pre- and postnatal exercises in Cape Town. “Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active. Unless you have a specific medical condition that puts you and your unborn child at high risk during pregnancy, it can only work to your advantage,” she says. “And in people with diabetes, it can help the body to process glucose more effectively.”

What can exercise do for pregnant diabetics?*

  • Lower blood sugar
  • Improve insulin sensitivity
  • Control blood pressure
  • Increase energy
  • Reduce after-meal blood sugar spikes
  • Encourage restful sleep
  • Lower gestational weight gain.

According to the American College of Obstetricians and Gynecologists (ACOG).

*Type 1, Type 2 and gestational diabetes

Remember: If you have diabetes, it is essential to get the all-clear from your doctor before starting an exercise programme, particularly if you are pregnant.

“Exercise in any form may require a reduced amount of insulin because exercise increases glucose uptake in the cells,” explains biokineticist Sarah Hall. “The intensity of the exercise you are doing will determine this: lower-intensity exercise can lead to a recommended insulin reduction of roughly 20%, as opposed to a possible 50% with higher intensity exercise.” This is further complicated by insulin needs often doubling during pregnancy, so consulting a doctor is a must.

Healthy exercise tips during pregnancy:

  • Check your blood sugar before and after exercise (Type 1 diabetics).
  • Always take a ‘quick-fix’ snack, such as a banana, along with you when you exercise, so that you have a sugar source on hand in case of hypoglycaemia (low blood sugar).
  • Stay away from forms of exercise that carry a high risk of falling, and avoid lying on your back with the head below the level of the heart, as this can restrict the blood flow to your baby.
  • Wear a heart rate monitor during cardiovascular exercise, and keep your heart rate to 140bpm or below. In the past, there was a widely held belief that pregnant women should stay away from all cardiovascular exercise – but modern research has shown that this does not hold true.

The good news? If you’ve been exercising regularly, you can carry on very much as normal, agree Hall and Lewin – provided the activities are not extremely high impact, do not involve fast or sharp changes in direction, or cause surges in blood pressure or adrenalin.

Ideal pregnancy exercise

Both experts recommend 30 minutes of moderate physical activity three times a week, such as walking, swimming, aqua aerobics and light weight lifting under the guidance of a certified ante-natal instructor. The ligaments tend to naturally relax during the second and third trimesters of pregnancy, so be careful not to overstretch during warm-ups – and if you are weight training, use machines rather than free weights to avoid any hyperextension injuries.

“Building up core strength is important in pregnancy,” says Lewin, “but as your tummy grows, you should stay away from certain intense core exercises, such as tummy crunches – instead opt for opposite leg and arm lifts, or practice stability work on a Pilates ball.” Kegel exercises are also important during pregnancy, as they strengthen the pelvic floor muscles.

Be gentle with yourself during pregnancy: stay away from contact sports and aggressive forms of exercise. And be aware of your body and how hard you are pushing yourself during workouts. “The ‘talk test’ is always a good marker of whether you are pushing yourself too hard,” says Lewin. “If you are exercising at the right level, you should be able to talk at the same time – but if you’re struggling to take in breath and unable to hold a conversation, it means you are pushing yourself too hard.”

Find out more about pregnancy exercise at www.homefit.co.za

“Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active.”

Ask the expert: Sarah Hall, Biokineticist

Warning Signs

Don’t exercise if you have:

  • Pregnancy-induced hypertension
  • Ruptured membranes
  • Placenta praevia
  • Vaginal bleeding of any kind
  • Incompetent cervix (when the cervix is weak and opens too early)
  • Or if you are expecting twins or more

If you experience any of the following during exercise, stop immediately and seek medical help:

  • Sudden calf swelling
  • Headaches
  • Decreased foetal movement
  • Chest pains
  • Any amniotic leakage
  • Excessive overheating

Support during a diabetic pregnancy

“I’m sure all husbands worry about their pregnant wives, but it’s extra worrying because my wife is diabetic and has to be in such strict control – or it could really harm our baby. I’m trying to be supportive, but sometimes it’s difficult… Especially because she’s so emotional!” Mark Roberts.

Dear Mark,

You have my sympathy!

Women who are pregnant can be on a real rollercoaster ride of emotions – highs and lows and everything in between. While some women seem to ‘bloom’ during pregnancy and are full of life, happiness and vitality, other women are tearful and apprehensive.

Pregnancy is a powerful experience: huge hormonal changes and a life-changing event are a lot to deal with. A woman who has diabetes has even more on her plate.

It is wonderful that you are supportive. Part of the support that you give should be helping your wife eat the right kind of diet, check her blood sugar regularly and do the right exercise.

The fear you have about the health of your baby is real, but this is also relevant for any pregnancy. Hopefully you have planned the pregnancy and worked out an action plan with your health care team. If your wife is keeping to her programme, the risk of anything going wrong is minimal. Contact her gynae or endocrinologist if you feel that something is not right: it is natural to worry, but one of the best solutions is not to nag her.

Mood swings tend to happen most frequently in the first 12 weeks of pregnancy. The mood swings usually decline between 3 to 6 months because the levels of the hormones become more constant. Here your wife will start to feel better and have more energy and hopefully be less emotional.

The emotions are difficult to cope with, I agree. It can be very helpful to allow yourself time out if the going gets tough! Remember that a pregnancy affects both partners: the golden rule is to talk about how you are feeling. You must voice your worries, concerns and anxieties. This goes a long way to relieving them.

Most importantly, don’t forget to take time for you and your wife to relax together and enjoy this wonderful, intimate and very exciting time.

Sometimes just being supportive and loving is the best thing you can do.

Enjoy your baby!

– Jeannie Berg, Diabetes Educator